Inspection on 12/02/07 for The Moorings

This inspection was carried out on 12th February 2007.

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

The Moorings 02/07/07

The Moorings 30/06/06

The Moorings 27/01/06

The Moorings 14/09/05

The Moorings 18/01/05

The Moorings 13/07/04

The Moorings 30/12/03

The Moorings 23/10/03

Similar services:

Chesham House

Argyll House

Dorset Lodge

Acacia House

Falcon House

Dial House Nursing Home

Cromwell Avenue (9)

Abbey Lodge

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

CARE HOMES FOR OLDER PEOPLE Moorings, The 167 Thorney Bay Road Canvey Island Essex SS8 0HN Lead Inspector Carolyn Delaney Unannounced Inspection 12th February 2007 09:00 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 Moorings, The DS0000015546.V329399.R01.S.doc Version 5.2 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. Moorings, The DS0000015546.V329399.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Moorings, The Address 167 Thorney Bay Road Canvey Island Essex SS8 0HN 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) 01268 514477 01268 514474 themoorings@abc-care-solutions.co.uk Independent Homes Limited Manager post vacant Care Home 39 Category(ies) of Dementia - over 65 years of age (39), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (39) Moorings, The DS0000015546.V329399.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Excluding any person who is liable to be detained under the provision of the Mental Health Act 1983 30th June 2006 Date of last inspection Brief Description of the Service: The Moorings provides purpose built accommodation for thirty-nine older people with dementia and mental disorders. The home is situated in a quiet residential area of Canvey Island within close proximity of the sea front. The Moorings offers 35 single occupancy bedrooms and 2 shared bedrooms. Residents at the home are accommodated on two floors, which are accessed by a passenger lift. Residents have access to the rear garden. There is parking facilities for approximately twelve cars adjacent to the home. The range of fees for accommodation and nursing care at the home is between £535.00 for a shared room and £560.00 for a single room. Moorings, The DS0000015546.V329399.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced Key inspection carried out on 12th February 2007 between the hours of 08.45 & 21.00. Lead inspector Carolyn Delaney and second inspector Michelle Love carried out the inspection. As part of the inspection process twenty four relatives were contacted and provided with a relatives/carers ‘ Have your say about…’ relative questionnaire so as to offer them the opportunity to express their views as to how they feel that the home meets the needs of their relatives living at the home. Thirteen people responded. The comments and views of residents and those people who responded to questionnaires have been used in conjunction with the findings of the inspection visit so as to make a judgement about the level of services provided by the home and have been included throughout the report. Records including assessments, care plans, daily care notes, and medication records and risk assessment documents in respect of a number of people living at the home were examined. Six members of staff including the homes acting manager were spoken with during the inspection. Duty rotas were assessed. Records in respect of staff recruitment, training and supervision were also assessed. A tour of the premises was carried out. Key standards as identified in the intended outcomes sections of this report are inspected at each key inspection. Key standards are identified for each section of the report. Where other standards have not been assessed these will have been assessed at previous inspections. Reports in respect of previous inspections may be accessed via the Commissions website www.csci.org.uk. What the service does well: Moorings, The DS0000015546.V329399.R01.S.doc Version 5.2 Page 6 Of the thirteen residents relatives who completed surveys five made comments about what in their opinion the home does well. Most positive comments were in respect of the staff working at the home. One relative commented that staff ‘seem to cope relatively well sometimes under difficult conditions..’ Another relative said that staff are ‘always very helpful and very polite..’ One person commented that ‘the home is much cleaner than before..’ A small number of staff working in the home during the day of the inspection were seen to interact well with residents. The home was noted to be clean and free from unpleasant odours throughout. What has improved since the last inspection? What they could do better: Wherever possible staff should consult with the relatives of prospective residents so as to obtain information about the wishes and need of persons who are to be admitted to the home, as many of these people are unable to express their needs due to cognitive impairment as a result of their dementia. Care plans should be clearer as to the care that residents are to receive and they should be updated when the care and treatment that people living at the home receive changes. More needs to be done so as to minimise the risks to resident’s health and safety. A number of people