Inspection on 15/02/07 for Moormead House Nursing Home

This inspection was carried out on 15th February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Moormead House Nursing Home 21/02/06

Moormead House Nursing Home 12/07/05

Moormead House Nursing Home 13/01/05

Moormead House Nursing Home 25/08/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Moormead House Nursing Home 67 Moormead Road Wroughton Swindon Wiltshire SN4 9BU Lead Inspector Karen Mandle Unannounced Inspection 15th February 2007 09:45 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Moormead House Nursing Home DS0000015931.V328525.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Moormead House Nursing Home DS0000015931.V328525.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Moormead House Nursing Home Address 67 Moormead Road Wroughton Swindon Wiltshire SN4 9BU 01793 814259 01793 879243 moormead@online Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Steven Barry Sharp Mrs Zandra Amelia Sharp Mr Steven Barry Sharp Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21), Terminally ill (1) of places Moormead House Nursing Home DS0000015931.V328525.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. No more than 21 service users in receipt of nursing care at anyone time No more than 1 service user in receipt of terminal care at anyone time Staffing levels as specified in the Notice of Proposal dated 14 November 2002 21st February 2006 Date of last inspection Brief Description of the Service: Moormead House is registered to provide nursing care, for up to 21 people aged 65 and over. Accommodation is provided on two floors with a passenger lift in between. There are nineteen single rooms, and one shared room. Five of the rooms have en-suite facilities. A communal lounge is located on the ground floor. This also incorporates a dining area. At the rear, there is an enclosed garden area with a patio. The home is privately owned, by Mr Steven and Mrs Zandra Sharp. Mr Sharp is also the registered manager of the home. A registered nurse is on duty at all times. They are supported by at least three care assistants in the morning, two in the afternoon, and one at night. The home also employs catering, housekeeping and maintenance staff. The home is in Wroughton, a village approximately one mile from Swindon. It is situated close to the village centre. This offers local amenities, including shops, pubs, and a health centre. There is a bus stop close to the home and some parking on site as well as street parking close by. Moormead House Nursing Home DS0000015931.V328525.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection took place on the 15th February 2007. The inspector was assisted by the nurse in charge and the manager and owner Mr Steve Sharp. The inspector was given a tour of the home at the commencement of the inspection but later freely toured the home, visiting with service users and speaking with staff. Prior to the site visit taking place the inspector sent surveys to the home to gain the opinions from the service users and families regarding the service provided by Moormead. Four surveys were returned, which gave positive answers to the questions. The inspector was able to visit with many of the service users, however communication was limited. The medication procedure was reviewed, as were care records and other various records. The home met the one requirement from the previous inspection. Four good recommendations were set following this inspection. The judgments contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. What the service does well: What has improved since the last inspection? Health and safety issues are more closely monitored. The fire training that staff receives is now provided by an outside professional at least once a year. Two members of staff sign handwritten medication orders. Moormead House Nursing Home DS0000015931.V328525.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Moormead House Nursing Home DS0000015931.V328525.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Moormead House Nursing Home DS0000015931.V328525.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. An admission procedure is in place and pre-admission assessments take place for all prospective service users. Moormead is not registered to provide intermediate care. EVIDENCE: Prospective service users are assessed by the registered manager, Steve Sharp, prior to admission to the home to ensure that through the assessment process, the home is able to meet the nursing needs of the service user. As good practice, Mr Sharp is assisted with the assessment by a member of the care team, which provides a different perspective of the assessment, such as personal and social care needs. This also provides the prospective service user who may be to unwell to visit the home, an opportunity to meet two members of staff before moving into Moormead. During the morning of the inspection Mr Moormead House Nursing Home DS0000015931.V328525.R01.S.doc Version 5.2 Page 9 Sharp and a carer went and completed an assessment. The inspector was able to see the written assessment when they returned, which was detailed. Mr Sharp where possible will support the assessment by obtaining information from families, hospitals and care managers. Moormead is not registered to provide intermediate care therefore Standard 6 is not applicable. Moormead House Nursing Home DS0000015931.V328525.