Care Home: Moorland House

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What the care home does well The home is a modern well-equipped environment in which to live and work, which has been maintained and developed with the people living there very much in mind. People living at the home and their relatives spoke highly of the comfort provided, particularly in their private rooms and also of the willingness of the staff to help them in patient and friendly ways. Methodist Homes have developed their links within the Methodist Church and the spiritual needs of the residents are well catered for, although this is not a criteria for coming to live at the home. People also spoke highly of the standards of the laundry service and for most people the home`s catering offers a flexible and satisfying experience. What has improved since the last inspection? The initial troubles with the extended building have now settled down and all the problems identified at the last inspection have been dealt with. A new manager has recently been appointed and she has already started to make a positive impact on the running of the home; everybody spoke highly of her style of management and her commitment to further improve standards. A new activities coordinator was appointed earlier this year and she has already made a positive impact on people`s social lives and leisure activities. As Methodist Homes has introduced new developments across all of its operations these have affected Moorland House and have included steady improvements in the standard of record keeping and care documentation, increased systems for checking quality and better Health and Safety standards. Hidden behind all of this has been a greater commitment to personalising the approach to care and making the life at their homes a more satisfying experience. What the care home could do better: CARE HOMES FOR OLDER PEOPLE Moorland House Station Road Hathersage Hope Valley Derbyshire S32 1DD Lead Inspector Brian Marks Unannounced Inspection 20th and 22nd August 2008 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Moorland House DS0000020057.V370224.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Moorland House DS0000020057.V370224.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Moorland House Address Station Road Hathersage Hope Valley Derbyshire S32 1DD 01433 650582 01433 650795 home.HAT@mha.org.uk www.mha.org.uk Methodist Homes for the Aged 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) Vacant Care Home 48 Category(ies) of Old age, not falling within any other category registration, with number (48) of places Moorland House DS0000020057.V370224.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th August 2006 Brief Description of the Service: Moorland House is a large extended Victorian building situated close to the facilities of Hathersage village. During 2006 there was substantial construction work at the home, in order to extend it further through the addition of two new wings, and also to upgrade the existing accommodation. The home is on two floors throughout and offers care and accommodation for to 48 older people, with one wing specifically designated for providing care to people who have nursing needs. The home also offers one day care place. All bedrooms are single with en suite facilities and there are several lounge and communal areas including an extended dining area. There are accessible sitting and garden areas at the rear of the home. Support services are available locally, including GP and other healthcare services, and the home has an active group of volunteers. At the time of this inspection visit the home’s scale of charges for accommodation was from £470 to £672 per week. Moorland House DS0000020057.V370224.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 2 star. This means the people who use this service experience good quality outcomes. This was a Key unannounced inspection that took place at the home over two day. Additionally, time was spent in preparation for the visit, looking at key documents such as previous inspection reports, records held by us, the written Annual Quality Assurance Assessment document (AQAA), which was returned before the inspection, and surveys that had been previously sent out to the home, its staff and the people living there. All of the above material assisted with the preparation of a structured plan for the inspection. Four resident surveys and five staff surveys were returned before the inspection and the information supplied in this way was analysed and the outcomes included in the inspection process and reflected in this written report. At the home, apart from examining documents, files and records, time was spent speaking to the manager, who was in charge of the home during the visit, and six of the staff working on the day shifts. The care records of four people who live at the home were examined in detail and three of these were interviewed along with seven others. Four relatives who were at the home on the day of the inspection were also spoken to. No other inspection visits have been made to the home since the last Key unannounced inspection on 9 August 2006 and the assessment was made against the key National Minimum Standards (NMS), identified at the beginning of each section of this report, as well as other Standards that were felt to be most relevant What the service does well: The home is a modern well-equipped environment in which to live and work, which has been maintained and developed with the people living there very much in mind. People living at the home and their relatives spoke highly of the comfort provided, particularly in their private rooms and also of the willingness of the staff to help them in patient and friendly ways. Methodist Homes have developed their links within the Methodist Church and the spiritual needs of the residents are well catered for, although this is not a criteria for coming to live at the home. People also spoke highly of the standards of the laundry service and for most people the home’s catering offers a flexible and satisfying experience. Moorland House DS0000020057.V370224.