Care Home: Morovahview Residential Home

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What the care home does well A Statement Of Purpose and Service Users guide informs prospective and current residents of the facilities and services that Moroahview provide. Each resident admitted to the care home is provided with a contract or terms and conditions of residency.New residents to the home confirmed that they met with a member of the management team prior to admission so that they were aware of what care they would receive at Moroahview. People who use the service commented this was done in a `sensitive` and `informative` manner and did not feel this area could be improved upon. From inspection of case records it was evident that staff undertake their own assessment plus gains the views and opinions of any specialist workers involved with the individual. From this an individual plan of care that summarises the person`s needs is implemented. The care plan forms the basis of the care and support provided. The plans are regularly reviewed to make sure the person`s needs are met at all times. People who use the service were positive about the care and support provided by the staff and said the staff was flexible and responsive to their needs. Some comments include `nothing is too much trouble...staff are so helpful`. People who use the service also stated they were always treated with dignity and respect. Good arrangements are in place to meet individual`s health needs and medical services are promptly accessed when required. Staff have been suitably trained in the administration of medication. People who use the service are able to decide the pattern of every day living and therefore the providers have a flexible approach to the care and support provided. Flexible visiting arrangements are in place and People who use the service decide where they meet with their visitors. People who use the service are positive about the varied and nutritional menu that reflects their preferences and choices. Some saying the food is `good` and we get `plenty of it`. The kitchen is suitably equipped and good standards of cleanliness are maintained. The environment is homely, clean and comfortable and people who use the service said they were satisfied with the accommodation provided. The recruitment, selection and vetting arrangements are robust to ensure that good arrangements are in place that safeguard residents. The care home is well managed by an experienced management team who plays an active role in the day-to-day operations. What has improved since the last inspection? The registered provider has addressed the previous six requirements. Health and safety risks assessments in respect of the environment have been completed and any work that was identified to minimise risk has been actioned, for example new radiators fitted in the home. A copy of the staff duty rota plus the hours that that the registered manager and registered provider works is now kept so that there is clear accountability of who has been working at particular times. A cook is now employed six days a week. Staff have attended updated training in the areas of first aid, food hygiene and 50% of the staff team have now gained a minimum of NVQ level 2 qualification. Therefore People who use the service can be confident that the staffs working with them is competent to do so. Formal and recorded supervision of staff ahs commenced which allows a venue for discussion around staffs care practices and identify any training needs. Staff said that they have found these sessions to be beneficial. The registered providers have signed a contract with a independent fire company who is now undertaking all their training, reviewing their fire procedures and risk assessments. The seventeen recommendations identified at the previous inspection have all been met. Theses include that individual signed contracts are now kept on the persons file so that it evidences their understanding and agreement to the terms and conditions of the placement. The care plans in the main direct, guide and inform staff in specifying what caring interventions are needed, this then allows consistent care to be provided. Access to dental and optician services has been facilitated and on the day of inspection a dentist visited the home. Copies of continence assessments are now kept on the individuals file and this care need is cross-referenced to the individuals care plan. A designated fridge for the storage of medicines has been purchased and temperatures are monitored regularly. In addition `borderline` controlled drugs are now stored as controlled drugs and records tallied with the amount of medication stored in this facility. People who use the service interests have been discussed with them and the home are actively attempting to meet their requests. The staff now record when an activity has occurred and who participated. Activities can be individual or group based and the registered providers acknowledge that this area will be continually developed. People who use the service said that they are `happy` with the meals provided and as there is a menu on display they can request an alternative meal if they do not wish to have the advertised meal. People who use the service said though that in the main they are satisfied with the menu available and `rarely` request an alternative. Staff were also aware of individuals likes and dislikes. Food records are now kept. Morovahview Residential Home DS0000069602.V371723.R01.S.doc Version 5.2 Page 8Staff were booked to attend adult protection training the day after the inspection so that their knowledge in this area will be expanded. The registered providers have a maintenance programme of works to be completed in the home. People who use the service said that they have `enjoyed` watching the building/ redecoration work that has been occurring, and was on the day of inspection, and all said that the environment has `improved greatly`. The registered providers have ordered new laundry equipment, which will