Care Home: Moorhouse

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Annual service review Name of Service: Moorhouse The quality rating for this care home is: The rating was made on: two star good service 0 9 0 1 2 0 0 9 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 review of the service. We call this review a ‘key’ inspection We do an annual service review when there has been no key inspection of the service in the last 12 months. It does not involve a visit to the service but is a summary of new information given to us, or collected by us, since the last key inspection or annual service review.   Has this annual service review changed our opinion of the service?   No You should read the last key inspection report for this service to get a full picture of how well outcomes for the people using the service are being met. The date by which we will do a key inspection: Name of inspector: Suzanne Magnier Date of this annual service review: 1 1 1 2 2 0 0 9 Annual Service Review Page 1 of 9 Information about the service Address of service: Tilford Road Hindhead Surrey GU26 6RA 01428604381 Telephone number: Fax number: Email address: Provider web address:   Name of registered provider(s): Conditions of registration: Category(ies) : old age, not falling within any other category Conditions of registration: Ashberry Healthcare Ltd. Number of places (if applicable): Under 65 Over 65 0 36 The maximum number of service users to be accommodated is 36. The registered person may provide the following category/ies of service only: Care home with nursing - (N) to service users 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 (OP) Have there been any changes in the ownership, management or the No service’s registration details in the last 12 months? If yes, what have they been: Date of last key inspection: Date of last annual service review (if applicable): Brief description of the service Moorhouse provides care and accommodation with nursing for thirty six residents. The property is located in a village setting close to public amenities and other facilities. Accommodation is on three floors accessed by stairs or a lift and comprises of an office, lounges, dining area, kitchen, bathrooms, toilets, a laundry room and bedrooms are either single or shared with some having en suite facilities. 0 9 0 1 2 0 0 9 Annual Service Review Page 2 of 9 The home has an attractive garden which is private and secure with wheelchair access. Private parking is available. Annual Service Review Page 3 of 9 Service update since the last key inspection or annual service review: What did we do for this annual service review? We looked at all the information that we have received, or asked for since the last key inspection or annual service review. This included: The annual quality assurance assessment AQAA that was sent to us by the service. The AQAA is a self assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. Information we have about how the service has managed any complaints. What the service has told us about things that have happened in the service these are called notifications and are a legal requirement. The previous key inspection and the results of any other visits that we have made to the service in the last 12 months and relevant information from other organisations. What has this told us about the service? The home sent us their annual quality assurance assessment when we asked for it. It was clear and gave us all the information we asked for. We looked at the information in the AQAA and our judgement is that the home is still providing a good service. The AQAA advises that the home has a Statement of Purpose and Service User guide. All prospective residents have their care and support needs assessed by a suitably qualified member of staff prior to their admission to the home. The assessment forms the residents care plan which is reviewed regularly and any necessary changes made. Each resident is allocated a key worker on admission. The home have identified areas of improvement that they have made over the last 12 months which include improved information regarding residents equality and diversity continuing to invite prospective residents and encourage them to spend a day in the home for meals and participating in the activity of the day to give them an insight into life at Moorhouse. Health care services, including regular visits from the general practitioner, remain available to all residents and the home has maintained professional relationships with outside health care professionals. The home have identified areas of improvement that they have made over the last 12 months which have included staff training in and the introduction of a recognised screening tool to assess any resident at risk from malnutrition. Fifteen residents surveys were returned to the commission and statements about the home included The home provides personal contact and Im very happy here. People are very helpful and friendly and are always willing to help. The personal care is very good, there is a great deal of care and help taken over clothing etc. There is a very good mix of ages and nationalities of carers who all take a personal interest. The speed of medical care for example attendance of the doctor visits to the dentist are Annual Service Review Page 4 of 9 excellent. All nice caring staff. The home looks after the residents very well and I am quite content and satisfied here. The day to day maintenance and cleaning and the staff are well trained and supervised. Matron is accessible and approachable and the gardens are lovely. The food and care is very good and there are lots of interesting activities arranged. The staff are very kind and caring. Theres a caring and friendly environment some of the staff are wholly dedicated to the care of the residents. The staff keep me clean and smart. Theres a family not institutional atmosphere. Friendly, good English speaking staff. Having the 4 flats as an in between own home and residential home is excellent. Its a pleasant house in fine