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Moorland House DS0000020057.V370224.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Moorland House DS0000020057.V370224.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 4 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People do not come to live at the home without the care they need being identified but there are concerns that not all needs are being met all of the time by the current arrangements of the home. EVIDENCE: The care records looked at, three of which were for people admitted to the home during the past three months, contain substantial assessment documents that are in use throughout all the company’s homes, and these were completed by the manager or senior staff as people move in. In addition relevant nursing or community assessment information is obtained from other agencies, such as hospital or social services departments. There is also evidence on these files that residents are involved in this process, where appropriate. However one record contained a medical assessment completed by the person’s GP as part of their admission to the home and referred to the fact that a diagnosis of dementia due to Alzheimer’s disease had been made in respect of them. Moorland House DS0000020057.V370224.R01.S.doc Version 5.2 Page 9 Additionally all care records looked at contain assessments of the general and specific areas of risk that are relevant to the individual concerned, such as safe moving and handling, skin breakdown and pressure sores, falls, nutrition and hypothermia. These are subject to a process of reviewing and revision if the area of risk is deemed to be high. Within the care records of the person referred to above as having a diagnosis of dementia, there was no further reference to the risks associated with this condition and how they were being affected by it. This latter subject was also referred to by one of the people living at the home when they spoke generally about life at the home: ‘When I read the brochure it said there were no dementia patients here but now almost everybody has it’. Others were more positive in the feedback they gave: ‘Staff are consistently good and I get good support for my health needs’. ‘I seem to have had a spontaneous recovery since I came here and overall I am very happy’. All of the written feedback received shared this more positive view of the home’s support arrangements. The home does not provide intermediate care so Standard 6 does not apply. Moorland House DS0000020057.V370224.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people living at the home have care plans and risk assessment records that promote safety and consistency in the support they receive, and staff work in ways that respect individuality, privacy and dignity. However there are concerns that not all needs are being met all of the time by the current arrangements of the home. EVIDENCE: In the AQAA the manager told us how everybody living at the home is involved in the development of a ‘comprehensive bespoke care plan in addition to any care plan provided by a placing authority’ and how this is linked to the assessments referred to in Section 1 above. We looked at four resident care files in detail, including two for people requiring nursing care. Overall the support plans are completed to the same standard and use the same comprehensive format provided by Methodist Homes. Aspects of support are up to date and monitored regularly but two of the files looked at did not indicate that evaluation was taking place at the recommended monthly interval and one of these was for somebody with complex health care needs. As referred to above areas of risk are covered on an individual basis, and the assessments of these are reviewed regularly when the risk changes or is Moorland House DS0000020057.V370224.R01.S.doc Version 5.2 Page 11 deemed to be high. As noted above however, in the care records of the person with a previous diagnosis of dementia there was no reference in the support plan to this and the potential risks associated with this had not been formally addressed. In the AQAA the manager told us how health promotion is encouraged and people living at the home have routine access to health care professionals such as chiropodist, optician, General Practitioner, district nurse and specialist clinics. These visits are recorded on all the files looked at and people confirmed this in the feedback received. The senior staff spoken to described how quality monitoring of the staff support activities is routine and ‘demanding’, and the AQAA described how Methodist Homes had highlighted practice improvements in falls prevention, the management of specific infections, oral and foot care. There was also space in the care documentation to monitor and record specific health issues such as dressings management and blood sugar levels but, in the files looked at, information on residents’ social needs was not always complete, with variable amounts of detail regarding leisure interests and social background. Feedback from people living at the home was generally positive about the practice and attitudes of care staff, who were observed interacting with residents in a warm and appropriate manner. However, as was noted in the last inspection report, residents