Inspection on 12/12/05 for Moss View

This inspection was carried out on 12th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 View 25/06/07

Moss View 24/02/06

Moss View 16/02/05

Moss View 09/06/04

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 View 77 Page Moss Lane Huyton Liverpool Merseyside L14 0JJ Lead Inspector Natalie Charnley Unannounced Inspection 12th December 2005 11:30 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 View DS0000025194.V273699.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 View DS0000025194.V273699.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Moss View Address 77 Page Moss Lane Huyton Liverpool Merseyside L14 0JJ 0151 482 1212 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) massview@highfield-care.com Southern Cross Care Homes Limited Mrs June Newton Care Home 78 Category(ies) of Dementia - over 65 years of age (27), Old age, registration, with number not falling within any other category (51) of places Moss View DS0000025194.V273699.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 78 Personal Care of which 51 Older Persons aged over 65 years (OP) and 27 Dementia over 65 years (DE/E) 27 Dementia over 65 years (DE(E)) 24 Nursing Older Persons (OP) aged over 65 years within a total of 51 Older Persons (OP) aged over 65 years (OP) 2 persons with a physical disability (PD) under the age of 65 years. 2 persons with mental disorder (MD) under the age of 65 years, To accommodate one named person with Dementia (DE) under the age of 65 years. 16th February 2005 Date of last inspection Brief Description of the Service: Moss view is a large nursing a residential home located in the Huyton area of Liverpool .It is close to local shops and transport links. The home is purpose built over two floors and accommodates residents who need dementia care and nursing care up to a total of 78 people, this is over two separate units. The home is owned by Southern Cross Health Care who have similar homes around the country. The home has a variety of lounge and dining areas on both units. All bedrooms are en-suite. The dementia wing has security door locks, however these are disguised by paintings on the doors themselves. Moss View DS0000025194.V273699.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out over a period of one day by two inspectors. The inspectors arrived at the home at 11.30 and left at 18.00 .The inspector spoke with 8 staff, the home manager, 9 residents and 2 visitors. The inspectors completed the inspection by looking at the homes records, a tour of the building, formal and informal interviews and information from previous inspection reports. The inspectors followed an inspection plan written before the start of the inspection to ensure that all areas that needed covering were done so. Feedback was given to the manager during and at the end of the inspection. Not all outstanding requirements and recommendations from the last inspection have been met. What the service does well: What has improved since the last inspection? What they could do better: The home must address the smell identified on the dementia unit. Moss View DS0000025194.V273699.R01.S.doc Version 5.0 Page 6 The home must address the recruitment practices and ensure two references are obtained and that these are dated to show they are genuine. Staff must be clear as to their accountability when giving out medication and must ensure they follow procedures at all times. The home must ensure all documents are legible and dated. 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 View DS0000025194.V273699.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 View DS0000025194.V273699.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): 3 The home carries out a full assessment before a resident moves to the home to ensure they can meet their individual needs. EVIDENCE: The home has a pre admission assessment in place for all new residents. This assessments is usually carried out by the home manager or other qualified person. The assessment carried out contain good information in which staff can then formulate a plan of care. Files looked at during the inspection, showed that this process is taking place and that on some occasions, social services assessments are also used. Specific assessments are used on the dementia wing, which are comprehensive. Moss View DS0000025194.V273699.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): 7,8 and 9 Care planning at the home is based on the individual and details how care is to be given. Residents health care needs are well managed and promote quality of life. Medication is well managed and protects the safety of residents. EVIDENCE: A sample of four care plans were looked at on each unit. The home has recently changed the format of plans which has meant a lot of work for staff moving information from one area to another, however all files are now have the new forms in place. The format of care planning is of a very good standard. Many entries made within care plans were very difficult to read due to poor handwriting. Evidence was in place showing that residents and their relatives are involved in developing their care plans and all plans are updated monthly. One file looked at from the dementia unit had very little information on why the resident was on that unit, except for information in the continence assessment, previous information from other plans could not be found at the home. A small number of other forms were not fully completed including life Moss View DS0000025194.V273699.R01.S.doc Version 5.0 Page 10 histories, care plan indexes and communication records. This was put down to the recent change over of records. Care records were also found in the lounge area unattended which is a breach of