Care Home: Moss Bank Elderly Persons Home

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What the care home does well Mossbank Support centre only offer people a service after their needs have been assessed and people are assured these needs will be met. The home`s routines are flexible which means that people can exercise choice in their daily lives. Staff ensures that residents health, safety and welfare are promoted and activities are arranged to meet their needs, wishes and capabilities. People living in their home and their representatives said that the staff and services provided are good and comments included: "I don`t know what I would do without this home. The staff and services provided are wonderful", "Everyone is so kind and caring, staff do a brilliant job", "We like being here, we can come and go as we please and basically do what we want". "Its champion here. Nice staff, good company, warm and cosy". Staff said they enjoyed their work and were well supported in their various roles. What has improved since the last inspection? Since the last inspection improvements have been made to care plans and safe handling of medication. All staff training has been updated and filing and recording systems have been fine tuned to ensure that all information is easily accessible. CARE HOMES FOR OLDER PEOPLE Moss Bank Elderly Persons Home Victoria Avenue Moss Bank St Helens Merseyside WA11 7BU Lead Inspector Mrs Lynn Paterson Key Unannounced Inspection 25th February 2008 09:30 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 Moss Bank Elderly Persons Home DS0000037920.V359908.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. Moss Bank Elderly Persons Home DS0000037920.V359908.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Moss Bank Elderly Persons Home Address Victoria Avenue Moss Bank St Helens Merseyside WA11 7BU 01744 677816 01744 677968 carolfletcher@sthelens.gov.uk 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) St Helens Metropolitan Borough Council New manager awaiting registration Care Home 32 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (22) of places Moss Bank Elderly Persons Home DS0000037920.V359908.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to a maximum 22 OP and up to a maximum of 10 DE(E). 14th March 2007 Date of last inspection Brief Description of the Service: Moss Bank care home provides accommodation and personal care for a maximum of 32 older people. St. Helens Council are the registered provider of the service and the manager is currently awaiting registration with CSCI. There have been no changes to Moss Banks conditions of registration since the last inspection. However, the care home has opened a day centre to provide a service to a maximum of twelve service users per day. The property is located in a distinct area of St. Helens with only a limited number of local facilities nearby. The premises are a two-storey building, which was purpose-built; a lift as well as stairs connects the floors. The care home is divided into three units, containing accommodation for eight residents in each. A fourth unit is now used as a day care facility. Two of the units accommodate permanent residents and one respite and transitional residents. The ground floor has both service user and staff accommodation; the latter includes a well-appointed staff room. There is one unit located on the ground floor as well as the day centre, a laundry and excellent kitchen. The upper floor also contains two units with sleeping accommodation and lounge areas. The care home has an appropriate number of aids and adaptations including grab rails to assist disabled residents users manage the premises. There is a call system throughout the care home. Moss Bank Elderly Persons Home DS0000037920.V359908.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 The inspection of Mossbank Support Centre was carried out over a one - day period and was undertaken on an unannounced basis. Information about the home was obtained through pre-inspection documentation (AQAA) and examination of the homes policies, procedures daily records, care plans and other supporting documentation. A tour of the premises also took place. Discussions were held with staff and residents and visitors to the home and great assistance was provided, throughout the inspection from the manager and assistant manager. Fees are between £98.60 - £594.00 per week. What the service does well: Mossbank Support centre only offer people a service after their needs have been assessed and people are assured these needs will be met. The home’s routines are flexible which means that people can exercise choice in their daily lives. Staff ensures that residents health, safety and welfare are promoted and activities are arranged to meet their needs, wishes and capabilities. People living in their home and their representatives said that the staff and services provided are good and comments included: “I don’t know what I would do without this home. The staff and services provided are wonderful”, “Everyone is so kind and caring, staff do a brilliant job”, “We like being here, we can come and go as we please and basically do what we want”. “Its champion here. Nice staff, good company, warm and cosy”. Staff said they enjoyed their work and were well supported in their various roles. Moss Bank Elderly Persons Home DS0000037920.V359908.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. Moss Bank Elderly Persons Home DS0000037920.V359908.