Inspection on 05/06/05 for Moreton

This inspection was carried out on 5th June 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.

Other inspections for this house

Moreton 15/01/08

Moreton 13/12/06

Moreton 21/10/05

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 Anita Sutcliffe Unannounced 5th June 2005 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. Moreton D54 D06 S21984 Moreton V230517 050605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Moreton Address 13 Drakes Avenue Exmouth EX8 4AA 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) 01395 272897 01395 223718 Methodist Homes for the Aged Mrs Tracy Nenadic CRH PC Care Home providing Personal Care 35 Category(ies) of OP Old Age [35] registration, with number PD Physical Disability [35] of places PD[E] Physical Disability over 65 [35] Moreton D54 D06 S21984 Moreton V230517 050605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 12th January 2005 Brief Description of the Service: Moreton is a two-storey care home in a residential area in the town of Exmouth, East Devon. It provides care 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 D54 D06 S21984 Moreton V230517 050605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place between 6:15 am and 11:45 am on a Sunday, with both night and day staff involved. The person in charge during the morning was Nicola Griffiths, relief senior carer. On arrival I looked around the home until joining staff for a meeting. I then chose 4 residents to ‘case track’, which involves looking in detail at their admission, the planning of their care, and how their care is actually delivered. I discussed this with the 4 residents, visited their rooms and read their care plans. During my tour of the home I observed staff interaction with residents; I later inspected the way the home handles medication, read health and safety records, and spoke with other residents and staff. Information about the Commission for Social Care Inspection, and my contact details, were left at different points around the home. What the service does well: What has improved since the last inspection? Weekend care staffing numbers have been increased so that they have more time to spend working with residents in an unhurried way. A new automatic door closure on the laundry door improves fire safety and a room on the top floor has been dedicated as an activities space. This provides a more intimate social meeting space than the large lounge where the majority of activities occur. The home has worked with the Osteoporosis Society toward a better understanding of falls and their prevention. A new format for planning individual care has been devised. Moreton D54 D06 S21984 Moreton V230517 050605 Stage 4.doc Version 1.30 Page 6 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. Moreton D54 D06 S21984 Moreton V230517 050605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Moreton D54 D06 S21984 Moreton V230517 050605 Stage 4.doc Version 1.30 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 standard(s) 3, 4 & 6 Care needs are well met following thorough assessment. Moreton does not provide Intermediate Care and so the standard does not apply. EVIDENCE: Needs are fully assessed prior to admission and a plan of how those needs are to be met is written. The assessment for 2 residents recently admitted included all comprehensive information on their needs, and they were very pleased with how their admission to the home had been managed. Residents felt that their care needs were well met by friendly and knowledgeable staff. Wheelchair dependent residents have space to manoeuvre and equipment and mobility aids were in good supply. The design of the home and gardens promote independence for the physically disabled and frail. Moreton D54 D06 S21984 Moreton V230517 050605 Stage 4.doc Version 1.30 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 standard(s) 7,8, 9 & 10 Health and care needs are fully met by well-informed staff, but plans of care lack the detail needed to assure consistency. Residents are treated with respect and with full regard for their privacy and dignity. Medication at Moreton is well managed. EVIDENCE: Residents said that the standard of care provided was excellent and staff felt that good care was their main achievement. The inspector observed that there was exceptional attention to personal care detail. The system used for care planning is still under review. Staff are using a new format, but the plans still lack the ‘why’, ‘what’, ‘how’ and ‘when’ necessary to deliver the care to a consistent standard. Daily records provided detail on how care is delivered and indicate that the health care needs of residents are fully understood, with evidence of advice sought from health care professions such as physiotherapy and district nursing. Moreton D54 D06 S21984 Moreton V230517 050605 Stage 4.doc Version 1.30 Page 10 Medication was stored and administered correctly, with clear records kept. The system allows for complete audit, and residents who choose to administer their own medicines are supported to do so safely. Residents’ felt that they were treated respectfully with dignity and privacy upheld. Moreton D54 D06 S21984 Moreton V230517 050605 Stage 4.doc Version 1.30 Page 11 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) These standards were not inspected on this occasion. EVIDENCE: Moreton D54 D06 S21984 Moreton V230517 050605 Stage 4.doc Version 1.30 Page 12 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) These standards were not inspected on this occasion. EVIDENCE: Moreton D54 D06 S21984 Moreton V230517 050605 Stage 4.doc Version 1.30 Page 13 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 & 26 The home is well maintained, safe, suitable for its purpose and meets residents’ needs. Independence is promoted by the facilities provided. EVIDENCE: Residents said they were very comfortable living at Moreton. There are laundry and kitchenettes for their personal use, and the new ‘day centre’ is enjoyed by small groups who meet to socialise and share activities. Once again the home was clean, fresh and well maintained. There is good provision of equipment to prompt independence, and high standards of hygiene practice were seen. The gardens are well kept and attractive. Fire safety records indicated that fire related safety was being addressed properly at the home. Moreton D54 D06 S21984 Moreton V230517 050605 Stage 4.doc Version 1.30 Page 14 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) 27 Residents’ needs are properly met through the numbers and skill mix of staff. EVIDENCE: Staff said that the numbers of carers had been increased and that they were now better able to achieve the standard of care they felt was appropriate. Agency care staff were working effectively with the home’s own staff. Retaining domestic staff remains a problem, but core staff are being flexible so as to meet gaps in the rota. During the visit staff were observed assisting residents in an unhurried way, and call bells were answered quickly. Residents felt there were sufficient staff most of the time. Moreton D54 D06 S21984 Moreton V230517 050605 Stage 4.doc Version 1.30 Page 15 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) 32 & 38 The home is welcoming, well-run and safe. EVIDENCE: Residents’ quality of life is enhanced through the open, friendly and professional attitude of the registered manager and staff, who set and achieve high standards. Records examined included fire safety, accidents and the assessment of individual and general risk and it was clear that health and safety are well managed. Staff talked of training they had received and their certificates were displayed. The home is maintained to a high standard. Moreton D54 D06 S21984 Moreton V230517 050605 Stage 4.doc Version 1.30 Page 16 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 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 4 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 4 x x x x x x 3 STAFFING Standard No Score 27 3 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 x x x x 3 x x x x x 3 Moreton D54 D06 S21984 Moreton V230517 050605 Stage 4.doc Version 1.30 Page 17 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 7 Regulation 15(1) Requirement Care plans must give detail as to how service user needs, in respect of health and welfare, are to be met (Previous timescale of 12/02/05) not met) Timescale for action 31 July 2005 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 Moreton D54 D06 S21984 Moreton V230517 050605 Stage 4.doc Version 1.30 Page 18 Commission for Social Care Inspection Suite 1, Renslade House Bonhay Road Exeter EX4 3AY 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 Moreton D54 D06 S21984 Moreton V230517 050605 Stage 4.doc Version 1.30 Page 19 - 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. 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