again mentioned that they thought staff were very stretched at times and for those people spending time in their rooms or who had mobility problems, responses to the call bell was ‘very variable’, ‘very poor’ and ‘sluggish’. This was described as being a particular problem when help is needed to get to the toilet, to get downstairs for meals and at night. Discussions with staff confirmed this (see Section 6 below) although there were other people living at the home who said that ‘I get support and help when I need it’ and ‘if I need anybody I can always find staff’ and all the written feedback described staff as being ‘always’ or ‘usually’ available. The home has a specific room for the storage of medicines and these were securely and managed appropriately with clear records and processes in place for their administration and disposal. Medicines are administered by the qualified nursing staff for people with nursing needs and by the senior carers, who have been properly trained, for people with personal care needs only. . Regular audits of these arrangements are undertaken through the pharmacist and by the manager as part of the home’s quality monitoring requirements. However it was noted that for one person who had been prescribed a strong tranquillizer for occasional use (PRN) the guidance for staff about how to use in the support records was not on the medicines file. It was also noted that this particular medicine was being used almost every day without reference back to the person’s GP for review. Another person had been prescribed a common painkiller but was not being given it as she had regularly refused it, being pain free; again without reference back to the GP for review. Moorland House DS0000020057.V370224.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People at the home enjoy lifestyles and routines that suit their varying levels of ability and interests, and have the opportunity to take part in organised leisure and social activities. EVIDENCE: In the AQAA the manager told us how the home has a full and varied activity programme running 7 days a week, devised following consultation with residents, and advertised to all residents and their families. We were also told that residents social needs and interests are assessed and documented in individual support plans; as noted above completion of this is in reality variable. The home employs an Activity Co-ordinator who focuses entirely on providing the opportunities and facilities for social care and who is assisted by a substantial group of volunteers who take an interest in individual residents as well as organised groups. Feedback from people living at the home confirmed this and said that ‘in the last few months we have an activities helper and things are greatly improved’ and that ‘things are better recently with the new coordinator who is full of ideas’. We visited the art and craft room upstairs with the manager, and noted a number of examples produced in this activity on display around the home. Moorland House DS0000020057.V370224.R01.S.doc Version 5.2 Page 13 In the AQAA we were also told that the home tries to focus on the spiritual needs of residents, and the home’s Chaplain was in the home during this inspection running a prayer group and service for two groups of people living at the home. He also offers support to the residents and their families for broad spiritual needs and we were told liaises with the local Methodist church and vicars/ministers of other churches to provide further opportunities for worship. We were also told how the home tries to maintain a strong community focus and there are links with the local Primary School, the Village Gala Committee and Community Transport; people described to us regular outings in the home’s minibus We spoke to a number of relatives visiting on the day of the inspection and they said that they were ‘always made very welcome and kept well informed about any changes’. Regular resident meetings have been maintained and detailed minutes are available. The latter showed a continuing interest from people living at the home in its operation and that resident views are encouraged on a range of issues such as health and safety matters, the state of the building, activities and catering. A brief visit was made to the kitchen and the cook described current arrangements. Good standards in the catering service have continued, and a 4-week menu is being followed, which had recently been changed to reflect resident requests. The menu indicates a choice at the main meals of the day and a hot option available for breakfast and afternoon tea, with a snack and hot drink available at suppertime. Arrangements in the dining room at breakfast had recently been changed to become more flexible, reflecting people’s varying times for getting up and a ‘buffet’ style of serving. One person described this as ‘a tall order but running well’. The cook routinely deals with people who have special dietary needs, and at the time of the inspection these included diabetic and softened; she described a good understanding of the necessity of making the latter appetising and tailored to individual circumstances and capability. Feedback indicated that most people enjoy the meals at the home and that staff are aware of their preferences when they come to live there. Others said that the food was ‘unimaginative’ and ‘not catering for people with different and wider tastes’. Moorland House DS0000020057.V370224.