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 Moss Bank Elderly Persons Home DS0000037920.V359908.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): 2.3.6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are provide with accommodation at the home only after their needs are assessed and they have been assured these needs will be met. EVIDENCE: An assessment of care and support needs is carried out prior to an offer of accommodation being made to ensure staff have all the information they need on how to provide care services in accordance with individual need. The manager and staff acknowledged issues relating to equality and diversity, such as residents age, disability, gender, race religion or belief and sexuality need to be explicitly addressed during the assessment process to ensure a holistic package of care can be provided. Risk assessments are also completed to ensure the safety and welfare of people living in the home. Moss Bank Elderly Persons Home DS0000037920.V359908.R01.S.doc Version 5.2 Page 9 Staff advised that any person who makes application for a short term placement at Mossbank Support centre is encouraged to make a visit to the home and experience what the home offers prior to committing themselves. Staff, say this enables the prospective resident to make an informed choice if they wish to stay at the home and also enables staff to make a further assessment of the persons needs and capabilities within the home setting. It was noted that care files held terms and conditions of residence for all permanent places at Mossbank. However terms and conditions for transitional and respite places would benefit from more clarity about time scales and service provision to ensure that people using these services are clear about what they entail. Intermediate care is not currently provided at Mossbank. Moss Bank Elderly Persons Home DS0000037920.V359908.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): 7.87.9.10.Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Health and social care needs of the people living in the home are monitored and met. EVIDENCE: Care plans have been updated since the last inspection and they now present as a documented plan of the support provided to each person living in the home and give guidance to staff as to individual care need can be met. Resident’s health care needs are monitored with a record of their daily welfare being maintained. People living in the home said they regularly see health care professionals such as their GP, chiropodist or dentist and they said they were able to read information about themselves if they wished. Moss Bank Elderly Persons Home DS0000037920.V359908.R01.S.doc Version 5.2 Page 11 Care plans viewed held signatures of the people who had been involved in drawing them up to include the resident. Residents said the felt their care plans were an accurate reflection of their health and social care needs and they said that the care were reviewed each month to make sure that any changes could be discussed and actioned where necessary. Comments from people living in the home included: “Staff always ask me what I want and when they help me get washed or something they make sure I am OK” “Staff are kind and treat me well, I like coming here”, “The staff find out what we need and write it down in a booklet. They ask us what we can do ourselves and then ask us what we want them to do. They help us all they can but they want us to do some things for ourselves to let us kept our independence”. Staff spoken with understood the need to treat residents with respect and ensure their privacy was upheld. Discussions with the officer in charge revealed that meetings were frequently held with the residents to find out their views about the standards of care and services provided by the home. Systems are in place to ensure residents receive their medication as prescribed by their GP and all records show all staff that administer medication are fully trained to do so. Discussion with the people living in the home confirmed that they receive their medication on time and comments included: “Staff bring me my medication morning noon and night, I can set my clock by them” “Staff give me my tablets and make sure I take them each time” “That lady over there sometimes pretends to take her tablets but staff always know what she is doing and make sure she really does take them”. It was noted that appropriate storage facilities are in place and all medication records were up to date. The manager has ensured that all staff have completed or are about to undertake a full days training in medication management to enable them to have full knowledge and understanding of all aspects of medication management. Moss Bank Elderly Persons Home DS0000037920.V359908.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): 12.13.14.15.Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The homes routines are flexible to enable the people living there to exercise choice with their daily living. EVIDENCE: A range of social activities is provided at the home which resident’s say meets their individual needs. It was noted that a church service was taking place during the morning of my visit and bingo taking place during the afternoon. Residents said the home provided a varied activity programme and staff encourage them to maintain links within the community. Residents were observed coming and going from the home, going out with family and friends, visiting the local shops. Residents visitors were also seen calling at the home and comments from visitors included: _ “I don’t know what I would do without this home and the staff. This home enables me to have some respite from my responsibilities as a carer and I know that my partner is very well looked after whilst here”. Moss Bank Elderly Persons Home DS0000037920.V359908.R01.S.doc Version 5.2 Page 13 “My mum loves being here and it makes her family happy that she is well cared for by staff who are friendly but professional in their roles”. During discussions with residents it was confirmed that they could go about their day as they wish with very little restriction in place. A varied menu is in place and residents spoken with said they enjoyed the meals and always had plenty to eat and drink. Systems are in place to ensure the kitchen is kept clean and tidy and it was very well managed at the time of the visit. The manager advised that the menu had been subject to a full review in consultation with the people living in the home and examination of the menu revealed that changes had been made to both the lunch time and evening choices to ensure all individual tastes were met. People living in the home said the food was good and they were looking forward to the new menu as it included all their choices. The home utilise separate dining areas for permanent, respite and transitional residents to ensure each person has a spacious and comfortable area in which to enjoy their meals. Moss Bank Elderly Persons Home DS0000037920.V359908.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): 16.18.Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The systems in place for the protection of residents from harm are robust. EVIDENCE: Records show that the home has received one complaint since the last inspection and no concerns or complaints have been received by CSCI. The complaints procedure used at the home is a corporate policy of St. Helens Local Authority and this policy was fully utilised in order to deal with the complaint received by the home. The policy is clear, easy to read and staff spoken with were very knowledgeable about the process. Discussions with people living in the home identified they knew how to complain and said if they were unhappy with anything they knew who to speak with. They said that staff, regularly ask them if everything is all right and they have monthly external visitors who ask them if they have any complaints or concerns about the home. However other than one person saying they did not get enough lemonade no concerns or complaints had been raised by any person currently living in the home. Staff advised that reason for “the lack of lemonade” was for medical reasons and this had been fully discussed with the person and his/her representative. The complaints policy was clearly visible in the main areas of the home and all residents had been provided with their personal copies. Moss Bank Elderly Persons Home DS0000037920.V359908.R01.S.doc Version 5.2 Page 15 Staff training records show they are fully trained in protecting vulnerable adults form abuse. During discussion staff demonstrated a good level of understanding of the different types of abuse that can occur and the action they should take in the event of them suspecting or knowing an incident of abuse had occurred. Moss Bank Elderly Persons Home DS0000037920.V359908.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): 19.26.Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The standard of décor needs to be improved to ensure a more comfortable and homely environment. EVIDENCE: The overall standard of the building is adequate and some work has been carried out to make it homely in appearance. Some parts of the home present as rather institutional in appearance and staff advised that they do the very best to make it cosy and comfortable within their restricted budget. The garden areas are tidy but would also benefit from a makeover to ensure they provide a pleasant environment for the residents. Moss Bank Elderly Persons Home DS0000037920.V359908.R01.S.doc Version 5.2 Page 17 Residents said their rooms were fine and they were allowed to personalise them if they wished. However rooms viewed were in need of redecoration and those rooms, which were not personalised by individuals were basic in fabrics and furnishings and would benefit from additional pictures, ornaments etc. being provided. Staff said they are constantly attempting to modernise the premises by way of additional decoration and furnishing but they need to stay within the home budget and therefore their attempts are limited. The premises have sufficient bathing facilities for the number of people in the home. These facilities are basic and would also benefit from an update. The home has benefited from the upstairs carpet being replaced and a new carpet being provided to Swift Lounge and although the premises is in need of a general update the atmosphere is one of calm and comfort. Moss Bank Elderly Persons Home DS0000037920.V359908.