Inspection on 21/08/07 for Moot Lodge

This inspection was carried out on 21st August 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

Moot Lodge 09/10/06

Moot Lodge 31/01/06

Moot Lodge 21/07/05

Moot Lodge 03/02/05

Moot Lodge 13/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Moot Lodge Market Place Brampton Cumbria CA8 1RW Lead Inspector Mrs Margaret Drury Unannounced Inspection 21st August 2007 09:40 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 Moot Lodge DS0000036477.V343205.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. Moot Lodge DS0000036477.V343205.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Moot Lodge Address Market Place Brampton Cumbria CA8 1RW 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) 016977 2643 moot.lodge@cumbriacc.gov.uk www.cumbriacare.org.uk Cumbria Care Care Home 19 Category(ies) of Dementia - over 65 years of age (4), Old age, registration, with number not falling within any other category (19) of places Moot Lodge DS0000036477.V343205.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The service must at all times employ a suitably qualified and experienced manager who is registered with the Ntional Care Standards Commission. A maximum of nineteen older people (19(OP)) may be accommodated four of whom may have dementia (4(DE(E)) The staffing levels for the home must meet the Residential Forum Care Staffing Formula for Older Adults by 1st April 2004. When single rooms of less than 12 sqm usable floor space become available they must not be used to accommodate wheelchair users, and where existing wheelchair users are in bedrooms of less than 12 sqm they must be given the opportunity to move to a larger room when one becomes available. 9th October 2006 Date of last inspection Brief Description of the Service: Moot Lodge is a care home for older people operated by Cumbria Care, an internal business unit of Cumbria County Council. The home is situated in the market square of Brampton, a town some 9 miles from Carlisle, and is close to all the local amenities and services. The home has four floors with the accommodation for service users situated on three. There is a passenger lift between the floors, and level access to the garden from the rear of the home on the lower ground floor. The home is divided into two separate living areas. On the ground floor there are bedrooms, a bathroom, toilets and a lounge. The dining room is on the lower ground floor together with a toilet, hairdressing room and the main kitchen. On the first floor there are bedrooms, a bathroom, toilets, a lounge/dining room with small kitchen area and a separate small, quiet lounge. There is a range of equipment in the home to assist people with a physical disability. There is a small sheltered patio area with seating accessed through the dining room on the lower ground floor, and a small parking area to the rear of the home Fees in this home range from £372.00 to £434.00 with extra charges for chiropody, hairdressing, newspapers, magazines, dry cleaning and private telephone calls. The home does not provide intermediate care. Moot Lodge DS0000036477.V343205.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site visit that forms part of the key inspection took place over one day and we were in the home for five and a half hours. Information about the service was gathered in different ways: • Annual Quality Assurance Assessment document completed by the manager • Survey questionnaires returned by residents and healthcare professionals • The service history • Interviews with residents, visitors and staff on the day of the visit. We looked at care planning documentation to ensure the level of care provided met the needs of those living in the home and a tour of the building to inspect the environmental standards was undertaken. Staff personnel files were examined. What the service does well: What has improved since the last inspection? Moot Lodge DS0000036477.V343205.R01.S.doc Version 5.2 Page 6 An improved activities programme has been introduced for people living at the home. A review of the daily routines at the home has allowed care staff more time to spend with residents. Care plans have been brought up to date with monthly reviews now taking place at the appropriate intervals. Staff supervision records have improved and all staff now have regular meetings with their line manager. All staff personnel files are now up to date. 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. Moot Lodge DS0000036477.V343205.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 Moot Lodge DS0000036477.V343205.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): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This service provides prospective residents and/or their representatives with the information needed to choose a home that will meet their needs. EVIDENCE: We looked at the statement of purpose and the manager explained that some parts had been updated but she felt this could be improved. This can be produced in different formats if required. During the visit we were able to speak to the manager and the residents about the way in which people are admitted to this home. The residents agreed that their admission was made easy because “the manager and staff were so kind and made me feel welcome”. Some residents had chosen their room but if this was not possible relatives had made the choice on their behalf. The residents Moot Lodge DS0000036477.V343205.R01.S.doc Version 5.2 Page 9 we spoke to said they had visited the home and “enjoyed a cup of coffee with the staff” when they were looking for accommodation. The manager completes a needs assessment before any resident is admitted to ensure the home can meet their needs. Details from these assessments are used when the care plans are prepared. We discussed with the manager how she involves healthcare professionals to ensure any specialist needs are met. District nurses from the nearby GP surgery visit the home on a regular basis and the community psychiatric nurses are readily available for advice when required. Moot Lodge DS0000036477.V343205.