Inspection on 31/07/07 for The Moorings

This inspection was carried out on 31st July 2007.

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

The Moorings 03/08/06

The Moorings 08/12/05

The Moorings 02/03/05

The Moorings 06/07/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE The Moorings Church Road Earsham Bungay Norfolk NR35 2TJ Lead Inspector Ruth Hannent Unannounced Inspection 31st July 2007 10:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Moorings DS0000027272.V347831.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. The Moorings DS0000027272.V347831.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Moorings Address Church Road Earsham Bungay Norfolk NR35 2TJ 01986 892269 F/P 01986 892269 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) Mr Malcolm Paul Blackham Mr Robert James Blackham, Mrs Sally Crawford Mrs Frances Friday Care Home 39 Category(ies) of Dementia - over 65 years of age (34), Old age, registration, with number not falling within any other category (39) of places The Moorings DS0000027272.V347831.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Thirty-nine (39) Older People may be accommodated of which thirtyfour (34) may have dementia. Total number not to exceed thirty-nine (39). The home shall have one person on shift at all times who has received training in dementia awareness. 3rd August 2006 Date of last inspection Brief Description of the Service: The Moorings is an extended property situated in six acres of grounds in the village of Earsham, close to the town of Bungay. The home is registered to accommodate up to thirty-nine older people but due to recent conversion of double bedrooms to single rooms, the home currently accommodates thirtyfour service users in twenty-eight single and three double bedrooms. The three double bedrooms have an en-suite facility. Four single rooms do not but there are plans for en-suite facilities to be provided in two of these. Bedrooms are on the ground and first floor with the first floor accessed by passenger lift. There is car parking to the front and the side of the property. Email - info@chevington.f9.co.uk Fees - £395 - £550 The Moorings DS0000027272.V347831.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report has been completed after an inspection visit that was carried out over a period of five hours with the assistance of the Manager and Proprietors. The Manager had returned to the Commission the completed AQAA (Annual Quality Assurance Assessment) prior to this visit. The information written in this assessment has been used in part as evidence to form judgements on the service provided. No comment cards were received from residents or relatives on this occasion but comments on the Homes quality monitoring systems and quarterly audits have been used. Throughout the day a tour of the building took place with residents spoken to and staff members observed and also talked to. Records were looked at that include care plans, maintenance files, staff training records, personnel files and residents finance records. The Home has to be commended on its aim to continuously develop and improve the service offered to residents. Although a well run, comfortable home there remain areas around dementia care that could be developed to enhance the lives of those who live there even further. What the service does well: The Home has a team of people, from the Proprietors to the domestic staff, who work as a team and all strive to offer a good service. All take an active interest in the whole home that has a comfortable, homely feel. The residents have plenty of space to be able to move from area to area with very pleasant gardens to sit in. The staff are recruited after very thorough scrutiny to ensure the person is suitable and then offered comprehensive induction and training. The Home has a good procedure for managing concerns/complaints and actively ensures the residents are cared for safely. They will always consult with the Inspector over any major concerns and complete the appropriate paperwork. The monitoring of the service through audits and questionnaires is thorough and robust with a constant strive to improve the service for the residents. The Moorings DS0000027272.V347831.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. The Moorings DS0000027272.V347831.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Moorings DS0000027272.V347831.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People do not move into the home until they have been assessed to ensure that the service offered at the Home is suitable. EVIDENCE: The Home has only admitted one new resident since the previous inspection. This person’s file was looked at in depth. The admission paperwork was appropriately completed and gave a picture of the needs of the person. The resident was spoken to throughout the day and it was evident that the relevant information originally gathered showed this person was suitably placed at the Moorings. The Moorings DS0000027272.V347831.R01.S.doc Version 5.2 Page 9 The Manager stated that people are encouraged to visit and on talking to the Proprietors the aim is to have a web site up and running shortly to give people an insight into the home to help people make the decision as to the suitability of the Home for their particular needs. The Moorings DS0000027272.V347831.R01.S.doc Version 5.2 Page 10 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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents do have a care plan that matches their needs and have good care support when required with all tasks carried out appropriately. EVIDENCE: The residents care plans are held in the carers office. In all three residents care plans were looked at, from someone who had been in the home a long time to the latest person to be admitted. The care plans do give a picture of the needs of the individual and do hold daily records of the care of the person but due to the paperwork in the files falling from the folders and the larger files loosing many of their pages the system used could be improved to ensure staff can turn straight to the relevant page when required. (Recommendation). The Moorings DS0000027272.V347831.R01.S.doc Version 5.2 Page 11 The most recently admitted resident was spoken to who, although was not able to answer current questions, gave lots of information about her past that was seen in the care plan. This person was very happy and ‘as long as they do not give me meat I will be fine’. (This person has her choices of likes and dislikes in the kitchen that are all meat free). The Home works very closely with the local GP practice and the residents nearly always see the same GP. The health care notes are also held in the carers office and information recorded by the District Nurse or the GP are transferred into the care plan folder on each visit or telephone conversation. The medication was being administered at lunchtime