Inspection on 30/06/06 for The Moorings

This inspection was carried out on 30th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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

The Moorings 02/07/07

The Moorings 12/02/07

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 Key Unannounced Inspection 30th June 2006 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.V300428.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.V300428.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 514474 01268 514477 moorings@independent-homes.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.V300428.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 27th January 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.V300428.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 10th August 2006. Lead inspector Carolyn Delaney carried out the inspection. As part of the inspection process a number of the Commissions ‘ Have your say about..’ service users questionnaires are normally posted to the home so as to obtain the views of the people who live at the home. However as the people at the Moorings would be unable to make judgements about the level of services provided these were not provided at this time. Three residents living at the home were spoken with during the inspection visit. The relatives of twenty residents at the home were contacted by post so as to offer them the opportunity to make comments about the services provided by the home. At the time of completing this report eleven of these people had responded. Information regarding health and social care professionals who are involved with the care of residents living at the home was requested prior to the inspection. However this was not provided and the views of these people will be sought and incorporated into the next key inspection report. 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 five people living at the home were examined. Four members of staff were spoken with during the inspection. Duty rotas were assessed. Records in respect of staff recruitment, training and supervision were not available for inspection. 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. Moorings, The DS0000015546.V300428.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: More information must be obtained about a persons needs before they are offered a place at the home and this information must be used to make the decision that the home will be able to meet the persons needs taking into Moorings, The DS0000015546.V300428.R01.S.doc Version 5.2 Page 7 account the needs of the people already living at the home and the resources available. Care plans could be better organised and more clear in respect of the nursing and care needs of the people living at the home and staff could pay much more attention to basic personal hygiene needs of residents including nail and oral care and ensuring that residents are dressed in clean and appropriate clothing. A number of residents looked dishevelled and uncared for on the day of the inspection. A number of resident’s relatives commented that more in the way of activities and stimulation could be provided. There were no activities provided for residents on the day of this and previous inspections and residents who are mobile and tend to wander are not provided with any form of stimulation or occupation. One relative who completed a comment card said that some residents had enjoyed watching television however it had been broken by a resident and that staff had removed it, however that no replacement had been provided. Staff working at the home do not always offer residents the opportunities to make choices where they can regarding care and daily activities. Meal times are chaotic and the routines at mealtimes does not ensure that the more dependent residents receive their meals with the level of support they require while facilitating independence for the more capable residents. While residents and their relatives are generally more satisfied with the level of care provided by the home and this has been reflected in the reduction in the number of complaints made to the home those people who have has cause to complain did not feel that complaints were resolved satisfactorily. One relative commented that ‘nothing seems to get resolved’ and another said that a residents glasses and dentures had been missing since Christmas and that nothing had been done about it. Some people living at the home are at risk of sustaining injury and harm at the hands of other residents who display aggressive and unpredictable behaviour. Staff are not trained or skilled in dealing with aggression and therefore do nor protect the more vulnerable residents satisfactorily. While there have been improvements in the general environment and in particular the cleanliness of the home, more could be done to make communal areas and residents bedrooms more comfortable and homely. Staffing levels and the routines and practices at the home should be reviewed so as to ensure that residents are supported according to their needs, in particular their needs regarding personal hygiene, maintaining safety and mealtimes. A number of resident’s relatives commented that they did not feel that there were always enough staff on duty for the needs of the people who live there. Moorings, The DS0000015546.V300428.R01.S.doc Version 5.2 Page 8 Records to evidence that staff have been employed in a robust manner with all of the checks as required by regulation must be kept up to date and available for inspection upon request. Overall the home while better managed than under the previous owners is not run for the benefit of the residents. There are a number of areas, which require improvement. At the time of this inspection only 13 of overall standards inspected and 10 of key inspections were met. The Moorings has been assessed as a level 1 home, which provides a poor level of service. 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. Moorings, The DS0000015546.V300428.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.V300428.