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home responds to complaints made by residents and their representatives according to a written procedure, and aims to protect them from harm. EVIDENCE: The AQAA told us how the home’s residents and their relatives are given information about how to complain and how both the home’s management and Methodist Homes welcome complaints and comments about how the home is being run. We were told that the organisation monitors any complaints to ensure that lessons are learnt and necessary changes made. Written and verbal feedback indicated that people are clear about how to get problems resolved and are confident that they would be listened to. Records contained in the AQAA and at the home indicated two complaints or concerns received in the past 12 months and how they had been resolved properly. One of these was recently made, and relates to the issue of staff response to the call bell referred to in section 2 above, which resulted in the person experiencing a fall. Safeguarding adults procedures are in place and records indicate that in the past year all staff, apart from very recent starters, have attended the full day training about dealing with abuse, provided by the Social Services Department. The staff spoken to were able to describe an understanding of their responsibilities in reporting suspicions of abuse, and the manager is familiar with reporting procedures and how to refer to the Protection of Vulnerable Adults (POVA) list. There has been one situation at the beginning of this year when the home’s line management met with local statutory agencies under these procedures following concerns about the standard of care planning Moorland House DS0000020057.V370224.R01.S.doc Version 5.2 Page 15 documentation of a person living to the home; serious concerns about this issue were allayed as a result of these meetings. Moorland House DS0000020057.V370224.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The environment within the home has been maintained and improved to meet the special needs of the people living there; it provides them with a homely, modern place in which to live. EVIDENCE: The upgrading and extension of the home was completed in 2006 and the outstanding issues identified at the last inspection have all been dealt with. The overall environment of the home presents as light, spacious, clean and hygienic with a good range of facilities for residents. Décor, fixtures and fittings and general furnishing of the home have been renewed to a high standard throughout and bedrooms are of a good size, all with en-suite facilities; a number that were visited had been personalised by their occupants. There are several lounge areas available throughout the building that were in use during this inspection, some of which have kitchenette facilities available which are regularly used. Bathrooms have a range of aids and adaptations to assist residents with mobility difficulties and these areas are well maintained and clean. In the AQAA the manager described how they Moorland House DS0000020057.V370224.R01.S.doc Version 5.2 Page 17 value the therapeutic benefits that outside space can bring and encourage the creation of sensory gardens, attractive planted areas, seating and paths within safe secure gardens. A volunteer gardener was working at the home during the inspection. The manager told us in the AQAA that maintenance personnel closely monitor the fabric of the building and equipment within, and an estates management team is available for guidance and assistance. On the day of the inspection the home was clean, tidy and free from odours and all residents observed in the home wore clean and well-presented clothing. Staff have received training in the management and control of infection and the importance of this continues to be promoted by Methodist Homes. Feedback from the people living at the home and their relatives was very poitive about the style of the home and more than one commenetd that in spite of its increased sizie it is still a ‘home from home’. Moorland House DS0000020057.V370224.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Levels of staff at the home are not always sufficient to meet the needs of everybody living at the home, although they are recruited properly and they have received training that helps them do their jobs in a more professional way. EVIDENCE: The manager told us in the AQAA that the home maintains staffing levels that meet the needs of the residents by day and night and that these are higher than required by the nationally set guidelines. We were also told that numbers of domestic and catering staff are appropriate for the needs of the home and the services provided. However as mentioned in Section 2 above there were several comments from residents that they thought staffing levels for care staff were not high enough: ‘There appears to be a shortage of staff; although it doesn’t affect me I see it around me’ ‘More often than not there is not enough staff’. All of the staff spoken to indicated that they were of the same view: ‘Staffing levels are not up to match dependency. There are insufficient carers to meet the changed needs of residents’. ‘We are regularly aware that people have to wait and there’s not much opportunity for 1-to-1 time with residents’. ‘Staff are consistently stretched’. Moorland House DS0000020057.V370224.R01.S.doc Version 5.2 Page 19 We were told in the AQAA that 26 people living at the home require the help of two carers with their personal care needs. As reported above other people living at the home expressed satisfaction with the availability of staff support. Examination of the staffing roster indicated an increased level of carers on the morning shift since the last inspection and there is also a qualified nurse on each shift. Vacancies in the nursing establishment have been covered by the appointment of a deputy manager who is a qualified nurse. The AQAA told us how all staff