confidentiality. Residents have access to a range of other heath professionals such as dentists, chiropodists and specialist nurses. Visits and discussions with these people are clearly recorded in care files. Residents are risk assessed against a variety of possible problems such as nutrition and pressure areas, these assessments are reviewed on a regular basis. Some of these risk assessments were not dated. Records of residents weights were recorded in two separate documents, however these were not always kept up to date. Medication records for both units and storage areas were observed. Residents photos were on files, which helps with identification and there were samples of staff signatures. Some areas of concerns were identified. Handwritten entries were not double signed by staff to prevent errors and one resident has received no night time medication for 12 days as he had been ‘asleep’. There were 12 gaps in the recording of medication administration and one resident who was prescribed a tablet twice a day and for 6 days had only got it once per day. One resident had a sticky label stuck over the prescription, which meant that the original prescription could not be read and when medications had not been given and were recorded as ‘0’, this was not defined. The medication policy was clear however contained no information regarding the home keeping medication for 7 days if a resident dies. The treatment room was found to be very warm (79 degrees) and needs to urgently be cooled to an appropriate temperature to store medication, other wise it was clean and tidy and provided correct storage facilities for medication. Moss View DS0000025194.V273699.R01.S.doc Version 5.0 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 the following standard(s): 13 and 14 Residents are supported to maintain community links as part of providing a fulfilling lifestyle Residents make choices on a daily basis and are supported by staff to make independent decisions. EVIDENCE: The home has an open visiting policy on both units and residents can meet with relatives in private or communal areas. One resident commented, “my relatives visit me each day”, another stated, “Visiting times are flexible”. Residents also made comments on how they can make choices on a daily basis such as “I am able to do as I please”, “I can go out whenever I want” and “I can sleep in if I want to which is nice”. The home has access to a variety of local advocacy groups to help support residents who have little or no family and all residents are encouraged to personalise their bedrooms when they move in with items of furniture and pictures. Moss View DS0000025194.V273699.R01.S.doc Version 5.0 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 the following standard(s): 16 and 18 The home has a satisfactory complaints procedure, which is easy for residents or families to use. Staff have a good knowledge of adult protection procedures which protects residents from abuse. EVIDENCE: The home has a policy on managing complaints which is accessible for residents and their families. All complaints are dealt with by the home manager who has to respond within 28 working days. 6 complaints had been recorded since the last inspection. Residents spoken to knew how to make a complaint if they needed to. The home use and follow the local social services adult protection policy as well as having their own individual policy in place. All staff are Police checked and have their names checked against the POVA register (Protection of Vulnerable Adults) Staff spoken to had a good knowledge of adult protection procedures and stated that they had received training in this area. Moss View DS0000025194.V273699.R01.S.doc Version 5.0 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 the following standard(s): 19 and 26 The layout, facilities and location of the home are suitable for the residents who live there. The home is safe and clean and provides residents with a good standard of accommodation. The dementia unit has a malodorous smell that may be offensive to residents and visitors. EVIDENCE: The dementia unit is pleasantly decorated and has been specifically designed to meet the needs of the residents who live there. The unit has 2 themed gardens and the corridor walls have items to touch and feel to stimulate residents. Residents bedroom doors have letterboxes and doorknockers in place and are painted in bright colours to help residents identify where they ‘live’. The bathroom opposite room 31 was found to have shelving that was not secure to the wall. The coridoor and lounge areas were found to have a malodorous smell to them, which must be addressed by the manager. Moss View DS0000025194.V273699.R01.S.doc Version 5.0 Page 14 The general residential unit has two very large lounge areas and a dining room where residents can chose to sit. Décor is homely and pleasant and redecoration is on a rolling programme. Residents spoken to on both units made comments such as “ it’s nice and clean in here” and “ I have my room cleaned daily” and “ it’s peaceful in this lounge and I can sit in the quiet”. The home has a policy in place for infection control and have a contract with a supplier to remove their waste. Staff spoken to stated that the home has good supplies of gloves, aprons, wipes and soap and that some staff had received training on infection control and COSHH (control of substances hazardous to health) The home is easily accessible and has access for wheelchairs. The main entrance has a large reception area and has access to both units, however access to the dementia unit is by a secure door lock. Visitor at the home are let into the unit by staff. Moss View DS0000025194.V273699.R01.S.doc Version 5.0 Page 15 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 