gardens, the staff are generally pleasant and caring and there is good visitor access. Medication policies and procedures have been maintained to ensure staff administer prescribed medicines to residents in a safe and efficient way. Six completed written surveys were received from health care professionals who visit the service and statements about the home included Very caring, clean well organised home. Well staffed and a pleasure to go to. They regularly ask for training if there are any problems with looking after people with diabetes and generally do a great job. If I were looking for a home for a parent I would be very confident to suggest Moorhouse. The homes care is always fully completed and they act on any suggestions that are made and endeavour to keep the management plan updated. The manager is excellent and is passionate about the home and carers and is in touch with what is going on in the home. Moorhouse Nursing Home continues to provide a friendly family and homely atmosphere for disabled and elderly residents. Staff treat the residents as individuals and give them the respect they deserve. They also understand the limited mental and physical capabilities for example self medication or consumption of alcohol and keep vigilance and organisation to the benefit of the individual. Most of the nursing and caring staff have served Moorhouse for a long time and in general there is a lot of loyalty to the general working of the nursing home. The home meets the needs of patients and they are treated as individuals. There is a high staff ratio to patients. Staff are well trained and knowledgeable. They have advanced care planning and phone for medical and nursing advice if they are unsure. They have good working relationships with us. We have a very good working relationship with Moorhouse, their monthly drugs are always ordered on time and accurately with all the required prescriptions. The patients all seem very contented with the staff. The staff are helpful and the surroundings and the rooms are always clean, tidy and welcoming. If I had to choose a nursing home for a relative of mine I would always choose Moorhouse. The home has continued to offer meaningful pastimes and activities which include visits from the hairdresser, beauty therapist, physiotherapy and chiropody upon request. The home have identified areas of improvement that they have made over the last 12 months which have included staff receiving an activity workshop in order to support them in understanding the importance of suitable activities for the residents and how to effectively carry out activities. The AQAA advises that a wider programme of activities is now available to include the introduction of outside entertainers who come to the home to entertain on a regular basis and an adapted minibus has been purchased to support residents to appointments and outings and it is reported that this has greatly increased residents contact with their local community and has improved their choices regarding when and where to go for outings. The home has continued to operate an open door policy and residents are supported to Annual Service Review Page 5 of 9 keep in touch with family and friends and visits can be held in private. The AQAA advises that residents are provided with three meals a day, together with snacks and drinks at any time. Special requests and diets are discussed with the chef and the home offers Protected Meal Times which supports staff to help, encourage and monitor the residents food intake to ensure that the residents nutritional needs are satisfied. The home have purchased a new hot trolley to ensure food is hot when taken around the home, particularly at supper time and new crockery has been purchased for the use of the residents. The home has a formal complaints procedure. The AQAA advises that no complaints have been received by the home within the last 12 months. The home has been subject to one safeguarding vulnerable adult referral of which the commission are informed has been satisfactorily concluded. The home continues to encourage residents to have their own belongings in their rooms which include small items of furniture and personal effects in order to make their rooms more familiar and comfortable. Improvements in the home include the installation of a Jacuzzi bath on the ground floor, one room has been furnished with a profiling bed, some rooms have had carpets and radiators replaced, new curtains, wardrobes, wall cabinets and windows and doors. The AQAA advises that a continuous programme of refurbishment has been maintained as and when rooms become vacant within the home. To further ensure residents health and safety door guards have been attached to all fire doors that did not have self closing closure facilities. New fire doors and signs have been put into some areas to comply with new fire regulations, thermostatic valves have been installed on sinks and baths to ensure the right temperature of water is always on hand and two new boilers have been installed. The AQAA advises that the garden has been maintained and improvements to the external areas have benefited the residents by having some trees cut down and others lopped in the car park allowing more light into some ground floor rooms and some outdoor areas have been improved to make easier access in the garden for residents who use wheelchairs. A proposed change to the garden area includes developing an orangery which will be an area for residents to sit and relax. Further improvements to the home are planned which include the provision of 8 new luxury en suite garden rooms, a purpose built hairdressing salon, an extra assisted bath and shower room, more storage space and a larger communal day room. A conservatory is proposed to be sited off the dining room which will give more room to cater for the extra residents after the extension is built. Alarms are to be fitted to fire escape doors which will be linked to the nurse call bell system for the safety of the residents, a flat roof is planned to be