from a suitable locked trolley. The Senior on duty was able to state the procedures used in the Home. The medication charts had been completed correctly and on observation it was noted that a dot was placed on the administration chart on taking the medication to the person and only signed for once it was clear the medication had been administered. This staff member appeared very competent and carried out the task well and without interruption. Throughout the day staff were observed and conversations were listened to. All care was delivered with dignity in an appropriate manner as people were assisted around the building and conversations were suitable and encouraging when sometimes people were having difficulty understanding. It was also noted that staff induction plays a big part in the staff’s understanding of how to assist residents correctly. The Moorings DS0000027272.V347831.R01.S.doc Version 5.2 Page 12 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): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents do find the lifestyle suits their interests and needs and receive visitors whenever they wish. The meals do offer choice but could be more appealing. EVIDENCE: The Home has introduced life story books for families and relatives to be actively involved in. The development and value of these books will be come more evident as the Home introduces the Key Worker and gets them actively using and adding to the content as they get to know the whole person. On the day of the visit an entertainer arrived to have a”good old sing along” session. This was observed for a while, and noted was the enjoyment on many faces with those who were able singing out and smiling. Activities are planned regularly and records of who has participated are kept. With the development of the life story books more varied stimulation should be seen in the future. One plan mentioned by the Manager is to have more ‘chore’ related activities and in fact on the day of this visit, when a resident had a The Moorings DS0000027272.V347831.R01.S.doc Version 5.2 Page 13 duster placed in her hand she became very contented and started to dust and polish the furniture. Visitors are able to come and go as they wish and are able to join in as much as they would like. The signing in book at the entrance shows many visitors coming and going. Some comment cards on how the service is seen were sent out to family members by the Commission, but none had been returned at the time of completing this report. The mealtime was observed at length and it was good to notice that the cook had spoken to the new resident to find out her likes and dislikes. The food for the day was corn beef hash or cheese flan. A sample of the meal was also tasted and although choice was available the meal quality could have been improved with better presentation. (Recommendation). The meal time is also a time for food to be enjoyed. On the previous inspection and again on this inspection it was noted that residents are helped to the table well before the meal is ready to be served. It is not advisable for people with short term memories to be at the table for a length of time with nothing in front of them. (Recommendation). The residents now have the opportunity to eat fresh fruit every afternoon that is cut into sizable pieces for the person to manage alongside fortified milky drinks that residents say they really enjoy. This is an improvement since the last inspection and is to be commended. The Moorings DS0000027272.V347831.R01.S.doc Version 5.2 Page 14 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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s complaints are listened to and acted upon and they are safeguarded from abuse. EVIDENCE: The manager has received three complaints/concerns since the last inspection. The file was looked at with evidence seen of the way the complaints are handled and the outcomes that resolved the issues. The Home has a very user friendly complaints procedure that is issued to all new residents and is also displayed in the Home. No comment cards have been received to tell the Commission if any one is not happy with the service and the Manager states ‘We try to nip any problems in the bud before they have a chance to escalate’. The Home has worked hard at ensuring staff are very aware of potential abuse. The induction process takes a new staff member through the signs and symptoms and how to report concerns. Answer sheets on questions on this subject were held in staff files (seen) with questions such as what is whistle blowing and how is the whistle blower protected. On the day of the inspection one new staff member was watching a video on potential abuse with the help of the designated training staff member. The Moorings DS0000027272.V347831.R01.S.doc Version 5.2 Page 15 The Moorings DS0000027272.V347831.R01.S.doc Version 5.2 Page 16 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, 23 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Home environment is suitable clean and comfortable ensuring residents live in a well-maintained building. EVIDENCE: A tour of the building took place with six bedrooms seen that were picked at random. The Home is well maintained with a rolling programme of improvement and redecoration. Everywhere is light and suitable. Throughout the building there are many areas where someone can sit and relax in comfort. Noted were the much improved chairs and tables in the dining room and new curtains in other areas. The bathrooms are in need of improving which is a The Moorings DS0000027272.V347831.R01.S.doc Version 5.2 Page 17 project already planned by the Home with a change of décor for the walls and curtains to be hung at the windows. The last inspection noted that not all residents could have a bath if they were dependent on hoist transfers. The Home has now improved this situation and has raised one of the baths to allow a hoist to be wheeled underneath allowing all residents to have a bath if they so wish. Each of the six bedrooms seen were all clean, nicely furnished and had residents own belongings making them homely and a room that was theirs. The rooms are all slightly different in shape and size giving the Home character. The outside grounds are very attractive with colourful flower beds and nice areas to sit. The main lounge has large patio windows that were opened out on the hot day of the inspection for residents to look onto the large lawn area and enjoy the wildlife. Throughout the walk around it was noted how clean and tidy everywhere was and that no area had any unpleasant odours. The laundry assistant was spoken to and the room and facilities she works in were discussed. The machines are suitable for sluice washing and noted by early afternoon all washing had been completed and the room was cleared and tidy. The Moorings DS0000027272.V347831.R01.S.doc Version 5.2 Page 18 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 