Care Home: Moor View

What the care home does well The accommodation provides a homely environment and the staff team are committed to ensuring that people feel valued and respected and treated with dignity. The home is committed to promoting the rights of people living at the home. Everybody is listened to and people are positively encouraged to influence the way the home is run. All people living at the home have direct access to an independent advocate, the advocacy service is funded by the Primary Care Trust and all people are given the opportunity to meet with them in private if they wish. People are encouraged to develop and maintain independent living skills. People use a wide range of community social and recreational activities and are encouraged to develop new interests. Staffing levels are sufficient to enable the staff team to work flexibly to make sure that the people`s social and emotional needs are met. Relationships between staff and people living at the home are relaxed and friendly with appropriate use of informality and humour. The organisation places a high priority on staff training and development. Over 50% of the care staff hold the National Vocational Qualification (NVQ) level 2 or 3. The staff training undertaken is clearly reflected in the high standard of care given to the people who use the service. What has improved since the last inspection? Systems are now in place to make sure that people who manage their own medication can do so safely. The care planning documentation has been improved and everybody living at the home has a detailed Individual Support Plan which is written by the individual. What the care home could do better: The home continues to provide a good standard of care and attention to people living at the home. No requirements or recommendations have been made as a result of this visit. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Moor View 20 Georges Street Nursery Lane Ovenden Halifax HX3 5TA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Cheryl Stovin     Date: 1 8 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Moor View 20 Georges Street Nursery Lane Ovenden Halifax HX3 5TA 01422368716 01422368738 pete.lidster@richmondfellowship.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Richmond Fellowship care home 14 Number of places (if applicable): Under 65 Over 65 0 mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home 14 Moor View is owned and managed by The Richmond Fellowship and is registered to provide accommodation and nursing care for up to 14 adults with severe and enduring mental health needs. There is always a qualified Registered Mental Nurse on duty supported by a team of well trained Assistant Project Workers. The establishment, a purpose built property, is situated in the Ovenden district of Halifax with easy access to local facilities and on a bus route to the town centre. The accommodation comprises of 14 single bedrooms all equipped with full en-suite facilities, and spacious and comfortable communal areas. The Calderdale Primary Care Trust makes referrals to the establishment and is also responsible for funding the placements. The people living at the home are not required to pay for their care. Care Homes for Adults (18-65 years) Page 4 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This report brings together evidence gathered during the Key Inspection of Moor View. This included a visit made to the home on 18th december 2008. The visit was undertaken by one inspector and a total of 7 hours was spent at the home. During this visit we looked round the building looked at records and talked to people living at the home and to management and staff. The last inspection of the home was on 4th April 2007 and no additional visits have been made. A Annual Quality Assurance Assessment (AQAA) was completed by the home which Care Homes for Adults (18-65 years) Page 5 of 27 gave useful information about the services provided at the home and about the people who live and work there. The purpose of the inspection is to make sure that people receive the care and support they need and that they and their families are satisfied with the service. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 27 Care Homes for Adults (18-65 years) Page 8 of 27 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are fully assessed before moving into the home to make sure the Moor View is suitable for them. Evidence: The care records of four people were seen which confirmed that people have a full and detailed assessment before moving into the home. Any prospective resident visits Moor View several times before making a decision to move in. Great care is taken over the admission process to make sure that Moorview is going to meet their needs. Indepedent advocates are also involved in the admission process to make sure that peoples views are taken fully into account. Referrals to the home are made by the Calderdale Primary Care Trust who are also responsible for funding the placements, which means that the people using the service do not have to pay for their care. They do, however, have to pay for clothing and personal items. Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: People are given written information about the services and facilities provided at Moor View which makes sure that people know what to expect whilst living at the home. Care Homes for Adults (18-65 years) Page 11 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are fully involved in all aspects of daily life within the home and are encouraged and enabled to be as independent as possible. Evidence: The care records of four people were seen. Everybody contributes to drawing up their Individual Personal Support Plan with input from fellow professionals where appropriate. The support plans are very detailed and cover all activities of daily living. The support plans identify peoples strengths and abilities and detail the actions to be taken to give people as much autonomy and control over their lives. The support plans have much improved since the last inspection. Clear guidelines are in place to minimise putting undue pressure on people and to guide staff to work with people at a level that they are comfortable with, and how staff are to approach and support people during various phases of their mental health. People living at the home are encouraged to be fully involved in the day to day running Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: of the home, and their representatives are involved in reviewing the policies and procedures. An independent advocate is actively involved in the home to make sure that everyones views are taken into account and acted upon. The organisation has adopted the recovery model of meeting the peoples mental health needs, and the home fully supports this. This means that the people living in the home are enabled to take responsible risks to make sure they live an ordinary life in the community. Care Homes for Adults (18-65 years) Page 13 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People enjoy active and varied lifestyles and participate in a wide range of community activities whilst living at the home. Evidence: People are encouraged and enabled to develop social and independent living skills and to learn and experience practical life skills. They are encouraged and enabled to fulfil their cultural and spiritual needs. People access a wide range of community social and recreational facilities and are encouraged and enabled develop and maintain new interests. The staff team work flexibly to make sure that people can access social activities of their choice. One person living at the home uses English as a second language. An interpreter accompanies them to all medical and Care Programme Approach (CPA) meetings to Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: ensure that they are kept fully informed of all aspects of their medical care. Plans are underway for this person to visit the country of their birth which will greatly enhance their quality of life, the planning has taken considerable time but everybody is committed to ensuring this goal is achieved. People are assisted to take a holiday with the destination and duration of their choice. Destinations being planned at the time of the visit included: Gran Canaria, Ireland and the Yorkshire Dales. One person proudly showed us momentos of a holiday taken in the Channel Islands. Volunteers who visit the home have a particular interest in gardening and have developed an allotment which some of the people living at the home help to plant and water the vegetables. The volunteers are subject to the same Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) checks and references as the staff. This ensures that the welfare of the people living at the home is protected. People said that they are happy living at Moor View and were seen to be choosing where to spend their time and to follow their interests. People are encouraged and helped to maintain contact with family and friends. The home has a healthy eating policy and meals served are balanced and nutritional. The lunch being served on the day of the visit was: Vienna steak served with brocolli, cauliflower and swede, or halloumi cheese, followed by rice pudding, jam sponge, fresh fruit or ice cream. The mealtime was seen to be relaxed with everyone including the staff sitting down together, making it a social occasion. People can help themselves to hot and cold drinks at all times of the day and night. People said they enjoyed their meals. The homes kitchen facilities has recently been inspected by the environmental health department and awarded a four star rating this means that the kitchen hygiene and food handling systems have been rated as good. This makes sure that people are protected by the systems in place. Care Homes for Adults (18-65 years) Page 15 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health care needs are met and personal care is given in accordance with their preferences. Evidence: Peoples personal support needs are assessed and form part of their plan of care. All personal care is given in private. Peoples physical and psychological health care needs are assessed and detailed in their individual support specification. Everyone is under the care of an identified Psychiatrist who visits the home on a monthly basis for consultation, this ensures that any changes in peoples mental health is picked up quickly and appropriate treatment given. There is always a member of staff on duty who holds an up to date first aid certificate, which makes sure that minor and major medical emergencies are dealt with promptly. The home uses a Monitored Dose System (MDS) supplied by a local pharmacy for the administration of medication. The stocks of medication are securely stored in a Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: medication room. The medication is administered by the qualified nurses in accordance with Nursing and Midwifery Council (NMC) guidelines. A weekly audit of medication is carried out to make sure that there are no discrepencies in the stocks of medication held. One person handles their own medication. A risk assessment and monitoring system is in place to ensure that the management of self medication is safe. An appropriate system for disposing of unused medication is in place which ensures that surplus medication is held safely prior to disposal. Care Homes for Adults (18-65 years) Page 17 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Procedures are in place to make sure that people are protected from abuse and neglect and that their welfare is safeguarded. Evidence: The home has a complaints procedure and all of people living in the home are aware of who to talk to if they are unhappy about anything in the home. All of the people have access to an independent advocate who can take up any issues raised on their behalf. No complaints have been received since the last inspection either by the home or direct to the Commission. All staff have received training in the Protection of Vulnerable Adults (POVA) and