Inspection on 20/10/05 for Moss Bank Elderly Persons Home

This inspection was carried out on 20th October 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

Moss Bank Elderly Persons Home 14/03/07

Moss Bank Elderly Persons Home 23/04/05

Moss Bank Elderly Persons Home 20/12/04

Moss Bank Elderly Persons Home 05/07/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Moss Bank Elderly Persons Home Victoria Avenue Moss Bank St Helens Merseyside WA11 7BU Lead Inspector Mr John Mullen Unannounced Inspection 20th 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 Moss Bank Elderly Persons Home DS0000037920.V260646.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. Moss Bank Elderly Persons Home DS0000037920.V260646.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Moss Bank Elderly Persons Home Address Victoria Avenue Moss Bank St Helens Merseyside WA11 7BU 01744 677816 01744 677968 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) St Helens Metropolitan Borough Council Ms Jillian Margaret Quigley Care Home 32 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (22) of places Moss Bank Elderly Persons Home DS0000037920.V260646.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Service users to include up to a maximum 22 OP and up to a maximum of 10 DE(E). One named male out of category service user with LD and under pensionable age. The Service may accommodate up to a maximum of 2 service users aged 60 years and over. 21st April 2005 Date of last inspection Brief Description of the Service: Moss Bank care home provides accommodation and personal care for a maximum of 32 older people. It is owned by St.Helens Council and the registered manager is Ms. J. Quigley. There have been no changes to Moss Banks conditions of registration since the last inspection. However, the care home has opened a day centre to provide a service to a maximum of five service users per day. It is located in a distinct area of St. Helens with only a limited number of local facilities nearby. The premises are a two-storey building, which was purposebuilt; a lift as well as stairs connects the floors. The care home is divided into three units, containing accommodation for eight residents in each. A fourth unit is now used as a day care facility. Two of the units accommodate permanent residents and one respite and transitional residents. The ground floor has both service user and staff accommodation; the latter includes a well-appointed staff room. There is one unit located on the ground floor as well as the day centre, a laundry and excellent kitchen. The upper floor also contains two units with sleeping accommodation and lounge areas. The care home has an appropriate number of aids and adaptations including grab rails to assist disabled residents users manage the premises. There is a call system throughout the care home. Moss Bank Elderly Persons Home DS0000037920.V260646.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over two days. It was a routine, unannounced inspection. A tour of the premises took place; staff were spoken to and care records inspected. The registered manager, two assistant managers and three members of the care staff were interviewed. Six residents were spoken to as well as three family members. What the service does well: What has improved since the last inspection? What they could do better: Although Moss Bank has care plans on permanent residents it still does not provide such plans for those on short term or transitional care. The general policies and procedures in respect of medication are of a good standard but there are still deficits in the recording which are a cause for concern. Although activities have been increased these do not appear to be always known to residents and this would be improved by listing them within the units. Moss Moss Bank Elderly Persons Home DS0000037920.V260646.R01.S.doc Version 5.0 Page 6 Bank is generally a comfortable and pleasant environment for the care of older people but this would be improved by some further decoration in certain areas. 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. Moss Bank Elderly Persons Home DS0000037920.V260646.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 Moss Bank Elderly Persons Home DS0000037920.V260646.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): 2&3 The admission policies include a full assessment of residents’ needs, which enables staff to be familiar with the people in their care. The care home provides a clear statement of the terms and conditions surrounding their care so that residents and their families are clear about the basis of their stays in Moss Bank. EVIDENCE: An examination of a selection of case files found each to have a needs assessment which had been provided by the Social Services Department. One of the files referred to an emergency admission and, again, there had been full papers submitted to give a clear picture of the individual’s needs. Interviews with care staff found them well aware of the needs of residents which has been assisted by the low numbers within Moss Bank. Contacts with relatives, including one who had been admitted for a short stay, showed that they were happy that the care home was meeting the needs of their relatives. Interviews with residents confirmed that their needs were being met so that they had confidence about their stays within the care home. Moss Bank Elderly Persons Home DS0000037920.V260646.R01.S.doc Version 5.0 Page 9 An examination of case files revealed that each had a statement of terms and conditions contained within them. Interviews with residents and contacts with relatives showed that both were confident about the basis of their stays in the care home. There has been some disquiet amongst residents and relatives due to the discussions about the care home’s future but this has reduced with the development of the day centre so that less anxiety was revealed during the inspection. Moss Bank Elderly Persons Home DS0000037920.V260646.R01.S.doc Version 5.0 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 the following standard(s): 7, 8, 9 & 10 Moss Bank keeps full care plans on its permanent residents but not for all others, which means that individualised care planning is lacking in some cases. The care home