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): 27.28.29.30’Quality in this outcome area is good, This judgement has been made using available evidence including a visit to this service. Staff are recruited and trained to ensure the safety and wellbeing of people living in the home. EVIDENCE: Record show that staff turnover is very low and most staff has been employed by the local authority for many years. Staff files looked at held all relevant information to include references; Criminal records bureaux (CRB) checks, contracts, supervision, appraisal and training. Record show that most staff have a minimum of NVQ level 2 qualifications. Staff advised that they have completed training in equality and diversity to enable them to have information and guidance on how to manage individual and sometimes complex needs. All staff spoken with said they enjoyed their work despite having to work through many changes due to home closures and amalgam nation of staff. Staff said they felt supported by colleagues and managers and felt that they had managed the changes well. Moss Bank Elderly Persons Home DS0000037920.V359908.R01.S.doc Version 5.2 Page 19 Staff said they worked hard but generally had sufficient staff to meet all individual needs. It was noted that staffing levels on the upstairs permanent units were one staff per unit. Staff said this generally works all right if the needs of the people living in each unit are not excessive. However records viewed showed that a respite resident had been placed on a permanent unit for a temporary stay and this person needed 2 staff to transfer. When asked about this staff said they had needed to get the assistance of another staff member and this left the other permanent unit without staff for a short time each day. It must be noted that staffing levels must at all times be sufficient to meet the assessed needs of all the people living in the home. Moss Bank Elderly Persons Home DS0000037920.V359908.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): 31.33.35.38.Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed to ensure residents comfort and welfare is maintained at all times. EVIDENCE: The manager is a qualified, experienced and knowledgeable person who is employed by St.Helens Local Authority and has managed various adult services for many years. Due to changes in the local authorities residential care provision she has recently been appointed to the role as Manager of Mossbank Support centre and is currently awaiting her registration with CSCI. Moss Bank Elderly Persons Home DS0000037920.V359908.R01.S.doc Version 5.2 Page 21 On appointment the manager acknowledged the need to update staff training to ensure that all mandatory training was in place. Staff say they have clear lines of accountability and are supported by the line management structure. The manager advised that all policies and procedures relating to the care of the residents and the running of the home are in place and have been reviewed and updated as required. Systems are in place to ensure the ongoing monitoring of the service. Staff are supervised and monitored in the role and administrative systems in place to ensure that all information is available as and when required. The local authority ensures that monthly quality assurance visits are made to the home and makes these records available to CSCI for perusal. The records hold information about the views and experiences of those who work and live in the home and are obtained for the purpose of identifying and addressing deficiencies as well as highlighting proficiencies. The finance section of the local authority takes responsibility for the management of resident’s finances if they or their representatives are unable to do so. Daily monies are managed by the manager and her deputies, who ensure all records and receipts are kept and double signatures are in place when any cash is exchanged. Residents’ Health, safety and welfare are promoted in the home. The manager advised that the equipment in the home such as the fire system, hoists and electrical wiring etc is checked / serviced regularly and it was noted that the heating boilers were being serviced during my visit. Staff said they had completed a range of training in health and safety to ensure that the safety and welfare of those who live and work in the home. Moss Bank Elderly Persons Home DS0000037920.V359908.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 2 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 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 X X X X X X 3 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 3 X 3 X 3 X X 3 Moss Bank Elderly Persons Home DS0000037920.V359908.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? YES 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 OP19 Regulation 23(2)(d) Timescale for action The home must continue with an 22/04/08 ongoing refurbishment programme to ensure the residents are provided with a safe and well-maintained environment, which presents as homely and comfortable. Staff must be provided in 22/03/08 sufficient numbers and skill mix to meet the assessed needs of all the people living in the home. Requirement 2 OP27 18 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 Good Practice Recommendations People who stay at the home for respite and transitional placements should have clear contracts to enable them to be fully aware of time scales and services provided. Moss Bank Elderly Persons Home DS0000037920.V359908.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North West Regional Contact Team Unit 1, 3rd Floor Tustin Court Port Way Preston PR2 2YQ 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 Moss Bank Elderly Persons Home DS0000037920.V359908.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. 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