include a sluice facility. This will promote infection control procedures. The registered providers have implemented a staff training and developmental plan to ensure that all staff attend mandatory training, refresher courses and are applying to attend more specialist courses i.e. dementia. Staff have attended first aid courses so that there is always a member of staff on duty with this qualification. A cook is now employed six days a week. Where oxygen is in use appropriate signage is displayed to ensure the health and safety of all who live, work and visit the home. Continued improvements to the environment are ongoing to ensure that the home remains attractive and comfortable to those who live, visit and work at the home. What the care home could do better: Discussion occurred over how the needs assessment and care plan document should be separated so that staff are more easily aware of what the individuals current needs are and how staff are to intervene so that consistent care is provided From a tablet count of PRN medication theses did not tally with what was stored in the medication cabinet. This was discussed with the management team who agreed that medicines had not been carried forward if the course had not been used in the month and hence the discrepancy. The management team reminded staff that lactulose should be used for the person it is prescribed for. Due to the fact that the registered persons have worked with us well and have agreed to address the issues immediately no requirements have been issued. Some entries made in the daily recording tend to be brief and do not always identify the level of participation in activities for all residents or their enjoyment of that activity. Further consideration should be given to elaborating the social / recreational information and ascertaining their wishes in respect of activities for each resident. It is recommended that the cook consider attending the intermediate food hygiene course to widen her knowledge in this field furtherAll incidents under Regulation 37 must be notified to the commission without delay as per the Care Standards Act. The registered providers have a ongoing maintenance and refurbishment plan for the homes environment which will improve the homes facilities further. The inspector would like to thank People who use the service, staff and registered providers for their kind assistance during this inspection process. CARE HOMES FOR OLDER PEOPLE Morovahview Residential Home 1 Bar View Lane Hayle Cornwall TR27 4AJ Lead Inspector Lynda Kirtland Unannounced Inspection 11th September 2008 9:30 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 Morovahview Residential Home DS0000069602.V371723.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. Morovahview Residential Home DS0000069602.V371723.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Morovahview Residential Home Address 1 Bar View Lane Hayle Cornwall TR27 4AJ 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) 01736 753772 Mr Philip John Jefferies Mrs Caroline Anne Jefferies Mr Philip John Jefferies Care Home 16 Category(ies) of Dementia (3), Mental disorder, excluding registration, with number learning disability or dementia (3), Old age, not of places falling within any other category (16) Morovahview Residential Home DS0000069602.V371723.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service: Care Home providing personal care only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE - maximum 3 places Mental disorder, excluding learning disability or dementia - Code MD maximum of 3 places The maximum number of service users who can be accommodated is 16. 28th March 2008 2. Date of last inspection Brief Description of the Service: Moroahview is a large detached dormer style bungalow that has been adapted and extended to provide residential accommodation for up to a maximum of sixteen people. There is a chair lift up from the ground to the first floor. The home offers both long term and respite care to older persons three of who may suffer from a dementia or mental illness. The home has good access all round the premises and ample car parking space. The home is located up a quiet lane yet is close to all the amenities offered in Hayle. Residents and relatives are positive about the care provided. Morovahview Residential Home DS0000069602.V371723.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. A key inspection took place on 11 September 2008. The visit lasted for approximately seven and a half hours. Information about the home received by the Commission since the previous inspection was taken into account when planning the inspection. The purpose of the inspection was to ensure that people who use the service needs are appropriately met in the home, with particular regard for ensuring good outcomes for them. This involved interviews with people who use the service, plus receiving 10 surveys, observation of their daily life and care provided. There was an inspection of the home’s premises and of written documents concerning the care and protection of the people who use the service and the ongoing management of the home. Staff were interviewed and observed in relation to their care practices and there was a discussion with the registered providers. The principle method used was case tracking. This involves examining the care notes and documents for a select number of people who use the service and following this through with interviews with them and staff working with them. This provides a useful, in-depth insight as to how their needs are being met in the home. At this inspection, three people who use the service were case tracked. In talking with some of the people who use the service they said that they were ‘happy’, ‘care is excellent’ and ‘its good here’. They cold not think of any improvements on the care and services that Moroahview currently provides. The surveys completed also reflected this. The Commission received the Annual Quality Assurance Assessment, which is a questionnaire that the registered