Care Home: Moor Park House Ltd

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What the care home does well The information gathered before admission was detailed, providing staff with a clear picture of each individual, so that they were confident that the assessed needs of people could be adequately met. When asked what the service does well, the responsible individual wrote on the home`s self-assessment, `Individual care plans are developed, which are very comprehensive and include input from relatives. These are reviewed monthly and amended as dictated by the changing needs of the service user. Generic care plans are in place in respect of clinical procedures, which are tailored to the individual. We promote choice and independence and the right to self medicate. Needs are communicated to the care team via daily handovers with work sheets used as aide memoirs so that teams are aware of their respective care duties.` The plans of care were extremely well written documents, providing staff with clear guidance about how the assessed needs of people living at the home were to be met and how people were to be supported to maintain their privacy and dignity. Residents had been involved in the care planning process and a review of care provided was conducted on a monthly basis to ensure that current needs were accurately reflected in the plan of care. One resident said, "The staff are all very good. My needs are definitely being met", and another said, "The staff are very respectful". A variety of external professionals had been involved in the care of people living at Moor Park House to ensure that their health care needs were being appropriately met. The management of medications was good and a range of detailed risk assessments were in place to ensure that systems were implemented to protect the health and welfare of the people living at the home. Relatives spoken to were happy about how visitors were received into the home and they informed the inspectors that the staff were all very respectful, friendly, kind and caring. Sufficient information was provided to people about the use of the local advocacy services to act on their behalf, should they so require and people living at the home were able to have some control over their lives by managing their own finances, should they so wish. Activities were provided both in the home and outside, so that people were able to continue their leisure interests whilst living at the home and so that they were able to maintain links with the community. The routine of the home was fairly flexible and aimed to allow residents their freedom and independence by enabling them to have some control over their lives. Meal times were well managed and people were provided with a choice of nutritious and well-balanced food to ensure adequate dietary intake. Meals Moor Park House Ltd DS0000071357.V362756.R01.S.doc Version 5.2 Page 7were well presented to promote appetite and to aid in nutrition. Those requiring support with eating their meals were assisted in a discreet manner, whilst others were encouraged to eat independently. The manager had recently audited the quality of food served in accordance with people`s preferences, so that any issues raised could be addressed. The complaints procedure was freely available within the home and it was also included within the service users guide so that people were given enough information about how they could make a complaint should they so wish. The policies and procedures in relation to safeguarding adults were in accordance with the Department of Health guidance `No Secrets`, so that people knew the procedure to take should an allegation of abuse be received by the home. The home was tastefully furnished and decorated to a very high standard and the premises, both internally and externally were well maintained providing those living at Moor Park House with a safe, clean, comfortable and homely environment in which to live. The home was pleasant smelling and effective infection control measures were in place to ensure that the health and safety of people was adequately protected. When asked what the service does well, the responsible individual told us, `the level of staff reflects the very high dependency of our clients. Our ratio of care staff achieving a recognised care qualification is over 75%. And we have a positive and successful strategy regarding staff training. We have a stringent recruitment policy in force and all prospective staff are thoroughly vetted via Criminal Record Bureau disclosures and reference procedures. For new staff members the first shift is supernumerary and then they are `shadowed` by an experienced member of staff until their induction is completed and it is felt that the new staff member is competent and confident enough to undertake their duties. Staffing levels were calculated in accordance with the assessed needs of people to ensure that adequate care was delivered. Recruitment procedures and financial arrangements were in place at the home, which demonstrated that those living at Moor Park House were adequately protected. A lot of training had been provided for all staff so that they were kept up to date with current policies, procedures and legislation and so that they were sufficiently trained to meet people`s assessed needs. The home was well managed by competent people and a team of skilled staff, who together had completed a wide range of training so that they were able to deliver the care required by the individual residentsThe registered manager held relevant qualifications, had a lot of experience and was appropriately trained to manage the care home. Those spoken to felt supported by the management of the home. Systems were in place to ensure that the quality of service provided was closely monitored so that any shortfalls identified could be promptly addressed. The health, safety and welfare of residents were protected by the policies, procedures and practices of the home so that any hazards, which