Inspection on 13/12/06 for Moreton

This inspection was carried out on 13th December 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

Moreton 15/01/08

Moreton 21/10/05

Moreton 05/06/05

Moreton 12/01/05

Moreton 28/07/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Moreton 13 Drakes Avenue Exmouth Devon EX8 4AA Lead Inspector Caroline Rowland-Lapwood Unannounced Inspection 13th December 2006 10:00 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 Moreton DS0000021984.V307026.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. Moreton DS0000021984.V307026.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Moreton Address 13 Drakes Avenue Exmouth Devon EX8 4AA 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) 01395 272897 01395 223718 home.exm@methodisthomes.org.uk home.fxg@mha.org.uk Methodist Homes for the Aged Mrs Tracy Nenadic Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35), Physical disability (35), Physical disability of places over 65 years of age (35) Moreton DS0000021984.V307026.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st October 2005 Brief Description of the Service: Moreton is a two-storey care home in a residential area of Exmouth, East Devon. There is a large communal lounge on the ground floor, and another smaller lounge/craft area on the first floor. There is a dining room and large conservatory on the ground floor. A passenger lift provides access to the upper floors. To the front there is ample parking and well-tended gardens. To the rear and the side of the property there are large attractive gardens with a level pathway with handrails that leads all the way around the building. Care is provided for up to 35 older people some of whom may have a physical disability. It is run by the Methodist Homes for the Aged. There is a strong religious ethos to the Home, which will admit from any denomination. Fees range from £404 to £489.00 per week. Fees do not include hairdressing, chiropody, taxis, papers or shopping. The reports from CSCI inspections are displayed on the notice board. Moreton DS0000021984.V307026.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over one day on the 13th December 2006, with a total of six and a quarter hours being spent at the home. The home had been notified that an inspection would take place within three months and had returned a pre-inspection questionnaire, information from which was used to write this report. Part of the inspection process includes questionnaires being sent out to a variety of people who may have an interest in the home, asking for their comments about the service given by the home. Prior to this inspection, questionnaires were sent out to 11 staff, 16 residents and 5 GPs. At the time of writing the report, replies had been received from 6 staff 5 GPs and all 16 residents. During the inspection 3 residents were case tracked. This involves the inspector looking at the residents’ individual plan of care, and speaking with the resident and the staff who care for them. This enables the Commission to better understand the experience of residents living at the home. Four residents and seven staff were spoken with individually and a number of residents were spoken within a group situation. The inspector sat for some time in both lounges and the dining room observing the interactions between staff and residents. A sample of records were inspected including, the fire log book, residents’ finances, care plans, medication records and some policies and procedures. What the service does well: Moreton House is well managed and provides a comfortable and homely place for residents to live. There was friendly banter between residents and staff and those residents who were spoken with were happy with the care they receive at the home. The home tries to treat residents as individuals with each one receiving the care and support they need and want. There is a good assessment process that assures prospective residents that their needs will be met, and there is good care planning that ensures all aspects of care continue to be monitored and needs met. Staffing levels are sufficient and recruitment and training is robust to ensure residents are protected from harm. All records, including those relating to medication administration, fire precautions; risks and residents’ finances were well maintained. There is a Moreton DS0000021984.V307026.R01.S.doc Version 5.2 Page 6 simple complaints procedure and any complaints made to the home are thoroughly investigated. Residents felt that meals were very good and there was a good variety of food available. Residents were also satisfied with the level of activities and entertainment available. Positive comment cards were received back from care professionals, staff, visitors and residents. 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. The summary of this inspection report can be made available in other formats on request. Moreton DS0000021984.V307026.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 Moreton DS0000021984.V307026.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information about the home is available for prospective residents, which enables them to make an informed choice before moving into the home. Resident’s benefit from a good admission and assessment process, which ensures that the home can meet their needs. The home does not provide intermediate care. EVIDENCE: Three residents’ files were looked at as part of the case tracking process, including the most recent admission, all three contained pre-admission Moreton DS0000021984.V307026.R01.S.doc Version 5.2 Page 9 assessment information. These provide good basic information, and are used to decide whether the home can meet the needs of the prospective resident. Three surveys from residents confirmed that they had visited the home on several occasions before they were admitted. One resident said that the manager had visited them at home prior to admission. The service user guide and statement of purpose for the home are given to the resident prior to admission to the home. The home does not provide intermediate care. Moreton DS0000021984.V307026.