provider completed. The AQAA describes the services and facilities that Moroahview provide and identifies what areas they do well in and where they want to make further improvements What the service does well: A Statement Of Purpose and Service Users guide informs prospective and current residents of the facilities and services that Moroahview provide. Each resident admitted to the care home is provided with a contract or terms and conditions of residency. Morovahview Residential Home DS0000069602.V371723.R01.S.doc Version 5.2 Page 6 New residents to the home confirmed that they met with a member of the management team prior to admission so that they were aware of what care they would receive at Moroahview. People who use the service commented this was done in a ‘sensitive’ and ‘informative’ manner and did not feel this area could be improved upon. From inspection of case records it was evident that staff undertake their own assessment plus gains the views and opinions of any specialist workers involved with the individual. From this an individual plan of care that summarises the person’s needs is implemented. The care plan forms the basis of the care and support provided. The plans are regularly reviewed to make sure the person’s needs are met at all times. People who use the service were positive about the care and support provided by the staff and said the staff was flexible and responsive to their needs. Some comments include ‘nothing is too much trouble…staff are so helpful’. People who use the service also stated they were always treated with dignity and respect. Good arrangements are in place to meet individual’s health needs and medical services are promptly accessed when required. Staff have been suitably trained in the administration of medication. People who use the service are able to decide the pattern of every day living and therefore the providers have a flexible approach to the care and support provided. Flexible visiting arrangements are in place and People who use the service decide where they meet with their visitors. People who use the service are positive about the varied and nutritional menu that reflects their preferences and choices. Some saying the food is ‘good’ and we get ‘plenty of it’. The kitchen is suitably equipped and good standards of cleanliness are maintained. The environment is homely, clean and comfortable and people who use the service said they were satisfied with the accommodation provided. The recruitment, selection and vetting arrangements are robust to ensure that good arrangements are in place that safeguard residents. The care home is well managed by an experienced management team who plays an active role in the day-to-day operations. What has improved since the last inspection? The registered provider has addressed the previous six requirements. Health and safety risks assessments in respect of the environment have been completed and any work that was identified to minimise risk has been actioned, for example new radiators fitted in the home. Morovahview Residential Home DS0000069602.V371723.R01.S.doc Version 5.2 Page 7 A copy of the staff duty rota plus the hours that that the registered manager and registered provider works is now kept so that there is clear accountability of who has been working at particular times. A cook is now employed six days a week. Staff have attended updated training in the areas of first aid, food hygiene and 50 of the staff team have now gained a minimum of NVQ level 2 qualification. Therefore People who use the service can be confident that the staffs working with them is competent to do so. Formal and recorded supervision of staff ahs commenced which allows a venue for discussion around staffs care practices and identify any training needs. Staff said that they have found these sessions to be beneficial. The registered providers have signed a contract with a independent fire company who is now undertaking all their training, reviewing their fire procedures and risk assessments. The seventeen recommendations identified at the previous inspection have all been met. Theses include that individual signed contracts are now kept on the persons file so that it evidences their understanding and agreement to the terms and conditions of the placement. The care plans in the main direct, guide and inform staff in specifying what caring interventions are needed, this then allows consistent care to be provided. Access to dental and optician services has been facilitated and on the day of inspection a dentist visited the home. Copies of continence assessments are now kept on the individuals file and this care need is cross-referenced to the individuals care plan. A designated fridge for the storage of medicines has been purchased and temperatures are monitored regularly. In addition ‘borderline’ controlled drugs are now stored as controlled drugs and records tallied with the amount of medication stored in this facility. People who use the service interests have been discussed with them and the home are actively attempting to meet their requests. The staff now record when an activity has occurred and who participated. Activities can be individual or group based and the registered providers acknowledge that this area will be continually developed. People who use the service said that they are ‘happy’ with the meals provided and as there is a menu on display they can request an alternative meal if they do not wish to have the advertised meal. People who use the service said though that in the main they are satisfied with the menu available and ‘rarely’ request an alternative. Staff were also aware of individuals likes and dislikes. Food records are now kept. Morovahview Residential Home DS0000069602.V371723.R01.S.doc Version 5.2 Page 8 Staff were booked to attend adult protection training the day after the inspection so that their knowledge in this area will be expanded. The registered providers have a maintenance programme of works to be completed in the home. People who use the service said that they have ‘enjoyed’ watching the building/ redecoration work that has been occurring, and was on the day of inspection, and all said that the environment has ‘improved greatly’. The registered providers have ordered new laundry equipment, which will include a sluice facility. This will promote infection control procedures. The registered providers have implemented a staff training and developmental plan to ensure that all staff attend mandatory training, refresher courses and are applying to attend more specialist courses i.e. dementia. Staff have attended first aid courses so that there is always a member of staff on duty with this qualification. A cook is now employed six days a week. Where oxygen is in use appropriate signage is displayed to ensure the health and safety of all who live, work and visit the home. Continued improvements to the environment are ongoing to ensure that the home remains attractive and comfortable to those who live, visit and work at the home. What they could do better: Discussion occurred over how the needs assessment and care plan document should be separated so that staff are more easily aware of what the individuals current needs are and how staff are to intervene so that consistent care is provided From a tablet count of PRN medication theses did not tally with what was stored in the medication cabinet. This was discussed with the management team who agreed that medicines had not been carried forward if the course had not been used in the month and hence the discrepancy. The management team reminded staff that lactulose should be used for the person it is prescribed for. Due to the fact that the registered persons have worked with us well and have agreed to address the issues immediately no requirements have been issued. Some entries made in the daily recording tend to be brief and do not always identify the level of participation in activities for all residents or their enjoyment of that activity. Further consideration should be given to elaborating the social / recreational information and ascertaining their wishes in respect of activities for each resident. It is recommended that the cook consider attending the intermediate food hygiene course to widen her knowledge in this field further Morovahview Residential Home DS0000069602.V371723.R01.S.doc Version 5.2 Page 9 All incidents under Regulation 37 must be notified to the commission without delay as per the Care Standards Act. The registered providers have a ongoing maintenance and refurbishment plan for the homes environment which will improve the homes facilities further. The inspector would like to thank People who use the service, staff and registered providers for their kind assistance during this inspection process. 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. Morovahview Residential Home DS0000069602.V371723.R01.S.doc Version 5.2 Page 10 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 Morovahview Residential Home DS0000069602.V371723.R01.S.doc Version 5.2 Page 11 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): 2,3,4,5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The needs of prospective service users are assessed so that they can be assured that the home can provide adequate care. EVIDENCE: Managers from the home visit prospective residents and complete a needs assessment. This documentation shows that prospective residents physical, emotional, social and diverse needs are taken into account. All the residents’ records case tracked contained needs assessments completed by the home’s managers. These assessment records recorded their assessed needs in detail and included their views and preferences and who was present at the assessment. People who use the service feel that the home involved them in their care arrangements and did not feel any improvements could be made in this area. Each person that is admitted to the care home is provided with a contract or a statement regarding the terms and conditions of residency. Morovahview Residential Home DS0000069602.V371723.R01.S.doc Version 5.2 Page 12 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): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Written care plans direct and inform staff about peoples health and personal care needs so that these can be consistently met. The healthcare needs of people are monitored and addressed so that their needs are met. Medicine system would benefit from review to ensure medication errors are prevented. People who use the service stated they are treated respectfully at all times so that they retain their dignity and enjoy a good quality of life in the home. EVIDENCE: Each person who uses the service has a care plan that covers the individuals physical, emotional, and diverse care needs. The care plans in the main direct, guide and inform staff in specifying what caring interventions are needed, this then allows consistent care to be provided. Discussion occurred over how the needs assessment and care plan document should be separated so that staff are more easily aware of what the individuals current needs are and how staff are to intervene so that consistent care is provided. The managers agreed that the documents would be separated more clearly and that they would be more specific i.e. when using the word prompt as to what they expected staff to do. Morovahview Residential Home DS0000069602.V371723.R01.S.doc Version 5.2 Page 13 Staff stated that they understood the care plans and verbalised a good knowledge of individuals needs. Care plans are regularly reviewed to make sure they are up to date and appropriately reflect the individual’s needs, preferences and choices. People who use the service are involved in these reviews and sign to say the review has occurred and if any changes are to be made to their care plan that they are in agreement to them. People who use the service were satisfied with the care and support they receive and many were positive about the manner in which the staff undertakes their duties and responsibilities Assessment tools for