Inspection on 09/10/06 for Moot Lodge

This inspection was carried out on 9th October 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

Moot Lodge 21/08/07

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 9th October 2006 09:45 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Moot Lodge DS0000036477.V308620.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.V308620.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@cumbria.gov.uk www.cumbriacare.org.uk Cumbria Care Mrs Ann Pattinson 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.V308620.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 National 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. 31st January 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 £363.00 to £422.00 with extra charges for chiropody, hairdressing, newspapers, magazines, dry cleaning and private telephone calls. The home does not provide intermediate care. Moot Lodge DS0000036477.V308620.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit, which forms part of the key inspection, took place over one day in October. The manager, who is preparing to retire from the home, was on annual leave on the day of the visit but the supervisor in charge was available to assist the inspector. A pre-inspection questionnaire had been completed by the manager prior to the visit, which contained information about residents, fees, staffing and facilities on offer at the home. Five completed questionnaires were received from residents but none had been received back from relatives/advocates. Those received all contained positive comments about the staff and the running of the home. The inspector was able to spend time talking to residents in the lounges and some who were spending time in their rooms. Visitors to the home were interviewed and time was also spent talking to care staff and the cook. During the visit the inspector spent time with supervisor on duty discussing the operation of the home and looking at the administrative procedures, care plans and records. A tour of the building looking at the environment was undertaken. What the service does well: Residents and visitors spoke very highly of the staff and praised the level of care and support provided. The inspector observed warm interaction between staff and residents and visitors said they were “always made welcome and offered tea and biscuits”. The home provides a warm and homely atmosphere with staff supporting residents in their daily life and ensuring the routines within the home are applicable to the assessed needs. Care plans are well kept with all the monthly reviews up to date. Information on them was relevant and provided sufficient detail for the support workers to meet the assessed needs. Details of professional healthcare visits are noted on the daily records as well as the supervisors’ notes. Medication records were examined and found to be up to date and correctly completed. Moot Lodge DS0000036477.V308620.R01.S.doc Version 5.2 Page 6 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. Moot Lodge DS0000036477.V308620.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.V308620.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, 4 & 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager and/or supervisor complete care needs assessments prior to admission, which ensures the care given is appropriate to meet the needs of the residents. EVIDENCE: Admissions to Moot Lodge do not take place until a full assessment of needs has been completed. The dependency levels of those already living in the home are also taken into consideration when assessing those wishing to move in. All prospective residents and their families are invited and encouraged to visit the home prior to their admission. This gives opportunity for them to meet the staff and talk to other people living in the home. Some residents have previously had periods of respite care and were familiar with the home and the facilities on offer prior to being admitted. All residents are given a contract and terms and conditions of residency and there is a copy held on each resident’s file. Moot Lodge DS0000036477.V308620.R01.S.doc Version 5.2 Page 9 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. An effective and efficient care planning system is in place showing that personal, social and healthcare needs are being met effectively. Medical records demonstrate care is taken to ensure resident’s safety at all times. EVIDENCE: Each resident has a care plan that is used as a working tool and is understood by all staff. It is written in clear language, with resident and/or family member involvement wherever possible and is used to ensure the correct level of care is provided. Each care plan includes a comprehensive risk assessment, which is reviewed monthly, at the same time as the care plans. The rights of others living in the home are also considered when drawing up an assessment of risk. The care plans are updated each month by the supervisors, working closely with the key workers. All professional healthcare visits are recorded in detail and the supervisor confirmed that they have a very good working relationship with doctors and Moot Lodge DS0000036477.V308620.R01.S.doc Version 5.2 Page 10 district nurses who visit the home when required. Optical, chiropody and dental services are arranged when necessary. The medication is received in a monitored dosage system and all the supervisors responsible for giving out the medication have completed training in “safe handling of medication”. Records were checked and found to be in order. The home follows the corporate policy of having a second member of staff acting as a “checker” when the medication is being given to residents. Residents who spoke with the inspector said that the staff always treated them with respect and kindness and that any personal care required is given in the privacy of their own rooms. They are always asked how they wish to be addressed when they are admitted. Doctor’s visits are arranged on request and those residents who spoke with the inspector confirmed that they always receive their medication on time. Moot Lodge DS0000036477.V308620.R01.S.doc Version 5.2 Page 11 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): 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. The routines of the home are planned around the residents’ needs and wishes and are flexible enough to meet the changing needs of the individual. Some activities are arranged and a nutritious and balanced menu is provided. EVIDENCE: Routines in the home are flexible and suit the needs of the residents. Those who spoke to the inspector were pleased that they could spend their days as they wish. Some residents choose to take their meals in their rooms. Cultural needs are met by regular visits by the clergy and communion for those residents who wish to take it. One resident told the inspector her minister comes to give her Communion in her own room, which she enjoys very much. There are some activities organised but the supervisor and members of staff told the inspector it was not always possible to persuade the residents to take part. These include, dominoes, scrabble and bingo. Staff who spoke to the Moot Lodge DS0000036477.V308620.R01.S.doc Version 5.2 Page 12 inspector said many residents just like to sit and chat but this was not always possible as they are so busy. Visitors to the home are welcome at any time and are invited to stay for a meal if their visit coincides with lunch or tea. Four visitors who spoke with the inspector said what “a lovely welcome they received” and they were “always given refreshments when they arrived”. A visit to the kitchen was made during which the inspector discussed the daily menus with the cook. Fresh meat and produce are delivered and there was a good supply of provisions in the storeroom. Diabetic meals are prepared for those requiring them