Care Home: Moss View

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What the care home does well People told us their home is comfortable and clean and that staff are helpful and answer call bells without delay. On the dementia unit there are plenty of visual aids, pictures and symbols to make the environment interesting and stimulating for the people who live there. A visitor who commented said staff respect people`s opinions and make improvements to meet their stated preferences. People who live in Moss View said they have activities during the day and go on outings. They told us that religious ministers visit the home to give spiritual support to those who are frail and are unable to go out to church. People said the food is very good and they are offered choices and alternatives to the menu. All the people we spoke with told us they are satisfied with the care and support they receive. There are good management systems in this home which enable ongoing consultation with people who use the service through regular service audits, care reviews, residents` meetings and quality surveys. The outcomes are reviewed and used as part of the service development plan. This means that people who live at the home have a say in planning future developments and improvements in Moss View. What has improved since the last inspection? The AQAA informs us that to give people more say in their home, work has been carried out to involve them in the staff recruitment and induction processes. This means that the opinions of the people living there will be at the centre of the way people are selected to work in the home and the skills they develop from the start of their employment. People who live in the home have been consulted about background information for a book, which has been written by staff of Moss View. This details past every day life in Liverpool through words and pictures. Moss View is involved in the Skills for Life project in the community and people who live in the home have been involved in planting vegetables and cooking as part of this initiative. Some further improvements to Moss View since our last visit which are mentioned in the AQAA are the developing of person centred care plans, increase in NVQ qualified staff and ongoing decoration of the building. What the care home could do better: We think that cleanliness and infection control in the home are to a good standard. However two areas in need of cleaning were the food stores and the medication room. Staff need to keep these areas clean to avoid contamination of food or medication. The building was in good condition during our visit. However we saw that the floor surface in the kitchen was uneven and could eventually cause a tripping hazard. Remedial work needs to be done to make the floor surface even and help avoid accident or injury to people who work in or use the kitchen. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Moss View 77 Page Moss Lane Huyton Liverpool Merseyside L14 0JJ     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Patricia Thomas     Date: 1 6 0 7 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Moss View 77 Page Moss Lane Huyton Liverpool Merseyside L14 0JJ 01514821212 01514821845 mossview@schealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Southern Cross Care Homes Limited care home 78 Number of places (if applicable): Under 65 Over 65 27 51 dementia old age, not falling within any other category Additional conditions: 0 0 2 persons with a physical disability (PD) under the age of 65 years. 2 persons with mental disorder (MD) under the age of 65 years, 24 Nursing Older Persons (OP) aged over 65 years within a total of 51 Older Persons (OP) aged over 65 years (OP) 78 Personal Care of which 51 Older Persons aged over 65 years (OP) and 27 Dementia over 65 years (DE/E) 27 Dementia over 65 years (DE(E)) To accommodate one named person with Dementia (DE) under the age of 65 years. Date of last inspection Brief description of the care home Moss view is a purpose built nursing and residential care home located in the Huyton area of Liverpool. There is off street parking at the front of the home and secluded gardens at the back. The home is close to local shops and transport links. Moss View is registered to accommodate seventy eight people to provide dementia care and nursing Care Homes for Older People Page 4 of 25 Brief description of the care home care. Services are provided in two separate units. The home has a number of lounge and dining areas on both units and all bedrooms have en-suite facilities. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is three stars. This means that people who use this service experience excellent quality outcomes. This visit was just one part of the inspection. Before the visit took place, we (the commission) asked the manager to complete a questionnaire called an Annual Quality Assurance Assessment (AQAA). It gives us information about how the home is meeting the needs of the people who use the service and includes plans for further development. We felt this form was filled in honestly and that a lot of time and effort had been given to filling it in. During our visit, we looked at various records and walked round the home. We spoke Care Homes for Older People Page 6 of 25 with a number of people who live at Moss View, as well as relatives who were visiting whilst we were there, and staff who were on duty. They gave us their opinions about Moss View. We used a system called case tracking. This is a way of inspecting that allows us to follow or track a particular situation in order to ensure it was dealt with appropriately. Records for six of the people who live in the home were checked to see the care they receive. Some people were spoken with and their views were taken into account. The weekly fee for Moss View ranges from £330 - £691.30 depending on the level of support received. The fee does not include hairdressing. References to we or us in this report represent the Care Quality Commission. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Older People Page 8 of 25 The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are given information and have their needs assessed before deciding to move into Moss View. In this way they know their needs can be met in the home. Evidence: We looked at the care files of two people who had recently moved in. We found that there is a good system to introduce people to the home with information provided and needs assessments done so they know their needs can be met in Moss View. We spoke with a visitor, whose relative has recently moved in, who told us that a brochure about the home had been given to them before a decision was reached. The person hoping to move in had been visited by staff from the home to find out about the help the person needed and about their likes and dislikes. This information helps staff to write a care plan for each person which is individual to their needs and choices. Care Homes for Older People Page 11 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health care and personal care that people receive is based on their individual needs so they receive support in the way they prefer and in a way that shows respect for their privacy and dignity. Evidence: The staff team have worked hard with people who live at the