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, & 6 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Information about the home has not been reviewed and amended in light of the change of ownership and does not accurately reflect the homes aims and objectives and the services it provides. Assessments of people needs are carried out prior to them being offered a place at the home however they are not sufficiently detailed so as to determine that the home will be the best place for the person to live. EVIDENCE: Due to the nature of their illness the people living at the home are generally not capable of making a decision as to whether the home would be suited to their needs and rely on others such as family or health and social care professionals making this decision on their behalf. Moorings, The DS0000015546.V300428.R01.S.doc Version 5.2 Page 11 The homes service users guide and statement of purpose have not been updated in light of the change in ownership in February 2006 and the information available is not detailed so as to provide prospective service users relatives or Commissioners with a good overview of the service to enable them to determine that The Moorings will meet the needs of the person moving into the home. The assessments for two residents who have moved into the home and one for a person due to move into the home on the day following the inspection were assessed. These were generally lacking in detail and what information was recorded it was not specific to the individual’s nursing and care needs. For example for one resident there was no information recorded about their behavioural needs, mobility eyesight or hearing and there was no record of what medicines the person was prescribed. The lack of recorded information about peoples needs is particularly significant as the majority of people moving into the Moorings are not capable of expressing their needs to staff. The Moorings does not provide intermediate or rehabilitative care. Moorings, The DS0000015546.V300428.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 at least once during a 12 month period. 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. While there have been some improvements in this area particularly in respect the administration of medicines to residents, the information recorded for each person living at the home is not sufficiently detailed or kept up to date so as to ensure that care is delivered in a proper and consistent way. Staff do not pay enough attention to residents basic personal care needs or ensure that residents have the necessary aids so as to maximise independence and quality of life. EVIDENCE: There have been some improvements in how information about residents is recorded in care plans however information is often conflicting and does not reflect the needs of the individual. This is particularly so where there have been changes in a persons health. Some residents have more than one care plan for a particular need both containing different and conflicting information. Moorings, The DS0000015546.V300428.R01.S.doc Version 5.2 Page 13 It was noted that where one resident had sustained a number of falls their plan of care in respect of managing the risk had not been updated. This was found to be the case for a number of care plans. Information recorded about the risks to individuals such as risk of falls, developing pressure sores etc is poorly recorded and not updated properly so that information available is accurate and can assist staff in carrying out care and supporting residents. This is particularly important, as the majority of people living at the home cannot always make staff aware of their needs. Where risk have been identified it was not clear as to how these risks were to be managed so as to minimise the impact upon residents. It is also noted that the local tissue viability nurse specialist who visited the home some months prior to this inspection did not feel in her opinion that staff acted in accordance with her instructions and advice in respect of managing existing pressure sores and minimising the risks to residents of developing pressure area damage. It was disappointing to note that records are not maintained on a daily basis for each resident and where important information was recorded there was no evidence of any follow up action by staff. For example it was recorded for one resident that they had refused to go to bed and that their legs were swollen. There was no further information recorded as to what action staff took, whether this was a regular occurrence or an isolated incident. Three of the eleven residents relatives who completed comment cards said that they were not always consulted regarding care where the resident is not able to make decisions independently. One said that they were not always kept informed of important matters affecting their relative. There have been changes to the arrangements and routines at the home so as to ensure that the residents receive their medicines at the appropriate time. Records in respect of medicines administered to residents were well maintained and where residents had refused medicines this was clearly recorded. Medicines at the home were noted to be stored safely and securely. Many of the residents appear to be better cared for and two relatives made comments to this effect. However a number of residents looked dishevelled with hair uncombed and some of the male residents were unshaven. Some residents clothing was stained and dirty. More attention could be paid to basic personal care and in particular mouth and nail care. A number of resident’s relatives who completed comment cards also commented that personal care could be better and one relative said that her mother’s dentures and glasses had been missing since Christmas and despite having reported this; staff have not done anything about it. Moorings, The DS0000015546.V300428.R01.S.doc Version 5.2 Page 14 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, 13, 14 & 15 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The home does not provide suitable and regular forms of activities and stimulation for the people who live there. Resident’s capacity for making decisions and expressing preferences is not maximised. Residents are not supported at meal times in a manner, which promotes a congenial setting for the more able residents living at the home while ensuring the more dependent people are supported according to their needs. EVIDENCE: On the day of the inspection as at previous inspections there was very little in the way of activities or stimulation provided for the people living at the home. A number of residents who are mobile and who tend to wander around the home were not provided with any