and 30 Staff morale is high resulting in an enthusiastic workforce that works positively with residents to improve their quality of life. Recruitment practices need to be tighten at the home to ensure the safety of residents. Staff have the necessary skills and training to care for residents appropriately. EVIDENCE: A selection of staff files were looked at and staff interviews confirmed that a variety of training takes place at the home. Staff who work on the dementia unit have all received specialist training on dementia care. Other recent training had been given to staff on medication administration and abuse awareness. Rotas showed that there are enough staff to look after all the residents who live at the home, and staff on the whole, felt that staffing numbers were good. One member of staff interviewed stated that, in her opinion, the home need an additional trained nurse on the morning shift. This was fed back to the manager. Residents spoke highly of staff and comments were made such as “the staff are very nice”, “you can always get hold of staff if you need help” and “the staff here look after me very well”. One visitor commented that she felt that the staff at the home “very committed and caring”. Moss View DS0000025194.V273699.R01.S.doc Version 5.0 Page 16 The 5 staff files sampled showed that appropriate Police checks had been completed and that staff had received a full induction. All nursing staff had proof that they were registered with the NMC (Nursing and Midwifery council). One of the staff files only had one reference in place and some of the other references were not dated. The home must address these concerns. Staff confirmed that they had been given terms and conditions of employment and job descriptions when they started work at the home. Moss View DS0000025194.V273699.R01.S.doc Version 5.0 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 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 and 38 The manager leads by example and provides a positive, supportive role model for staff. The home maintains the health and safety of staff and residents at all times, protecting them from harm. EVIDENCE: The home manager has worked at Mossview for the past 3 years and is a registered nurse. The manager has 16 years experience in the field of care management and is in the process of registering for the NVQ level 4 registered managers award. The home also has a unit manager who is responsible for managing the dementia unit and a team manager on the residential unit. Residents and staff spoke highly of the home management and commented that they had also received support from the area manager who visits on a Moss View DS0000025194.V273699.R01.S.doc Version 5.0 Page 18 regular basis. Comments were made such as “ the manager is always there to give support and guidance” and “the manager is very good”. Accidents are well recorded at the home and maintain the confidentiality of residents, all of these records are then checked by the home manager and audited. Fire records show that staff receive regular fire drills and that regular fire checks take place. The home has comprehensive health and safety policies in place which staff have access to, staff also receive health and safety training. All health and safety certificates were in place and up to date. Moss View DS0000025194.V273699.R01.S.doc Version 5.0 Page 19 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 2 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X X X 3 Moss View DS0000025194.V273699.R01.S.doc Version 5.0 Page 20 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 OP8 Regulation 14(1) Requirement The registered person must ensure that all documentation kept in relation to residents is clear, legible and dated. Timescale for action 30/01/06 2 OP9 13(2) 3 OP19 23(1) The registered person must ensure that all residents living on the dementia wing have supporting information within their care documents to ensure they are in the correct placement 30/01/06 The registered person must ensure that in relation to medication at the home: 1.All handwritten entries are double signed by staff 2.All medications are given as prescribed 3.When ‘0’ is recorded, this is defined. 4.Sticky labels are not placed over prescription information 5. The medication policy reflects the need to keep medicines for a period for 7 days in the event of a residents death. The registered person must 01/03/06 ensure that the shelving unit in the bathroom opposite room 31 on the dementia unit is repaired DS0000025194.V273699.R01.S.doc Version 5.0 Page 21 Moss View 4 OP29 18(1) The registered person must address the areas of malodorous smells on the dementia wing The registered person must ensure two written references are obtained for staff and that they are dated. Remains outstanding from last report.Previous timescale: IMMEDIATE 01/02/06 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 2 Refer to Standard OP8 OP24 Good Practice Recommendations The registered person may wish to keep all weight records in one place, making accessing this information easier. The registered person may wish to fit privacy locks to bedroom doors that do not have ones Recommendation outstanding from last inspection The registered person may wish to re locate the phone for residents to ensure privacy Recommendation outstanding from last inspection The registered person may wish to provide staff with supervision at least 6 times per year Recommendation outstanding from last inspection 3 OP36 Moss View DS0000025194.V273699.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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 Moss View DS0000025194.V273699.R01.S.doc Version 5.0 Page 23 - 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!