are given an organised programme of basic training when they start work at the home in line with nationally agreed standards and that additional mandatory and developmental training is also provided with an allowance of at least 5 days per person made in the staffing budget. This was borne out from records at the home and from discussion with staff: ‘Methodist Homes are very good for training; they try to do a lot through inhouse trainers’. The numbers of staff who have achieved a National Vocational Qualification (NVQ) is over 60 , which exceeds the nationally set target. We looked at the files of two recently appointed staff for evidence of the procedure that had been followed for their recruitment, and they contained safe and satisfactory information showing that proper checks had been carried out. These included two written references and checks by the POVA1st system and Criminal Records Bureau obtained before they started work. Moorland House DS0000020057.V370224.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has well-organised and comprehensive systems in place to ensure it is a safe place in which to live and work, and the new manager has made an impact on the running of the home and has identified ways in which it needs to be further improved. EVIDENCE: The manager has been very recently appointed and has not yet applied to register with us as is required by law. The AQAA told us that she has considerable experience of management within the care sector and has clear lines of responsibility and accountability within a set staffing structure adopted by MHA. The home has recently appointed a deputy manager who is very experienced nurse. Everybody spoken to was very positive about the impact the new manager has had on the running of the home and about the problems carried over from the previous management regime: Moorland House DS0000020057.V370224.R01.S.doc Version 5.2 Page 21 ‘Things were arranged to suit staff, now we’re changing things to suit the residents’. ‘Things have improved since the new manager started – morale was poor but now everybody is working together’. ‘We have a new home manager who is doing a lot of sorting and whom we all (including staff) seem to trust and like very much’. Senior staff told us that there are things to put right and these include the key tasks of staff support and supervision. Although the system for meeting with staff is in place, the arrangements are not yet occurring regularly enough to meet the National Standard. The AQAA told us about the extensive systems put in place by Methodist Homes to ensure the service of the home is the best it can be, and these include an annual self-assessment (Standards and Values Assessment) carried out be senior advisers in MHA, a six monthly internal audit involving residents and junior staff, an annual resident satisfaction survey, and internal management review action plans from these audits. Examples of these were seen at the home and the overall report of this activity for the past year rates the home well. It was noted that the written reports required by law to be made monthly by the proprietor into the operation of the home were not available for 4 of the months in 2008, which has been an important period in the development of this home. The AQAA told how the home does not generally handle residents’ money other than a small float for each person for day-to-day spending. The systems in place were found to be satisfactory and remain unchanged since the last inspection. The AQAA also indicated good standards of health and safety activity and regular servicing of equipment; the home’s handyman makes sure that any problems are dealt with quickly. Observations made around the building and a sample of fire safety and servicing records indicate that the home is hazard free. Moorland House DS0000020057.V370224.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 2 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 4 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X X 2 X 3 Moorland House DS0000020057.V370224.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP4 OP7 Regulation 12(1) Requirement Timescale for action 30/11/08 2. OP27 18(1)(a) 3. 4. RQN OP33 9(1) 26(1-5) The primary health and social care needs of all residents must be reviewed, particularly those that have developed mental health needs so that it is established that those needs can be met by the services provided by the home and that the conditions of registration of the home are being complied with. The numbers of staff on duty 30/11/08 must be reviewed in line with the available guidance and must be set so that there are sufficient staff to meet the needs and personal requirements of all of the people living at the home. The manager must apply to 30/09/08 register with the CSCI as is required by law. The named person responsible 30/09/08 for the home or their representative must carry out their legal responsibilities to visit, inspect and report on the home’s operation and must do this every month. Moorland House DS0000020057.V370224.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP9 Good Practice Recommendations Medicines being administered at the home should be regularly reviewed with the residents prescribing doctor particularly where patterns of use of occasional (PRN) medicines change. Staff supervision should take place every two months and include career development needs, and philosophy of care in the home. 2, OP36 Moorland House DS0000020057.V370224.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Moorland House DS0000020057.V370224.R01.S.doc Version 5.2 Page 26 - 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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