Inspection on 20/09/05 for Moston Grange Nursing Home

This inspection was carried out on 20th September 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Moston Grange Nursing Home 17/12/08

Moston Grange Nursing Home 02/02/07

Moston Grange Nursing Home 12/03/05

Moston Grange Nursing Home 14/02/05

Moston Grange Nursing Home 04/08/04

Moston Grange Nursing Home 25/02/04

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

CARE HOME ADULTS 18-65 Moston Grange Nursing Home 29 High Peak Street Newton Heath Manchester M40 3AJ Lead Inspector John Oliver Unannounced Inspection 20th September 2005 10:00 Moston Grange Nursing Home DS0000043121.V253258.R01.S.doc Version 5.0 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 Moston Grange Nursing Home DS0000043121.V253258.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 Adults 18-65. 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. Moston Grange Nursing Home DS0000043121.V253258.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Moston Grange Nursing Home Address 29 High Peak Street Newton Heath Manchester M40 3AJ 0161 219 1300 0161 219 1118 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) EHC Moston Grange Limited Susan Arnold Care Home 64 Category(ies) of Dementia (63), Dementia - over 65 years of age registration, with number (1) of places Moston Grange Nursing Home DS0000043121.V253258.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. That the number of persons requiring nursing care at any one time shall not exceed 64 aged less than 65 years at the time of their referral, except for a variation granted in respect of age for one named individual. That the home provides accommodation for service users on four separate nursing units with discrete and identifiable staff groups. The maximum number of service users assessed as requiring nursing care that can be accommodated within each unit of the home must not exceed 16. The minimum nursing staffing levels as specified in the Notice served under Section 13 of the Care Standards Act 2000 issued on 26th November 2003 must be maintaned in relation to those service users accommodated for nursing care. That in addition to the agreed qualified nurse and nursing assistant staff levels, the company provides activity organisers for 84 hours per week across the Moston Grange site. The service should,at all times,employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 14th February 2005 2. 3. 4. 5. 6. Date of last inspection Brief Description of the Service: Moston Grange Nursing Home provides accommodation with nursing care for a maximum of 64 adults with dementia. The premises are owned by E.H.C Moston Grange Limited, which is a wholly owned subsidiary of Equilibrium Healthcare Limited. Mr. Patrick J. Keely is the Responsible Individual and Mrs. Susan Arnold, RMN, is the registered manager. The home is situated in the North of Manchester City Centre close to main transport routes to and from the city with local shops and amenities within walking distance. The home offers single storey accommodation within bungalow style buildings and all bedrooms are single with en-suite facilities. Off-the-road parking is available for approximately 15 vehicles and gardens were accessible to the people living in the home. Moston Grange Nursing Home DS0000043121.V253258.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place on 20 September 2005. It was carried out over a 6 hour period and included talking with a number of residents, staff and management and examining a number of records, policies and procedures. Some time was also spent looking around the inside of the home as well as having a walk around the outside of the building. At the last inspection, which was done in February 2005, no improvements were identified to be carried out. Again, following this inspection, this position has been maintained. Not all standards were checked at this inspection and it is strongly advised that this report should be read together with the last report and any future inspection reports to get a full picture of how the service is meeting the needs of the residents living there. What the service does well: The manager and staff team of the home have worked hard to provide residents with a comfortable and safe place to live. Watching staff at work gave a good indication of their commitment to providing residents with a pleasant atmosphere in which to live. A lot of time has been spent in making sure that individual residents get support in the way that is most important to them. The atmosphere of the home was relaxed and residents were encouraged to take part in making decisions about how they would like to spend their day. Good record keeping is seen as important by the manager and staff team. Those records seen during the inspection were well written, accurate and, up to date. This enabled staff working in the home to supply support to the residents to a high standard. Talking with two particular residents one inspector was told that “we are well looked after here, nothing is too much trouble”, “I can go out when I want as long as I tell someone where I’m going”, “good food here”. Residents are encouraged to get involved in social activities that they are particularly interested in or have been involved in before coming to live in Moston Grange. There is a large ‘activities’ room where people can play snooker, paint, use the computer or enjoy other things. Moston Grange Nursing Home DS0000043121.V253258.R01.S.doc Version 5.0 Page 6 Although a number of residents spoken to were uncertain how to make a complaint these same residents were comfortable enough to state that they would talk to a member of staff if they had a worry or concern. Residents also said most staff were friendly and helpful. What has improved since the last inspection? 