nutritional screening, Tullamore Falls risk assessment, moving and handling assessments, personal profile and life history are in place. Continence assessments are now received. This information is then cross referenced to the individuals care plan so that staff are aware of how to manage these areas of care. People who use the service are registered with local GP practices. They felt that their health care needs were monitored and attention obtained promptly when needed. The registered providers have arranged for a dentist to visit the home, which occurred on the day of inspection. They are in the process of securing visits from the optician for people who require this service. A chiropodist visits regularly. Records are held of when these professionals visit. Medication is stored securely in the office in appropriate cupboards and a medicine trolley. MAR (medication administration sheets) are printed by the Alliance Pharmacy. Hand written entries are checked by two staff and two initials entered as evidence. MAR sheets were in good order. From a tablet count of PRN medication these did not tally with what was stored in the medication cabinet. This was discussed with the management team who agreed that medicines had not been carried forward if the course had not been used in the month and hence the discrepancy. The management team reminded staff that lactulose should be used for the person it is prescribed for. Due to the fact that the registered persons have worked with us well and have agreed to address the issues immediately no requirements have been issued. A controlled drugs (CD) cupboard is available and records were accurate. Since the last inspection a designated drugs fridge has been purchased. An up to date British National Formulary and Royal Pharmaceutical Society guidelines is available for staff to refer to. The registered person told us that all staff have now received medication training and documentation was seen. Morovahview Residential Home DS0000069602.V371723.R01.S.doc Version 5.2 Page 14 From discussion with people who use the service plus looking at recent surveys completed by them, it is clear that positive relationships are established with staff and that individuals who use the service feel that they are treated with dignity and respect at all times. Some comments from individuals who use the service describe staff as “very kind”, “marvellous” and “I get spoilt here”. Examples of staff providing skilled and sensitive care were observed during the inspection The daily records for people who use the service summarised if care had been provided that day and reflect for example when visitors or participation in activities occurred. Care needs to be taken regarding how information on occasions is recorded. Morovahview Residential Home DS0000069602.V371723.R01.S.doc Version 5.2 Page 15 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): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are supported in a lifestyle, which accords as far as possible with their own expectations and preferences. A range of activities takes place that meets peoples’ social, religious and recreational interests. The diet provided is varied and nutritious with attention to individual preferences EVIDENCE: People who use the service felt that they had control over their daily lives and were supported to make choices about their routines and activities. They felt that there was in the main ‘enough to do’. Individual care plans detail their social and activity interests. The home provides a range of planned activities in the mornings such as music, bingo, ‘pamper sessions’ and quizzes. The registered persons are trying to encourage more 1:1 activities as well as group activities and see this as an ongoing development. People who use the service were observed during the inspection to, read the paper and generally socialising. Some entries made in the daily recording tend to be brief and do not always identify the level of participation in activities for all residents or their enjoyment of that activity. Further consideration should be given to elaborating the social / recreational information and ascertaining their wishes in respect of activities for each resident. Morovahview Residential Home DS0000069602.V371723.R01.S.doc Version 5.2 Page 16 People who use the service said that they found the visiting arrangements open and flexible. They felt that visitors were made welcome and could choose where they meet their guests. People who use the service confirmed they have a lockable facility for small items of value and can bring in possessions and furniture at admission by agreement with the provider. People who use the service were aware that they could lock their rooms if wished, but have chosen not too. All residents currently handle their own affairs, with some supported by their family and / or other representatives. The registered persons are actively seeking contact details for independent advocates who will act in their best interests of their residents if necessary. People who use the service were complimentary about the quality and quantity of food provided, comments such as ‘good’, ‘enough choice’ and ‘very tasty’ were given. Menus were on display so that People who use the service were aware of the meals available and could request a alternative if wished. Each person’s preferences and choices of food are recorded. The registered persons said that people who use the service are encouraged to share ideas for the menus, this needs to be evidenced. A cook is employed six days a week who prepares the main meal, teas and home baking. Care staff prepares breakfast, which in the main is taken in the lounge/ dining area but the option to have it in the resident’s room is available. People who use the service were satisfied with the choices available. Hot and cold drinks are served between meals. On the day of inspection the cook was not in so care staff were taking on this role. From inspection of care plans, discussion with staff, catering records and training