are aware of the procedure to follow if they witness or suspect that abuse is taking place. Independent advocates have been working with the people living at the home and have produeced an easy to read booklet working together to be safe which raises awareness of what abuse is and who to contact if they feel they havnt been treated properly. Care Homes for Adults (18-65 years) Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean, safe and comfortable environment. Evidence: The home is situated in a residential area in the Ovenden district of Halifax close to local facilities and on a bus route to the town centre. The home is purpose built and provides accommodation in 14 single bedrooms all equipped with en-suite shower or bathing facilities. A full tour of the building was undertaken and the home was seen to be clean and tidy throughout. Communal areas are spacious and comfortable and furnished and fitted to a good standard. A smoking area for people living at the home is provided in a well ventilated conservatory. The manager said that it would not be safe to not have a designated smoking area as the majority of people smoke and there is a danger that people would covertly smoke if a smoking area was not provided. One person chooses to smoke in his room, the manager said that a risk assessment is in place for this. Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: There is a programme of routine maintenance and refurbishment in place which makes sure that the living environment is kept safe and comfortable. People are encouraged to personalise their own rooms to reflect their interests and tastes. The bedrooms are sufficiently spacious to enable this. The home was seen to be clean and fresh throughout. There are well maintained and safe and accessible garden areas for the people living in the home to enjoy in the warm weather. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are met by a well trained and competent staff team, and are protected by the rigorous recruitment practices. Evidence: There are sufficient staff on duty at all times to make sure that peoples needs are met. There is always a Registered Mental Nurse (RMN) on duty supported by a team of Assistant Project Workers. Staff rotas showed that there are three care staff plus an RMN on duty during the day time hours and two waking night staff. These staffing levels are appropriate to meet the social and emotional needs of the people living at the home. In addition to the nursing and care staff catering, domestic and administrative staff are also employed. All new staff receive induction training to Skills for Care Council common induction standards. This ensures that staff have the required competences to meet peoples needs. Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: There is a programme of National Vocational Training (NVQ) in the home and it is an expectation that all care staff undertake NVQ training. Over 50 of the care staff hold the award This means that the care staff are qualified and competent to meet peoples needs. In addition to the mandatory health and safety training, staff at the home access training opportunities from both the Richmond Fellowship organisation and the local authority Health and Social Care Training and Development Unit. Staff confirmed that they had a good knowledge of the needs of the people living at the home and stated that they work together as a team. There are relatively low rates of sickness and staff turnover which gives a consistent and reliable service to the people who live in the home. One member of staff said coming to work here was the best thing that I ever did. Staff were seen to be treating people with dignity and relationships between everybody was relaxed and friendly with appopriate use of informality and humour. The home operates safe and robust recruitment practices. Staff files seen showed that all the required pre-employment checks are carried out. There was evidence of Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) disclosures. A copy of the completed application form and references were also seen. There was documented evidence that people living at the home are fully involved in the interview process. All new staff are required to undertake a probationary period before they are employed on a permanent basis. There was evidence that this is a thorough process and that employees have to demonstrate competence before they complete their probationary period. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a well run and managed home with their health and safety protected. Evidence: The Registered Manager of the home is qualified and competent to run the home. He is a qualified nurse (RMN) and has also completed the NVQ IV Registered Managers Award. He is committed to making sure that an open and positive atmosphere is prevalent in the home, and dictates a clear sense of leadership. He regularly attends training and networking opportunities to keep abreast of current good practice in meeting peoples mental health needs. Staff spoken to said that the manager is approachable, fair and knowledable. The views of people living at the home genuinely influence the way it is run with input from independent advocates to help get their views across. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: The manager of the home completed the Annual Quality Assurance Assessment (AQAA) promptly which gave detailed information about how the home is run and the areas for development. All staff receive mandatory health and safety training and work in accordance with the comprehensive policies and procedures to promote a safe working environment. This protects the health and welfare of all living and working in the home. All the required safety checks are carried out regularly, and certificates were seen showing compliance with health and safety regulations. Financial procedures are in place to make sure that peoples money is kept safely. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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