could pose a potential risk, were minimised or eliminated. What has improved since the last inspection? As Moor Park House is a new service because of a recent change of provider, this is the first key inspection conducted under the new ownership. However, the registered manager has not changed and we were told that very little changes have been made. As there were no requirements or recommendations made at the last inspection and all the assessed standards were either fully met or exceeded at that time it is difficult to evidence what has improved. However, a consistently high standard of service continues to be provided for those living at the home, which is reflected throughout this report and which is commendable. What the care home could do better: Although the care planning process provided staff with a clear picture of people`s needs one plan of care could have been a little more person centred so that it was more individualised to the resident concerned. One relative wrote on the comment card, `I do feel that my son who is only a young man does not always get enough stimulation, the kind a young person requires`. The manager could audit the provision of activities to ensure that the social care needs of everyone living at the home are consistently met. Comment cards received from people living at the home indicated that they usually or sometimes enjoyed their meals. One person wrote, `the meals can be disappointing`, and another stated, `soup at tea time is too salty to eat`. CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Moor Park House Ltd 81 - 83 Garstang Road Preston Lancashire PR1 1LD Lead Inspector Vivienne Morris Unannounced Inspection 12th June 2008 09:00 X10029.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 Moor Park House Ltd DS0000071357.V362756.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 and Care Homes for Adults 18 – 65*. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Moor Park House Ltd DS0000071357.V362756.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Moor Park House Ltd Address 81 - 83 Garstang Road Preston Lancashire PR1 1LD 01772 883603 01772 883611 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) Moor Park House Ltd Mrs Christine Schofield Care Home 50 Category(ies) of Learning disability (1), Old age, not falling registration, with number within any other category (50), Physical of places disability (50) Moor Park House Ltd DS0000071357.V362756.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only. Care home with Nursing - code N, to people of the following gender:Either. Whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category - Code OP. Physical Disability - Code PD Learning Disability - Code LD (maximum number of places: 1) The maximum number of people who can be accommodated is: 50 Date of last inspection New Service Brief Description of the Service: Moor Park House has changed ownership since the last key inspection and therefore it is classed as a new service. Moor Park House is a modern purpose built home, providing both personal and nursing care for up to fifty people. The home is registered to accommodate older people, younger adults with physical disabilities and one place is available for a younger adult with learning disabilities. Staff are able to meet a diverse range of needs and are led by a team of experienced managers. The home is furnished to a high standard and is set in well-tended gardens with good off road parking for visitors. All bedrooms, except one have full en suite facilities and the home provides a range of communal living and dining areas. Moor Park House is situated on a main road position, near to the city centre, close to a large park and with other amenities in easy reach. The home provides a range of services and activities for the people living there, including a hydrotherapy pool on the ground floor, which is available for leisure or therapeutic use. The fees at the time of the site visit ranged from £405.65 for personal care to £2,576.05 per week for those with complex nursing needs, being funded under continuing care arrangements. Additional charges were being incurred for hairdressing, chiropody, newspapers, toiletries and aromatherapy. Moor Park House Ltd DS0000071357.V362756.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 stars. This means that the people who use this service experience excellent quality outcomes. The unannounced site visit to this service took place over one day during June 2008. This visit formed part of the key inspection process. Every year the provider completes an Annual Quality Assurance Assessment (AQAA). This is a self-assessment, which gives information to the Commission about how the home is meeting outcomes for people using the service and how the quality of service provided is monitored. The self-assessment was completed and submitted, as requested. Some of the information provided in the assessment is included within this report. During the course of the site visit discussions took place with people living at the home, relatives and staff members. Relevant records and documents were examined and a tour of the premises took place, when a random selection of private accommodation was viewed and all communal areas were seen. The inspector closely observed the daily routines and activities, which took place at the home. We sent comment cards to the home in advance of this key inspection, so that staff and people living at Moor Park could provide us with their views about the quality of service provided. We received completed comment cards from seven people living at the home, five relatives and six staff members, who provided, in general positive comments about the service, some of which are included in this report. There were forty-four people living at Moor Park at the time of the site visit. The inspector ‘tracked’ the care of three of these people, not to the exclusion of others using the service. The total key inspection process focused on the outcomes