certificates it is evident that staff are aware of individual dietary requirements and cater for this. It is recommended that the cook consider attending the intermediate food hygiene course to widen her knowledge in this field further. The environmental health inspection occurred last November and was satisfactory. Training in the management of Safer Food Better Business has just occurred. The registered persons informed us that they have plans to redesign the kitchen in the near future Morovahview Residential Home DS0000069602.V371723.R01.S.doc Version 5.2 Page 17 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): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People know how to make a complaint and are protected from abuse by the agencies policies, procedures and staff training programme. EVIDENCE: The home has a complaints procedure that is provided to People who use the service and their relatives / representatives within the service users guide and statement of purpose. This provides information to the resident on how to make a complaint and the process of who to contact. The registered provider told us that no complaints had been received by the home. A complaints / compliments book is available in reception for anybody to complete. A complaints log has been introduced so if complaints are received then an audit trial of how it was managed, the outcome and any actions the home need to implement are recorded. The agency has a satisfactory policy and procedure regarding safe guarding adults. A poster is displayed in the hall that advises people who to contact should they be concerned that any abuse has taken place. Staff are provided with adult protection training during induction by in house trainers making use of external training material (Mulberry House). All staff have dates to attend external local multi agency adult protection training in the next 2 weeks. The registered providers will then apply to attend the Investigators multi agency course following their attendance at the alerter course. Morovahview Residential Home DS0000069602.V371723.R01.S.doc Version 5.2 Page 18 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, 20, 23,25, 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The accommodation provided is comfortable and homely. There are areas of the home that require redecoration, the Providers are committed to making improvements to the home and this work is in process. Environmental risks in the home have been assessed or removed to provide a safe environment to the people living and working there. EVIDENCE: During the inspection some redecoration and alteration work to the premises was occurring. People who use the service said that they had enjoyed seeing the changes being made and felt that it had ‘greatly improved’ the facilities that he home provided. The registered providers have identified continued areas of redecoration/ refurbishment / building works and have prioritised the work to be completed first. Despite all the building/ redecoration work in progress the home was clean and tidy at this unannounced visit, which is a credit to the staff team. Morovahview Residential Home DS0000069602.V371723.R01.S.doc Version 5.2 Page 19 The bedrooms are located on the first and ground floor, many were observed to be personalised by the occupants. All sixteen bedrooms have a wash hand basin. There are several bathrooms and toilets distributed throughout the care home that are within a reasonable distance of the communal areas and resident’s bedrooms. Lockable spaces are provided as they are redecorated. Environmental risks within the home have been assessed and measures are now in place to ensure that People who use the service, staff and visitors are not placed at risk e.g. water temperatures now regulated, radiators covered. The registered providers have ordered new laundry equipment, which will include a sluice facility. This will promote infection control further in the home. Morovahview Residential Home DS0000069602.V371723.R01.S.doc Version 5.2 Page 20 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): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are qualified and competent to work with the People who use the service. They are recruited on the basis of fair, safe and effective recruitment and selection policies and practices. They have good access to ongoing training to maintain their knowledge and skills. EVIDENCE: From surveys completed plus discussion with people who use the service, they all spoke positively about staff ‘caring attitude’ and felt that they could approach staff with any queries or concerns. This was also observed during the inspection when a request for additional heating (due to building works) was responded to immediately. It is clear that positive and trusting relationships have been established. People who use the service said they felt in control of the care and support provided which they viewed as sensitive, positive, reliable and flexible. On each shift there are two care staff on duty plus a manager on call a cook is now employed. There are two waking night staff members on duty. Staff stated they felt there were sufficient staffs on duty at all times. Eight care staff have achieved a minimum of NVQ at level 2 and five are in the process of completing it. This means that the staff team have exceeded the NVQ level 2 minimum qualifications so that People who use the service can be confident of the competency of the people looking after them. Morovahview Residential Home DS0000069602.V371723.R01.S.doc Version 5.2 Page 21 Recently recruited staff spoke positively about their appointment seeing it as a fair process. They felt their induction programme was appropriate to their work. The registered person is currently reviewing the induction programme in line with the Skills for Care guidance. Staff records showed that for all staff a satisfactory POVA and CRB had been gained along with references. Staff at the home said they were well supported and were clear about their roles and responsibilities. It