Inspection on 16/09/08 for Moray Lodge

This inspection was carried out on 16th September 2008.

CSCI found this care home to be providing an Good service.

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

Moray Lodge 27/02/06

Moray Lodge 26/04/05

Moray Lodge 26/01/05

Moray Lodge 13/07/04

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Moray Lodge 5 Peveril Road Old Duston Northampton NN5 6JW     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Irene Miller     Date: 1 6 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 25 Information about the care home Name of care home: Address: Moray Lodge 5 Peveril Road Old Duston Northampton NN5 6JW 01604753887 01604750728 trish.ribano@nht.northants.nhs.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Patricia Ribano Type of registration: Number of places registered: Northamptonshire County Council care home 13 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home Moray Lodge Care Home offers respite care to service users who have mental health needs, excluding learning disability and dementia. Northamptonshire County Council provides the service in partnership with the Northamptonshire Primary Care Trust, and weekly fees are based upon the level of support required and dependency level. Moray Lodge is located in the village of Duston close to Northampton Town centre with access to a range of community facilities and services. Private accommodation is in single bedrooms and there is a range of communal areas including a games room. Accommodation charges are not made however people using this respite service pay #5.00 per day for meals prepared by the home. 13 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 stars. This means that the people using this service experience good quality outcomes. The focus of all inspections undertaken by the Commission for Social Care Inspection (CSCI) are based upon seeking the outcomes for people using the service and their views of the services provided. This visit was unannounced and focused on the key standards under the National Minimum Standards and the Care Standards Act 2000 for homes providing care for older people. Care Homes for Adults (18-65 years) Page 5 of 25 The care records people using the service were sample checked which involved looking through written information available on their care, such as their individual care plans (a care plan sets out how the home aims to meet the individual service users personal, healthcare, social and spiritual needs). An expert by experience who has experience of both using mental health services and in supporting people with mental disorders was present during part of this inspection visit. This person was introduced to the people using the service and spent time talking with individuals in order to make an assessment of the level of support provided at the service. In addition time was spent talking with staff to assess their understanding and awareness of mental disorders, the mental capacity act and human rights act, and how staff support and promote people with mental disorders to continue to lead full and productive lives. During the visit people using the service were consulted on how they view the care provided at the home, and discussions with staff gave an insight into the support and training provided at the home. Observations of care practises and discussions with people using the service gave an indication on the quality of the service provided at Moray Lodge. Comments received from people using the service were praising such as The staff are caring and thoughtful, The Lodge is great, I feel comfortable and can relax, The people are nice. Records in relation to the homes management and administration systems, quality assurance, staffing and general policies and procedures were viewed and seen to be well managed. Prior to this visit the Commission for Social Care Inspection sent out to the provider an Annual Quality Assurance Assessment (AQAA) this document allows the provider to supply us with information on how they view their own performance, such as what they do well, what they could do better and plans for future improvements. The AQAA was returned to the Commission for Social Care Inspection (CSCI) within the timescale set, and gave an insight into how the home is managed and quality assessed. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 25 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Thorough assessment procedures ensure that people choosing to use the service have all the information they need to make a choice as to whether the service is right for them. Evidence: Within the care plans viewed there was pre admission assessments available that had formed the basis to identify the care and support required by the person using the service. There was records of the pre admission input from health care agencies, such as the Care Programme Approach (CPA) coordinator following admission into the service. There was signed contracts available that detailed the terms and conditions for the length of stay at the service. Each person is provided with a trial period of respite care before becoming permanent. Care Homes for Adults (18-65 years) Page 9 of 25 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Support is provided for people using the service to take risks and make their own decisions to enable them to live as independently as possible. Evidence: Within the care plans and risk assessments viewed there was information on the needs and preferences of people using the service. Individual routines were identified such as going shopping, housework and individual social and leisure activities. Some of the people using the service prepare their own food in the various small kitchen areas of the home whilst some choose to pay a daily charge for meals provided by the service. Risk assessments were in place that identified particular areas of risk to individuals who choose to prepare their own meals. Care Homes for Adults (18-65 years) Page 10 of 25 Care Homes for Adults (18-65 years) Page 11 of 25 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this 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 service provided at Moray Lodge is individualised and supports those using the service to lead as independent a lifestyle as possible. Evidence: Many of the people continue to use work or day placements. Friends and relatives are encouraged to visit and external visits are encouraged for people to spend the day or have overnight stays with friends and family where appropriate. The people spoken with said that they had contributed to their care plans, although a common theme within the care plans was an emphasis on completing domestic tasks. Within the care plans there was evidence to demonstrate the frequency of when people have access to the community, to go visit the theatre, cinema, clothes and food Care Homes for Adults (18-65 years) Page 12 of 25 Evidence: shopping or to socialise with friends and family. The people using the service are provided with a varied diet and evidenced that food preferences are taken into account and choice is made available. Care Homes for Adults (18-65 years) Page 13 of 25 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this 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 care needs of people using the service are met. Evidence: The people using the service require minimal personal healthcare support from the staff as most of the people are self caring in this area, however support is provided by staff where personal care is required and this is documented within the care plans as appropriate. Within the care plans viewed there was records of available on the frequency of when people using the service had attended appointments to see their general practitioner and records of the input from health and social care agencies evidenced that the service works well with these agencies to ensure that daily routines as followed as set out in the individual care programme agreements. The medication storage and administration records were sample checked and appeared satisfactory, with only one exception when staff had failed to recorded on the medication administration record (MAR) sheet that a person