and 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are cared for by staff who are skilled, qualified and recruited appropriately to ensure they are competent to do the work they are employed to do. EVIDENCE: A copy of the staff rota’s had been received along with the AQAA that showed staff are employed in numbers and at the appropriate times to meet the needs of the residents. On the day of this site visit the staff numbers were appropriate and noted were the extra hands available with the meal time as more people were needing assistance at this time. Unfortunately, although enough staff were in the building, it was not always evident that they were in the most suitable place at certain times. Noted was the lack of staff in one dining room while staff were assisting residents in another. Without a staff member being in the dining room and with the residents all sitting with nothing in front of them a situation arose that had to be dealt with by the Manager who happened to be passing as an incident The Moorings DS0000027272.V347831.R01.S.doc Version 5.2 Page 19 occurred. Staff need to be placed so that one area where a number of residents are is not left unattended and (as mentioned previously) ensuring that residents have something to do or occupy them when sitting at the table. (See previous Recommendation). The home works hard to achieve a high number of staff who have an NVQ qualification from domestic staff to senior staff members. Seen on the wall in the staff room was the training and qualifications achieved by each staff member. The training process is carefully planned with the manager and designated training staff member. The skills for care induction pack was being used on the day of the visit and was being completed comprehensively for the new staff member, quietly, away from distractions and at a pace that suited when English was not the first language. The training records are stored in a filing cabinet with one seen at random. Another staff member said ‘we are supported and trained well with regular discussions with Management and support in staff meetings if we are unsure of something’. The personnel file of the staff member being inducted was seen and all relevant paperwork was in place. The Home recruit staff from overseas and use a reputable agency who work closely with the Home to ensure the right personnel are picked for the Home’s needs. Recruitment as a problem for rural homes was discussed with both the Manager and Proprietors. Advertising locally has had limited responses from people who have often been found to be unsuitable and up until now staff from other countries recruited through a stringent process have been successful. The problems are beginning to arise as the Home Office is tightening their procedures and good staff who have worked for a couple of years and wish to stay are made to return to their own country. The Management are working on strategies to ensure that the quality of staff remains high but are finding it more difficult. The Home is to be commended on the quality of the staff they have at present. This was noted throughout the day as people went about their tasks. The Moorings DS0000027272.V347831.R01.S.doc Version 5.2 Page 20 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 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Home is managed and owned by competent people who ensures it is run safely, and in the best interest of the residents. EVIDENCE: Most of this visit was spent with the Manager both looking at records and touring the building. She is a competent and suitably qualified manager who has worked in the Home for many years. She is in the process of gaining more knowledge on the subject of dementia and is part the way through a distancelearning course that she stated is one of the best awareness courses she has The Moorings DS0000027272.V347831.R01.S.doc Version 5.2 Page 21 ever done. Once she has completed she will then encourage other staff to do the training also. The Home must be commended for the excellent job it carries out with quality checks on a regular basis. The Commission receives a comprehensive copy four times a year of who has checked the Home, what needs to be changed and by what timescale. The next quality check will ensure that the changes have taken place and if not why not. The Home also issue questionnaires to interested people who are involved in the home to ask their opinion of the service and the most recent one gave a 90 return. On talking with the Manager and the Proprietors and reading what has been written on the improvements planned for the future - that also includes ‘Investors In People’ - it was clear that the focus is on continuous improvement. The Proprietor has also just completed a full check on all policies and procedures to update the information and remove any documents that no longer apply. The Home encourages families to be responsible for the residents personal allowance but do hold some money for small items such as toiletries. Two accounts were looked at and the money was counted. The balance sheet, receipts and cash were all correct and signed for appropriately. The Home promotes the health and safety of residents by ensuring staff are fully aware of how they should carry out their tasks day by day with good training, induction and regular supervision. Notices are posted around the Home and staff are aware of risks. The water temperature for the baths is displayed in the bathroom and each bath is tested with a thermometer to ensure the water is at the correct temperature. There is also a thermostatic valve that is tested regularly as are the fire alarms, emergency lighting and water checks for legionella. The Proprietors or Manager notify the commission of all accidents and incidents that have happen within the Home. The Moorings DS0000027272.V347831.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 x x 3 x x 3 STAFFING Standard No Score 27 4 28 3 29 4 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 4 x 3 x x 3 The Moorings DS0000027272.V347831.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO 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 OP7 Good Practice Recommendations It is good practice to ensure the care plan folders do not become too full or rip from the folder if regular transferring of paperwork into a non active folder takes place. It also helps stop records being placed out of date order. If residents are to be sat at the table for lunch prior to the meal being served, it would be good practice for an activity to take place and for the cutlery etc to be placed in front of the person when the meal is about to arrive. The presentation and quality of the meal produced could be improved. 2 OP12 3 OP15 The Moorings DS0000027272.V347831.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 The Moorings DS0000027272.V347831.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!