Inspection on 14/12/06 for Moorside Hall

This inspection was carried out on 14th December 2006.

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

Moorside Hall 17/03/06

Moorside Hall 16/06/05

Moorside Hall 29/03/05

Moorside Hall 30/07/04

Moorside Hall 05/02/04

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

CARE HOMES FOR OLDER PEOPLE Moorside Hall Wyresdale Road Lancaster Lancashire LA1 3DY Lead Inspector Mrs Jennifer Dunkeld Unannounced Inspection 14th December 2006 10:00 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 Moorside Hall DS0000009681.V299079.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. Moorside Hall DS0000009681.V299079.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Moorside Hall Address Wyresdale Road Lancaster Lancashire LA1 3DY 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) 01524 69901 Mrs Kathryn Lesley Regan Mr Robert John Murray *** Post Vacant *** Care Home 22 Category(ies) of Dementia - over 65 years of age (22), Old age, registration, with number not falling within any other category (6) of places Moorside Hall DS0000009681.V299079.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service is registered to accommodate a maximum of 22 residents in the category DE (Dementia). The service may accommodate 6 named residents in the category of OP (older persons 65 and over) within the overall maximum number of 22 17th March 2006 Date of last inspection Brief Description of the Service: Moorside Hall is a care home registered with the Commission for Social Care Inspection to accommodate up to 22 people with a dementia, it can accommodate 6 named people who are aged over 65 years within the overall total of 22. Set in its own grounds, and close to Lancaster City Centre, the home offers accommodation on either a single or shared room basis. The home has had major building alterations, which now enables the majority of residents to have a single bedroom with en-suite facilities with a toilet and a hand-wash basin. There is a large conservatory with a dining room and a lounge adjacent to it. There is also a small lounge on the first floor. The first floor is accessible by a passenger lift. Mr Murray is one of the proprietors of Moorside Hall and also employs a care manager, Prior to admission, residents care needs are assessed and individual care plans are implemented. Access to health care services such as General Practitioners or District Nurses is arranged as required, as is the services of visiting professional such as Dentists, and Chiropodists. The current fees at the home range from £420 to £470 per week depending upon the needs of the individual. Moorside Hall DS0000009681.V299079.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This home has been inspected against the National Minimum Standards for older people introduced in April 2002. This inspection was over one day and lasted for a total of 5.5-hour during the day on 14/12/06. This inspection was unannounced in that neither the residents, staff nor management team were aware that it was to take place that day. The inspection looked at various aspects of care. In the report there are references to the “tracking process”, this is a method whereby the inspector focuses on a small group of residents. All records relating to these individuals are examined, along with the rooms they occupy in the home. The residents are invited to discuss their experiences of the home with the inspector; this is not to the exclusion of the other residents who contributed in many ways. The Commission for Social care Inspection is trying to improve the way we engage with people who use services so we gain a real understanding of their views and experiences of social care services. We are currently testing a method of working where ‘experts by experience’ are an important part of the inspection team and help inspectors get a picture of what it is like to live in or use a social care service. The term ‘experts by experience’ used in this report describes people who have been appointed by Help the Aged, under the direction of the Commission for Social care inspection, to take part in the inspection of services for older people. The inspection involved; • • • • • Observations of care practices Discussions with the residents Discussions with visitors to the home Interviews with the staff and the manager. Examination of records that are required to be maintained including plans of care. The plan of care is a document outlining the needs of the individual resident and how these are to be met. The plans of care cover all aspects of the individual’s life including health, personal care and social activities. A new type of plan of care being used at Moorside Hall and is a very comprehensive document and clearly identifies people’s needs. Thereby ensuring people are content in the care they receive. However these have not as yet been fully completed for all the residents. The process is on going. Moorside Hall DS0000009681.V299079.R01.S.doc Version 5.2 Page 6 The residents the inspector and the Expert by Experience spoke with were happy with life at Moorside Hall. One resident said, “We are very lucky to have such a lovely home, we are well looked after” The 3 comment cards received from the relatives of residents reflected their general satisfaction in the care offered. Comments included; ‘A fantastic home with fantastic staff which are always happy to help.’ However 1 of these relatives implied that there are times when there is not enough staff on duty to meet the needs of the residents. The question was ‘‘in your opinion are there always sufficient staff on duty?’ the response was ‘NO’. The staff rotas examined as part of this inspection reflected there is currently sufficient staff on rota and staff said they have enough time to spend with the residents albeit that the mornings are hectic. 2 health professionals who visit the home expressed general satisfaction about the home and staff in the completed questionnaires they returned to the CSCI. However one made the following response to the question ‘Do staff demonstrate a clear understanding of the care needs of residents?’ Response was ‘Mostly’. These questionnaires were returned to the CSCI in July 2006. The Expert by experience made the following observations; Observation. • The home appeared to be very clean and did not smell • Most residents were in the two main lounges and sat around the wall asleep at 10.30am. • Most residents can walk with the aid of a Zimmer frame if necessary. • On speaking with the residents and staff it was apparent that the residents do not go out very much at this time of the year and because of the residents conditions. • In the dinning room the tables have table covers and are set with 4 place settings. Some residents prefer to stay in their rooms to have some meals. • Residents were offered a choice of meal for each meal. • Residents were having their hair styled by the visiting hairdresser and booking perms for the next week in preparation for Christmas. • The staff seemed to be very caring with the residents. • The residents were clean and well cared for. • Residents were offered a choice of where to sit within the lounges and asked if they wanted the television on. • A newly admitted resident had an Abbeyfield society carer with her to help settle her into the home, which is very good for the resident. • On the morning of this inspection I observed very little activity but was told by the one resident that they had been out to the local pub for a Christmas meal and a drink 2 days before. A member of staff and the manager of the home confirmed this. • In the summer the residents are able to go over into the park for a change of scene and fresh air with a members of staff. Moorside Hall DS0000009681.V299079.R01.S.doc Version 5.2 Page 7 What the service does well: What has improved since the last inspection? 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. Moorside Hall DS0000009681.V299079.R01.S.doc Version 5.2 Page 8 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 Moorside Hall DS0000009681.V299079.R01.S.doc Version 5.2 Page 9 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&6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good arrangements for the needs of potential residents to be assessed prior to them taking up residency at Moorside Hall thereby ensuring the service is able to meet their needs. EVIDENCE: Pre-admission assessments were looked at and were completed satisfactorily; they include all aspects of physical, social and psychological care, making sure that the prospective resident’s needs are identified and that the home can provide the care that is needed. Moorside Hall DS0000009681.V299079.R01.S.doc Version 5.2 Page 10 These assessments are done by a the care manager and agreed by the resident and/or their family. All residents are assessed by the same tool, thus promoting equality of assessment and care provision. One resident admitted to the home recently remembered the care manager visiting her in her previous home to carry out the assessment. She confirmed that she was content in the home and had been enabled to continue to follow her interests. On the day of this visit she was being transported via Dial-a- bus to go to her church. Moorside Hall DS0000009681.V299079.R01.S.doc Version 5.2 Page 11 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, & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements to meet the health, personal and social care needs of the residents are outlined in the individual’s care plan. This results in people feeling content in the home. EVIDENCE: The management has recently developed a new system for recording information about the individual and their needs. This includes health care, personal and social care. The care plans for three people were viewed as part of the tracking process. All but one file contained the following; Moorside Hall DS0000009681.V299079.R01.S.doc Version 5.2 Page 12 - Social Services “Core Assessment” in addition to a full assessment by the home prior to the persons admission to Moorside Hall. - An in-depth care plan reflecting all needs and how these are to be met. Including how to manage/prevent behaviours that challenge. - Risk assessments as appropriate to the individual. - A record of residents meetings and issues raised. - Moving and handling needs - Dietary needs - Record of activities that the person has participated in Each resident has a Key worker who co-ordinates the care plan. Each resident also has a “My life story” book that the resident and their relatives have contributed to, this tells of the persons life, past and present. On file for some residents is a document “when I die” this is a diverse document that outlines the persons wishes upon death and is appropriate for all cultures, sexes and religions. It ensures the person’s wishes are known and are then carried out according to their religious needs and wishes. This needs to be completed for all residents thereby ensuring their final wishes are known. A Progress Record is held on their file (diary note of events) The residents said they are ‘Well looked after’ ‘and ‘The staff are good’. One file did not have an in-depth plan of care, this was for the most recently admitted resident whose family was away and the service wanted some additional information from them. The staff spoken with were aware of the individual care plans and of people’s needs. Medication is administered and stored correctly. Medication Administration Record sheets are signed at the time of administration therefore ensuring medication is not administered incorrectly. Medication is frequently reviewed, indeed during this visit the Snr carer was talking to a GP about one resident requiring medication in liquid form as there was a difficulty in swallowing tablets. Moorside Hall DS0000009681.V299079.R01.S.doc Version 5.2 Page 13 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&15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People have a fairly fulfilling lifestyle dependant on their diverse needs. The residents’ benefit from a healthy balanced diet. EVIDENCE: Some residents spoke about the social side of life at Moorside Hall. Activities such as knitting, tai chi, visiting entertainers and sing-along are regularly provided. Each resident’s activities programme is recorded on his or her file. Moorside Hall DS0000009681.V299079.R01.S.doc Version 5.2 Page 14 Residents said that they like to be taken around the lovely park opposite the home but a number said they can’t walk it now’ but occasionally staff take them in a wheelchair when the weather is better. People spoke about the night out they had 2 days previously at a local pub where they had a party and really enjoyed themselves. Comment cards received from 2 relatives questioned whether there were enough activities in the home to keep people from becoming bored. The care manager explained they are developing photo albums of significant events in the individuals’ life to use as a discussion point. The home also uses a DVD ‘Reminiscence’ which some residents enjoy. Discussions with the staff at Oaklands House or Altham Meadows may be able to assist in identifying activities that people with a dementia may benefit from. The dietary needs of each resident are recorded on their file. The menus reflect choice and a healthy balanced diet was on offer. All meals are home made with cakes and puddings being popular. The inspector found the meal served on the day of the visit to be tasty, well presented and of a balanced diet. The residents stated that the food was good. 2 Comment cards received from relatives of the