had stayed over at their Care Homes for Adults (18-65 years) Page 14 of 25 Evidence: relatives for the night. The section where staff should have made an entry had been left blank. It was pointed with the staff at the time of the visit that where a person has not received their medication the reason why should be indicated on the MAR sheet. Controlled drugs held at the service were checked and found to be stored and records correctly maintained. Where people using the service are responsible for taking their own medications the systems for recording and storing medication was well managed. Care Homes for Adults (18-65 years) Page 15 of 25 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. In general the systems in place to ensure that people using the service are protected are robust, however failure to notify the Commission for Social Care Inspection of notifiable events places the service of being in breach of the Care Standard 2001 Regulation 37. Evidence: As part of the preparation for this inspection visit the inspector spent time gathering information received on the service since the last Inspection visit of 12th October 2006 and it was noted that CSCI had not received any notifiable events since the last inspection. Notifiable events fall under Regulation 37 of the Care Standards Act 2001 the service is required to formally notify CSCI whenever there is a death, illness or other event which adversely affects the well being or safety of any service user. Within the care plans viewed there was records of incidents where the well being and safety of service users and others had been placed at risk. In discussion with the senior staff on duty they were unaware of the requirement to report any notifiable events to CSCI, and therefore time was spent during the inspection explaining the notification procedures to the staff. Care Homes for Adults (18-65 years) Page 16 of 25 Evidence: On checking accidents and incidents reports at the service there were records of the NHS Trust being made aware of accidents and incidents. The complaints procedure was available within the front entrance of the home, and the the link keyworker role is used to ensure that people using the service are provided with regular one to one opportunities to discuss any concerns or complaints they may have with their keyworker. Records were seen within the care plans of discussions between the keyworker and the person with whom they are linked (keyworker). These were stored securely and only made available to people who are authorised to view them. People spoken with demonstrated a sound knowledge of the staffing structure within the lodge and of the appropriate person(s) to contact in the event of any complaint. It was indicated that a comfortable relationship existed between the staff and clients when asked if staff listen to concerns and act on them one person said If they can, they will. People using the service reported having complete autonomy in their financial affairs. Staff training is provided on Safeguarding, this ensures that all staff are fully aware of ensuring peoples rights are promoted and protected. Observations made during the visit of staff interactions with the people using the service indicated that people are treated with respect and their rights to privacy and dignity promoted. Care Homes for Adults (18-65 years) Page 17 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this 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 the service are provided with a clean well maintained environment. Evidence: A limited tour of the build took place and all areas seen were very clean and tidy, there is a choice of several communal areas for people to use such as a pool and music room, communal lounges with television and book-lending facilities. The bedrooms viewed had been personalised to individual taste, and people using the service are are responsible for ensuring that their own bedrooms are kept clean. There is a small laundry facility which deals with the household laundry and additional laundry facilities are located within the small kitchen areas to enable people using the service to take responsibility for laundering their own personal items. Care Homes for Adults (18-65 years) Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this 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 process of staff recruitment and training ensure that people using the service receive are provided with support from a team of staff that are appropriately trained to meet their needs. Evidence: On the day of this visit there was sufficient staff on duty to meet the needs of the people using the service, staff were observed to spend time with individuals providing support with completing household tasks and were seen to be socialising with the people using the service. In discussion with staff they demonstrated that they know the individuals who use the service very well and are fully aware of individual needs. Regular communication takes place with health and social care professionals involved in the individual care of people using the service. Access to staff recruitment files was limited due to the registered manager not being available, so in order to assess the recruitment process staff were asked about their experience of applying for a post at the service, and the training opportunities available. Staff confirmed verbally that they were aware that the service had carried out pre employment checks which included obtaining written references and police clearance through the Criminal Records Bureau (CRB) and confirmed that opportunities Care Homes for Adults (18-65 years) Page 19 of 25 Evidence: for self development were good and that all mandatory training is provided. Care Homes for Adults (18-65 years) Page 20 of 25 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this 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 people using the service benefit from a service which is run in their best interests. Evidence: Discussion with the staff on duty evidenced that they consider the management support as being good, the staff take a pride in the service they provide for the people using the service. The staff team work well with the health and social care professionals to provide a pro active positive approach to supporting the people using the service. Records were available of accidents and incidents and there was evidence to show that information is shared between Northants NHS Trust and Northants County Council, however there was an absence of CSCI being informed of notifiable events under Regulation 37 of the Care Standards Act 2001. The service is required to formally notify CSCI whenever there is a death, illness or Care Homes for Adults (18-65 years) Page 21 of 25 Evidence: other event which adversely affects the well being or safety of any service user. Within the care plans viewed there were records of incidents which had taken place which had the potential to place the well being and safety of service users at risk. Regular quality assurance audits take place to gain feedback from the people using the service to evaluate the quality of the support provided. The systems in place to record the care and support required for individuals was seen to be organised and records stored securely. The care plans viewed contained sufficient information to inform staff on the care and support required for individuals using the service. People using the respite facilities had care plans in place that reflected the changes in their needs. Meetings for people using the service are held regularly and minutes are circulated on the notice board and staff team meetings take place weekly. Care Homes for Adults (18-65 years) Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action 1 23 37 Notifications in accordance with regulation 37 must be forwarded to CSCI without delay. This will ensure compliance with regulation 37 and that the Commission for Social Care Inspection are kept informed of events that affect the well being and safety of people using the service. 12/11/2008 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 24 of 25 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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