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Inspection on 09/05/05 for Moreland House

Also see our care home review for Moreland House for more information

This inspection was carried out on 9th May 2005.

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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Staff in the home have a good understanding of the service users support needs and work hard to build up positive relationships between themselves and service users. They are keen to maintain a good standard of care to people in the home. The atmosphere in the home is very welcoming and offers service users a family- like environment. Many of the service users have lived in the home for many years. Those service users spoken to said that "they receive every care and attention from staff" and that staff "treat them with courtesy".

What has improved since the last inspection?

Following the recent resignation of the registered manager, the proprietor has promoted a long serving senior carer to the role of acting manager, and is actively seeking a replacement for registration. The staff rota shows that consideration has been given to the covering of shifts to ensure that the acting role has not created a shortage in numbers of staff on each shift. Following a requirement made in the previous inspection report, with regard to the staff accessing the laundry area through the kitchen, major reconstruction work has been undertaken to allow staff access without using the kitchen. This work did not affect the service users whilst it was being undertaken as the kitchen is a separate area, and the wall was erected within the kitchen. The manager has reviewed the policy, procedures and administration practice for medication in the care home, to ensure that they fully meet the requirements, and ensure safe practice in the administration of service users medication.

What the care home could do better:

Moreland House is a very comfortable and homely residential home, where the staff pay particular attention to small details that ensure service users feel at home. The decoration in some areas is need of refreshing and some of the furniture is showing signs of general wear and tear. The manager assured the inspector that plans are in place for renovations and during the renovations replacement of carpets and furnishings will be made. The proprietors must ensure that the very high standards set are maintained during this time and that the home is not allowed to fall into disrepair whilst the work is being undertaken.

