Inspection on 24/02/06 for Moss View

This inspection was carried out on 24th February 2006.

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 12/12/05

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 24th February 2006 09:15 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.V284981.R01.S.doc Version 5.1 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.V284981.R01.S.doc Version 5.1 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.V284981.R01.S.doc Version 5.1 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. 12th December 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.V284981.R01.S.doc Version 5.1 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 09:15 and left at 15.00 .The inspectors spoke with 6 staff, the home manager, 10 residents and 3 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 of the standards have been covered during this inspection, however the home has been assessed on all core standards over the 2005/06-inspection year. What the service does well: What has improved since the last inspection? Handwriting in records had improved and was now clear and legible. Checks on personnel files showed that two written references were now available for all staff working at the home. Moss View DS0000025194.V284981.R01.S.doc Version 5.1 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. Moss View DS0000025194.V284981.R01.S.doc Version 5.1 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.V284981.R01.S.doc Version 5.1 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): EVIDENCE: None of the above standards were assessed in full during this inspection. Moss View DS0000025194.V284981.R01.S.doc Version 5.1 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): 7,9 and 10 Care planning at the home is based on the individual and details how care is to be given, however this needs expanding to show how residents religious and cultural needs are managed. Some medication practices need tightening to ensure residents are protected. Residents do not always feel that their privacy is respected. EVIDENCE: Six care plans were sampled. Care plans are comprehensive and well recorded, showing that residents and or their relatives are being involved in the planning of care. Plans are always reviewed monthly and have clear guidance for staff on what the individual needs of residents are. Staff must expand on the information recorded regarding how residents are to be supported on religious and cultural matters. One file recorded a resident’s religion as ‘Jewish’ on one page and ‘CE’ on another. Details of religious activities were very brief such as ‘prays at night’ and ‘attends communion’. Medication records were sampled for both units. A large amount of sticky labels were found on all MAR (medication administration records) charts. Whilst this is acceptable the home could improve their practice as sticky labels Moss View DS0000025194.V284981.R01.S.doc Version 5.1 Page 10 can peel off the record, by either handwriting records and double signing them or requesting printed sheets from the pharmacy. Three residents had handwritten MAR charts that had not been checked by two staff members for accuracy, this put residents at possible risk. A small number of MAR charts had gaps in them indicating that medications had not been given and one resident had the prescription labels for three medications crossed out, making records unable to be read clearly. Another resident was prescribed ‘Calshake’ twice a day, but staff had signed for this as given six times per day. This serious error was discussed with the manager during the inspection. One tube of cream and a bottle of talc were found in the dementia wing office, left out. Medications and other such items must always be kept securely to protect the residents. Residents living on the nursing wing were complementary about how staff maintain their dignity. Examples were given such as “staff talk to me nicely and are polite” and “staff don’t disturb me unless I need them”. Residents living on the dementia wing felt that their privacy and respect was not always upheld. One lady stated that other residents “drive me mad by walking into my bedroom” she went on to say that some residents eat her food and take things from her bedroom. The lady also stated that she felt uneasy being cared for by male staff stating that “I have just had to get used to it, but I don’t enjoy it”. The home must look into this lady’s concerns as a matter of urgency. Another resident also complained that other residents come into her at night and keep her awake, stating, “Sometimes they think my room belongs to them, it isn’t nice”. Moss View DS0000025194.V284981.R01.S.doc Version 5.1 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): 12 and 15 Activities at the home are varied to suit the needs of individual residents. Dietary needs of residents are well catered for with a balanced selection of food that meets the tastes of residents. EVIDENCE: The home has a designated activity coordinator and activity room. Throughout the home there are pictures and photographs showing different types of activities that residents have participated in. The home also produces a newsletter for residents and families to be kept informed. Activities are based on a four week programme and involves residents from both units, however the dementia wing have a separate activity coordinator who works two days per week. Residents spoken to said that they enjoyed the activities at the home and commented, “we have great parties here”, “I am satisfied with the range of activities here” and “ we have trips out and events here at the home, where staff and my family join in”. The activity coordinator records when residents join in with activities and discussed how the home also provide 1:1 support for residents who are unable to join in group activities. Menus at the home rotate form week to week and are listed on