form of occupation or stimulation. Other less mobile residents were not provided with any stimulation. Some staff did spend time chatting with residents but on the whole there was very little in the way of activities provided. Two of the resident’s relatives who returned completed comment cards commented that there could be more activities provided. One Moorings, The DS0000015546.V300428.R01.S.doc Version 5.2 Page 15 relative also commented that residents could spend more time in the garden during the summer. A relative commented that they had donated two televisions to the home last year and that since then one had been broken by a resident and had not been replaced. Each of the eleven residents relatives who completed comment cards said that they were welcomed by staff / owners at anytime. Ten of the eleven said that they could visit their relative in private. One commented that they only had access to the resident’s bedroom for any private consultation. Many of the residents living at the home are not capable of making decisions about their care. However where residents would have capacity for making choice this is not always facilitated. For example on the day of the inspection it was noted that drinks were not readily available in between meal times. When this was discussed with the nurse in charge staff were asked to provide cold (as it was a warm day) drinks for all residents. Residents who could have made a choice as to what type of drink they would wish to have were not offered this opportunity. The meals served to residents on the day of the inspection looked appetising and residents who were spoken with said that they enjoyed lunch. A significant number of residents require assistance of staff at mealtimes. Some residents require the assistance of two members of staff to access the dining area and other residents are dependent upon staff for assistance with feeding. As observed on previous inspections lunchtime was very chaotic and staff struggled to support residents in a proper manner. Lunch was served to some residents while other were being seated. This was causing some disruption to the serving of the meal and also did not allow for adequate supervision and support of those residents who are dependant upon staff assistance. The suggestion made at previous inspections to provide meals in two sittings so as to best utilise staffing resources and provide a proper level of support for all residents at the home, had not been implemented. Moorings, The DS0000015546.V300428.R01.S.doc Version 5.2 Page 16 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 & 18 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. While improvements have been made and there has been a reduction in the number of complaints received about the service residents relatives do not feel confident that complaints are handled appropriately. Staff are not trained appropriately so as to protect residents from risks of unnecessary harm. Staff do not always treat residents in a way, which protects them from neglect. EVIDENCE: Seven of the eleven residents relatives who completed surveys said that they have had reason to make complaints about the services provided by the home, the majority of these had been made prior to the change of ownership at the home. However those who had cause to complain since the change of management did not indicate that they were satisfied with the action taken by the home. One relative commented that ‘things do not ever seem to be resolved’. This was echoed by a relative who contacted the Commission by telephone and who had expressed concerns to staff about injuries sustained to their father in the home. One relative commented that it was often difficult to communicate with some staff who have been employed from overseas due to their poor command of English language and one relative commented that the only real point of contact was the homes acting manager who is responsible for managing on of the company’s other home and therefore spends insufficient time at the home. Moorings, The DS0000015546.V300428.R01.S.doc Version 5.2 Page 17 There was no evidence available in respect of the training and support made available for staff so as to protect the people who are very vulnerable living at the home from abuse, harm or neglect. Records indicate that staff have received training about Dementia Awareness. However it was not clear from observing how staff interact and support some residents that they were fully aware of how to deal with resident’s violent and aggressive behaviours. A number of people living at the home sustain injuries as a result of altercations with other residents and it is not evident that all measures have been implemented so as to minimise these risks and to protect those people who are at particular risk. There are shortfalls in some areas of personal care and some staff are neglectful in ensuring that residents have the necessary support aids such as glasses and hearing aids etc. that they require so as to enhance the quality of their lives. Moorings, The DS0000015546.V300428.R01.S.doc Version 5.2 Page 18 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, 20 & 26 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. While improvements have been made in terms of the furniture and removal of old carpets from communal areas the home environment is not overall homely and comfortable and residents are not supported in accessing the garden space when weather permits. EVIDENCE: Since the change in ownership at the home there have been improvements made in respect of the environment. Old carpets have been removed and replaced with vinyl type floor coverings. This has improved the persistent problem of odour control within the home and it is positive to note that the home was clean and free from odours at this and the last two visits made to the home. The proprietor has also purchased some new chairs for the communal areas. Moorings, The DS0000015546.V300428.R01.S.doc Version 5.2 Page 19 However there is much to be done so as to provide a homely atmosphere for residents at the home. A number of bedrooms are sparsely furnished and in need of redecoration. Some of the furniture such as wardrobes are old with broken doors and fixings etc. Communal areas such as the lounges are also in need of redecoration and the arrangement of resident’s chairs could be reviewed so as to provide a more homely and congenial atmosphere for the people living at the home. The home has an attractive garden area however there was little evidence to suggest that those residents who would be capable of accessing the garden are supported in doing so. On the day of the inspection it was noted that the door in one of the lounge areas, which leads to the garden, was open but a chair placed in the doorway restricted access. This not only restricted the freedom of movement of residents but could also cause potential injury to a resident if they attempted to move the chair to go out into the garden. Moorings, The DS0000015546.V300428.