is clear the staff group are committed to helping people maintain their independence as far as possible. Staff confirmed that there has been recent training e.g. first aid, food hygiene. Some staff has attended the instructors’ course for moving and handling so that they can train the staff team. The registered person had booked for staff to attend other courses such as adult protection. There is a staff-training plan for the home, which sets out training staff have had and are expected to undertake, so that they maintain their knowledge and skills. Morovahview Residential Home DS0000069602.V371723.R01.S.doc Version 5.2 Page 22 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): 31,32,33,36, 37,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has an experienced and qualified management team who have a sound understanding of their responsibilities. The home is well run and managed for the benefit of the People who use the service. Quality assurances processes demonstrate that service users their representatives, and staff are consulted about the service that the home provides. Records are maintained and handled in accordance with good practice, for the welfare and safety of the People who use the service. EVIDENCE: The registered persons have managed Moroahview for 16 months and ensure that training in elder persons care is kept updated. They are competent managers in the daily running of the home and are viewed positively by staff and people who use the service. The registered providers have worked hard to ensure that all the requirements and recommendations identified in the last two inspections have been complied with in full and are enthusiastic and keen to ensure that they provide a ‘first class service’ to its residents. Their Morovahview Residential Home DS0000069602.V371723.R01.S.doc Version 5.2 Page 23 commitment to turn around the home that they purchased and to develop a enthusiastic staff team is to be complimented on. The registered persons have established a range of measures to annually review and monitor the quality of the service and facilities and sent these findings to the Commission. The surveys demonstrated that People who use the service, plus discussions with them they felt positively about the care that Moroahview provide. The registered providers wants to introduce formal ‘resident meetings’ to give a further opportunity for People who use the service to express their views. Staff meetings are held which is another avenue to express ideas on how to improve the service further. Formal recorded supervision has been implemented which staff said they found beneficial as it concentrates on their work practice and is a venue to discuss any further training needs. People who use the service monies were inspected at the last inspection and was found to be satisfactory. Therefore it was not inspected on this occasion. A range of measures has been put in place to promote safe working practices and the equipment and services to the care home are regularly maintained and serviced. Records reviewed at this inspection indicate that they are appropriately maintained and held, to ensure the welfare and safety of people who use the service. There are suitable storage facilities and records are kept in ways that protect their confidentiality. Accidents are recorded in an Accident book that comply with data protection legislation. The risk assessment and risk management arrangements for individual people are satisfactory. The registered persons were informed about the need to notify the Commission under Regulation 37 of incidents that occur in the home as this has not been happening in certain incidents. The registered persons agreed to act on this immediately. The providers have commenced a new contract with an independent fire organisation. They have provided fire training to all staff and reviewed the homes fire risk assessment and any actions highlighted have been addressed. Documentation also evidence that equipment is regularly serviced and maintained to ensure the health and safety of service users and staff. Staff training in the areas of moving and handling, food hygiene, first aid, infection control, health and safety and fire have been completed. Morovahview Residential Home DS0000069602.V371723.R01.S.doc Version 5.2 Page 24 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 3 3 3 3 N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 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 2 2 X X 3 X 3 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 4 4 3 X X 3 2 3 Morovahview Residential Home DS0000069602.V371723.R01.S.doc Version 5.2 Page 25 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. 1 Refer to Standard OP2 OP7 Good Practice Recommendations The pre admission and care plan processes would benefit from being separate documents so that staff are able to identify the current care need and what caring interventions they are expected to provide so that care is given in a consistent manner. All medication received in the home should be accounted for and tally with written records e.g. PRN (loose medicines) so that a audit trail of medicines can be undertaken. In addition lactulose must only be used for the individual it is prescribed for. It is recommended that the cook attend the Intermediate food hygiene course, to expand her knowledge in this area further. DS0000069602.V371723.R01.S.doc Version 5.2 Page 26 2 OP9 3 OP15 Morovahview Residential Home 4 OP37 The registered provider s should monitor the content of daily records to ensure that it accurately reflects the day a People who use the service experiences. All incidents under Regulation 37 must be notified to the commission without delay as per the Care Standards Act. 5 OP38 Morovahview Residential Home DS0000069602.V371723.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Morovahview Residential Home DS0000069602.V371723.R01.S.doc Version 5.2 Page 28 - 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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