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. Moston Grange Nursing Home DS0000043121.V253258.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Moston Grange Nursing Home DS0000043121.V253258.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3 and 4 Resident’s individual needs and goals were assessed prior to admission and on an ongoing basis. Opportunities for trial visits were arranged to the home prior to any admission taking place. EVIDENCE: Residents were only admitted to the home following full pre-admission assessments by their social worker, a National Health Service nurse and the home’s registered manager. The assessments of needs appeared to be used in determining whether the home was able to offer prospective residents a placement in the home. Where people had been admitted to the home as a condition of the Care Programme Approach (CPA) the home had obtained a copy of the single care management assessment and the single care plan. The home offered each person a six-week trial stay. Staff in the home conducted an ongoing assessment of needs during this period and information was used as part of the person centred care planning approach. Care plans also had risk assessments integrated into them and there was evidence that these had been fully discussed and agreed with the resident and or his/her family member or representative. Moston Grange Nursing Home DS0000043121.V253258.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 and 10 The home has identified resident’s goals and aspirations and offers them the opportunity to make meaningful choices in relation to their day-to-day lives based on the risk assessment process. EVIDENCE: Resident’s Care Plans were seen and were found to contain information that was descriptive, informative and set out people’s needs, goals and the support required to meet those goals from a person centred focus. Cross referencing information indicated that the identified goals correspond with the assessment of need for the individual. The files of three people resident in the home were examined during the inspection process. All contained relevant and sufficient information to enable care to be delivered in the most appropriate way to the individual. However, information contained within the daily recordings of one person clearly indicated that he was receiving treatment for a ‘painful toe’. This information had not been updated into the care plan of the resident and could, therefore, be over looked as part of meeting the individual’s needs. Moston Grange Nursing Home DS0000043121.V253258.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13,14,15,16 and 17 The home offers people the opportunities and support to participate in social, leisure and household activities. EVIDENCE: Records available demonstrated how residents were supported in integrating with the local community. Such integration was limited only by the individual residents’ assessed capacity. Information contained with the home’s activity log demonstrated that the residents were encouraged to visit local shops, markets, public houses, cinemas and other social and recreational amenities. Residents living in the home appeared to be supported in pursuing their interests and hobbies. Those residents spoken to during the course of the inspection also expressed their satisfaction at the quality of food prepared and served in the home. One resident said, “It is good food here”. Staff were observed to unobtrusively assist those residents who needed support during meal times. Moston Grange Nursing Home DS0000043121.V253258.R01.S.doc Version 5.0 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 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 and 20 The home supports people to maintain their person and healthcare in the way they prefer and has a medication administration policy, procedures and system that protects people and maintains their wellbeing. EVIDENCE: Nursing and personal care were conducted in the privacy of the residents’ bedrooms. Risk assessments were in place that covered individual moving and handling needs and these were reviewed on a monthly basis. Care Plans indicated that residents’ had determined their own bed and rising times. One resident said “I had a lie in and got up for lunch”. The home was equipped with aids and equipment to meet the needs of people living in the home. Moston Grange Nursing Home DS0000043121.V253258.R01.S.doc Version 5.0 Page 12 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 The home has the policies, procedures and systems in place to raise concerns and to protect people from abuse and neglect. EVIDENCE: The home had received two complaints that had been investigated since the last inspection. Both complaints had been appropriately dealt with following the complaints procedure displayed in the home. The complaint policy stated that all complaints were dealt with within a 28-day timeframe. Where this was not possible, the policy stated that the home manager would write