Inspection on 10/01/06 for Moorside Nursing Home

This inspection was carried out on 10th January 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 Nursing Home 15/03/07

Moorside Nursing Home 18/08/05

Moorside Nursing Home 04/11/04

Moorside Nursing Home 21/06/04

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

CARE HOMES FOR OLDER PEOPLE Moorside Nursing Home Durngate Winchester Hampshire SO23 8DU Lead Inspector Marilyn Lewis Unannounced Inspection 10th January 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 Nursing Home DS0000012129.V274144.R01.S.doc Version 5.1 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 Nursing Home DS0000012129.V274144.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Moorside Nursing Home Address Durngate Winchester Hampshire SO23 8DU 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) 00962 854548 01962 854811 St John`s Winchester Charity Mrs Victoria Joan Davies Care Home 26 Category(ies) of Dementia (26), Dementia - over 65 years of age registration, with number (26), Mental disorder, excluding learning of places disability or dementia (26), Mental Disorder, excluding learning disability or dementia - over 65 years of age (26) Moorside Nursing Home DS0000012129.V274144.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th August 2005 Brief Description of the Service: Moorside is a care home providing nursing care for 26 persons with dementia or mental health problems. The home was purpose built and has accommodation arranged in cluster formation, with bedrooms, lounge, dining room with small kitchen area and bathroom facilities provided in each unit. All residents are accommodated in single rooms with twenty-four of the twenty-six rooms fitted with en-suite facilities. The well maintained enclosed rear garden provides a pleasant sitting area for residents. A day centre situated on the ground floor of the home, operates on two days of the week. The home is owned and operated by a Christian organisation, The St Johns Winchester Charity, a provider of a range of integrated care for the people of Winchester. Moorside is situated within the centre of the city of Winchester, close to all amenities. Limited parking is available at the home. Moorside Nursing Home DS0000012129.V274144.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 10th January 2005. The inspector met with five residents, a relative, four staff members, the charity’s training manager and the registered manager. The inspector also toured the home. Care plans for three residents were sampled and records seen for medicines, staff training, staff recruitment and maintenance checks on equipment. This was the second unannounced inspection for the year 2005/2006. Information on standards assessed at the first inspection can be found in the inspection report dated the 18th August 2005. What the service does well: No one is admitted to the home without a full care needs assessment and prospective residents and their relatives are able to visit the home before making a decision about living there. Good care plans provide staff with all the information they require to fully support the residents. Residents are protected by the home’s clear procedures for dealing with medicines and they are treated with sensitivity and respect throughout their stay at the home. Residents are protected by staff awareness of abuse issues and their willingness to report any concerns. The home provides a clean, safe, comfortable environment for all who live and work there. Resident’s needs are met by the number and skill mix of staff on duty during each shift. Staff receive support and encouragement to attend training sessions and obtain qualifications. The registered manager has the qualifications and experience required to run the home and residents and staff benefit from her open approach to management. Moorside Nursing Home DS0000012129.V274144.R01.S.doc Version 5.1 Page 6 The safe working practices in operation at the home protects Resident’s health, safety and welfare. 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. Moorside Nursing Home DS0000012129.V274144.R01.S.doc Version 5.1 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 Moorside Nursing Home DS0000012129.V274144.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5 and 6 A full care needs assessment is undertaken for all prospective residents and they are able to visit the home before making a decision about living there and receive a clear written contract on admission. EVIDENCE: The home has a Statement of Purpose and Service User Guide that provide prospective residents and their relatives with information about life at the home. The documents include a brief outline of the charity that operates the home, the admission process, accommodation and the services. The documents have not been updated to include the name, qualifications and experience of the registered manager. Since the inspection the registered manager has provided the commission with an up to date version of the documents. Each resident is given a written contract that provides details of the terms and conditions for residency. Contracts state the room to be occupied, the services provided in the fees and services available at an additional cost such as hairdressing. Moorside Nursing Home DS0000012129.V274144.R01.S.doc Version 5.1 Page 9 The registered manager or senior nurse complete a full care needs assessment for each prospective resident before a place at the home is offered. Many of the people who are admitted to the home have already been attending a day centre run on two days of the week at the home. Staff know the care needs of these people and an assessment is undertaken while they are attending the day centre. Staff visit prospective