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 at least once during a 12 month period. 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. Records as required by legislation in respect of staff working at the home were not available for inspection. Staff are not trained appropriately to manage the level of physical aggression displayed by some of the people who live at the home. EVIDENCE: Duty rotas indicated that staff do not generally work excessive hours and that all staff have appropriate off duty time each week. The home employs two nurses and seven care staff to work during the morning, two nurses and five care staff for the afternoon / evening duty and one nurse and two care staff at night. Of the eleven relatives who completed comment cards six expressed the opinion that there were not always sufficient staff on duty at the home. A further two relatives who telephoned the Commission also felt that more staff were needed to care for the residents living at the home. One relative commented that they felt that things were ‘getting better under the new management’ During this and recent random inspections carried out to the home it was clear that the key times such as meal times could be very chaotic. For example at lunchtime on the day of the inspection staff were assisting some residents to the dining room where other residents had commenced their meal. This was Moorings, The DS0000015546.V300428.R01.S.doc Version 5.2 Page 21 causing some disruption to the serving of the meal and also did not allow for adequate supervision and support of those residents who are dependant upon staff assistance. It had been suggested at previous inspections that due to the needs of the people living at the home and the number of staff employed that it may benefit residents if the lunch was served over two sittings so as to allow the more capable people to enjoy their meal without disruption and to allow staff to provide support for the less able people. However there was no evidence that this practice had been implemented. It was reported that as the homes acting manager was on annual leave that there was no access to records in respect of staff recruitment and training. During the inspection there was evidence that staff were not trained and competent in dealing with verbal and physical aggression displayed by some residents as part of their deteriorating mental health. For example two members of staff were observed trying to coax and cajole a resident who was being verbally aggressive towards them, however staffs interaction only aggravated the situation and resulted in a deterioration in the residents behaviour. The decision made in respect of this outcome is based upon lack of access to records and the findings of the previous random inspection (23/5/06) and the last full inspection (27/01/06) where records did not provide evidence that staff were recruited to work at the home in a consistent and safe manner with all of the checks as required by regulation having been carried out in a satisfactory manner so as to protect the interests and welfare of the people living at the home. Moorings, The DS0000015546.V300428.R01.S.doc Version 5.2 Page 22 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, 33, 35, & 38 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The Moorings is not managed effectively in the best interests of the people who live there. Records were not available so as to determine that the home is maintained so as to protect the health, safety and welfare of residents and staff. EVIDENCE: The current management arrangements at the home are that a registered manager of another of the company’s homes located in Rayleigh spends up to three days per week at the home. While the manager is a competent and capable individual the level of input required so as to deal with the long standing issues is substantial and the current arrangements are not sufficient. Moorings, The DS0000015546.V300428.R01.S.doc Version 5.2 Page 23 A number of people have commented that the manager does not spend enough time at the home. This has an impact upon the rate and level of improvements made since the new owners bought the home in February 2006. The registered providers do not carry out unannounced visits to the home in accordance with Care Homes Regulation 26 so as to consult with residents and /or their representatives and make an inspection of the homes premises in order to form an opinion as to the standard of care provided by the home. Records in respect of monies held on behalf of residents and the supervision of staff were not available so it was not possible to determine that the national minimum standard and regulatory requirement in respect of this has been met in a satisfactory way. Records in respect of the checks, maintenance, repair and renewal of fire, gas, electrical and other mechanical systems and equipment at the home were not available for inspection. It was therefore not possible to determine that appropriate checks are made so as to provide a safe environment for the people who live in, work at or visit the home. Moorings, The DS0000015546.V300428.R01.S.doc Version 5.2 Page 24 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 1 X 2 1 3 X HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 1 2 X X X X 1 X 3 STAFFING Standard No Score 27 2 28 X 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 1 X 1 X 2 1 Moorings, The DS0000015546.V300428.R01.S.doc Version 5.2 Page 25 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. 