to the complainant to explain why the complaint had not been concluded. The procedure contained details of the complainants’ right to contact the Commission for Social Care Inspection (CSCI) or other agencies at any stage. The complaint register contained details of the complaints, the action taken and the outcome. The home had a vulnerable adult protection procedure. This procedure was compliant with the Department of Health guidelines “No Secrets”. The home had a Whistle Blowing policy. Discussion with the registered manager confirmed that she had a clear understanding of the vulnerable adult protection procedure. Training and development for staff included sessions on management of aggression and vulnerable adult protection. This training ensured that all staff had an awareness of how to protect people living in the home from issues that may affect their wellbeing. Moston Grange Nursing Home DS0000043121.V253258.R01.S.doc Version 5.0 Page 13 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 30 There were sufficient toilet and bathrooms available to meet people’s needs in privacy. Those parts of the home seen during the inspection were clean and hygienic. EVIDENCE: Although all bedrooms were complete with en-suite facilities comprising of WC and hand washbasin there were also additional toilet facilities available on the individual units. All of the toilet and bathing facilities were fitted with appropriate privacy locks, which could be overridden by staff members in the event of emergency access being required. The home had an infection control policy that was available to all staff. A tour of the premises indicated that the home was clean and free of any unpleasant odours. Laundry facilities were suitable for their purpose and were sited away from any food storage or preparation areas. This minimised the risk of any cross contamination. Moston Grange Nursing Home DS0000043121.V253258.R01.S.doc Version 5.0 Page 14 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35 The home’s recruitment and training policies and procedures provide support to enable sufficient well-trained staff to be employed in the home. EVIDENCE: Staff seen and spoken to during the inspection were seen to be committed to their role and had the skills and experience required meeting the needs of the people living in the home. It was seen that staff were easily accessible and approachable to residents. The file of a new member of staff was examined. All relevant documentation had been completed including a Criminal Record Bureau check. The home’s training and development programme was available for inspection. A dedicated training budget was available and there was evidence of extensive staff training records. All staff had received a structured induction package within six weeks of their appointment and foundation training within sixmonths of their appointment. Training and development was linked to the home’s service aims and to the residents’ identified needs. Moston Grange Nursing Home DS0000043121.V253258.R01.S.doc Version 5.0 Page 15 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38 and 42 People living in the home benefit from having a manager with the management skills to provide a quality service and the home has systems in place to help people express their views, opinions and influence change in the service they receive. EVIDENCE: The home manager was registered with the Commission for Social Care Inspection (CSCI). She was qualified as a Registered Mental Nurse (RMN) and had numerous years experience in the independent sector caring for people with dementia. Since the last inspection, the home manager had completed the Registered Managers’ Award and had commenced NVQ level 5 in Management. The home’s policies, procedures and general risk assessments, including the home’s Health and Safety file and minutes of meetings, were displayed within the home and accessible to all staff and visitors to the home. Those staff members spoken with during the inspection confirmed that the management approach of the home was open, inclusive and supportive. Moston Grange Nursing Home DS0000043121.V253258.R01.S.doc Version 5.0 Page 16 The home manager confirmed that all servicing and maintenance of equipment in the home had been carried out. The home’s insurance was valid and appropriately displayed. Moston Grange Nursing Home DS0000043121.V253258.R01.S.doc Version 5.0 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 3 X X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score X X X 3 X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 4 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Moston Grange Nursing Home Score 3 X 3 X Standard No 37 38 39 40 41 42 43 Score 3 3 X X X 3 X DS0000043121.V253258.R01.S.doc Version 5.0 Page 18 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard 6 Good Practice Recommendations It is recommended that all ‘short term’ care needs are identified and planned for within the care planning format. Moston Grange Nursing Home DS0000043121.V253258.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection CSCI, Local office 9th Floor Oakland House Talbot Road Manchester M16 0PQ 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 Moston Grange Nursing Home DS0000043121.V253258.R01.S.doc Version 5.0 Page 20 - 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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