for people living at Moor Park House and involved gathering information about the service from a wide range of sources over a period of time. The Commission for Social Care Inspection had not received any complaints about this service since the change of ownership. Moor Park House Ltd DS0000071357.V362756.R01.S.doc Version 5.2 Page 6 What the service does well: The information gathered before admission was detailed, providing staff with a clear picture of each individual, so that they were confident that the assessed needs of people could be adequately met. When asked what the service does well, the responsible individual wrote on the home’s self-assessment, ‘Individual care plans are developed, which are very comprehensive and include input from relatives. These are reviewed monthly and amended as dictated by the changing needs of the service user. Generic care plans are in place in respect of clinical procedures, which are tailored to the individual. We promote choice and independence and the right to self medicate. Needs are communicated to the care team via daily handovers with work sheets used as aide memoirs so that teams are aware of their respective care duties.’ The plans of care were extremely well written documents, providing staff with clear guidance about how the assessed needs of people living at the home were to be met and how people were to be supported to maintain their privacy and dignity. Residents had been involved in the care planning process and a review of care provided was conducted on a monthly basis to ensure that current needs were accurately reflected in the plan of care. One resident said, “The staff are all very good. My needs are definitely being met”, and another said, “The staff are very respectful”. A variety of external professionals had been involved in the care of people living at Moor Park House to ensure that their health care needs were being appropriately met. The management of medications was good and a range of detailed risk assessments were in place to ensure that systems were implemented to protect the health and welfare of the people living at the home. Relatives spoken to were happy about how visitors were received into the home and they informed the inspectors that the staff were all very respectful, friendly, kind and caring. Sufficient information was provided to people about the use of the local advocacy services to act on their behalf, should they so require and people living at the home were able to have some control over their lives by managing their own finances, should they so wish. Activities were provided both in the home and outside, so that people were able to continue their leisure interests whilst living at the home and so that they were able to maintain links with the community. The routine of the home was fairly flexible and aimed to allow residents their freedom and independence by enabling them to have some control over their lives. Meal times were well managed and people were provided with a choice of nutritious and well-balanced food to ensure adequate dietary intake. Meals Moor Park House Ltd DS0000071357.V362756.R01.S.doc Version 5.2 Page 7 were well presented to promote appetite and to aid in nutrition. Those requiring support with eating their meals were assisted in a discreet manner, whilst others were encouraged to eat independently. The manager had recently audited the quality of food served in accordance with people’s preferences, so that any issues raised could be addressed. The complaints procedure was freely available within the home and it was also included within the service users guide so that people were given enough information about how they could make a complaint should they so wish. The policies and procedures in relation to safeguarding adults were in accordance with the Department of Health guidance ‘No Secrets’, so that people knew the procedure to take should an allegation of abuse be received by the home. The home was tastefully furnished and decorated to a very high standard and the premises, both internally and externally were well maintained providing those living at Moor Park House with a safe, clean, comfortable and homely environment in which to live. The home was pleasant smelling and effective infection control measures were in place to ensure that the health and safety of people was adequately protected. When asked what the service does well, the responsible individual told us, ‘the level of staff reflects the very high dependency of our clients. Our ratio of care staff achieving a recognised care qualification is over 75 . And we have a positive and successful strategy regarding staff training. We have a stringent recruitment policy in force and all prospective staff are thoroughly vetted via Criminal Record Bureau disclosures and reference procedures. For new staff members the first shift is supernumerary and then they are ‘shadowed’ by an experienced member of staff until their induction is completed and it is felt that the new staff member is competent and confident enough to undertake their duties. Staffing levels were calculated in accordance with the assessed needs of people to ensure that adequate care was delivered. Recruitment procedures and financial arrangements were in place at the home, which demonstrated that those living at Moor Park House were adequately protected. A lot of training had been provided for all staff so that they were kept up to date with current policies, procedures and legislation and so that they were sufficiently trained to meet people’s assessed needs. The home was well managed by competent people and a team of skilled staff, who together had completed a wide range of training so that they were able to deliver the care required by the individual residents. Moor Park House Ltd DS0000071357.V362756.R01.S.doc Version 5.2 Page 8 The registered manager held relevant qualifications, had a lot of experience and was appropriately trained to manage the care home. Those spoken to felt supported by the management of the home. Systems were in place to ensure that the quality of service provided was closely monitored so that any shortfalls identified could be promptly addressed. The health, safety and welfare of residents were protected by the policies, procedures and practices of the home so that any hazards, which could pose a potential risk, were minimised or eliminated. 