1. Standard OP1 Regulation 4, 5 & 6 Requirement The registered persons must ensure that information as required by regulation in respect of the home readily available and kept up to date. This requirement has not been met and is outstanding from the previous inspection and the timescale of 31/05/06 has not been met. 2. OP3 14 (1) (2) The registered persons must ensure that people are only offered a place at the home following a detailed assessment of the persons nursing and care needs and a decision has been made that taking into account the individuals specific needs, the needs of the current residents and the resources available at the home, that the home can best meet the needs of the individual. The registered person must ensure that care plans and other information recorded about residents needs is maintained up to date and accurate and that DS0000015546.V300428.R01.S.doc Timescale for action 31/10/06 30/09/06 3. OP7 15(1) (2) 31/10/06 Moorings, The Version 5.2 Page 26 staff act in accordance with these plans consistently so as to ensure that residents receive appropriate care and treatment. This requirement has not been met and is outstanding from the previous three inspections and the timescale of 31/05/06 has not been met. 4. OP7 12(1) (2) The registered persons must 30/10/06 ensure that staff act in accordance with each residents needs and that personal care needs are met and that residents have the necessary aids so as to ensure maximum independence and an improved quality of life. 31/10/06 The registered person must ensure that so far as it is practicable that people living at the home are protected from harm and injury, through assessment of risks and planning care to minimise these risks. This requirement has not been met and is outstanding from the previous four inspections and the timescale of 31/05/06 has not been met. 6. 7. OP10 OP12 12 16(2) (m) & (n) The registered persons must 30/09/06 ensure that residents receive an acceptable level of personal care. The registered person must 31/10/06 ensure that people living at the home are provided with a range of suitable activities which meet their needs and so far as practicable their wishes. This requirement has not been met and is outstanding from the previous four inspections and the Moorings, The DS0000015546.V300428.R01.S.doc Version 5.2 Page 27 5. OP8 13(4) (a) (b) & (c) 8. OP14 12 (2) (3) 9. OP15 12 (2) (3) 16(2) (i) 10. OP16 22 11. OP18 13(6) previous timescale of 31/05/06 has not been met. The registered persons must ensure that residents are encouraged where possible to make choices about the care they receive and their capacity for independence in their daily lives is considered when planning and delivering care and support. The registered persons must ensure that residents are supported according to their needs and capabilities at mealtimes in accordance with planned care. The registered person must ensure that all complaints are dealt with and responded to in accordance with the homes complaints policy and procedure and that records as required by regulation in respect of complaints are maintained and made available for inspection upon request. The registered person must ensure that people living at the home are so far as it is practicable protected from harm and abuse and abuse by neglect. Elements of this requirement are outstanding from the previous two inspections and the previous timescale of 31/05/06 has not been met. 31/10/06 30/09/09 31/10/06 31/10/06 12. OP19 12, 13 & 16 12, 13 & 16 13. OP24 The registered persons must ensure that residents have access to communal areas including outdoor areas. The registered persons must ensure that residents have access to and the use of furniture, which is well safe and well maintained. DS0000015546.V300428.R01.S.doc 30/11/06 30/09/06 Moorings, The Version 5.2 Page 28 14. OP27 18 The registered person must ensure that appropriately trained and skilled staff are employed at the home in suitable numbers so as to meet the needs and ensure the protection of the people living at the home. Elements of this requirement are outstanding from the previous three inspections and the timescale of 31/05/06 has not been met. 31/10/06 15. OP29 19 & sch. 2&4 The registered person must ensure that staff are employed at the home only after all appropriate checks including references, checks in respect of previous employment and Criminal Records Bureau disclosures have been obtained. This requirement has not been met and is outstanding from the previous two inspections. The previous timescale of 30/06/06 has not been met. 30/09/06 16. OP30 18(1) (c) The registered person must ensure that staff working at the home receive training in respect of the work they are to perform, the needs, welfare and safety of the people living at the home. 31/10/06 17. 18. OP31 OP33 This requirement is outstanding from the previous inspection and the timescale of 31/05/06 has not been met. 8 The registered persons must appoint a suitably qualified person to manage the home. 4, 24 & 26 The registered person must ensure that the home is DS0000015546.V300428.R01.S.doc 31/10/06 31/10/06 Page 29 Moorings, The Version 5.2 managed in a manner, which promotes the health, wellbeing and safety of the people who live there and make unannounced visits to the home and report to the Commission in accordance with regulation 26 so as to obtain the views of residents and their relatives and staff, and make an assessment of the premises and facilities so as to make a determination about the level of services provided by the home. 19. OP35 16(2) (l) & 17 The registered persons must ensure residents have access to monies held on their behalf and that records are maintained in respect of any monies held by the home on behalf of residents and that these records are made available for inspection upon request. 4, 17, & The registered persons must 19 ensure that records as required by 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. 12, 13, 17 The registered person must & 23 ensure that all checks in respect of maintenance, repair and renewal of fire, electricity, gas and mechanical systems and equipment are kept up to date and made available for inspection upon request. 31/10/06 20. OP37 30/09/06 21. OP38 30/09/06 Moorings, The DS0000015546.V300428.R01.S.doc Version 5.2 Page 30 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Moorings, The DS0000015546.V300428.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: 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 Moorings, The DS0000015546.V300428.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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