Care Home: Moorside Nursing Home

What the care home does well There are good systems to assess people`s needs before they move into the home. This reassures people that the home will be able to meet their needs. People are supported to access the health services they need and they are treated with respect and their privacy upheld. The home provides excellent support for people to take part in a wide range of activities and events that meet individual needs. Visitors are made to feel welcome and people`s nutritional needs are well met. There are good systems to investigate complaints and protect people from abuse. This gives people confidence that any complaints will be taken seriously and responded to. The home is well maintained, clean and hygienic. Staff are thoroughly checked before they work in the home, which helps to ensure people are protected and their needs are met. The home is well managed and there are good systems to plan improvements and keep people safe. What has improved since the last inspection? The care planning system has been improved, with regular reviews of plans and needs assessments. This helps to ensure that plans are accurate and give staff the right information to meet people`s needs. The medication systems have been improved and two staff now sign handwritten entries on the medication records. This helps to ensure people receive the medication they are prescribed. What the care home could do better: The manager needs to complete the work started to update the staff training records. This will help to make sure all staff have received the training they need. The manager needs to submit an application for registration to us. CARE HOMES FOR OLDER PEOPLE Moorside Nursing Home Durngate Winchester Hampshire SO23 8DU Lead Inspector Craig Willis Unannounced Inspection 14th November 2007 08:50 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 Moorside Nursing Home DS0000012129.V354073.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. Moorside Nursing Home DS0000012129.V354073.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Moorside Nursing Home Address Durngate Winchester Hampshire SO23 8DU 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) 00962 854548 01962 854811 St John’s Winchester Charity Post Vacant Care Home 26 Category(ies) of Dementia (26), Dementia - over 65 years of age registration, with number (26), Mental disorder, excluding learning of places disability or dementia (26), Mental Disorder, excluding learning disability or dementia - over 65 years of age (26) Moorside Nursing Home DS0000012129.V354073.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th March 2007 Brief Description of the Service: Moorside is a care home providing nursing care for 26 people with dementia or mental health problems. The home was purpose built and has accommodation arranged in cluster formation, with bedrooms, lounge, dining room with small kitchen area and bathroom facilities provided in each unit. All residents are accommodated in single rooms with twenty-four of the twenty-six rooms fitted with en-suite facilities. The well maintained enclosed rear garden provides a pleasant sitting and walking area for residents. A day centre situated on the ground floor of the home, operates on two days of the week. The home is owned and operated by a Christian organisation, The St Johns Winchester Charity. The home is situated within the centre of the city of Winchester, close to all amenities. Limited parking is available at the home. A public car park is situated opposite the home. The manager reported that weekly charges range from £395.64 to £541.12, with additional charges for hairdressing, chiropody, papers, toiletries, labels, clothing, excursions and trips. Moorside Nursing Home DS0000012129.V354073.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The evidence used to write this report was gained from a review of the information the provider sent to us since the last visit and the previous inspection report. This information included incident reports and an annual quality assurance assessment. A site visit to the home was made on 14 November 2007. During the visit we spoke with two people who live in the home and two relatives. We also received surveys from sixteen relatives of people who live in the home. We spoke with the manager and staff on duty. The communal areas of the building were viewed and documents relating to the running of the home were inspected during the visit. What the service does well: What has improved since the last inspection? Moorside Nursing Home DS0000012129.V354073.R01.S.doc Version 5.2 Page 6 The care planning system has been improved, with regular reviews of plans and needs assessments. This helps to ensure that plans are accurate and give staff the right information to meet people’s needs. The medication systems have been improved and two staff now sign handwritten entries on the medication records. This helps to ensure people receive the medication they are prescribed. 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. Moorside Nursing Home DS0000012129.V354073.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 Moorside Nursing Home DS0000012129.V354073.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): Standards 3 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good systems to assess people’s needs before they move into the home. This reassures people that the home will be able to meet their needs. EVIDENCE: The records of six people who live in the home were inspected during the visit. All six records contained a comprehensive assessment of the person’s needs. The manager had completed this assessment before the people had been offered a place in the home. The assessments cover people’s physical and psychological needs, communication, medication, history of falls, nutrition and pressure areas. Staff spoken with said they felt the details in assessments were accurate and gave them the information they need. Completed surveys were received from sixteen relatives of people who live in the home. Nine said the home always meets the needs of their relative, seven said the home usually meets their needs. Moorside Nursing Home DS0000012129.V354073.R01.S.doc Version 5.2 Page 9 People do not move into the home to receive intermediate care and therefore standard six is not applicable. Moorside Nursing Home DS0000012129.V354073.