residents who do not attend the day centre in their own homes to complete the assessment. The full assessment includes information on the medical history of the person, the emotional state, personal care needs and social needs. Information from relatives, GPs and care managers is included in the completed report, which then forms the basis for the individual care plans. Assessments seen for three residents gave clear information on their care needs. The registered manager is a trained nurse with experience in providing care for people with dementia. Staff receive training in all aspects of care provision and specific topics that are relevant to the residents including dementia care. Prospective residents are welcome to visit the home before making a decision about living there. Relatives are also welcome to visit. Admission to the home is for a trial period of four weeks. Although the home admits people for respite care it does not provide intermediate care and therefore standard 6 does not apply. Moorside Nursing Home DS0000012129.V274144.R01.S.doc Version 5.1 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 the following standard(s): 7, 8, 9, 10 and 11 Good care plans provide staff with the information they require to fully support the residents, who are protected by the home’s clear procedures for dealing with medicines and who are treated with sensitivity and respect throughout their stay at the home. EVIDENCE: Individual care plans were seen for three residents. The plans were good and provided staff with clear information on the care needs of the residents including personal, emotional and social care needs. Risk assessments including those for pressure areas, nutrition, mobility and falls were contained in the plans. The plans showed evidence of the resident or their relatives involvement and regular review. The care plans seen indicated that residents received support and advice from GPs and other health professionals as required. Advice is sought from physiotherapists, occupational therapists and dieticians when necessary through GP referral. Residents are able to visit their dentist and optician in the local community or a dentist and optician will visit on request. A chiropodist visits the home every six weeks. Moorside Nursing Home DS0000012129.V274144.R01.S.doc Version 5.1 Page 11 The home has clear procedures in place for dealing with medicines. There are systems for medicines entering the home and for the disposal of unwanted medication. Medication records seen had been completed appropriately. At the time of the inspection there were no medicines stored in the controlled medicines cupboard and no residents were administering their own medication. The minimum and maximum temperature of the fridge used to store some medicines, such as eye drops, was being monitored and recorded to ensure the medicines were kept at the appropriate temperature. The registered manager said that training by a pharmacist on new medicines, was being arranged for the trained nurses, who administer the medicines and up to date information on the medicines used at the home was available. It was evident during the inspection visit that residents were treated with respect and their right to privacy was upheld. Staff were seen to knock on doors and wait before entering rooms and they spoke to the residents in a friendly caring manner. The registered manager said that residents were able to stay at the home when very ill if at all possible. Procedures seen for care of the dying resident indicated that the resident and their relatives would be treated with sensitivity and respect. A letter seen from a relative of one resident, who had recently died at the home, said that the resident had received ‘love, peace and dignity’. Moorside Nursing Home DS0000012129.V274144.R01.S.doc Version 5.1 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 the following standard(s): EVIDENCE: These standards were met when assessed during the last inspection. Information can be found in the inspection report dated the 18th August 2005. Moorside Nursing Home DS0000012129.V274144.R01.S.doc Version 5.1 Page 13 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 the following standard(s): Residents are protected by staff awareness of abuse issues and the procedures to be followed should abuse be suspected. EVIDENCE: The home has procedures in place to be followed should abuse be suspected. The procedures provided by Hampshire County Council and the home’s own procedures are readily available to staff. Two staff members asked about the procedures, were aware of them and indicated that they would have no hesitation in reporting any concerns. Staff receive abuse awareness training during their induction programme. The charity’s training manager and a trained nurse employed at the home have attended training in the Protection of Vulnerable Adults and they are starting a training programme for all the home’s staff in February 2006. Moorside Nursing Home DS0000012129.V274144.R01.S.doc Version 5.1 Page 14 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 the following standard(s): 25 Moorside provides residents with a clean, safe, homely environment. EVIDENCE: These standards were assessed during the last inspection and information can be found in the inspection report dated 18th August 2005. The only standard not met was 25, as call alarms were not accessible to some residents who were able to use them. On this occasion call alarms were available and accessible to residents able to use them. On the day of the inspection the home looked clean and welcoming. Communal rooms looked cheerful and resident’s rooms were homely and contained many personal items. Moorside Nursing Home DS0000012129.V274144.R01.