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 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. Residents’ care is well planned, providing staff with information they need to meet residents’ needs. Residents’ health needs are met and supported by the appropriate involvement of other health professionals. There are good systems for managing medications. Staff and the management team promote residents’ privacy and dignity. EVIDENCE: Residents spoken with were happy with the care, health and social care professionals indicated they were also satisfied. Comments from residents included, “I am very happy” and “there is no where else I would rather be”. Moreton DS0000021984.V307026.R01.S.doc Version 5.2 Page 11 Residents were well dressed and groomed, and attention to their personal care was good. Many female residents were wearing make up and jewellery, several residents said that they have their hair done by the visiting hairdresser regularly. Care plans seen provided a good description of residents’ needs and how they should be met. Staff spoken with and observed demonstrated a good understanding of the residents needs; Personal histories have been developed that contain important information about residents’ past lives and occupations, which gives a sense of who this person is. Care plans are reviewed every month. Residents’ health needs are met; five GPs were happy with the overall care and felt that the home always works in partnership with them. Professionals were confident that any specialist advice given is incorporated into care plans. Care plans and daily notes show good monitoring of health needs. A local GP holds a surgery at the home every month on a Friday afternoon; this enables the residents to speak to a GP about any non-urgent health care concerns they may have. Several residents said they found this really valuable and praised the service. Medication is very well managed by the home; all health and social care professionals’ felt that residents’ medication was appropriately managed. Medicines are stored and disposed of safely. Medicine administration records were fully completed and included a photo of each resident on the individual sheet. Residents that wish to self medicate are assessed to ensure that they are able to do this safely. Every three months, or before if necessary, this is checked and reassessed. Each resident has their medication reviewed every six months by the GP to ensure that they still need what has been subscribed for them. Residents confirmed that most staff are friendly, kind and treat them as they wish to be treated. Throughout the inspection staff were seen to treated residents with respect and kindness. The home has a friendly atmosphere and there was laughter and chatting in the lounge and dining room during the day. Moreton DS0000021984.V307026.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Residents benefit from contact with their family and friends, which is encouraged and supported by the home. Residents enjoy a balanced diet which takes into account the likes and dislikes of most individuals. Routines are flexible and social activities are available for those who wish to participate. Residents are helped to exercise choice and control over their lives. EVIDENCE: The home provides a flexible service that meets individual requirements. Regular residents’ meetings at which individual requests can be made achieve this. These meetings are recorded and the minutes were seen. Moreton DS0000021984.V307026.R01.S.doc Version 5.2 Page 13 The home employs two activities organisers that are at the home every day. On the day of the inspection the residents were enjoying some armchair exercises in the lounge and later on they were seen having fun doing a quiz together. On the first floor of the home there is a quiet lounge, which is referred to as “The haven” (the residents named this themselves). This is where arts and crafts take place, there is a large stock of materials that the residents can use to be creative and enjoy using their imagination. All the residents that were spoken with said there were “always” activities on offer. Not all residents want to participate in organised activities, some choose to stay in their rooms or go out instead. One resident said that the home had allowed her to have a small part of the garden, which she tends with great care. Another resident confirmed that she goes out whenever she wants to and that the staff help her with anything she needs to enable her to do this. Able residents are supported to make decisions about their daily lives. Several residents were seen undertaking their own hobbies. The home has separate kitchens and laundry rooms in which the residents can cook or bake or do their own laundry if they so wish to. The menu is varied. Residents’ comments on food included: “very good” and “lots of choice”. The staff ask all the residents in advance what they would like for their main meal and their supper. A wide choice is available. Specialist diets are provided if required so that health care needs can be met. Residents eat in the large attractively laid dining room; the meal is served and a good choice of vegetables is served in dishes on each table for residents to help themselves. There is a menu displayed. Visitors were made welcome at the home, and there are no visiting restrictions. There is a large notice board in the foyer of the home which displays the day and date and notifies the residents of all that’s happening in the home. Moreton DS0000021984.V307026.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 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 satisfactory complaints process with evidence that complaints are listened to and acted upon. Residents are clear how and to whom to complain. Residents are safeguarded from abuse. EVIDENCE: All residents spoken with and those responding with surveys felt that staff listen and act on what they say. All knew who to speak with should they have any concerns or complaints. A good record of complaints and outcomes is kept. No complaints have been received by CSCI since the last inspection. Residents say they feel safe at the home. Staff spoken with demonstrated a good understanding of abuse and would report any concerns to the manager. The assistant manager had an adequate understanding of the procedures to be followed and is aware of her responsibilities. All staff has received training in the prevention of abuse and were able to demonstrate through discussion that they were fully aware of how to whistle blow and their responsibilities in keeping residents safe. Moreton DS0000021984.V307026.R01.S.doc Version 5.2 Page 15 Moreton DS0000021984.V307026.