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): Standards 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 home has improved the care planning system, ensuring that people’s needs are met. Support is provided to access health services and people are treated with respect and their privacy upheld. There are good systems for safely managing people’s medication, which helps to ensure people receive the medication they are prescribed. EVIDENCE: The manager reported that the requirement made at the last inspection that care plans must be kept under review had been complied with. The plans of six people who live in the home were inspected during the visit. These plans set out how the person’s assessed needs should be met and had all been reviewed each month. Where people’s needs had changed, care plans had been amended. Completed surveys were received from sixteen relatives of people who live in the home. Twelve said the home always gives the care to Moorside Nursing Home DS0000012129.V354073.R01.S.doc Version 5.2 Page 11 their relative that they expect; four said the home usually provides the care expected. The manager reported that she feels the current care planning system contains good information, but is not in a format that is easily accessible to staff using them. As a result the manager has developed a new system, which she hopes to introduce over the next two months. Staff spoken with said they thought the information in the care plans was accurate and helped them meet people’s needs but the proposed changes would make them better. People are supported to receive the medical services they need, with records of regular access to GPs, opticians, chiropodist and dentist and any specialist health services that people needed. People spoken with confirmed that they were able to attend health services when they need to. Medication was checked and was well managed. Medication was stored in a locked trolley and locked cupboards in the clinical room. Administration records had been fully completed and there was a record of medication received, administered, and destroyed. Controlled drugs were stored in a separate locked cabinet and a controlled drugs register had been fully completed. The balance recorded matched the balance held for one controlled drug that was checked. Regular checks of medication stock are undertaken to ensure medication is not over ordered. There is a medication fridge available, with temperature checks taken daily. The manager reported that since the last inspection the recommendation that handwritten entries on medication charts are countersigned has been implemented. There were no handwritten entries on the medication records inspected. Staff were observed providing support in a sensitive manner, that maintained people’s privacy and treated them with respect. This was particularly evident in the support provided to people with higher needs due to dementia, enabling people to communicate their needs, for example to use the toilet, without compromising their dignity. Staff spoken with demonstrated a good understanding of people’s needs and how to meet them. Moorside Nursing Home DS0000012129.V354073.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): Standards 12, 13, 14 and 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home provides excellent support for people to take part in a wide range of activities and events that meet individual needs. Visitors are made to feel welcome and people’s nutritional needs are well met. EVIDENCE: The needs assessments inspected included details of people’s social, cultural and religious needs. A range of activities and events are organised to meet these assessed needs. The home has a day centre that provides a variety of activities for people who live in the home and the local community. The home provides SONAS therapy twice a week, which is designed for people with dementia to provide stimulation to all the senses and to enable people to express themselves. The staff who provide this therapy have received specific training. Other activities include a breakfast club, singing, visiting entertainers, a summer fete and trips out, for example to a local garden centre. Staff spoken with demonstrated a good understanding of people’s social and cultural needs and how they should be met. People are supported to practise their religion. Staff particularly understood the need for one to one Moorside Nursing Home DS0000012129.V354073.R01.S.doc Version 5.2 Page 13 interaction with some people due to the effects of their dementia. Completed surveys were received from sixteen relatives of people who live in the home. Seven said the home always meets the different needs of people, seven said the home usually meets people’s different needs and two did not answer the question. The home has an open visiting policy and relatives spoken with said they were always made to feel welcome. Of the sixteen completed relatives’ surveys, ten said they were always kept up to date with important issues affecting their relative and six said they usually were. People who live in the home are supported to make as many decisions about their lives as possible. Details about how people make decisions are recorded in the care planning documents. The manager reported that she had recently attended training on the Mental Capacity Act and was passing information on to all staff. People who live in the home and relatives spoken with said that the food was generally good, with a choice of meals and individual dietary requirements being taken into account. During the visit staff were observed providing sensitive support for people that need help to eat. Food was well presented and people were observed chatting and relaxing during their meal. Moorside Nursing Home DS0000012129.V354073.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): Standards 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 has good systems to investigate complaints and protect people from abuse. This gives people confidence that any complaints will be taken seriously and responded to. EVIDENCE: The home has a complaints procedure, which is made available to everybody who lives in the home and their representatives. Of the sixteen relatives who completed a survey, twelve said they know how to make a complaint, three said they did not know and one did not answer the question. People spoken with during the visit said they were confident any complaint they made would be taken seriously and responded to. The home has received one complaint since the last inspection concerning the care a person received. The complaint was investigated and the outcome was that the person had received the right care, although there had been some failings in the recording of an incident. Systems have been put in place to prevent this happening again. Records of the investigations and letters to the complainant were available for inspection. We have not received any complaints about the home. The home has policies and procedures in place to safeguard people from abuse. Staff spoken with demonstrated a good awareness of these procedures and action they should take if abuse is witnessed, reported or suspected. The Moorside Nursing Home DS0000012129.V354073.R01.S.doc Version 5.2 Page 15 home has made one referral to adult social services following an allegation that a visitor to the home was abusive towards a resident. Following investigations systems were put in place to ensure the safety of the person who lives in the home. Documents relating to the incident and investigations were available in the home for inspection. Moorside Nursing Home DS0000012129.V354073.