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. Moor Park House Ltd DS0000071357.V362756.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Outcomes Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) Moor Park House Ltd DS0000071357.V362756.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards. JUDGEMENT – we looked at outcomes for the following standard(s): 2 (Adults 18 – 56) and 3 (Older People). Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The preadmission process was thorough enough to ensure that the staff team were confident that individual needs could be met and so that the independence of people could be maximised. EVIDENCE: At the time of the site visit the inspector ‘tracked’ the care of three people living at the home. People’s individual needs had been thoroughly assessed before they were offered a place at Moor Park House, to ensure that the staff team were able to meet these assessed needs, so that people living at the home received the Moor Park House Ltd DS0000071357.V362756.R01.S.doc Version 5.2 Page 11 care required. The written assessments contained detailed information about how the needs of people were to be best met, which was consistently transferred to the plans of care, so that those working at the home were able to access relevant information and provide the care needed. All six comment cards received from residents indicated that they had been given sufficient information about the home to enable them to make an informed choice about moving into Moor Park. One resident told us that they visited beforehand and that the staff took a lot of time and trouble to discuss things with them and another commented, ‘I am a lifelong resident in the area, and so I knew of the very good reputation of my care home’. When asked what the service does well, the responsible individual wrote on the home’s self-assessment, ‘ A comprehensive brochure is provided to prospective service users and an initial enquiry form is completed and followed up with a full needs assessment. Prospective service users and their families are actively encouraged to visit and spend time in the home to ensure that they are making the right choice. It is helpful for them to meet other residents and hear their opinion about the home’. Staff knew about the needs of people and how to access the care plans, policies and procedures, which showed that they were able to obtain relevant information if they needed it. Moor Park House Ltd DS0000071357.V362756.R01.S.doc Version 5.2 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) 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, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are the key standards. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 (Older People) and 6, 9, 16 and 20 (Adults 18 – 65). Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The health and personal care needs of people living at the home were being consistently met and their privacy and dignity was always respected. EVIDENCE: The care of three people living at the home was ‘tracked’ during the course of the site visit. Moor Park House Ltd DS0000071357.V362756.R01.S.doc Version 5.2 Page 13 All three plans of care had been developed from the information gathered prior to admission to the home. The information recorded was very detailed, which enabled staff to have a clear picture of people’s assessed needs and how these needs were to be appropriately met. Although one care plan seen provided a lot of detailed information, it could have been a little more person centred to make it more pertinent to the individual concerned. Residents or their relatives had been given the opportunity to be involved in the care planning process, so that they could have some input into the care provided. The plans of care had been consistently reviewed every month to show that the needs of people were being regularly assessed so that their current needs were accurately reflected. One relative told us, “The staff are excellent. They are very attentive to the needs of my relative. The care is second to none”. All comment cards received from five relatives showed that they were, in general, satisfied with the overall care provided to the people living at the home and that the differing needs of people were usually met, which showed that everyone was treated equally at Moor Park House. One relative wrote, ‘my relative’s sight is very poor. However, the staff are conscious of this and help her’. The registered manager and staff team are to be commended on the consistently high standard of care planning adopted by the home. One relative stated on the comment card, “because of my relative’s disabilities, the care staff are very supportive of her needs and cope well with the mood swings. I am happy that the staff notify me if they are not able to cope, so that I can be at hand to help to overcome any problems”, and another wrote, “The nursing staff are excellent. They have let me know instantly when my relative was admitted to hospital. Whenever my relative is ill the nursing staff know what to do and always treat him with the best experience and skill they have. I have every faith in them”. The care records showed that appropriate pressure relief was being delivered and specialised equipment was provided to make the lives of people living at the home as comfortable as possible. The plans of care were being followed in day-to-day practice and staff spoken to were fully aware of individual needs and how these were to be met. A wide range of detailed assessments was in place so that the health and safety of people living at the home