Inspection on 27/02/06 for Moray Lodge

This inspection was carried out on 27th February 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 found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Moray Lodge 16/09/08

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 09/07/2008.

CARE HOME ADULTS 18-65 Moray Lodge 5 Peveril Road Old Duston Northampton Northants NN5 6JW Lead Inspector Mrs Helen Wilson Unannounced Inspection 27th February 2006 10:00 Moray Lodge DS0000032887.V282986.R01.S.doc Version 5.1 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 Moray Lodge DS0000032887.V282986.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 Adults 18-65. 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. Moray Lodge DS0000032887.V282986.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Moray Lodge Address 5 Peveril Road Old Duston Northampton Northants NN5 6JW 01604 753887 01604 750728 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) www.northamptonshire.gov.uk Northamptonshire County Council vacant Care Home 18 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (18) of places Moray Lodge DS0000032887.V282986.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Within 1 Month of registration the Home is required to submit in writing a proposed redecoration/replacement/refurbishment plan that includes all areas for the next 12 months. That the undersized bedroom identified in the Brown Flat will not be used as a bedroom. 26th April 2005 2. Date of last inspection Brief Description of the Service: 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 Health Care Trust. 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. Moray Lodge DS0000032887.V282986.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is on outcomes for Service Users and their views of the service provided. This process considers the home’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provisions that need further development. The inspection was unannounced on the morning of 27 February 2006 and in total some five hours were spent at the home and two hours of pre-inspection preparation work. Discussions were held with the person-in-charge, specific case files and records checked and conversations held with people living at the home and staff. Three service users were interviewed in greater depth. A full premises tour was carried out and the lunchtime meal was shared with staff and service users. The primary method of inspection used was ‘case tracking’ which involved selecting three service users and tracking the care received through review of the case records. This was a positive inspection with good outcomes for service users using the respite service at Moray Lodge. What the service does well: Service users said that staff were very pleasant and supportive. One person said that Moray Lodge gave people the opportunity to mix with others who have a mental health condition. Two people said that it was great to get away from the anxieties of their normal routines and come in for periods of rest. The standard of housekeeping is high and overall bedrooms are airy, bright and clean. Two bedrooms in the ‘brown’ flat are due for redecoration to bring them up to the standard of all other rooms. Any maintenance issues are quickly remedied. There is a choice of lounges and a pool room and music, television and booklending facilities. Service users said that they felt at home in Moray Lodge and that the facilities were very good. Service users can prepare their own food in the various small kitchen areas of the home or opt to pay a daily charge for meals provided by the house. Staff and service users can eat together in the main dining room and conversation is relaxed. Moray Lodge DS0000032887.V282986.R01.S.doc Version 5.1 Page 6 There are well-established routines for admission and discharge that includes the recording of all prescribed medication being brought into the house. Service user files evidenced that daily logs are in sufficient detail to show the care and support given at the home. Good records are held of any relevant meetings with other mental health agencies and of pre-admission assessments. 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. Moray Lodge DS0000032887.V282986.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Moray Lodge DS0000032887.V282986.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3 Information about the type of service provided is out of date. There is a thorough process for assessing the needs of prospective service users that is supported by written information. EVIDENCE: From this inspection CSCI was informed that Moray Lodge provides respite care and no longer offers a rehabilitation service. The home’s Statement of Purpose needs to be reviewed and revised to reflect this change and circulated to all users of the service, relevant agencies and submitted to CSCI. One person said that Moray Lodge gave people the opportunity to mix with others who have a mental health condition. Two people said that it was great to get away from the anxieties of their normal routines and come in for periods of respite. Good records are held of any relevant meetings with other mental health agencies and of pre-admission assessments. The information in individual service users case files included the Care Programme documentation and Moray Lodge assessment. Moray Lodge DS0000032887.V282986.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8 Service users are encouraged and supported to be as independent as possible. EVIDENCE: From checking case files it was seen that for one person support plans have not been drawn up although the service user has been at the home for four periods of respite care and for another person that support plans have not been reviewed following many months of absence when respite had been refused by the service user. Moray Lodge must ensure that support plans are developed and revised appropriately for each user of the respite service. There are well established routines for admission and discharge that includes the recording of all prescribed medication being brought into the house. Currently the home does not hold any monies for safe-keeping on behalf of service users but has a system in place should this be necessary at any point. Service users can prepare their own food in the various small kitchen areas of the home or opt to pay a daily charge for meals provided by the house. Staff are aware of potential risks relevant to each person relating to preparing and cooking food. Moray Lodge DS0000032887.V282986.R01.S.doc Version 5.1 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16,17 Service users’ own lifestyles and positive routines are supported whilst staying at the home. EVIDENCE: Service users said they are supported to make their own decisions and carry on with their lives as usual, for example going to work or day placement. Service users said that family members including their children can visit Moray House and are made very welcome by staff. One of the smaller lounge/kitchen areas is used during visits. Three people confirmed that they shop locally and go out to the local public house during respite stays. In conversations three service users said that staff used to organise a variety of activities that they all enjoyed such as trips out to the cinema, swimming, craft groups, etc, but that these