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): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people receive is based on their individual needs. Privacy and dignity are respected at all times. EVIDENCE: We looked at the care plans for three people and the information provided covered areas such as mobility, diet, health and personal care. The care plans are reviewed monthly but during the time the home was without a registered manager not all the reviews had been completed on time. However, since the appointment of a new manager the staff have worked hard to ensure they are now all up to date. Records of healthcare visits are kept and the manager confirmed that the nurses at the local practice are extremely helpful and supportive. This was confirmed by the surveys that were returned to the Commission for Social Care Inspection. Moot Lodge DS0000036477.V343205.R01.S.doc Version 5.2 Page 11 Cumbria Care is currently making changes to the format of the care plans that will improve the care planning system. A more person-centred approach is being introduced. A recent random pharmacy inspection was carried out at Moot Lodge on the 26th of July this year. The quality in this area was judged to be good. Residents are protected by safe systems for handling medication and record keeping was completed in an appropriate manner. A report regarding this visit is available if required. We observed the delivery of personal care during the visit and found it to be varied to meet the individual needs and preferences. Staff respected the privacy of the residents and were seen to listen attentively when residents spoke to them One resident said, “I like to joke with the staff and have a laugh” and “the staff are always so polite and kind”. All residents are asked how they wish to be addressed and are supported and encouraged to remain as independent as possible. From discussions with the staff it was evident that they understood the needs of the residents and supported them whilst meeting those needs. Moot Lodge DS0000036477.V343205.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): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service are able to make choices about their lifestyle and are supported to maintain their independence. EVIDENCE: The routines in this home are flexible and meet the needs of those people living there. As the home has no designated activities organiser the manager has introduced the practice whereby a team of carers, together with a supervisor, organise one main activity each month. This is proving very popular and has so far included, a visit to the circus, a garden party that raised £600 for residents’ funds, visiting entertainers and a “pie and pea” supper. Other smaller activities are provided also, the most popular being a chat with the staff over tea or coffee. A regular church service is conducted and Communion is provided for those who wish to take it. Moot Lodge DS0000036477.V343205.R01.S.doc Version 5.2 Page 13 Visitors to the home are welcome any time and when we discussed this with the residents they said their visitors “are always offered tea and coffee when they come to see me”. There are currently no residents who are able or choose to manager their own affairs. As one resident told us “ I would much rather let my son manage my affairs as it saves me worrying about it”. All residents have chosen to bring some personal items from home and this has ensured their rooms are homely and personal. We observed lunch being served and obviously enjoyed by the residents. The menus are varied and nutritious although the cook advised us that plans are in hand to review them after discussions with the residents. There is a choice at all meals and vegetarian and diabetic diets are catered for. When we asked the residents if they enjoyed their meals they all said they did and that there was “always plenty to eat Moot Lodge DS0000036477.V343205.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): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service are able to express their concerns knowing they will be listened to and acted upon. EVIDENCE: We discussed the recording of complaints and concerns with the manager. There is a complaints log in place although there have not been any to record and none have been made to the Commission for Social Care Inspection. The manager expressed her concern that staff did not feel it necessary to record even the smallest comment made by residents or visitors and will discuss this at future staff meetings and supervision. Residents who spoke to us during the visit all agreed they knew who to speak to if they had a concern or if there was anything troubling them. They did say, however, that they had never “had a concern or complaint since they moved into the home”. We discussed the adult protection procedures that are in place to safeguard the residents. The manager has only been in post since January of this year and had completed the recently introduced staff induction programme. She told us that she was impressed by the way in which this subject is covered as it gives staff a comprehensive understanding of the process to follow. She hopes to cover this subject with all staff regardless of how long they have Moot Lodge DS0000036477.V343205.R01.S.doc Version 5.2 Page 15 worked at the home, during staff meetings and supervision. This will ensure that everyone knows what to do and that residents will be protected at all times. All staff have access to Cumbria Care’s policy and procedure and guidance and there is a copy of Cumbria’s policy on the Protection of Vulnerable Adults also available in the home. Moot Lodge DS0000036477.V343205.R01.S.doc Version 5.2 Page 16 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): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents enjoy a comfortable and homely living environment. The premises are reasonably well maintained and kept to a good standard of cleanliness. EVIDENCE: We conducted a tour of the building with the manager looking at the environmental standards within the home. All the residents have single rooms and although many of them are rather small, all who spoke to us were pleased with their accommodation. One resident commented that he saw the room before he moved in and “ I am very happy with it as I can see the town centre from my window”. No bedrooms in this service have en-suite