were protected within a risk management framework. Records showed that a variety of external professionals were involved in the care of residents to ensure that their health care needs were being met. Three of these people were on site at the time of our visit and discussions took place with two of them, who told us that they had no concerns about the care people were receiving and that staff were confident and able to safely administer Moor Park House Ltd DS0000071357.V362756.R01.S.doc Version 5.2 Page 14 medications. One visiting palliative care nurse said, “The needs of people living at Moor Park are definitely met. We wish all care homes were like this one”. Clear medication records were maintained to ensure that a thorough audit trail was evident and photographs were retained of each resident on their Medication Administration Records for identification purposes. The management of medications was good and those care assistants identified as being responsible for the administration of medications to people requiring personal care only had received specialised training to ensure that they were competent to do the job required. People spoken to stated that the staff treat them well and respect their privacy and dignity at all times. The inspector observed staff speaking to residents in a respectful manner and knocking on bedroom doors before entering to ensure that privacy and dignity was consistently maintained. A written policy was in place and available to staff, which demonstrated that those living at the home were supported to maintain their privacy and dignity at all times. Induction records showed that staff had been instructed to treat residents with respect and care records demonstrated that the wishes of people were respected in relation to maintaining privacy and dignity when giving personal care. Moor Park House Ltd DS0000071357.V362756.R01.S.doc Version 5.2 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. 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 have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with assistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 (Older People) and 12, 13, 15 and 17 (Adults 18 – 65) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Social and recreational activities were provided in accordance with residents’ expectations and the rights of people were upheld. Residents received wholesome food and the special dietary needs of people were met. EVIDENCE: When asked what the service does well, the responsible individual wrote on the home’s self-assessment, ‘ Service users can make their own choices according to their individual preferences. This of course is risk assessed. We have a daily Moor Park House Ltd DS0000071357.V362756.R01.S.doc Version 5.2 Page 16 activities programme and two activities organisers who encourage residents to participate in planned events, including those with a sensory impairment. Outings in the ‘fun bus’ (the home’s mini bus) are undertaken with enthusiasm, visiting local places of interest. We also encourage outside entertainers and retailers to visit the home on a regular basis to provide cinema shows, clothing and jewellery parties, and live musical entertainment and tai chi classes’. We saw that two staff were employed solely for planning and implementing a programme of activities, so that those living at the home were stimulated and motivated. The varied activities programme was designed in accordance with the seasons, so that activities suitable for weather conditions and special festivals were arranged. The programme demonstrated that those planning the activities were open to new suggestions, so that those living at the home had some input into what they wanted to do. A clear record was retained so that an audit trail could be conducted to show if people were being given the same opportunities to join in activities of their choice. We saw people being offered a place on that days outing and noted that places were allocated fairly. The activities organiser gave clear explanations and examples of meeting people’s individual social needs, such as ex-military personnel visiting army barracks and war museums. One man wanted to go fishing, so it was arranged that a member of staff took him. Some people are taken to football matches so that they can support their local teams. Comment cards received from people living in the home indicated that there were always or usually activities arranged which they could take part in. One person wrote, ‘I enjoy going out in the mini bus, but I would like to go into the park more often’. A pictorial and informative Newsletter was published every two months, so that people knew what was going on in the home. The hydrotherapy pool was being used on a regular basis for therapeutic reasons and for leisure activities. One relative wrote on the comment card, ‘The home tries to provide diverse entertainment for residents’, and another commented, ‘my daughter is taken out on trips or shopping and she is given the opportunity to choose things herself, like items of clothing or treats. She also enjoys going into the pool with the physiotherapist’. People spoken to said that the routine of the home was relaxed and that they were able to get up and go to bed when they wanted to. One person said that they could have their meals in their rooms if they wished to do so and that there was always a choice of menu offered. Staff were seen offering people a variety of choices in relation to daily living and residents spoken to said that staff were very helpful. One resident wrote on the comment card, ‘The menu is varied, well cooked and there is usually a choice’. Records were retained about people’s leisure interests and hobbies, including religious needs so that staff were aware of individual social care needs, and Moor Park House Ltd DS0000071357.V362756.R01.S.doc Version 5.2 Page 17 could therefore plan activities accordingly, showing that those who were less able to participate were given the same