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 and 30 Resident’s needs are met by the good number and skill mix of staff on duty at the home and by the ongoing training programme provided for staff members. EVIDENCE: The home employs the registered manager, deputy manager, eleven trained nurses and thirteen carers. Separate staff are employed for administration, catering, laundry and domestic duties. Staffing levels on each shift are good, with two trained nurses and nine carers on throughout the day and evening and one trained nurse on at night and four carers. The rota seen indicated that two trained nurses and three carers were on duty that night. The registered manager said that the residents’ dependency levels were constantly reviewed and the number of trained staff on duty at night was organised to meet the residents assessed needs. Staff spoken with said that they felt there was a good level of staffing on each shift. The home is able to call on the services of a bank of staff members when cover is required. Agency staff are also employed as required. The home uses one agency and the agency staff are used to the home and know the residents. Five of the thirteen carers hold National Vocational Qualification level 2 or above and a further five carers are due to start later in the month. The registered manager is aware of the need for fifty percent of care staff to hold or be in the process of obtaining NVQ level 2 or above and is working with the charity’s training manager to ensure staff obtain the qualifications. Moorside Nursing Home DS0000012129.V274144.R01.S.doc Version 5.1 Page 16 The inspector met with the training manager to discuss the training programme provided for staff at the home. All new staff undertake an in depth induction course that is completed over three months. The induction covers all aspects of care provision and also literacy, numeracy and computer skills. The training manager said that the induction course would help staff to prepare for NVQ courses. All staff have received training in moving and handling. Two staff members have completed training to train staff in moving and handling and a programme of updating training has begun, that will run through the year to allow all staff to attend. The training includes risk assessments in relation to the home environment and theory and practice sessions. Staff are also receiving training in infection control, equality and diversity, first aid and food hygiene. Some staff members have attended training courses on dementia care and arrangements are being made for more staff to attend the sessions. Staff spoken with said that they were encouraged and supported by the registered manager, to attend training sessions and obtain qualifications. Staff recruitment records were assessed at the last inspection and met the required standard. Moorside Nursing Home DS0000012129.V274144.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 37 and 38 The registered manager has the qualifications and experience required to run the home and residents benefit from her open approach to management and the safe working practices in operation there. EVIDENCE: The registered manager, Mrs Davies, is a trained nurse with experience in providing care for the elderly and people with dementia and mental disorder. Mrs Davies is currently studying for the Registered Managers Award. A weekly meeting is held for staff of each cluster of rooms and a general staff meeting takes place every three weeks. Records are kept of the meetings and are available for staff unable to attend. The registered manager said that at present meetings are not held at a convenient time for night staff so she meets with night staff on a one to one basis while they are on duty. Moorside Nursing Home DS0000012129.V274144.R01.S.doc Version 5.1 Page 18 Meetings are also held for relatives on a monthly basis. These are also recorded. The registered manager said that a good number of relatives attend. The registered manager operates an open door approach to management and so residents, relatives and staff have a good opportunity to meet with her as they wish. Three staff spoken with said that the registered manager was supportive and approachable and a visitor also said that she felt able to speak to Mrs Davies at any time. At the time of the last inspection the resident’s individual care plans were stored in an insecure manner in the dining rooms and were accessible to other residents and visitors to the home. On this occasion the care plans were stored safely in cupboards in the dining rooms. Records and certificates seen indicate that maintenance checks on equipment such as hoists, lifts and the home’s electrical and water systems are undertaken as required. On the day of the inspection the kitchen looked clean and in good order. When touring the home it was noted that hazardous substances such as cleaning fluids were stored securely. Health and safety notices were displayed around the home. As previously stated in standard 30, staff receive training in moving and handling, first aid, food hygiene and infection control. Moorside Nursing Home DS0000012129.V274144.R01.S.doc Version 5.1 Page 19 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 2 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 3 x x x x x x 3 x STAFFING Standard No Score 27 3 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x x x 3 3 Moorside Nursing Home DS0000012129.V274144.R01.S.doc Version 5.1 Page 20 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. Refer to Standard Good Practice Recommendations Moorside Nursing Home DS0000012129.V274144.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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. 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