ensures that residents’ health is being promoted and treats residents appropriately so they feel confident in the care of the home. Medication policies are of a good standard but recording needs to be more exact so that errors are minimised. EVIDENCE: An examination of case files found a care plan in those for permanent residents but not for those receiving either short term or transitional care. The registered manager has devised a shortened care plan for the latter and these were present in the files but had not been completed. Staff were aware of the needs of residents and residents felt that their care was appropriate. However, the lack of care plans for some residents means that the care home could not show that it is providing care on the basis of an individualised and relevant plan for all. An examination of case files showed that residents’ health needs are both assessed and met, including regular weighing, so that any unexplained weight Moss Bank Elderly Persons Home DS0000037920.V260646.R01.S.doc Version 5.0 Page 11 gain or loss can be acted upon. Staff could show that they are familiar with the health needs of residents and both families and residents spoken to thought they were being cared for in a responsible manner. Moss Bank has correct policies on the administration of medicines as was shown by discussions with managers and staff. Appropriate training has been given, including in the area of controlled drugs. One resident was on controlled drugs and an examination of the records showed that this was being administered correctly. Generally, sheets recording medicines were correctly completed although there were two minor exceptions to this which need to be corrected so that the possibility of error in this field is minimised. Observations during the inspection showed that there was a proper relationship between residents and staff so that the former were treated in a dignified and correct manner. Both residents and families interviewed were very complimentary about the staff of the care home who they felt treated people appropriately. There was a friendly atmosphere within Moss Bank so that residents felt relaxed and comfortable in their care. Moss Bank Elderly Persons Home DS0000037920.V260646.R01.S.doc Version 5.0 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 the following standard(s): 12 & 14 The care home provides a number of activities for residents although this could be better publicised to encourage greater participation. Moss Bank encourages residents to make choices so that their preferences are respected. EVIDENCE: A tour of the premises showed that more activities have been purchased for the care home, particularly to accommodate day care service users. Interviews with managers and staff confirm that activities are taking place and good instances of varied activities were given. However, some residents spoken to felt that the activities were not as extensive as previously, although staff said that the difficulty was in residents refusing to take part. An examination of case files showed that residents’ interests are recorded there but a tour of the premises showed that activities are no longer advertised in the units so that residents are kept up to date about these. Interviews with residents and their families confirmed that they are encouraged to manage their affairs as far as their capabilities allow. A tour of the premises showed a number of instances where residents have brought personal possessions with them and residents felt that they were free to manage their lives as they wished. St Helens Council has a commitment of access to personal records and this is documented within the care home Moss Bank Elderly Persons Home DS0000037920.V260646.R01.S.doc Version 5.0 Page 13 although, in practice, residents have not wished to avail themselves of this. Observations during the inspection showed that residents were encouraged to make choices, particularly in the area of food, so that individual preferences are met. Moss Bank Elderly Persons Home DS0000037920.V260646.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 The care home has a full vulnerable adults procedure and has trained staff to ensure that there would be a proper response to any suspicion of allegation of abuse. EVIDENCE: St Helens Council has a thorough and complete policy on the protection of adults from abuse. Training records confirmed that all care staff have undertaken training in the area of elder abuse over the last 12 months. All members of the care staff interviewed were clear of the action to be taken in the event of an allegation of abuse although none had any experience of this. Moss Bank Elderly Persons Home DS0000037920.V260646.R01.S.doc Version 5.0 Page 15 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): 19 & 26 Moss Bank is a comfortable and pleasant care home with a good level of hygiene so that residents feel at ease in their surroundings. Some further redecoration would ensure that this standard is maintained. EVIDENCE: A tour of the premises found Moss Bank to be a pleasant and comfortable care home for the care of elderly people. Since the last inspection, one bedroom has been converted to provide office space for the registered manager although there has been no request for re-registration of the numbers. One bedroom was found to have a strong incontinence smell but this was the exception. Since the last inspection the care home has devised a form whereby any resident not requiring a chair in their bedroom has this documented. This was a requirement from the last report and represents an improvement in practice. The care home has a programme of redecoration but some areas would benefit from further work so that standards can be maintained. Interviews with residents found them satisfied with their Moss Bank Elderly Persons Home DS0000037920.V260646.R01.S.doc Version 5.0 Page 16 accommodation, including a married couple who had recently moved to a new unit. The care home has a full complement of domestic staff and employs two domestic staff in the morning and one in the afternoon. As a result, a good level of hygiene is maintained and this was confirmed by a tour of the premises. Interviews with residents and their families confirmed satisfaction with the