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): Standards 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained, clean and hygienic, which provides a safe, comfortable and homely environment for people who live there. EVIDENCE: During the visit, all of the communal areas of the house were viewed. All areas were clean and well maintained. The home is arranged in three clusters, each with a dining room, lounge and bathroom with an assisted bath. In addition to these areas there are quiet areas and quiet rooms. The manager reported that she plans to create an arts and craft room. The home has an enclosed garden that has level access. People spoken with during the visit said that the home has good facilities and is always clean. Staff spoken with said Moorside Nursing Home DS0000012129.V354073.R01.S.doc Version 5.2 Page 17 they though the building provides good facilities for people and is well maintained. The laundry is equipped with machines that are suitable for washing soiled items and there are dedicated laundry staff. There are hand-washing facilities in the toilets, bathrooms, laundry and kitchen. Moorside Nursing Home DS0000012129.V354073.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): Standards 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are thoroughly checked before they work in the home and deployed in sufficient numbers. This helps to ensure that people are protected and their needs are met. There is a good training programme, although the current recording systems do not effectively monitor the training that staff have completed. EVIDENCE: The home’s rotas were inspected during the visit. There are two nurses and nine care staff on duty between 8am and 8pm, with one nurse and four care staff between 8pm and 8am. In addition to these staff there is a deputy manager providing support and additional staffing numbers where necessary and the manager works each weekday morning from 7am in order to meet with all staff throughout the day. There are additional kitchen, domestic and laundry staff. People spoken with said they felt there were enough staff working at all times to meet their needs. Staff spoken with said they felt there were enough staff working for them to be able to do their job effectively and meet people’s needs. Moorside Nursing Home DS0000012129.V354073.R01.S.doc Version 5.2 Page 19 The manager reported in the annual quality assurance assessment for us that satisfactory pre-employment checks have been completed for all staff who have worked in the home over the last twelve months. The only member of staff employed since the last inspection is the manager, whose records were inspected. These demonstrated that a Criminal Records Bureau enhanced disclosure and two written references were obtained before she started work. The manager reported that she is currently in the process of recruiting new staff. Interviews were held the week before the inspection but no posts were offered, as the applicants were not judged to have the right skills to work in the home. As a result of the staff vacancies, the home uses a number of agency staff, who have received an induction into the operation of the home. The manager reported that she tries to use the same agency staff to provide some consistency to people who live in the home. The manager also reported that where agency staff have not had the right skills to work in the home they have not been used again. The manager reported in the annual quality assurance assessment that 36 of the permanent care staff have achieved the National Vocational Qualification (NVQ) at level 2 or above and two staff are working towards the award. Staff complete an induction when they start work, which prepares them for the NVQ courses. There is a comprehensive training programme for staff, with courses including moving and handling, safeguarding adults, fire safety, infection control, first aid, food hygiene, person centred approaches to dementia care and Parkinson’s care. The manager reported that she does not currently have an accurate record of the training that staff have completed. This information is being collated and additional courses planned to fill gaps in training that are identified. Staff spoken with said they felt the training provided was good and helped them to do their job effectively. Moorside Nursing Home DS0000012129.V354073.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): Standards 31, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed by a qualified person and there are good systems to plan improvements and keep people safe. EVIDENCE: The manager has been in post for approximately three months and is a registered nurse. Her qualifications include the registered manager’s award and a diploma in dementia care. The manager has not yet submitted an application for registration to us and reported that she needs to obtain some of the supporting information. The process for obtaining this information was Moorside Nursing Home DS0000012129.V354073.R01.S.doc Version 5.2 Page 21 explained during the visit and the manager was informed that an application should be submitted urgently. The home has a quality assurance system in place, which includes quarterly health and safety audits. Surveys are completed of people living in the home and their relatives and staff. The results of the surveys are collated and used to plan improvements to address the issues raised. The manager reported that the home’s directors visit three or four times each week and complete monthly reports on how the home is running and any actions they feel are necessary. These reports were available in the home for inspection. Monthly meetings are held for relatives to receive information and express their views about how the home is operating. The trustees of the charity meet quarterly with the manager and director to assess how the home is operating. The information for the quality assurance systems is collated and used to create an annual development plan for the home. The home looks after cash for some people, although no accounts are operated on people’s behalf. The money is individually stored in the safe and was checked for three people during the visit. The cash held was found to match the balance recorded for all three. The manager reported in the annual quality assurance assessment for us that regular checks and servicing are completed on the fire alarm and fire fighting equipment, electrical systems, portable electrical equipment, lifts, hoists and gas appliances. The records for the fire systems were checked during the visit and confirmed the manager’s report. A record of accidents to people living in the home and staff is kept. Moorside Nursing Home DS0000012129.V354073.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 4 X 3 X X 3 Moorside Nursing Home DS0000012129.V354073.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Moorside Nursing Home DS0000012129.V354073.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Moorside Nursing Home DS0000012129.V354073.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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