a blackboard in the dining room. Residents are asked on a daily basis by staff to make choices about their meals, this information is then sent to the kitchen. The chef Moss View DS0000025194.V284981.R01.S.doc Version 5.1 Page 12 explained that he caters for a variety of different diets such as a diabetic diet and a soft diet for residents who can’t chew. Residents on the nursing wing were observed during lunchtime. They all enjoyed their lunch stating it was “ tasty” and “lovely”. Lunch was observed to be a social and unhurried occasion that gave staff opportunities to sit and speak with residents. Moss View DS0000025194.V284981.R01.S.doc Version 5.1 Page 13 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): EVIDENCE: None of the above standards were assessed in full during this inspection. Moss View DS0000025194.V284981.R01.S.doc Version 5.1 Page 14 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): 26 The dementia unit has a malodorous smell that may be offensive to residents and visitors. EVIDENCE: A tour of the home was carried out. During the visit to the dementia unit, it was identified that a strong malodorous smell was present, specifically on the main corridor outside the dining area. This problem was identified during the last inspection and must be addressed urgently. The outside of the main lounge on the nursing unit had scuffmarks where wheelchairs had pulled paint from the wall. This area needs repainting. All other areas of the home were found to be clean and tidy. Moss View DS0000025194.V284981.R01.S.doc Version 5.1 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): 28 Staff are developing the necessary skills and training to care for residents appropriately and are being supported by the home to achieve a specialist qualification. EVIDENCE: The home employs a total of thirty-nine care staff and five registered nurses. Care staff are supported by the home to undertake specialist qualifications (NVQ’s National Vocational Qualifications) and currently 41 of staff are trained to this level. The manager must continue to provide this training to ensure the home meets the required 50 target. Moss View DS0000025194.V284981.R01.S.doc Version 5.1 Page 16 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): 33 and 35 The home seeks to find out the needs of staff, relatives and residents. These views are then acted upon swiftly. Financial records at the home safeguard residents and allow them to use money independently EVIDENCE: The home use a large amount of audit tools to monitor quality, visits are also undertaken from the operations manager on a regular basis. Residents have formal meetings that are recorded and run by staff in which they can express their ideas and opinions about any aspect of living at the home. A residents meeting was being held on the day of the inspection and minutes were seen from previous meetings. Staff also meet with the manager on a regular basis to discuss developments for the home. Moss View DS0000025194.V284981.R01.S.doc Version 5.1 Page 17 The manager explained that the home use an annual ‘client opinion survey’ to monitor quality, however the results of this are never fed back to residents or families which would be good practice. Resident’s financial records were checked. Most residents have a personal allowance and have small amounts of money stored in the homes safe. Two residents have their own individual bank accounts and manage money independently. The administrators keep accurate and up to date records of any money spent on behalf of a resident. Records were checked for hairdressing, chiropody, aromatherapy and clothing alterations. These were all found to be accurate. The home manager acts as an ‘appointee’ for three residents and has financial audits completed on all accounts from internal and external people on a regular basis. Moss View DS0000025194.V284981.R01.S.doc Version 5.1 Page 18 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 2 8 X 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X 2 STAFFING Standard No Score 27 X 28 2 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X X Moss View DS0000025194.V284981.R01.S.doc Version 5.1 Page 19 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 OP7 Regulation 15 Requirement The registered person must ensure that care plans reflect residents religious and cultural needs. 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 These requirements remain outstanding from the previous inspection: Timescale 30.1.06 3. Medications should be kept in a secure trolley or cupboard at all times. The registered person must ensure that the concerns highlighted on the dementia wing by residents are investigated and resolved. Privacy and dignity must be maintained at all times The registered person must address the areas of malodorous smells on the dementia wing. This remains outstanding DS0000025194.V284981.R01.S.doc Timescale for action 30/04/06 2. OP9 13(2) 01/04/06 3 OP10 12(3) 30/04/06 4 OP26 23(1) 30/04/06 Moss View Version 5.1 Page 20 from the previous inspection: Timescale 1.3.06 The area outside the main dining area on the nursing wing must have the scuffed areas repainted. 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 OP9 OP24 Good Practice Recommendations The registered person may wish to review the amount of labels used on MAR chars The registered person may wish to fit privacy locks to bedroom doors that do not have one The registered person may wish to re locate the phone for residents to ensure privacy The registered person may wish to continue with NVQ training for staff to reach a target of 50 The registered person may wish to provide staff with supervision at least 6 times per year 3 4 OP28 OP36 Moss View DS0000025194.V284981.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Liverpool Local 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. 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