premises, which meant they felt comfortable within their surroundings. Moss Bank Elderly Persons Home DS0000037920.V260646.R01.S.doc Version 5.0 Page 17 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, 29 & 30 St Helens Council is employing a competent and experienced staff group who have been recruited in a correct manner. Training opportunities have been increased and vocational training is at a good level. As a result, a high degree of satisfaction with the staff group was expressed by both residents and their families. EVIDENCE: Staff rotas showed that the care home is employing one manager and three care staff during the day. In addition, a further member of the care staff is being employed on Friday to accommodate the numbers of day care attendees for that day. The staffing establishment of the care home is the registered manager, two assistant managers, two relief managers and sixteen care staff, which represents sufficient numbers for the people accommodated. Two new members of the care staff have been transferred from another care home to complete the numbers. An interview with the registered manager showed that the Council is ready to employ further staff as and when the day care provision is increased so that staffing levels are maintained. St Helens Council has full and correct procedures for the appointment of staff so that residents and their families can be confident that they are being supported by staff who have been thoroughly checked before appointment. This was reflected in the interviews with care staff who appeared competent in their work and this was supported by comments from residents and families Moss Bank Elderly Persons Home DS0000037920.V260646.R01.S.doc Version 5.0 Page 18 who have a high opinion of the staff employed by the care home. As a result, residents are being supported in a positive manner. Of the sixteen care staff twelve already possess a vocational qualification and two are currently undertaking it. In addition, two of the management staff are also doing an advanced vocational qualification. As a result, staff are being well trained to support residents in accordance with good practice. In addition to the vocational qualifications, an examination of the training records for staff in the care home showed that further training in elder abuse, moving and handling and first aid has been provided to care staff which represents an improvement in the amount of training given to staff over the recent past. Interviews with care staff showed that they felt themselves well trained in their work and, therefore, felt confident and capable in caring for residents. This was reflected in the positive comments made by residents and their families. Moss Bank Elderly Persons Home DS0000037920.V260646.R01.S.doc Version 5.0 Page 19 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 & 38 Moss Bank is well led and well managed. Residents’ finances are correctly administered to enable them, when appropriate, to manager their own monies. The care home has correct policies and procedures to ensure that residents are cared for in a safe manner. EVIDENCE: There has been no change in the registered manager and she remains fully qualified for the post in terms of both her experience and qualifications. An interview with her showed that she is happy with the decisions made about the future of the care home and confident that she could lead Moss Bank positively in the future. Interviews with other managers and care staff showed a high respect for the registered manager and the way she was leading the staff team. Interviews with relatives and residents confirmed that the care home was well lead and this was reflected in the attitudes of staff. Moss Bank Elderly Persons Home DS0000037920.V260646.R01.S.doc Version 5.0 Page 20 An examination of case files showed that there are individual records to record any financial transactions with residents. Residents can control their own money depending on capacity and individual records are kept. The registered manager does not act as an appointee and there is a safe for the use of residents as well as individual lockable facilities in each bedroom, as was shown by a tour of the premises. As a result, residents can be confident that their money is being managed correctly and this was confirmed in interviews with them. A tour of the premises found it a safe area for the care of residents. Since the last inspection, a risk assessment of the premises has been undertaken and training records show that staff have been trained in a number of areas relating to health and safety so that they are aware of their responsibilities in these matters. The fire book had been correctly completed and the care home had the required safety certificates. Moss Bank Elderly Persons Home DS0000037920.V260646.R01.S.doc Version 5.0 Page 21 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 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 3 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x x x 3 x x 3 Moss Bank Elderly Persons Home DS0000037920.V260646.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? YES 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 OP9 Regulation 13 Requirement The registered manager to ensure that MARS sheets are correctly completed. (Previous timescale of 1st June 2005 not met). The registered manager to ensure that all residents on short stays have a care plan. (Previous timescale of 1st June 2005 not met). The registered manager to ensure that activities are listed in the units The registered manager to ensure that some areas of the home are re-decorated. Timescale for action 01/12/05 2. OP7 15 01/12/05 3. 4 OP12 OP19 16(n) 23(2)(d) 01/12/05 01/08/06 Moss Bank Elderly Persons Home DS0000037920.V260646.R01.S.doc Version 5.0 Page 23 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 OP4 Good Practice Recommendations The registered provider is recommended to advise Care Management of the registration conditions that apply to the care home and that inappropriate applications should not be made. Moss Bank Elderly Persons Home DS0000037920.V260646.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG 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. 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