have stopped. From discussion with the person-in charge it appears that Moray Lodge encourage individuals to continue their own leisure pursuits in the main with other group activities taking place on a more ad hoc arrangement. These arrangements for a less Moray Lodge DS0000032887.V282986.R01.S.doc Version 5.1 Page 11 structured activity programme should be explained and discussed between the service users and the staff to clarify expectations and levels of support. Menu plans evidenced that a wide range of food is provided from the main kitchen. In addition service users can choose to cook for themselves in the smaller lounge/kitchen areas. People who were smokers said they were pleased that there is still an outside wooden building that is available to them although it was said to be very cold as no heaters are installed. Moray Lodge DS0000032887.V282986.R01.S.doc Version 5.1 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21 Service users’ health care needs are met. EVIDENCE: Service users confirmed that staff at the home help them make appointments with GPs as necessary. People are taken to clinic appointments as necessary. One person spoke positively about the care and support she had been given following recent health problems. People said that they were able to self-administer medication and confirmed that medication supplies were recorded on admission and discharge. Moray Lodge DS0000032887.V282986.R01.S.doc Version 5.1 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 The home has robust systems in place to protect service users and to resolve any complaint. EVIDENCE: The home’s records show that there were six complaints made about the home’s services in 2005. Five have been investigated and resolved, one remains awaiting further information from the complainant. Several service users knew that the home holds regular residents meetings however these may not take place during their stay. People had read the minutes of these meetings. Moray Lodge DS0000032887.V282986.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,30 The clean well maintained environment of Moray Lodge meets the needs of service users. EVIDENCE: All accommodation is in single bedrooms giving a total of fourteen beds available for use. The standard of housekeeping is high and overall bedrooms are airy, bright and clean. Two bedrooms in the ‘brown’ flat are due for redecoration to bring them up to the standard of all other rooms. Any maintenance issues are quickly remedied and wardrobe doors were reported for remedial action on the day of inspection. During the inspection a glazier was replacing window glass in the pool room following an incident during the previous weekend. Service users said that the home is very comfortable, warm and clean. A very small room in the ‘brown’ flat is no longer used as a bedroom but is available as a quiet corner. Moray Lodge DS0000032887.V282986.R01.S.doc Version 5.1 Page 15 There is a choice of lounges and a pool room for use and music, television and book-lending facilities. Service users said that they felt at home in Moray Lodge and that the facilities were very good. Staff and service users can eat together in the main dining room and conversation is relaxed. The home’s laundry deals with household washing and service users have use of washing machines in the small lounge/kitchens for personal laundry. The flooring in the male toilet area on the ground floor needs replacing due to heavy staining around the urinals and gaps in the floor covering around where a recently installed wc pan. A water fire hose adjacent to the lift doors on the ground floor has been condemned as unfit for use. The home should request removal of this outmoded apparatus via the authority’s Property Services. Moray Lodge DS0000032887.V282986.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,36 Service users feel well supported by staff at Moray Lodge. EVIDENCE: Service users said that staff were very pleasant and supportive and said even during the night staff will make tea and discuss issues with them. Staff rosters evidenced that the home has appropriate numbers of staff on duty each day and overnight. Each service user is allocated a key-worker and people staying at Moray Lodge say this works well. It was also evident through discussion with staff that staff know people well and there are good systems for communication and handover of information. The person-in-charge stated that support staff are given formal supervision on a monthly basis. Moray Lodge DS0000032887.V282986.R01.S.doc Version 5.1 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,40,41 Sound management procedures ensure that service users benefit from this well organised effective service. EVIDENCE: The registered manager of the home has left the employ of the Northamptonshire County Council and currently the home is managed by the Clinical Advisor. An application for registration of a manager should be submitted to CSCI as soon as practicable. Sound administration systems are in place. Moray Lodge records show that the home dealt with approx 150 referrals for respite services in the last twelve months. The home’s recording systems and case files are organised and well documented. Service user files evidenced that daily logs are recorded appropriately and entries detail the care and support given at the home. Support plan documentation needs to be promptly developed for each person on admission and kept under review. Moray Lodge DS0000032887.V282986.R01.S.doc Version 5.1 Page 18 There is a system for receipting payments for meals. Details of daily charges for food are clearly shown on the home’s notice board. Service user meetings are held regularly and minutes are circulated on the notice board. Moray Lodge DS0000032887.V282986.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 Adults 18-65 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 2 3 3 3 4 X 5 X X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 2 28 3 29 N/A 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 x 35 x 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 1 3 3 X x LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 3 3 2 3 X 3 3 X X Moray Lodge DS0000032887.V282986.R01.S.doc Version 5.1 Page 20 NO 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 YA1 Regulation 17(2) Schedule 4 Requirement The home’s Statement of Purpose needs to be reviewed and revised to reflect the change to only respite care services and circulated to all users of the service, relevant agencies and submitted to CSCI. Support plans must be promptly developed on admission and revised appropriately for each user of the respite service. The flooring in the ground floor male toilet area requires replacement. Timescale for action 30/06/06 2 YA6 15 30/06/06 3 YA27 16(2) 30/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard YA37 YA24 Good Practice Recommendations An application for registration of a manager should be submitted to CSCI as soon as practicable. The home should request removal of the outmoded fire water hose apparatus via the authority’s Property Services. Moray Lodge DS0000032887.V282986.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Moray Lodge DS0000032887.V282986.R01.S.doc Version 5.1 Page 22 - 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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