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each service user is provided with a care plan, which supports their health care needs. The health care needs of the service users are monitored and appropriate action taken when the health care needs change. Service users are fully supported with all aspects of personal care. The medication procedure was safe. Service users are treated with respect. EVIDENCE: The care records of four service users were reviewed following visits with all the service users. The care needs of the service users had been identified and a care plan was in place to support the individual care need. The care records were reviewed monthly. The long term care assessment form should be more detailed as some information was limited. Also when a decision regarding how to ensure the safety of a service user has been conducted through a multi disciplinary team approach, this should be fully documented in the care Moormead House Nursing Home DS0000015931.V328525.R01.S.doc Version 5.2 Page 11 records. Appropriate risk assessments had been completed such as manual handling, nutritional and pressure area assessments. The health care needs of the service users are monitored with appropriate action taken when their health care needs change. All service users are registered with a local GP who visits the home fortnightly or when requested by the staff. Service users with high care needs were observed to be supported, with appropriate nursing equipment in place. Those service users also had frequent care charts in place, which were well recorded. The tissue viability nurse was involved with the care of one service user who was visiting the home frequently. The inspector visited with many of the service users, some of which were not able to fully communicate. Those who could communicate, provided positive comments to the standard of care they received such as, “The staff couldn’t do more for you” and “I like the staff here, they help me”. The medication administration procedure was observed taking place which was safe. The qualified nurses are responsible for administering the medications. The disposal of medications was in line with current legislation. The medications were stored correctly, as were the controlled medications. The controlled medication register was correct. The medication administration records were up to date. The medication administration sheets are currently hand written, it will be recommended that this system be reviewed. The staff provided personal and nursing care behind closed doors, either in the privacy of the service users bedroom or bathroom. The staff were observed knocking on doors before entering and addressing service users by their preferred name. The personal care standards were good with service users appearance being well groomed and clothes nicely maintained. A service user told the inspector “They treat you as an individual here, which is very important to me”. The staff were observed interacting well with service users in the communal room, friendly but respectful. Moormead House Nursing Home DS0000015931.V328525.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The activities provided ensured that the social needs of the service users were met. Service users are supported to maintain links with family and friends. Service users are provided with choice and control over their own lives where possible. The standard of food and the choice provided is very good. EVIDENCE: A member of the care team has a combined role of carer and activities coordinator providing three to fours hours of activities daily. The inspector was able to spend time with the activities person, who discussed a range of activities such as, pampering day for the ladies, bingo, skittles, puzzles and themed activities, service users were currently making Easter cards for their families. Those service users not wishing to participate in-group activities were provided with one to one visits. Other service users were observed spending time in the privacy of their own room reading or watching TV. Moormead House Nursing Home DS0000015931.V328525.R01.S.doc Version 5.2 Page 13 Service users are supported by the home to maintain links with family and friends. The visitors signing in book showed visits taking place throughout the day. A service user told the inspector “I often go out for lunch with my friends and they can visit me here anytime in my room”. Due to the age and frailty of many of the service users currently living at the home, maintaining choice and control over their daily lives might be considered limited. However the approach of the staff towards the service users and the questions they asked provided service users with some choice such as, where would they like to sit and where would they like to spend the day. The dining area is combined with the communal room where the majority of service users spend their day. Service users not wishing to have their meals in the dining area could have them in their rooms. The standard of the food is very good with two hot choices provided daily. It was observed whilst the inspector was having lunch with the service users, a service user who had tried both hot meals and didn’t want either then choose to have a cheese sandwich, which she then was given. Service users can have a cooked breakfast every morning, which several do and reported as enjoying. The staff were continually offering a range of drinks to service users. All weights are monitored monthly and each service user had a nutritional risk assessment in place. Service users requiring assistance with their meals received assistance on a one to one basis. The comments received were positive about the standard of food such as “The meals are really good but if I don’t fancy what is on the menu, they make me what I like” and “I love my breakfast, bacon and eggs”. The kitchen was seen, which was clean and organised. Moormead House Nursing Home DS0000015931.V328525.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A complaints policy and procedure are in place. The staff had received training in abuse awareness. The employment procedures are robust and protect the service users. EVIDENCE: A complaints policy and procedure is in place. The complaints procedure is openly displayed in the entrance of the home. A record of complaints is maintained along with the outcome of the complaint and what action was taken by the home. The manager is able to competently investigate complaints in line with the homes procedure. Service users were asked whom they would speak to if they had a concern or a complaint regarding the service provided, two answered, “I would talk to Steve”. The CSCI have not received any complaints regarding this service. The manager is fully informed in how to implement the local vulnerable adults procedure if an allegation of abuse was reported. Staff had received training in abuse awareness. The employment procedures are robust and protect the service users as far as possible. Moormead House Nursing Home DS0000015931.V328525.