facilities but there are two bathrooms and a separate shower room for the residents to use. Moot Lodge DS0000036477.V343205.R01.S.doc Version 5.2 Page 17 All are suitable for residents who may have a disability. There are handrails on the corridors to assist with mobility around the home. A passenger lift ensures residents have access to all parts of the building. Communal space is found on all floors with a large lounge on the ground floor and a lounge/diner on the first floor. There is also a small lounge on the first floor that can be used for private visits if required. The main dining room is situated on the lower ground floor from which residents are able to access the garden area. Due to financial constraints within the organisation there has been very little redecoration since the last inspection and parts of the home are now in need of some refurbishment. However, plans are now in place for some redecoration to be completed within this financial year. All the rooms were clean and tidy although one did have an unpleasant odour. The manager did say she was hoping to have the flooring replaced but we felt it necessary to make a requirement that the floor covering was replaced in the near future. Moot Lodge DS0000036477.V343205.R01.S.doc Version 5.2 Page 18 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): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using this service are protected by robust recruiting procedures. Trained and experienced staff ensure all residents are supported and cared for. EVIDENCE: We discussed the staffing arrangements with the manager in the light of the current staff shortages. These are due, in the most part to staff sickness and some holidays. At the moment existing staff are covering to ensure continuity of care and to avoid the use of agency staff. This has worked as far as the care hours but some agency staff are currently used for a small number of cooking hours. Comments from residents about the staff included, “the staff are lovely and always kind and considerate” and “ I really like to have a joke and a laugh with them and they don’t mind a bit”. We looked at the staff files and recruitment process for 3 members of staff. These were very well maintained and contained all the necessary checks including Criminal Records Bureau (CRB) checks and references. Moot Lodge DS0000036477.V343205.R01.S.doc Version 5.2 Page 19 Staff training is on going with 72 of the care staff qualified to NVQ level 2. Cumbria Care provides an annual training programme but places are limited and available on a first come first served basis throughout the county. This means that sometimes all places are taken before the manager has had time to book places for her staff. We discussed this at length and it was felt that there should be a fairer allocation procedure as many staff felt they were “missing out”. The supervisor also said it is sometimes difficult to ensure the staff receive the statutory 3 days training a year. Training has been completed in, food hygiene, medication appraisals (manager) and moving and handling. Moot Lodge DS0000036477.V343205.R01.S.doc Version 5.2 Page 20 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): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service live in a home that is safe, well managed and run in their best interests. EVIDENCE: The manager was appointed to this service in January of this year and is currently awaiting registration by The Commission for Social Care Inspection (CSCI). She is a qualified nurse and experienced in the care of older people. She has a relaxed style of management and feedback from residents and staff about her leadership and support was positive. Comments from staff included “she is very supportive and approachable” and “she has settled down well and Moot Lodge DS0000036477.V343205.R01.S.doc Version 5.2 Page 21 is making a difference to the home”. Residents said “she is very nice to talk to and I see her often when I am walking around the home”. Care staff have supervision with their line manager that helps them to develop their own practice and discuss their training needs. These meetings now take place regularly every 2 months with details kept on individual files. The service takes care of a small amount of personal allowance on behalf of some residents. This is used for toiletries, hairdressing, newspapers and magazine. Records of the individual amounts spent are kept and show that 2 members of staff record and check all transactions. This helps to ensure that residents’ personal finances are protected and managed safely. Quality assurance survey forms are sent to residents and their families 2/ 3 times a year and regular meetings are held with residents to ask for their opinions about the running of the home. The manager also ensures that she is always available to speak with residents and visitors. A recent visit made to the home by the fire officer confirmed that the fire risk assessments were in place and up to date. The only recommendations made were for some extra signs to be put up. This was done immediately and they were in place when the fire officer returned the day before the inspection visit to check the work had been completed. All health and safety measures are in place with an annual audit completed by the organisation’s health and safety manager. All equipment is serviced under annual service level agreements. Moot Lodge DS0000036477.V343205.R01.S.doc Version 5.2 Page 22 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 3 X 3 3 3 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 3 3 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 3 3 3 X 3 3 X 3 Moot Lodge DS0000036477.V343205.R01.S.doc Version 5.2 Page 23 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 OP24 Regulation 23 Requirement The manager must ensure the floor covering in room 2 is replaced Timescale for action 30/09/07 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 Moot Lodge DS0000036477.V343205.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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 Moot Lodge DS0000036477.V343205.R01.S.doc Version 5.2 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. 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