Inspection on 16/06/05 for Moorside Hall

This inspection was carried out on 16th June 2005.

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 14/12/06

Moorside Hall 17/03/06

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 Jenny Dunkeld Unannounced 16 June 2005 10:00am h 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 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 F57 F09 S9681 Moorside Hall V217816 160605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Moorside Hall Address Wyresdale Road, Lancaster, Lancashire LA1 3DY Telephone number Fax number Email 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 and Mr Robert John Murray CRH Care Home 22 Category(ies) of DE(E) Dementia 22, OP Old Age 6 registration, with number of places Moorside Hall F57 F09 S9681 Moorside Hall V217816 160605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service is registered to accommodate a maximum of 22 service users in the category DE (Dementia) 2. The service may accommodate 6 named service users in the category of OP (Older Persons 65 and over) within the overall maximum number of 22 Date of last inspection 29th March 2005 Brief Description of the Service: Moorside Hall is a care home registered with the Commission for Social Care Inspection to accommodate up to 23 people with a dementia, it can also 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 recently had major building alterations which now enables the majority of residents to have a single bedroom with en-suite facilities of 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 the proprietor of Moorside Hall and also employs a care manager, Christine Pullen, who oversees the general day-to-day running of the home.Prior to admission, service users’ 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. Moorside Hall F57 F09 S9681 Moorside Hall V217816 160605 Stage 4.doc Version 1.30 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 year, all registered Care Homes are to be inspected at least twice this year and both visits can be unannounced. This inspection was over a 5 hour period during the day on 16/6/05 and included a visit by the Pharmacist Inspector who looked at the policies, procedures and practices surrounding the storage and administration of medication. Two Regulatory Inspectors 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. 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. This inspection included discussion with residents, staff and the manager in addition to viewing the home’s required written information such as policies and procedures about various issues for instance ‘Health and Safety’. The residents written plans of care were also viewed for 5 people. 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. The new types of plans of care being used at Moorside Hall are a very comprehensive document and clearly identify people’s needs. Thereby ensuring people are content in the care they receive. The residents the inspectors spoke with happy with life at Moorside Hall. One resident said, ‘Oh they are very good to us here, the staff are lovely’ Whilst the people who live at Moorside hall are very glad the building work is completed as it did affect their calm atmosphere, they expressed satisfaction with the standards of care at the home and spoke highly of the staff and Christine (the care manager) Comments received form residents included ‘Nothing is too much trouble’ ‘The staff are lovely’ ‘Christine is so The comment 2 comment cards received from the relatives of 2 residents, reflected their satisfaction in the care offered. Moorside Hall F57 F09 S9681 Moorside Hall V217816 160605 Stage 4.doc Version 1.30 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Moorside Hall F57 F09 S9681 Moorside Hall V217816 160605 Stage 4.doc Version 1.30 Page 7 The Pharmacist Inspector accompanied the Lead inspector for this visit and he has offered advice in relation to the storage, administration and recording of medication in a separate letter. The requirements and recommendations he made are included at the end of this report. A doorbell is needed for the back door of the home (car park entrance) so that visitors are not left standing outside the home, as a knock on the door can not be heard from the lounges etc. The residents would find it easier to remember which is their bedroom if their photograph was on the door. Similarly the picture of a toilet on the toilet doors would help confused people to enter the right room, as all doors look the same. The management need to ensure there is sufficient space at the dining tables to accommodate all the residents. There is a need to ensure the pre-admission assessments include a history of the persons medical ailments and frequency of falls etc. this would help the staff to be aware of the possibilities of these. Screens should be available in shared rooms at all times, in order that the residents can use them when they choose to be more private. 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. Moorside Hall F57 F09 S9681 Moorside Hall V217816 160605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Moorside Hall F57 F09 S9681 Moorside Hall V217816 160605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 & 6 There are good arrangements for the needs of potential residents to be assessed prior to them taking up residency at Moorside Hall. This means the management team are able to ensure the persons needs can be met at the home. Moorside Hall does not offer intermediate care. EVIDENCE: Each person living at Moorside Hall has an individual plan of care, which includes the written assessments. The inspectors viewed 5 of these as part of the ‘tracking process’. The assessments covered all aspects of the individuals needs including health and personal care needs as well as an in-depth social history enabling the reader to know of the person’s present and past interests. However whilst their current medical needs were recorded there was little information about the persons medical history, to enable staff to know of any likely recurring ailments or the possibility of falling. Moorside Hall F57 F09 S9681 Moorside Hall V217816 160605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 8,9 & 10 Arrangements to meet the health care needs of the residents are good. Policies and training ensure the staff