opportunities as others by the provision of 1:1 activities. People said that outside entertainers visited the home and regular trips out were arranged, which they enjoyed. A variety of notices were displayed informing people about what activities were available and one relative said that visitors are encouraged to become involved. Information about the provision of activities was included within the statement of purpose and service uses guide, so that people were aware of what activities were provided. We saw that policies were in place in relation to equal opportunities and these included an explanation of the six principals of care, including rights, fulfilment, independence and choice, showing that all those living at the home were given the same opportunities to make decisions and informed choices about their daily lives. The plans of care showed that people’s choices had been taken into consideration and they included information about the leisure interests of people so that staff were able to provide activities in accordance with their preferences. The care plans recorded people’s social histories well so that staff could get a clear picture of each person’s life, interests and hobbies. Evidence was available to show that people were satisfied with the visiting arrangements at the home and those spoken to felt that anyone visiting the home was made to feel very welcome. Information was readily available about access to the local advocacy service, should someone wish to appoint an independent person to act on their behalf. The four weekly menus were examined and were found to provide a choice of well-balanced meals to ensure that those living at the home received a nutritious dietary intake. The menu of the day was clearly displayed, so that people were aware of the choices they had been given for lunch. Staff were seen offering people choices of meals and a resident confirmed that there were alternatives to the menu available if required. One resident said, “the meals can get a little monotonous, but the chef is more than willing to provide an alternative as required”. However, another commented, “The staff will get you anything you want. Nothing is too much trouble and they are all very polite”. The food served at lunchtime was wholesome and well presented, so that appetite and nutrition was promoted. It was pleasing to see tureens of potatoes and vegetables on dining tables, so that people could help themselves, in order to encourage independence wherever possible. However, people were also supported with their meals in a dignified manner as required and were able to dine within the privacy of their own rooms, if they so wished. Moor Park House Ltd DS0000071357.V362756.R01.S.doc Version 5.2 Page 18 The dining rooms were found to be relaxed areas for people to eat in, with well-presented tables and unhurried atmospheres, so that those dining were comfortable and enjoyed having their meals in pleasant surroundings. A small number of people dining in one area of the home said that the quality of food on the whole was good. Others said that the food was excellent. Comment cards received from people living at the home indicated that they usually or sometimes enjoyed their meals. One person wrote, ‘the meals can be disappointing’, another stated, ‘soup at tea time is too salty to eat’, and a third commented, ‘the chef is always willing to provide an alternative option if the menu is not to personal taste’. The home had recently been inspected by the Environmental Health Officer and had received a five star rating for food safety, which is an excellent outcome. Moor Park House Ltd DS0000071357.V362756.R01.S.doc Version 5.2 Page 19 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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 feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 (Older People) and 22 and 23 (Adults 18 – 65) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints were well managed and people living at the home were adequately safeguarded. EVIDENCE: When asked what the service does well, the responsible individual wrote on the home’s self-assessment, ‘A comprehensive complaints procedure is in place with all residents and staff aware of how to implement this. Most staff have now completed POVA training which includes guidance on whistle-blowing and this training will be concluded in the near future for newly contracted staff. All staff have a Criminal Record Bureau disclosure carried out prior to commencement of employment’. A detailed complaints procedure was seen to be in place at the home, which was displayed prominently and which was included within the service users guide, showing that people were given enough information about making a complaint should they wish to do so. People spoken to at the time of the site visit said that they would know what to do if they were not happy about something at the home. However, out of eleven comment cards received from Moor Park House Ltd DS0000071357.V362756.R01.S.doc Version 5.2 Page 20 residents and relatives, two people indicated that they would not know how to make a complaint, although the rest would. A system was in place at the home so that any complaints received could be recorded and any recurring patterns identified and regularly monitored. The Commission for Social Care Inspection had not received any complaints about this service since the last inspection. No complaints had been recorded by the home either. Policies and procedures were in place at the home in relation to safeguarding adults, which were in accordance with Department of Health guidance, so that people were fully aware of the action to take should an allegation of abuse be reported to the home. Staff spoken to confirmed that they had received training in relation to safeguarding adults and the training certificates seen supported this information. Staff were aware of what they should do if they had any concerns about the welfare of anyone in their care to ensure that appropriate action would be taken. When asked what improvements are planned for the next twelve months, the home’s self-assessment stated, ‘With regard to the Mental Capacity Act 2005 we wish all our senior staff to be trained in its interpretation and to be aware of the issues and procedures to be followed. Moor Park House Ltd DS0000071357.V362756.R01.S.doc Version 5.2 Page 21 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 (Older People) and 24 and 30 (Adults 18-65). Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home provided a safe and exceptionally well-maintained environment for people to live in, which was homely, clean and hygienic. EVIDENCE: Moor Park House Ltd DS0000071357.V362756.R01.S.doc Version 5.2 Page 22 Moor Park House is purpose built care home designed to meet service users’ individual and collective needs. Furnishings, fittings and decoration were of a very high standard, so that people living at the home benefited from a comfortable environment. A full time maintenance person was employed to ensure that these high standards were maintained. A programme of routine maintenance was in place with regular checks taking place, so that any work needed was promptly attended to. The grounds were attractive, with welltended gardens and parking areas. The home offered good access to local amenities and transport links. In addition, Moor Park House also provided an attractive hydrotherapy pool for recreational and health purposes. Specialist equipment was available for all types of disability, so that the needs of everyone living at the home were being met. Bedrooms were spacious, with room for nursing and medical equipment, where necessary. All bedrooms were tastefully decorated and furnished, being individualised with people’s own belongings in order to create a homely atmosphere. The bedrooms for younger adults were based on a more modern design, so that their surroundings were in keeping with their tastes and preferences. All those spoken to were more than happy with their private accommodation. Moor Park House is to be commended for the sustained record of consistently providing an exceptionally high standard of environment for people to live in. All bedrooms, except one had en-suite facilities and toilets and bathrooms were conveniently located throughout the home, which were found to be suitable to meet the needs of people living there. At the time of the site visit the home was found to be warm, thoroughly clean and pleasant smelling, providing people with a comfortable and homely environment in which to live. Comment cards received from those using the service stated that the home was always fresh and clean, one person simply added, “immaculate”. The laundry department was well organised and fitted with equipment suitable for the needs of the home and the needs of people living there. Infection control policies and procedures were in place and staff confirmed that they received appropriate training to ensure that the risk of infection was minimised. Moor Park House Ltd DS0000071357.V362756.R01.S.doc Version 5.2 Page 23 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 28, 29 and 30 (Older People) and Standards 32, 34 and 35 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 (0lder People) and 32, 34 and 35 (Adults 18 – 65). Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff working at the home were appropriately trained and in sufficient numbers to meet changing needs of residents and the recruitment procedures safeguarded those living at the home. EVIDENCE: At the time of the site visit there were 44 people living at Moor Park House. All six staff members who sent in comment cards indicated that there was enough staff employed to adequately cover shifts. However, staffing levels could sometimes fall because of staff sickness. Two relatives who sent in comment cards indicated that there were not enough staff on duty. One wrote, ‘I’m not sure that the staffing ratio is as good since the change of ownership’ and another stated, ‘the staff are excellent, but as with any other similar establishment more staff would be ideal’. Moor Park House Ltd DS0000071357.V362756.R01.S.doc Version 5.2 Page 24 At the time of our site visit the needs of people were being met and we noted that five people living at the home were receiving continuous 1:1 care, due to complex nursing needs and in line with their plans of care. The registered manager told us that staffing levels were being calculated in accordance with the needs of people living at the home using a dependency classification tool and therefore the number of staff on duty at any one time could vary at regular intervals, as the needs of people change. People living at the home felt, in general, that staff were usually available when they were needed. One resident wrote on the comment card, ‘Staff are only unavailable if they are already engaged with other residents’. Equal opportunity policies were in place at the home to ensure that everyone applying for work was treated the same and was given the same job opportunities. The home’s self assessment showed that over 75 of care staff had achieved a recognised qualification in care, showing that these staff members were suitably qualified to deliver the care required and to oversee the performance of newer care staff, which was commendable. Staff records showed that formal induction processes had been adopted by the home so that staff understood their role and were able to perform the duties expected of them. The home’s self-assessment showed that a wide range of training was provided for staff so that people working at the home were competent to look after the people in their care. All staff completed a variety of mandatory core-training courses to ensure that there was a skilled workforce and that people had the necessary knowledge to meet the needs of the people they were caring for. Staff spoken to felt that a lot of training was provided to meet their needs, including training specific to the care of people living in the home and staff training certificates available on files supported this information. Three staff files were examined at the time of the site visit. It was found that recruitment procedures were being followed in day-to-day practice and that checks had been undertaken on staff to ensure that those living at the home were adequately protected. Moor Park House Ltd DS0000071357.V362756.R01.S.doc Version 5.2 Page 25 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. 