replaced, the floor and part of the kitchen corridor and storage room tiles are being replaced, the sluice area on the ground floor modernised and a new sign is going to be placed at the homes entrance. The homes recruitment and selection of staff ensures that all appropriate checks are made to make sure that residents are protected and safeguarded from any harm or abuse and new staff receive a structured induction training and the home have a planned mandatory training programme. The AQAA advises that at least seventy per Annual Service Review Page 6 of 9 cent of staff have achieved their NVQ Level 2 or above and twenty five per cent of the remaining staff are currently waiting to start Level 2 or 3. Improvements in the homes training programme have included training sessions to be given to all our staff by the McMillan Nurses, raised awareness of Dementia needs, Person Centred Planning and communication and understanding behaviour that tests the service and training regarding the Mental Capacity Act and corresponding legislation. Ten completed written surveys were received from staff and their comments about the home included Look after the residents well. Ive worked at the home for many years and everything is satisfactory. This is the best nursing home Ive ever worked in. We provide care for vulnerable people not only their physical needs and well being but their mental health as well. Afternoon entertainment and activities are provided such as musical movements, question time, crosswords, fun games like bongo and word games and an afternoon with a member of staff reading to the residents. I have always found the home to be a very caring environment and the training given is very good. The home maintains a caring and comfortable atmosphere for the resident. It offers outings and entertainment which are well received. The residents needs are met. All core values rights, choice, independence, fulfilment privacy is promoted. The staff are trained to meet residents needs and residents are treated as individuals. Residents have the rights to choose their meals. The updates training, has good team work and supplies the right equipment. Moorhouse provides a caring, kind and efficient home for the residents. It also provides good working conditions for staff. Matron is always available and approachable to discuss situations or potential changes. The atmosphere in the home is friendly and effort is made to incorporate as much as possible of the individual wishes of the residents in order to provide a high standard of care and comfort and dignity for the residents and their families. The standard of sharing information is very good. I work with a very good team of care assistants who maintain a high standard of care and are constantly assessing ways of improving care of the residents. Moorhouse is a very nice place to work I have enjoyed all my years working here. Looking after the resident seeing to all their needs and making them happy is most important. The home is run very well. Moorhouse is a very well run nursing home with a wonderful homely atmosphere. The home provides care for all its residents based on their needs. It develops good relationships with residents and any visitors. Ensures that residents physical and emotional needs are looked after. Provides a happy atmosphere for all work there and has good relationships with health care professionals. I enjoy coming to work and feel part of a large family. Look after the residents well. It is an inviting home for family and friends. A very good atmosphere between residents and colleagues. The AQAA advises that the home continues to update the Residents Questionnaire to gather feedback on any new facilities or improvements made to the home. Constructive feedback from residents, visitors and staff about how the home could improve included communication could be better. There is still no secretary or receptionist. Matron or the senior member of staff on duty have to take all the telephone calls. A greater diversity of activities. Since naturally there are a number of residents who are hard of hearing and walls are thin the volume of noise from TV and radios can be disturbing. The lunches are poor as the meat is steam cooked its tender but tasteless, more fresh vegetables would be nice as the meals are often Annual Service Review Page 7 of 9 bland, there is a lack of tempting sauce, presentation of meals is not tempting, could have pasta, noodles and Chinese food. Staff are very willing but not enough of them. The food is good but its not always hot. A variation of the supper menus plus use of fresh seasonal vegetable and fresh fruit. The home could do better by providing information and dealing with post and official documents which arrive for my mothers attention but she is unable to cope with them. More activities, staffing levels sometimes impaired by absenteeism and suppers could be more varied. There is less personal contact now the home is no longer family owned. Better time keeping of staff as sometimes there is not enough help given in the mornings. Maybe toilets nearer to some of the bedrooms. The registered manager is a registered nurse and has fifteen years management experience and has achieved an NVQ Level 4 qualification in Management and Care. The home have a stable staff team who work well to provide an open and friendly approach in the home. The management of the home continues to let the commission know about things that have happened since the last key inspection and they have shown that they have managed issues well. They work well with us and have shown us that their service continues to provide good outcomes for the residents. What are we going to do as a result of this annual service review? We are not going to change our inspection plan and will do a key inspection by the 31st December 2010, however we can inspect the service at any time if we have concerns about the quality of the service or the safety of the people using the service. 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