living at the home are at risk of falls and it was Moorings, The DS0000015546.V329399.R01.S.doc Version 5.2 Page 7 noted that following incidents of falls that staff do not monitor the person for any signs of injury, pain or discomfort. It was not clear that nursing staff ensure that residents receive the medication, which has been prescribed for them as part of their treatment. Some people do not receive the basic care that they require to maintain personal hygiene , and some resident’s hair, nails and clothing was dirty. A number of resident’s relatives have commented that more stimulation and activities could be offered to residents. Some relatives are unhappy that residents are left sitting for long periods of time in their chairs without any exercise or opportunities to go outside. There was very little in the way of activities provided for residents on the day of the inspection and staff interaction with residents was generally very poor. While there has been a reduction in the number of complaints made about the home some people have indicated that they have not been satisfied with the way complaints are dealt with and that they have had to wait some time for a response. More could be done so as to protect residents and staff from the risk of harm. Staff must be trained in dealing with aggressive behaviour. A number of resident’s relatives have commented that the staffing levels are not sufficient for the needs of the people living at the home. On the day of the inspection as on other occasions residents were left for period without any supervision and meal times were very chaotic. People are not recruited in a robust and consistent manner with all of the checks as required by regulation for the protection of residents having been carried out before a person is employed. Staff are not trained for the roles, which they are to perform. There have been some improvements in the way that the home is managed since the appointment of an acting manager. However there are a number of areas where there is significant work to be undertaken so as to provide a satisfactory level of care and services for the people living at the home. The acting manager does not spend enough time at the home for these improvements to be instigated in a timely and satisfactory way. The systems for detecting and warning of any outbreak of fire at the home must be maintained in good working order with repairs etc carried out in a prompt manner. Please contact the provider for advice of actions taken in response to this Moorings, The DS0000015546.V329399.R01.S.doc Version 5.2 Page 8 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Moorings, The DS0000015546.V329399.R01.S.doc Version 5.2 Page 9 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 Moorings, The DS0000015546.V329399.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, & 3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The information, which is made available about the home and the services offered, is not indicative of the actual services provided. The relatives/ representatives of prospective residents are not consulted and involved in the assessment process. EVIDENCE: The Moorings has a statement of purpose document, which sets out and describes the services that are offered by the home. However the actual services provided by the home fall short of those as described in this document. For example the statement of purpose states that staff are recruited according to a rigorous recruitment process, that there is a commitment to the development of staff and that a range of activities is available which is ‘individual to the service user…’ This was not evident during the inspection. Moorings, The DS0000015546.V329399.R01.S.doc Version 5.2 Page 11 The pre- admission assessments for two people who had been admitted to the home since the last inspection were examined. These had been carried out prior to the person’s admission to the home and contained details of the persons nursing and general care needs. There was no evidence that the person’s relative had been consulted in the assessment process. Many of the people who are admitted to the home are unable to express their needs fully at the time of the assessment. The Moorings does not provide intermediate or rehabilitative care. Moorings, The DS0000015546.V329399.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Risks to the health, welfare and safety of people living at the home are not well managed and people do not always receive the care and treatment they need. EVIDENCE: Two of the thirteen relatives residents who completed surveys said that they always get enough information so as to enable them to make decisions. Three said that they usually did and four said that they sometimes did. Three people said that they never did. Of these three one said that they are never informed when residents require new clothing or toiletries despite asking staff to inform them. One relative commented that when they do buy clothing for residents ‘it would be nice to know whether they fit or not, after all it is the care staff who dress residents…’ A number of relatives commented that they are not informed of important issues. Some relatives said that they have observed injuries to residents when Moorings, The DS0000015546.V329399.R01.S.doc Version 5.2 Page 13 they visit which they had not been informed of. One relative commented that when a resident fell and fractured their hip that the family were contacted but not informed of what had occurred. A number of relatives commented that some staff did not always communicate clearly as their ‘English is so poor..’ The care plans and risk assessments for seven people living at the home were examined. Care plans were generally detailed in respect of describing the persons nursing and treatment needs. However there was little information recorded in respect of the care to be provided and how staff were to act so at to provide care. For example where there was a plan in place for supporting residents with their personal hygiene needs, it was not clear as to what part of the process the resident was capable of doing and how much support they require. Care plans for managing outbursts of aggression did not identify how staff were to manage these so as to minimise risks of injury to themselves and other residents. A number of residents who live at the home are at risk of falls. The assessments in respect of these risks stated that residents were to be ‘monitored constantly..’ There were long periods of time where these residents were left unsupervised. From assessing the records in respect of accidents and incidents at the home it was not clear that following a fall or injury that staff monitored the persons condition periodically to determine if there was any serious injury. On the day of the inspection visit one resident fell backwards in a dining room chair onto the floor. Nursing and care staff went to attend to this person. However they did not assess the person properly before moving them. Staff did not check to see if the person was experiencing any pain. The records made in respect of the incident stated that the person had ‘slipped from their chair..’ which was incorrect. Staff did not monitor this person’s condition following this incident. One relative said that they felt that staff do not change continence pads frequently enough or ‘act quick enough with skin care …’ for residents whose skin tends to break down. One relative said that they were unhappy that residents are ‘left sitting in their chairs all day..’ without any form of exercise. Care plans were not always accurate. For example it was of concern to note that in one persons’ care plan it was recorded that staff ‘crush medication..’ before administering it. On checking with staff they said that they did not in fact crush medication and that the resident in question took their medication without any problems. One resident regularly refuses medication to control epilepsy. The plan of care for this person had not been updated with this information. When questioned staff said that this resident should have medication in liquid form. There was no evidence that any action had been taken by staff so as to achieve this. Moorings, The DS0000015546.V329399.R01.S.doc Version 5.2 Page 14 Many of the residents require support and assistance to maintain personal hygiene. One relative commented that residents often look ‘dirty’ , ‘have greasy and uncombed hair..’ Other relatives commented that clothing is not laundered properly and items of clothing go missing regularly and that residents wear clothing, which does not belong to them. One relative said that ‘staff do not seem to respect residents as people..’ During the day of the inspection some residents looked unkempt, with uncombed hair and dirt fingernails. Some residents clothing was stained and dirty. Some residents were wearing ill-fitting clothing. Moorings, The DS0000015546.V329399.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The routines of the home are not flexible and residents living at the home are not offered choices or opportunities for socialisation or participation in activities. EVIDENCE: There was no evidence of any activities or opportunities for providing stimulation for residents on the day of the inspection. Staff were very busy and did not interact or engage with residents, some even when providing care and support. Residents were left to their own devices and a number of them spent the morning wandering up and down the corridor. Others spent the morning in the lounge areas. On occasions during the day some staff spent time sitting in the lounge areas but even on these occasions there was very little interaction with residents. A number of resident’s relatives who completed surveys commented that more could be done to provide stimulation for residents such as walks outside, sitting in the garden etc. Moorings, The DS0000015546.V329399.R01.S.doc Version 5.2 Page 16 Most of the people who completed surveys said that where it was possible that the home helps residents keep in touch with relatives. The way in which meals are served and how people are supported at mealtimes could be improved. A number of residents require assistance with feeding. The lunchtime meal for two of these residents was left on the table for approximately two minutes before staff came to assist them with their meal. The serving of the lunchtime meal in the dining area was very chaotic. Residents were being brought to tables while residents were eating which was disruptive. There were a number of residents who were distracted and required supervision and coaxing to eat but staff were not available to provide this support. There was a choice of meals from the day’s menu offered at both lunch and suppertime and the food looked well presented and appetising. Residents however were not offered condiments or a choice of whether they wanted sauces or gravy with their meal. The suppertime meal commenced at 17.00 and was finished by 17.25 and was very rushed. Staff supporting residents did not interact with them and some looked disinterested. A number of resident’s relatives made comments about meals and drinks provided by the home. One relative commented that a resident ‘always seems to be hungry..’ Another relative commented that residents do not get enough to drink. It was noted that apart from the meal times and designated times for providing drinks i.e. midmorning and afternoon that residents were not offered any drinks. Moorings, The DS0000015546.V329399.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Complaints and concerns are not received and dealt with in a manner, which inspires confidence in the complainant that issues are taken seriously. Staff are not skilled in protecting residents from harm, abuse and neglect. EVIDENCE: People living at the home are unable to make complaints about the care that they receive due to their cognitive impairment. The number of complaints made in respect of the home has decreased since the new owners purchased the home last year Nine of the thirteen residents relatives who completed surveys said that they knew how to make a complaint about the care home if they needed to. Of these nine people four said that the home always responded appropriately. However of the remaining five people one person said that when they have complained or raised concerns that ‘usually nothing is done…’. Another relative said that it ‘took months’ for a response to a complaint and a relative said that they often feel that ‘concerns fall on deaf ears…’ Nineteen of the twenty-three staff working at the home had received Dementia Awareness training. Only two had received training for dealing with aggression Moorings, The DS0000015546.V329399.R01.S.doc Version 5.2 Page 18 in dementia. None of the staff working at the home had received training in respect of protecting vulnerable people since 2005. The Moorings provides care for people who have dementia and a variety of mental disorders. A number of residents are verbally and physically aggressive. Some staff when interacting and assisting these residents did not appear to have the skills to deal with outbursts of aggression and some staff by their actions actually aggravated the situation. Some residents call out and shout. Generally these residents are ignored and during the day staff were noted to sit in the lounge areas without speaking to residents when they were shouting or calling out. When I spoke to two such residents they did stop shouting for a period of time and answered questions, which were asked of them. During this as in previous inspections some residents displayed both verbal and physical aggression towards other residents and staff. During the inspection the provision of training in respect of the needs of people living at the home was discussed with the homes acting manager who agreed that the training provided may not be sufficient. She undertook to access more appropriate training. However she later denied this and stated that the training received by staff working at the home is appropriate. Moorings, The DS0000015546.V329399.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is ample communal space for residents living in the Moorings. Some resident’s relatives commented that the home could be ‘more comfortable..’ Others said that residents should be offered the opportunity to sit out in the garden. There was evidence that checks are made on a regular basis in respect of the furniture and equipment used at the home.. The removal of carpets in the home has eliminated the odour problem in the home. Moorings, The DS0000015546.V329399.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Staff are not recruited to work at the home in a robust & consistent manner, trained or employed in sufficient numbers so as to meet the needs of the people living at the home. EVIDENCE: It was not clear from the staff duty rota how many hours the acting manager spends at the home as she is also supporting another of the registered providers care homes. On the day of the inspection there were two qualified nurses and five care staff on duty including one carer who was completing the first day of their induction period. On assessing the duty rotas for the period between 1/1/07 & 16/2/07 it was noted that there were a number of occasions where the staffing levels were less that the agreed minimum levels for the home. A senior member of staff informed the Commission that the homes owners had reduced the numbers of staff working at the home. There was no evidence that this decision had been made taking into account the level of dependency and care needs of the people living at the home. During the day of the inspection as noted in previous inspections, residents were left for periods without any supervision. Residents wandered up and down the corridors and there were no activities or opportunities to keep residents occupied. Moorings, The DS0000015546.V329399.R01.S.doc Version 5.2 Page 21 Five of the thirteen residents relatives who completed ‘ Have Your Survey…’ surveys said that staff working at the home have the right skills and experience to look after people properly. Of the remaining eight, one said that they have observed staff feeding a resident to ‘shovel huge spoonfuls of food into the residents mouth..’ the resident could not swallow the food quickly enough. This relative also commented that some staff ‘do not seem to have much compassion..’ and that they ‘quite were rough when handling residents..’ One relative commented that staff are not trained but that ‘ they do their best.’ Two of the eighteen (11 ) care staff working at the home have undertaken National Vocational Qualification (NVQ) training. The recruitment files for three members of staff who had been recruited to work at the home since the last inspection were assessed. All of the checks as required by regulation had not been carried out before these people commenced work at the home. There were no references available for one of the three. References had not been sought from the most recent employer of one member of staff and the reason why this person had left the most recent employer had not been explored. References had been taken over the telephone and there were no written references for this person. There were no work permits on file for two people who had been recruited from overseas. There was no evidence that staff are interviewed so as to assess their fitness and suitability to work at the home and not all new staff had undertaken a period of induction. A letter of serious concern was sent to the registered providers, requiring them to address the issues. However the registered providers failed to respond in a satisfactory manner and chose instead to disagree with the inspector’s findings. During the inspection an up to date training tracker for all staff working at the home was requested and provided by the homes acting manager. Ten of the twenty-seven staff working at the home had undertaken Moving and handling training within the last twelve months. Only eleven of the twenty-seven had received Fire safety training within the past twelve months. Eight staff had received training in respect of food hygiene within the past twelve months. Nineteen of the twenty-three staff working at the home had received Dementia Awareness training. Only two had received training for dealing with aggression in dementia. However a number of residents are both verbally and physically aggressive and despite training provided, staff were observed to act around residents in a manner, which aggravated aggressive behaviour in some residents. No staff working at the home had received training in respect of protecting vulnerable people since 2005 and no staff working at the home had received basic first aid training. Moorings, The DS0000015546.V329399.R01.S.doc Version 5.2 Page 22 A statutory Requirement Notice was issued to the registered provider, in respect of their failure to ensure that all of the checks as required by regulation are carried out before a person is employed to work at the home and that all staff working at the home receive training for the roles they are to perform. The registered providers must comply with these notices in order to avoid possible prosecution. Moorings, The DS0000015546.V329399.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although there have been some improvements in the management of the home it is not consistently run and managed in the interests of the people who live there. EVIDENCE: A new acting manager was appointed in October 2006. A number of residents relatives said that they had not been informed that of this appointment and two relatives said that they had not yet met the manager. The acting manager is spending her time between two homes owned by the registered provider and it was not clear from the duty rota how much time the manager spends at The Moorings. Moorings, The DS0000015546.V329399.R01.S.doc Version 5.2 Page 24 Records in respect of residents monies held for safekeeping on their behalf were well maintained. Staff working at the home have received supervision However supervision of staff is not carried out regularly so as to ensure that staff practices are monitored and consistent. There was some evidence that checks in respect of the maintenance and repair of gas, electrical, fire safety and mechanical equipments and systems at the home were carried out on a regular basis and staff working at the home undertake regular fire safety exercises. However records in respect of maintenance and checks carried out were not maintained in good order so as to evidence that where issues have been identified that the appropriate action had been taken to address these issues. For example there was record in respect of a fault detected with the homes emergency lighting and fire alarm system. There were no records available to evidence what action had been take so as to rectify these issues. Moorings, The DS0000015546.V329399.R01.S.doc Version 5.2 Page 25 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 