treat the residents with respect and dignity and ensure their rights to privacy are respected. The residents are in general protected from errors of medication by the home’s policies and the staff receiving appropriate training. However some further training is required for some staff. EVIDENCE: There are care plans in place for every resident. The inspectors viewed 5 of these and found them to be of a good standard, ensuring people’s health care needs are addressed and met The new type of plan of care provide a comprehensive daily picture of residents’ care needs and intervention required to meet assessed needs was clearly stated and prescriptive. This enables staff to offer the right level of support for the individual. Moorside Hall F57 F09 S9681 Moorside Hall V217816 160605 Stage 4.doc Version 1.30 Page 11 However one residents plan of care reflected that she’d had a number of falls in recent weeks yet this had not been addressed in her plan of care. The care manager was able to tell the inspector what had caused this and what had been done to rectify the situation. This needs to be recorded in the plan of care. The staff were observed talking to the residents in a respectful manner throughout this inspection. Comments such as ‘Can I help you with that?’ were heard, which reflected the staff, respect people’s rights to maintain their dignity. The advice offered by the pharmacist inspector has been sent in a separate letter that is available from the Commission for Social Care Inspection office. The requirements and recommendations he made are incorporated at the end of this report. The home has policies and procedures in place providing practical care guidance to staff in the event of caring for a terminally ill resident. There is also provision on assessments to record the wishes of residents and their families in the event of their death. Through talking to residents and staff, the inspectors were able to determine that residents are enabled to access health care as and when they require it. There is a record of professional visits in respect of every resident. These records document visits from health care professionals such as district nurses and general practitioners. As stated above the residents generally have their rights to privacy upheld, however the residents should not be asked to sign a disclaimer in relation to the provision of a drawer that locks or somewhere to store their treasured possessions, this facility should be automatically supplied in order that the resident can then choose when they wish to use it. Similarly people should be supplied with a key to their bedroom door unless a risk assessment states to the contrary, for any individual. The residents told the inspector that the staff always knock on their bedroom door and wait to be invited in. Risk assessment in relation to falls for one resident was recorded on her file and indicated the actions to be taken by staff to minimise the risk. All accidents are recorded, however the ‘accident book’ should be one that conforms to the Data Protection Act. Moorside Hall F57 F09 S9681 Moorside Hall V217816 160605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13 & 14 There are no restrictions for families and friends of the residents to visit the home. Resident’s benefit from seeing their families when they wish to. The residents are given every opportunity, within their capability to exercise control over their lives. The residents are consulted about aspects of their lives including what to eat. EVIDENCE: In its Statement of Purpose (a brochure about the home given to prospective residents and/or their family) the home gives an undertaking to ensure that all residents are given the support they require in maintaining contact with their families and friends. Through discussion with residents, the inspector was able to determine that the home are completely flexible in terms of visiting and that residents are able to receive visitors at any time. The home also welcomes those friends and families from out of the area, to stay overnight if accommodation is available. The 2 comment cards received from relatives indicated that they were made welcome whenever they visit the home. The care manager said that visitors were welcome at any reasonable time. Moorside Hall F57 F09 S9681 Moorside Hall V217816 160605 Stage 4.doc Version 1.30 Page 13 Indeed during this inspection the inspector spoke with one relative visiting his mother and he said the staff always welcome him and ask him if he would like a drink. During this visit the staff were observed consulting with the residents over various aspects of care such as ‘What do you want for your dinner?’ ‘Do you want to sit in the conservatory?’ This reflects the understanding the staff have of people having a right to make choices. The residents said they choose when they want to get up/retire to bed and times varied according to the individuals choice that day. Some residents handle all their own finances where others receive need some help from relatives and/or the management of the home. All financial transactions carried out on behalf of the residents are recorded and countersigned to ensure the residents finances are protected. Residents meetings are periodically held and the inspector viewed a copy of the notes made at the last one. These reflected that people were being consulted about activities. On the day of this visit the residents were having a sing-a-long in the afternoon when a signer/keyboard player came to the home. Many residents were enjoying the entertainment. Moorside Hall F57 F09 S9681 Moorside Hall V217816 160605 Stage 4.doc Version 1.30 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 The arrangements for dealing with complaints are good. Many residents can speak up and feel that they are listened to. EVIDENCE: The home has a well-written policy on complaints. The procedure is that if the residents have any complaints they should in the first instance speak to a member of staff or the manager. Speaking to the Commission for Social Care Inspection if there is still dissatisfaction can follow this up. A record of any complaints is made. The residents said that if they weren’t happy about something they’d talk to Christine (care manager) and they were confident that she would put it right. Some of the resident’s and visitors were not aware of the written procedure, which is displayed in the home. Perhaps people need informing that the procedure is there. A copy of the procedure should be given to all new residents and/or their family. The staff spoken with were aware of the need to take all complaints seriously. Moorside Hall F57 F09 S9681 Moorside Hall V217816 160605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 & 26 EVIDENCE: Moorside Hall is a detached building set in it is own grounds with a garden that is secure for people to walk in. The home has undergone a major alteration and extension to the building which has improved the facilities for the residents. There have been one or two ‘snags’ such as some en-suite doors not closing effectively. The builder has begun to rectify these. 