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Moormead provides a homely, well-maintained environment for service users to live in. The bedrooms were well furnished and personalised. The home was clean throughout and infection control measures are in place. EVIDENCE: Moormead Nursing Home provides a homely environment due to the size, the furnishing and décor of the home that are domestic. The home is generally well maintained throughout providing a safe environment for service users to live in. The communal room is very light with good views, which provides seating and dining areas. The majority of service users spend much of their day in the communal room, which they appeared to enjoy. The manager should consider replacing the shower flooring, which was damaged and refurbishing the Moormead House Nursing Home DS0000015931.V328525.R01.S.doc Version 5.2 Page 16 assisted bathroom. A garden is to the rear of the home, which is accessible for wheelchair users. Many of the bedrooms were visited. The bedrooms are situated on the ground floor and 1st floor with a passenger lift for accessibility. All bedrooms are single apart from 1shared room, with some having an en-suite facility. The bedrooms have recently been decorated to a good standard, with domestic furnishings, again creating a homely environment. A service user said “I love my room, it is my home now”. The bedrooms were personalised and service users had obviously been encouraged to bring personal items from home with them. The cleanliness of the home was of a good standard with no unpleasant odours. The communal toilets and bathrooms were clean, as were the carpets throughout the home. Domestic staff are employed. Infection control measures were in place and clinical waste dealt with appropriately. Moormead House Nursing Home DS0000015931.V328525.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staffing levels provided can meet the nursing needs and personal care needs of the service users. The procedures for the recruitment of staff are robust and provide the necessary safeguards to offer protection to the service users. The staff had been provided with mandatory training. EVIDENCE: Moormead benefits from a stable staff group, some of which have worked at the home for many years and have a good understanding of the care needs of the service user group. The turnover of staff is minimal. The staffing rotas seen provided evidence that the home operates within the agreed staffing levels. A qualified nurse is on duty at all times supported by a team of carers. The home was calm and organised during the inspection and call bells were observed to being answered in a reasonable amount of time. Kitchen and domestic staff are employed. The manager reported that agency staff had not been used, as the staff will always cover for each other providing continuity to the service users. The employment files of three members of staff were reviewed. All the files contained two references, application form, contract of employment and appropriate police checks. Recruitment procedures are robust and protect the service users. Newly employed staff had been provided with an induction programme and supervision. Moormead House Nursing Home DS0000015931.V328525.R01.S.doc Version 5.2 Page 18 The home has successfully maintained the Investors in People Award. The written report following the review was seen which provided positive feed back on how staff felt about their employment at the home. The home has now achieved 80 of the staff having obtained NVQ Level 2 or 3. All mandatory training is provided. Further training is provided in line with the care needs of the service users such as, dementia training, palliative and wound care. Moormead House Nursing Home DS0000015931.V328525.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, and 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The manager is competent and experienced in running the home. Quality assurance systems are in place, which are inclusive of gaining the views of the service users and families. The home continues not to deal with any personal money belonging to the service users. The home is well maintained providing a safe environment for service users to live in. EVIDENCE: The manager, Mr Steve Sharp, is a qualified nurse who has much experience in caring for older people. Mr Sharp has a good understanding of his responsibilities as manager and owner of the home. The staff spoke positively Moormead House Nursing Home DS0000015931.V328525.R01.S.doc Version 5.2 Page 20 about the management of the home and comments were received such as, “Steve is really approachable if you have a problem”. Mr Sharp has obtained NVQ Level 4 in Management. Mr Sharp is very much involved with all aspects of the management of the home. Quality assurance systems are in place in the form of annual questionnaires designed to gain the views of the service users and families. Mr Sharp also projects an open approach to the management of the home and is always available to the service users and families if they wish to discuss any areas of the service provided. Mr Sharp confirmed that the home would not take responsibility for service users personal money. The home is well maintained throughout, providing a safe environment for service users to live in. Accidents are recorded, providing information of how the accident occurred and what action (if required) was taken. The manager regularly audits the accident record. All hoists are regularly serviced by an outside contractor, as is the passenger lift. A handyman is employed. Risk assessments of the home are in place. Moormead House Nursing Home DS0000015931.V328525.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 3 Moormead House Nursing Home DS0000015931.V328525.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP7 OP7 Good Practice Recommendations The manager should ensure that the long term assessments needs document provides more information. The manager should ensure that when a decision on how to meet a care need has been concluded through a multi disciplinary team, that this is all fully documented in the care plan. The manager should consider reviewing the current handwritten system used for the medication administration records. The manager should consider replacing the shower flooring and refurbishment of the assisted bathroom. 3. 4. OP9 OP19 Moormead House Nursing Home DS0000015931.V328525.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Moormead House Nursing Home DS0000015931.V328525.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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