2 X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 1 9 1 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 1 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 2 2 X X X X X 3 STAFFING Standard No Score 27 1 28 2 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 2 X 2 Moorings, The DS0000015546.V329399.R01.S.doc Version 5.2 Page 26 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 OP1 Regulation 4 Requirement The homes statement of purpose must be an accurate reflection of the services provided by the home, be kept up to date and made available to residents and others in accordance with Regulation. Timescale for action 30/08/07 2. OP3 14(1) (c) 3. OP7 15(1) (2) So far as it is practicable the 30/05/07 service user or their relative must be consulted when carrying out an assessment of the persons needs. The plan of care for each 30/05/07 individual must be accurate, kept under review and revised at any time where there is a change to the care and treatment to be provided This requirement has not been met and is outstanding from the previous two inspections. Risks to the health, safety and welfare of people living at the home must be assessed and managed 4. OP8 13(4) (a) (b) & (c) 30/07/07 Moorings, The DS0000015546.V329399.R01.S.doc Version 5.2 Page 27 This requirement has not been met and is outstanding from the previous five inspections and the timescales of 31/05/06 & 31/10/06 have not been met. 5. 6. OP9 OP12 12(1) 16(2) (m) & (n) People living at the home must receive the medical treatment they require. A programme of activities must be arranged and implemented which meets the wishes and needs of the people living at the home. This requirement has not been met and is outstanding from the previous four inspections and the previous timescales of 31/05/06 & 31/10/06 have not been met. 30/04/07 30/06/07 7. OP15 16(2) (i) 8. OP16 22 Food and drink must be offered 30/04/07 at any reasonable time as required by people living at the home. Complaints must be received and 30/05/07 dealt with in accordance with the homes policy and procedure and the provisions of regulation 22 of the Care Homes Regulations 2001. This is a repeat requirement. The previous timescale of 31/10/06 has not been met. 9. OP18 13(6) People living at the home must be protected from abuse, harm and neglect. This is a repeat requirement. The previous timescales of 31/05/06 & 31/10/06 has 30/05/07 Moorings, The DS0000015546.V329399.R01.S.doc Version 5.2 Page 28 not been met 10. OP27 18 Staffing levels must be reviewed in accordance with the changing needs of the people living at the home and the numbers of staff employed must be sufficient to meet the needs of residents. This is a repeat requirement. The previous timescales of 31/05/06 & 31/10/06 have not been met 11. OP29 19 & sch. 2&4 30/04/07 People must only be employed to work at the home once all of the checks as required by regulation have been carried out and are satisfactory. This requirement has not been met and is outstanding from the previous two inspections. The previous timescale of 30/06/06 & 30/09/06 have not been met. A Statutory Requirement Notice has been issued in respect of the registered providers failure to ensure that all of the checks as required by regulation for the protection of people living at the home are carried out before a person is employed to work at the home. 12. OP30 18(1) (c) Staff working at the home must staff receive training appropriate to the work they are to carry out. This requirement is outstanding from the Moorings, The DS0000015546.V329399.R01.S.doc Version 5.2 Page 29 30/05/07 22/07/07 previous two inspections and the timescales of 31/05/06 & 31/10/06 have not been met. A Statutory Requirement Notice has been issued in respect of the registered providers failure to ensure that staff working at the home are provided with training appropriate for the work they are to perform. 13. OP37 4, 17, & 19 Records as required by 30/05/07 regulation in respect of the home are maintained in good order are accurate and so far as it is practicable are made available for inspection upon request. This requirement is outstanding from the previous inspection and the timescales of 30/09/06 has not been met. There must be a robust and consistent procedure in place for ensuring that the systems and equipment for detecting and warning of an outbreak of fire at the home are regularly checks and maintained in good working order. 14. OP38 23(4) 30/05/07 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 OP15 Good Practice Recommendations Meals should be served in a congenial setting where residents have time to enjoy their meal with the support the need DS0000015546.V329399.R01.S.doc Version 5.2 Page 30 Moorings, The 2. 3. 4. OP19 OP28 OP36 More could be done so as to make the environment more homely and comfortable for residents. A minimum of 50 of care staff working at the home should achieve NVQ level 2 in care. All nursing and care staff should receive regular supervision. Moorings, The DS0000015546.V329399.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Moorings, The DS0000015546.V329399.R01.S.doc Version 5.2 Page 32 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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