CARE HOMES FOR OLDER PEOPLE Moreland House 5 Manor Avenue Hornchurch Essex RM11 2EB Lead Inspector Kim OConnell Unannounced Inspection 09 May 2005 10:00 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 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. Moreland House G55_S0000050729_Moreland House_V226656_090505_Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Moreland House Address 5 Manor Avenue, Hornchurch, Essex RM11 2EB Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01708 442564 01708 443526 Moreland House Care Home Ltd Prem Kanta Sharma CRH Care Home 16 Category(ies) of OP Old age registration, with number PD Physical disability of places Moreland House G55_S0000050729_Moreland House_V226656_090505_Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 14 March 2005 Brief Description of the Service: Moreland House is a large detached property in a residential area of Hornchurch. It is in keeping with other properties and does not stand out as being a care home. It is situated within walking distance of Gidea Park main line railway station. There is a small shopping area and library within easy walking distance of the home and the main shopping town of Romford is within easy access by bus or train. It offers accomodation to 16 elderly residents, the Manager ensures, by setting high standards, that the needs of service users are met within a comfortable and homely environment. Moreland House G55_S0000050729_Moreland House_V226656_090505_Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took part over 1.5 hours. It was undertaken within a short timescale to the last announced inspection. The reason for this being that the Registered Manager has resigned from her post and the Commission are required to ensure that appropriate action has been taken by the proprietor to ensure that adequate management cover is in place, and also the home have been subject to a recent investigation following a complaint from a service user. The inspector looked at the progress of the requirements made at the last inspection, although many have not yet reached the timescales set. So therefore will be repeated in this report. The inspector checked the staff rota to ensure that adequate staff and management cover is in place. The inspector discussed the plans to ensure a replacement manager is appointed and registration of same applied for in as short a period of time as possible. The inspector also checked the progress of the outstanding complaint. The inspector spoke with three service users and had a tour of the premises. What the service does well: Staff in the home have a good understanding of the service users support needs and work hard to build up positive relationships between themselves and service users. They are keen to maintain a good standard of care to people in the home. The atmosphere in the home is very welcoming and offers service users a family- like environment. Many of the service users have lived in the home for many years. Those service users spoken to said that “they receive every care and attention from staff” and that staff “treat them with courtesy”. Moreland House G55_S0000050729_Moreland House_V226656_090505_Stage 4.doc Version 1.30 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 Moreland House G55_S0000050729_Moreland House_V226656_090505_Stage 4.doc Version 1.30 Page 7 contacting your local CSCI office. Moreland House G55_S0000050729_Moreland House_V226656_090505_Stage 4.doc Version 1.30 Page 8 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 Standards Statutory Requirements Identified During the Inspection Moreland House G55_S0000050729_Moreland House_V226656_090505_Stage 4.doc Version 1.30 Page 9 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 standard(s) 0 Due to the reason for this specific visit, and it being within such a short timescale to the recent announced inspection (14/3/05) the inspector did not assess any standards within this heading. There are no outstanding requirements under this heading and standards will be assessed during future inspections in the inspection year. EVIDENCE: Previous reports. Moreland House G55_S0000050729_Moreland House_V226656_090505_Stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 9, 10 Service users are treated with respect and the arrangements for their personal care ensure that their right to privacy is upheld. The home’s medication policies and procedures have been reviewed and updated since the last inspection where a requirement had been made around the signing of medication records by staff at time of any changes in prescription, alterations to, or discontinuing of any medications for individual service users, which has ensured that records are clear and show by whom the changes have been made. EVIDENCE: Staff talked about and were observed to treat service users in a respectful and sensitive manner. They understood the need to promote their dignity through practices such as the way in which they addressed them and when entering bedrooms, bathrooms and toilets. Service users spoken to said that all staff were respectful and thoughtful when attending to their personal care. The inspector checked the medication charts for individual service users and was able to assess that changes had been made to ensure that staff signed for any medications administered, and that any changes in the prescriptions had Moreland House G55_S0000050729_Moreland House_V226656_090505_Stage 4.doc Version 1.30 Page 11 been signed by either the G.P or Doctor prescribing e.g. after a hospital visit or admission. This was made a requirement during the last inspection for action to be completed by 31/3/05, so therefore this requirement has been fully met within the timescale set. Moreland House G55_S0000050729_Moreland House_V226656_090505_Stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 0 Due to the reason for this specific visit, and it being within such a short timescale to the recent announced inspection (14/3/05) the inspector did not assess any standards within this heading. There are no outstanding requirements under this heading and standards will be assessed during future inspections in the inspection year. EVIDENCE: Previous reports. Moreland House G55_S0000050729_Moreland House_V226656_090505_Stage 4.doc Version 1.30 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 standard(s) 16,18 The staff are undergoing Adult Protection/Abuse Awareness training as required. The home has an adult protection policy in place and staff are aware of their role within the protection of vulnerable adults. EVIDENCE: From discussions with the acting manager, and viewing the changes made to the complaints procedure it was evident that the changes had been made as required. And relevant information for the Commission is now included in the complaints procedure. From discussions with staff and the acting manager during the inspection the inspector was satisfied that the staff are aware of their role and responsibilities in ensuring the safety of residents living at the home, they are aware of what constitutes abuse and how to deal with it. Staff training records were available and planned training recorded for staff to attend Adult Protection/ Abuse Awareness training, this has not yet reached the date set for compliance of the 4/6/05, so therefore had met the requirement within the timescales set. Moreland House G55_S0000050729_Moreland House_V226656_090505_Stage 4.doc Version 1.30 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 standard(s) 19,25,26 Moreland House is a generally well-maintained and comfortable residence, where the proprietor and staff pay particular attention to the small details within the home to ensure that it remains as homely an environment as is possible. Work has recently been undertaken to ensure that staff have access to the laundry other than through the kitchen, which was a concern raised during previous inspections due to the infection control issues of this practice. EVIDENCE: The residents spoken to all feel that it is a “nice place to live” and all said they were looking forward to the nice weather so that they could sit out in the garden which is secluded and very well maintained. Moreland House G55_S0000050729_Moreland House_V226656_090505_Stage 4.doc Version 1.30 Page 15 An area of the kitchen has been sectioned off with the erection of a wall, this has created an area that allows access to the laundry without having to go through the main kitchen. There is a door from this area into the kitchen. There is a hand washing basin and store cupboards, and the electrical boards for the home are situated there. As the home has a very large kitchen area with it’s own brick built storerooms outside, this renovation has not caused any detrimental effect on the main kitchen area. This was a requirement made in the previous inspection report and has been completed within the timescales set. Moreland House G55_S0000050729_Moreland House_V226656_090505_Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 0 Due to the reason for this specific visit, and it being within such a short timescale to the recent announced inspection (14/3/05) the inspector did not assess any standards within this heading. There are no outstanding requirements under this heading and standards will be assessed during future inspections in the inspection year. EVIDENCE: Previous reports. Moreland House G55_S0000050729_Moreland House_V226656_090505_Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33 The home is being managed well in the absence of a registered manager and provides a safe environment for the service users in the home. EVIDENCE: The Registered Manager has recently resigned and at present, the home is being managed on a temporary basis by an acting manager with support from the area manager and head office. The acting manager has worked at the home in a senior role for over 6 years and has acted up as manager on 2 previous occasions. She is well known by the staff and residents and they appear to have a great deal of respect for her. She has a good knowledge of each service user and the policies and procedures within the home, she is also aware of the ethos of the home. The Proprietors are actively looking for a replacement manager for registration and this will be made a requirement of this report. Moreland House G55_S0000050729_Moreland House_V226656_090505_Stage 4.doc Version 1.30 Page 18 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION 3 x x x x x 3 3 STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 2 3 3 x x x x x Moreland House G55_S0000050729_Moreland House_V226656_090505_Stage 4.doc Version 1.30 Page 19 yes 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 OP18 Regulation 13 Requirement Timescale for action 4/6/05 2. OP 28 18 3. OP33 24 4. OP31 8 The home must ensure that all staff in the home receive training in Adult Protection/ Abuse Awareness (not yet reached the timescale for compliance of 4/06/05) The home must have a minimum 4/12/05 of 50 care staff trained to NVQ level 2 by the end of this year and must continue to work towards this goal (not yet reached timescale for compliance of 4/12/05) The home must have effective 4/6/05 quality assurance in place and produce an annual development plan (not yet reached timescale for compliance of 4/06/05) The proprietor must recruit a 10/8/05 suitable permenant manager to the post and apply to the Commission for registration of said manager. 5. Moreland House G55_S0000050729_Moreland House_V226656_090505_Stage 4.doc Version 1.30 Page 20 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. Refer to Standard Good Practice Recommendations Moreland House G55_S0000050729_Moreland House_V226656_090505_Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Ferguson House 113 Cranbrook Road Ilford Essex IG1 4PU 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 Moreland House G55_S0000050729_Moreland House_V226656_090505_Stage 4.doc Version 1.30 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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