CARE HOMES FOR OLDER PEOPLE
Moreton 13 Drakes Avenue Exmouth Devon EX8 4AA Lead Inspector
Anita Sutcliffe Unannounced Inspection 21st October 2005 09:30 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.V258603.R01.S.doc Version 5.0 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.V258603.R01.S.doc Version 5.0 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 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.V258603.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 5th. June 2005 Brief Description of the Service: Moreton is a two-storey care home in a residential area of Exmouth, East Devon. 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. A group of volunteers help in some parts of the Home, and activities workers are employed. The Home has a kitchenette and laundry area on each floor for service users to use independently if they wish. There is a strong religious ethos to the Home, which will admit from any denomination. Moreton DS0000021984.V258603.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was the second unannounced inspection in this inspection year. In September a pre-inspection questionnaire had been received from the home and comments received from 15 service users (residents) and 8 service user relatives. The inspection took place on a Friday morning over 2 hours. The manager was present throughout. 2 male and 2 female residents, staff and senior carers were spoken with. 2 residents’ bedrooms, the kitchen, activities lounge, dining and sitting rooms were visited. Records were examined, including care plans, recruitment, induction and training. What the service does well: What has improved since the last inspection? What they could do better:
Care planning still needs to be better understood at the home. Moreton DS0000021984.V258603.R01.S.doc Version 5.0 Page 6 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. Moreton DS0000021984.V258603.R01.S.doc Version 5.0 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.V258603.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these Standards was inspected at this visit. The key Standards (3 & 6) were inspected at the previous inspection visit. EVIDENCE: Moreton DS0000021984.V258603.R01.S.doc Version 5.0 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 Residents’ care is planned and reviewed regularly. (Standards 8, 9 and 10 were inspected at the previous inspection visit). EVIDENCE: Staff have worked hard toward improved care plans. The manager regularly reviews care records, which provide the detail necessary to deliver care. Currently the format would still benefit from revision. Staff should have a clear action plan to follow so as to meet the set goals. Moreton DS0000021984.V258603.R01.S.doc Version 5.0 Page 10 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15 Residents benefit from a relaxed homely lifestyle and the opportunity to lead fulfilled lives. They receive a balanced nutritious diet. EVIDENCE: The 4 residents spoken with said they were very happy with their lifestyle at the home. Each was involved in activities during the inspection. These were seated exercise, a quiz and sewing and craftwork. Written comments indicated not all residents felt enough activities were provided. It was said: “ time sometimes hangs a little heavy”. There are two activities workers employed; social history, hobbies and interests are recorded in care plans. Bedrooms are personalised and residents are able to make daily lifestyle choices. The home is unusual in that there is a kitchenette on each floor for residents’ use. One resident said he chooses to get his own breakfast there each morning. There is also an informal lounge with kitchen, which is used by residents and visiting family. All but one resident commented how much the food was enjoyed. There are choices at each mealtime and specialist diets are catered for. The dining room is very pleasant. Moreton DS0000021984.V258603.R01.S.doc Version 5.0 Page 11 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Residents benefit from the home’s complaints policy. They are protected from abuse. EVIDENCE: Although not all residents nor visitors who commented knew about the complaints policy it is well displayed in the home and is used. Complaints may be made to the home itself, or to a representative of the organisation. It is also clear that the Commission may be contacted, and contact details are provided. The Commission have not received any complaints against the home. Staff are taught about abuse and the protection of vulnerable adults from the outset of employment. Residents said they felt very safe at the home. Moreton DS0000021984.V258603.R01.S.doc Version 5.0 Page 12 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these Standards was inspected at this visit. The key Standards (19 & 26) were inspected at the previous visit. EVIDENCE: Moreton DS0000021984.V258603.R01.S.doc Version 5.0 Page 13 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Residents’ needs are met through the number, skill mix and competence of staff. Residents are protected through the safe recruitment of staff. EVIDENCE: Staff records of recruitment, induction and training were seen. Each is undertaken in a methodical way so as to ensure that staff are suitable to work with older people, and are trained and competent to do the work. Staff are also encouraged to take an NVQ qualification in care, and the home has achieved a commendable level of success in this. Residents spoken with during the inspection said there are enough staff at the home, but 4 of the 9 comments from relatives said that there were not. Residents said that their needs were met, and the manager spoke of a recent recruitment campaign. Moreton DS0000021984.V258603.R01.S.doc Version 5.0 Page 14 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 & 35 The home is run by a manager who is experienced and competent. Residents’ financial interests are protected. The key Standards (33 & 38) were inspected at the previous visit. EVIDENCE: The manager has a commitment to high standards. She motivates staff and is innovative in her approach to problem solving. She works hard to improve the lives of residents and make the home a success. Residents look after their own financial affairs if they wish, but the home provides secure storage for money and valuables if required, with records of transactions correctly kept. Moreton DS0000021984.V258603.R01.S.doc Version 5.0 Page 15 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 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 X X X X X X X X STAFFING Standard No Score 27 3 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X X X 3 X X X Moreton DS0000021984.V258603.R01.S.doc Version 5.0 Page 16 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.V258603.R01.S.doc Version 5.0 Page 17 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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