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 a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s policies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 31, 33, 35 and 38 (Older People) and Standards 37, 39 and 42 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 (Older People) and 37, 39 and 42 (Adults 18 – 65). Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home was well managed by a competent person, having effective systems in place for monitoring the quality of service provided. The health, safety and welfare of people living at the home were sufficiently protected. Moor Park House Ltd DS0000071357.V362756.R01.S.doc Version 5.2 Page 26 EVIDENCE: The registered manager of Moor Park House had a lot of relevant experience, having completed the registered managers award, a diploma in Health and Education, an assessors’ award and a variety of relevant training courses. This demonstrated that she was competent to manage the care service and was able to educate her staff team, so that the outcome for those living at the home was positive. There were clear lines of accountability within the home so that the service was successfully managed and a good quality of life was provided for those living at the home. Staff spoken to felt very supported by the management of the home. There was a strong belief of being open and transparent in all areas of running the home so that people were kept informed of matters involving them. The management team were resident focused and the health, safety and welfare of those living at Moor Park was evidently their priority. Residents and staff spoken to were happy with the management of the home and felt that they would be able to approach the manager if they had any concerns or if they wished to discuss anything. The policies and procedures of the home were updated, as required in order to provide current information for anyone involved with the service. A variety of meetings had been held for staff and for people living at the home and their relatives, from which notes had been made of the discussions, which took place, so that people were kept up to date with any relevant matters. A business and development plan was in place, which was currently being reviewed and updated and a variety of audits were carried out regularly, showing that the quality of service provided was being continuously monitored. Surveys were completed at regular intervals by staff working at the home, by people living at Moor Park, their relatives and stakeholders in the community in order to obtain their views about the quality of service provided. Any issues identified on the questionnaires were discussed at the relevant meetings so that any problems could be rectified. Systems were in place to ensure that any money or valuables retained at the home on behalf of those living there was adequately protected, so that the possibility of any mishandling was reduced. Moor Park House Ltd DS0000071357.V362756.R01.S.doc Version 5.2 Page 27 The home’s self-assessment showed that all systems and equipment had been appropriately checked so that the health and safety of people living there was protected. This was confirmed by examination of a random selection of service certificates. Accidents occurring in the home had been accurately recorded so that the manager was able to audit and monitor the frequency of incidents. A wide range of risk assessments had been conducted, which were sufficiently detailed, showing that systems had been put in place in order to reduce the possibility of injury to people living at the home. The environment was free from any hazards, which could pose risks to those living at the home. Fire drills were conducted periodically to ensure that all staff were familiar with the fire procedure and evacuation plan within the home and a record was retained of staff attendance so that the home could ensure that all staff were involved in a fire drill at least annually. Policies and procedures were in place at the home in relation to Health and Safety issues, moving and handling, food hygiene and Infection Control practices, so that staff were aware of the importance to ensure that the health, welfare and safety of people living at the home was consistently protected. Moor Park House Ltd DS0000071357.V362756.R01.S.doc Version 5.2 Page 28 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 X 2 X 3 4 4 X 5 X 6 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 ENVIRONMENT Standard No Score 19 4 20 X 21 X 22 X 23 X 24 X 25 X 26 4 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No Score 31 4 32 X 33 3 34 X 35 3 36 X 37 X 38 4 Moor Park House Ltd DS0000071357.V362756.R01.S.doc Version 5.2 Page 29 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP7 OP12 Good Practice Recommendations It is recommended that all care plans are consistently person centred so that the needs of people living at the home are pertinent to the individual resident. It is recommended that an audit be conducted to ensure that activities are provided to meet the needs of all the people living at the home. Moor Park House Ltd DS0000071357.V362756.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Lancashire/Cumbria Hub Office 3rd Floor Unit 1 Tustin Court Port Way Preston PR2 2YQ 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. Moor Park House Ltd DS0000071357.V362756.R01.S.doc Version 5.2 Page 31 - 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. 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