residents reflected that the food is good. A four weekly menu is in operation. The expert by experience made the following comments; • In the dinning room the tables have table covers and are set with 4 place settings. Some residents prefer to stay in their rooms to have some meals. • Residents were offered a choice of meal for each meal. Moorside Hall DS0000009681.V299079.R01.S.doc Version 5.2 Page 15 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 & 18 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home provides a safe environment where the people are well protected from abuse. EVIDENCE: The homes complaints procedure ensures people’s diverse needs are met, in that it is in picture and large print format. The management have developed a complaints file, which includes a procedure entitled “ Managing Complaints”. This procedure requires that an acknowledgement letter be sent to the complainant. The complaints record reflects that complaints are taken seriously and acted upon. The solution/outcome is recorded. This positive attitude to complaints is indicative of the professional management style and ensures people feel free to raise small issues to prevent them from becoming major ones. Moorside Hall DS0000009681.V299079.R01.S.doc Version 5.2 Page 16 The management take very seriously all allegations of abuse and take appropriate steps to protect people from abuse. Moorside Hall DS0000009681.V299079.R01.S.doc Version 5.2 Page 17 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 & 26 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The resident’s benefit from living in a safe environment that is well maintained. EVIDENCE: Moorside Hall is a detached building set in it is own grounds with a garden that is secure for people to walk in. There are 18 single bedrooms and 2 twin bedded rooms. All bedrooms have an en suite facility. As a newly refurbished home it has been well carpeted and decorated offering a pleasant environment to live in. Moorside Hall DS0000009681.V299079.R01.S.doc Version 5.2 Page 18 Central heating radiators have been fitted with low heat surface covers to Prevent residents from burning themselves against very hot radiators. Hot water outlets have a thermostatically controlled valve on them to prevent people being scalded. Bedroom doors have an appropriate lock with the resident having the key to their own room, unless a risk assessment dictates otherwise. All bedroom doors have the occupants photograph on the door to make it easier for the residents to find their own room. The expert by experience made the following comments: Residents were offered a choice of where to sit within the lounges and asked if they wanted the television on. The home appeared to be very clean and did not smell Moorside Hall DS0000009681.V299079.R01.S.doc Version 5.2 Page 19 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): 27, 28, 29 & 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The residents’ benefit from a well recruited staff team. EVIDENCE: Staff training is seen as an imoortant factor in caring for vulnerable people, the home has a staff training room in the basement of the home. The staff training records that were examined showed that induction and training and the mandatory health and safety training programmes were in in place. Other training included Dementia Awareness First Aid Medication Awareness 4 staff have achieved a National Vocational Qualification in care and 4 others are presently in the process of completing the course. 1 Member of staff is awaiting her results. When these staff complete their training over 50 of the staff will have the qualification. Moorside Hall DS0000009681.V299079.R01.S.doc Version 5.2 Page 20 The information provided in staff files confirmed the registered provider of Moorside Hall operates a thorough recruitment procedure so as to ensure the safety and well being of residents accommodated there. In all staff files viewed, a full employment history had been obtained and in discussion, the care manager confirmed that any gaps in a candidate’s employment history would be investigated. In addition, two written references and a satisfactory Criminal Records Bureau clearance were available on the files examined. The expert by experience made the following observation; The staff seemed to be very caring with the residents A comment card received from one relative stated; ‘A fantastic home with fantastic staff which are always happy to help’ Moorside Hall DS0000009681.V299079.R01.S.doc Version 5.2 Page 21 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 & 38. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The management at Moorside Hall demonstrate they are open and honest. They ensure people’s finances are safe guarded. EVIDENCE: The service provider, care manager and the staff ensure that the home keeps the residents and their families informed at all times about the running of the home and the services on offer and welcome comments as to how they can improve the service. Moorside Hall DS0000009681.V299079.R01.S.doc Version 5.2 Page 22 The management team of the home have all achieved the National Vocational Qualification Registered Managers Award, ensuring they are aware of their role in managing a care home. The care manager of the home has a very ‘hands on’ approach to her work and closely monitors daily care practices and standards. In discussion, staff confirmed that Mrs Holroyd and Mr Murray were approachable managers who welcomed new ideas and suggestions. Residents are supported to manage their own financial affairs for as long at they are able or wish to do so. However for the majority of the current residents this is not possible, therefore third party advice such as from a relative or advocate is sought. Where the home has to be involved in handling any resident’s money, this is recorded in detail e.g. the amount credited/debited, the reason for the debit, the balance and this record is signed and witnessed at each transaction. Moorside Hall DS0000009681.V299079.R01.S.doc Version 5.2 Page 23 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 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X 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 3 X 3 X 3 X X 3 Moorside Hall DS0000009681.V299079.R01.S.doc Version 5.2 Page 24 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. Refer to Standard OP12 Good Practice Recommendations The service provider should ensure people have activities they wish to participate in and record when people refuse 1 Moorside Hall DS0000009681.V299079.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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 Moorside Hall DS0000009681.V299079.R01.S.doc Version 5.2 Page 26 - 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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