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. Central heating radiators have been fitted with low heat surface covers to Moorside Hall F57 F09 S9681 Moorside Hall V217816 160605 Stage 4.doc Version 1.30 Page 16 Prevent residents from burning themselves against very hot radiators. Hot water outlets have a thermostatically controlled valve on them to prevent people being scalded. However the water from the tap in the ground floor toilet was at 55 degrees and very hot to the hand. The new conservatory has been fitted with blinds to the windows and a ceiling fan to keep the temperature down in the summer sun. Whist staff always knock prior to entering a room all residents should have a lock to their bedroom door and be given a key unless a risk assessment indicates that this would not be advantageous for an individual. Moorside Hall F57 F09 S9681 Moorside Hall V217816 160605 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 & 30 The level and calibre of staff is good resulting in the residents being cared for by a dedicated staff team EVIDENCE: The staff rotas were viewed and these reflected that there were an adequate number of staff on duty during most shifts. If a member of staff goes off sick the management endeavour to ask an off duty member of staff to work an additional shift. The staff stated that there were enough of them to provide a good quality of care. The residents spoken to said the staff were kind and that nothing was too much trouble. The inspector observed the staff carrying their jobs in a friendly manner and spoke politely to the residents. Many of the staff have been at the home a number of years which helps to ensure there is consistency of care. 60 of the staff team at Moorside Hall have attained a National Vocational Qualification at level 2 or above in care. This reflects the management teams positive attitude to the importance of having a staff team that is trained to be able to meet the needs of the residents. The staff have also been receiving training in relation to ‘dementia awareness’ to ensure they understand the needs of the residents who have a dementia. Moorside Hall F57 F09 S9681 Moorside Hall V217816 160605 Stage 4.doc Version 1.30 Page 18 Other training includes; Food Hygiene First Aid Moving and handling The care manager is keen to ensure staff have the training they need to carry out their role effectively and with confidence. The staff and the residents appeared to get on well together and this generates the good atmosphere in the home Moorside Hall F57 F09 S9681 Moorside Hall V217816 160605 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 & 33 Experienced and qualified management staff run the home. The residents live in an environment that is well managed. The management and staff ensure the home is run in the best interests of the residents. The residents feel secure and content in the home. EVIDENCE: 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. Moorside Hall F57 F09 S9681 Moorside Hall V217816 160605 Stage 4.doc Version 1.30 Page 20 Residents who were consulted confirmed that they felt involved in the day to day running of the home as much as they could be. They have residents meetings where they can have their say, but they are also consulted on a daily basis about matters that affect them personally. Such as what to eat, where to sit and what time they want to go to bed. They said they were content in the care they receive. In discussion, staff confirmed that Mrs Pullen and Mr Murray were approachable managers who welcomed new ideas and suggestions. Moorside Hall F57 F09 S9681 Moorside Hall V217816 160605 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 x COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 x 3 x x x x x Moorside Hall F57 F09 S9681 Moorside Hall V217816 160605 Stage 4.doc Version 1.30 Page 22 Are there any outstanding requirements from the last inspection? 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. 1. Standard OP9 Regulation 13(2) Requirement The manager must ensure an accurate record of receipt is made for all medication received into the home. The manager must ensure the medication administration records are retained for a minimum of 3 years The manager must ensure an accurate record is made of all medicines leaving the home. The manager must ensure all medication is securely stored with reference to refrigerated items and tethering the medication trolley to the wall. The managemnet must ensure peoples medical history is recorded as part of the preadmission assessment. Timescale for action 30/7/05 2. OP9 3. 4. OP9 OP9 Schedule 3 17(1)(a)3 (i) 13(2) 13(2) 30/7/05 30/7/05 30/7/05 5. OP3 14(1)(a) 31/8/05 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. Refer to Standard OP9 Good Practice Recommendations A photograph of every resident should be kept with the F57 F09 S9681 Moorside Hall V217816 160605 Stage 4.doc Version 1.30 Page 23 Moorside Hall 2. 3. OP9 OP10 medication administration records. A standardised controlled drugs register should be obtained Each resident should be provided with a key to their bedroom door unless a risk assessment indicates this is not practical for an individual Moorside Hall F57 F09 S9681 Moorside Hall V217816 160605 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection 2nd Floor, Unit 1 Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: 0845 015 0120 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 F57 F09 S9681 Moorside Hall V217816 160605 Stage 4.doc Version 1.30 Page 25 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!