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,22 & 26 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Resident’s benefit from living in a clean, well-maintained, comfortable home. EVIDENCE: The home has a very well-maintained environment, which provides aids and equipment to meet the care needs of elderly people. The home employs two maintenance people who are employed full time and are responsible for all the maintenance and health and safety throughout the home. The home is decorated to a very good standard. The communal areas are very nice. Some comments from the residents included “the home is lovely” and “it is always well looked after”. There is ongoing decoration programme, residents’ benefit from pleasant surroundings. Moreton DS0000021984.V307026.R01.S.doc Version 5.2 Page 17 A tour of the building found the home was clean throughout and free from odour on the day of the inspection; residents confirmed that it was ‘always’ or ‘usually’ like this. Two residents commented about the domestic staff, one said” the cleaners are lovely” the other said they are “really cheerful and do a really good job”. Both sluicing areas were clean and gloves and alcohol gel were freely available to ensure good infection control. The home deals with clinical waste appropriately. The laundry facilities are well organised. There is a member of staff responsible for the laundry. There is a system in place for dealing with soiled laundry, which reduces the risk of infection. The garden is very large and looked well cared for. There is level access all around the garden by way of a new path with handrails. Kitchen and laundry facilities are available for residents to use to maximise their independence for as long as possible. Moreton DS0000021984.V307026.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 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. The needs of residents are met though the number and dedication of the staff. Staff are trained adequately to do their jobs. The homes recruitment procedures are robust and well managed. EVIDENCE: On the day of the inspection there were 34 residents living at the home. On duty that day was the assistant manager (in charge), plus five care assistants, the cook, kitchen assistant, three domestics and the laundry person. Residents described the staff team as “very good”, “kind and caring” and “really good”. Most residents felt that staff were “always” available when needed but two said, “ they were only “sometimes” available. One comment received via the survey stated, “the staff are sometimes stretched” On the day of the inspection the staff were busy but all residents looked comfortable and well cared for. Call bells were answered promptly. Moreton DS0000021984.V307026.R01.S.doc Version 5.2 Page 19 Several staff spoken with described good team working at the home and said the home was a friendly place to work. Three staff files were inspected to check recruitment procedures; they were all completed satisfactory. Residents, relatives and health professionals were confident that staff had a good understanding of individual needs. The pre-inspection questionnaire shows that around 66 of staff have achieved a nationally recognised qualification in care (NVQ). Various training has been undertaken since the last inspection including mandatory training, (fire training, moving & handling and protection of vulnerable adults training). Every new member of staff has a detailed induction (records confirm this). Moreton DS0000021984.V307026.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 & 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 well managed. Residents’ are involved in the running of the home. There are systems are in place to ensure that residents’ personal monies are correctly managed. Systems are in place to promote the safety and health of residents and staff. EVIDENCE: Moreton DS0000021984.V307026.R01.S.doc Version 5.2 Page 21 The home is organised and staff morale was good. The manager has the required experience to run the home. Staff and residents expressed their confidence in the manager who was described as ‘approachable’ and ‘very nice’. The home has a quality assurance system. Questionnaires are given to residents in order to obtain their views of the service. The completed questionnaires are looked at and any issues dealt with. The home has plans to develop this system further in the future. Residents meetings are held every three months. The home does not manage any financial affairs on behalf of residents but does administer small personal allowances. Three were checked; a clear and secure system is in place in order to protect residents’ monies. Health and safety at the home is well managed. Where necessary, staff have received mandatory training including, fire safety and moving handling. The assistant manager said there is always a member of staff qualified in first aid on duty. Fire safety appears to be dealt with well; the fire log showed that equipment was regularly checked and serviced. Moreton DS0000021984.V307026.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X 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 4 13 4 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X 3 X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Moreton DS0000021984.V307026.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO 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 Moreton DS0000021984.V307026.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Devon Area Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Moreton DS0000021984.V307026.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!