and soft diets are made available if necessary. The kitchen area was clean and tidy with all fridges and freezers labelled correctly. The inspector was present during the lunch period and was able to observe lunch being served in both dining rooms. The atmosphere was relaxed and it was evident that the residents enjoyed their meals and appreciated the choices they were given. Until recently the resident’s had a buffet tea on two days of the week but due to many requests, this has now been extended to five afternoons a week. This request was also made on one of the questionnaires returned by a resident. . Moot Lodge DS0000036477.V308620.R01.S.doc Version 5.2 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): 16 & 16 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a suitable complaints procedure and residents are confident that their views and concerns are listened to. Residents are protected by the adult protection procedure that is in place. EVIDENCE: The home has a complaints book in place but there have been none to record. The home encourages open dialogue and many of the residents are well able to express their opinions. Details of the complaints procedure forms part of the terms and conditions given to each resident and there is a copy on display. There are policies and procedures in place that outline the rights of those living in the home and these also form part of the terms and conditions of residency. Adult protection issues are discussed during staff induction and this area is also covered in the NVQ training course. Staff interviewed showed a good awareness of abuse issues and the process to follow should this be necessary. Moot Lodge DS0000036477.V308620.R01.S.doc Version 5.2 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): 19, 20, 22, 23, 24, 25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a home that is clean, hygienic and suitable for its intended use. This helps to ensure their safety and comfort. EVIDENCE: Although there has only been a limited amount of redecoration in the home since the last inspection, and there is still some required, the home remains quite well maintained. All planned maintenance of buildings has been put on hold by the organisation due to financial constraints. However, since the last visit, the front hallway has been decorated and a new battery operated hoist has been fitted in the ground floor bathroom. This has proved to be of great benefit to the residents and staff. There is a range of equipment available in the home to assist people in their day-to-day life. This includes a passenger lift, hand and grab rails, assisted Moot Lodge DS0000036477.V308620.R01.S.doc Version 5.2 Page 15 baths, toilets and hoists. There are rails on all the corridors to assist with movement around the building. The bedrooms that were inspected during the visit were all personal to the individual, with ornaments, pictures and photographs from the residents’ own homes. Although some are a little small all the residents who spoke to the inspector said how much they liked their rooms. The communal areas consist of a lounge/diner with kitchen facilities on the first floor and a separate lounge on the ground floor. There is a small quiet lounge on the first floor, which is used by residents to meet with their visitors in private or just to sit quietly. There is a small garden area accessed from the dining room on the lower floor with seating for the residents’ use. Domestic arrangements in the home ensure that the home is kept clean and hygienic at all times. Moot Lodge DS0000036477.V308620.R01.S.doc Version 5.2 Page 16 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, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a trained and experienced staff team to care for the residents that has been recruited using the organisation’s robust policies and procedures. EVIDENCE: Moot Lodge has a very low staff turnover with the result, there is a staff team that work together for the benefit of the residents. There is sufficient care staff on duty during the day to meet the assessed needs of the residents and provide a good standard of care. The home has 2 members of staff on waking night duty. There are, currently, staff vacancies but these posts have been filled, subject to the required health and legal checks being completed. Extra, allocated, staff hours have been utilised for a member of staff to work with the supervisors as a “checker” when giving out the medication. The home uses the organisation’s recruitment policy and procedure, which ensures all the required checks are completed prior to employment starting. The residents spoke very highly of the staff with one saying” the staff are wonderful” and “they can’t do enough for you”. Another told the inspector that the “ staff could not be kinder” and “they are all so polite”. There is a good training programme with each member of staff being responsible for keeping their own continuous professional development files up to date. Over half the staff are qualified to NVQ level 2 and a further two are working towards the award. Training recently completed includes, moving and handling updates, emergency action, equality and diversity, with infection control included in the induction programme. Moot Lodge DS0000036477.V308620.R01.S.doc Version 5.2 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, 33, 35, 36, 37 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is currently run by a competent and experienced manager who ensures it is run in the best interest of the residents. EVIDENCE: The manager was annual leave on the day of the inspection with this holiday immediately preceding her retirement, so she will not be returning to the home. The supervisor on duty was available to assist the inspector during the visit. There is a strong senior team at the home, this being evidenced by comments such as, “if I had a problem I would talk to Heather or one of the other supervisors”. The residents did, however, tell the inspector that they would “miss Anne (the manager) now she has retired” . Moot Lodge DS0000036477.V308620.R01.S.doc Version 5.2 Page 18 The atmosphere in the home was warm and friendly and the inspector was able to speak with visitors to the home and one voluntary church visitor who all confirmed that the home is run for the benefit of the residents and that the manager will be missed. Discussions with the supervisors during the visit confirmed that arrangements have been made to allow them extra shifts in order to complete managerial tasks, until a new manager is appointed. The post has been advertised and interviews have been arranged for early November. All staff supervision is up to date and training recently completed includes, medication, manual handling and equality and diversity, Where the home is responsible for looking after residents’ personal monies individual written records are kept and all receipts held on file. The home’s operations manager audits the records on a regular basis. The home has a corporate health and safety policy and manual in place. The organisation’s health and safety officer completes annual audits after which a report is prepared and given to the manager with an action plan if required. All risk assessments are in place and equipment is maintained via annual maintenance contracts. Moot Lodge DS0000036477.V308620.R01.S.doc Version 5.2 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 X 3 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 X 3 3 3 3 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 3 3 3 Moot Lodge DS0000036477.V308620.R01.S.doc Version 5.2 Page 20 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. 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 Moot Lodge DS0000036477.V308620.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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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