home, developing care plans that are unique to them so that they receive the right amount of support and care that meets their needs. This ensures that people using the service make their own informed decisions and have the right to take managed risks in their daily lives. We looked at the care files for six people and these had been regularly reviewed and changed if needed to ensure that each person is getting the right level of support. This helps people to stay as independent as possible in their home. People who live in the home whom we spoke with said they are satisfied with their care and support and that staff are skilled and helpful. There were records on individual files of the support people had received from doctors, Care Homes for Older People Page 12 of 25 Evidence: mental health services, specialist nurses and paramedical services, with the outcomes given. This means that peoples health care and wellbeing is well supported in the home and they are given access to community health services as needed. There is a good system for managing peoples medication in the home. There are secure storage facilities and auditing systems to ensure that all medication accepted into the home is accounted for. Medication administration records were up to date and satisfactory during the visit and there were satisfactory stocks for people whose prescribed medication we checked. A person who was asked said her medication is brought round at the same time by staff and they give her plenty of time to take her pills. We spoke with people about whether they feel the privacy is respected in the home and no one expressed any concerns. They told us they have single bedrooms and staff knock on the door before walking in. We asked them whether their clothing is always returned to them from the laundry and they said they could not recall clothing going missing and items are returned to their bedrooms clean and in good condition. Care Homes for Older People Page 13 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Social activities and meals are both well managed and provide daily variation and interest for people living in the home. Evidence: We read care files and activities records and found that staff have obtained information about the social, cultural and leisure needs of people living in the home. This means that they have the information they need to make sure the lifestyle in their home is right for each person who lives there. Two members of staff are designated to provide activities for people and these are arranged in consultation with people living in the home and their relatives in meetings and through the care planning process. There are good links with local organisations, (for example a football club and local church), and a number of outings take place as well as the regular home based activities. Two people told us they like a quiz and on the day of the visit, a group of people were discussing news items from the daily papers with staff while being served a drink. A visitor said she is always made welcome and staff are helpful. She said staff have listened to the way her relative want support to be given and have made arrangements to meet her needs. Peoples spiritual needs are recorded so they can be Care Homes for Older People Page 14 of 25 Evidence: given the opportunity and any help they need to continue to follow their faith if they wish. People told us that eucharistic ministers visit the home to support some of the people who live there. The visual aids in the dementia unit, such as tactile pictures and mobiles, help provide a stimulating environment for people. These aids also improve quality of life by helping people to find their way around their home through recognizing familiar symbols and picture aids. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Moss View are protected by the complaints and safeguarding procedures which were understood by staff. Evidence: Moss View has a complaints procedure which is clear and given to people when they move in. This means people will know about their right to complain and that any concerns they have will be taken seriously. There are safeguarding and whistleblowing procedures to help ensure that staff will have the guidance they need to protect people from abuse. Staff told us they have received training in safeguarding and they showed awareness of the indicators of abuse and of how to report suspected abuse for investigation. The commission has not received any safeguarding referrals or complaints about Moss View since our last visit to the home. Care Homes for Older People Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Moss View live in suitably adapted, comfortable and pleasant surroundings that suit their needs. Evidence: Moss View is a purpose built care home with gardens at the back and some off street parking at the front. There is level access from outside and a series of aids for people who are frail, such as assisted baths and showers, grab rails and raised toilets. A number of moving aids, such as hoists and slide sheets, are provided for staff to assist people who need a lot of help. Bedrooms are for single occupancy and have en suite facilities. There is a variety of communal areas and two dining rooms which are furnished in a comfortable and domestic style. There are toilets and bathrooms throughout the home for convenience. The gardens are well maintained with planting, patio areas and have seating and shade to make them suitable for people in hot weather. People said they are comfortable in their home, that their bedrooms are to their liking and they have brought in photographs and ornaments to make them homely. Domestic staff are employed and records showed us they have procedures for infection control and control of substances hazardous to health to guide them and have received training. They told us there is always plenty of protective clothing and cleaning Care Homes for Older People Page 17 of 25 Evidence: materials available to them. Cleaning schedules were up to date and the building was clean in all the areas visited, including the kitchen and laundry, other than in two areas. The medication room was dusty in some areas and in the food store, the floor and bases of the freezers were in need of cleaning. Staff need to keep these areas clean and hygienic to avoid contamination. There is a maintenance programme which is ongoing and the building was generally safe; however in the kitchen, the flooring is uneven and could cause a tripping hazard if not attended to. Tripping hazards need to be identified and as far as possible eliminated to keep the building safe for people to live and work in. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home are supported by well trained, effective staff who have gone through a thorough recruitment process. In this way peoples needs are met and they are safe from possible harm or poor practice. Evidence: We looked at the staff rosters to check that staffing levels were being maintained and these were found to be satisfactory. On the day of our visit there was a good skill mix of staff carrying out their designated duties. We looked at staff records to check how they are recruited, vetted and trained. We found that there is a rigorous recruitment procedure followed and that staff have criminal records bureau and protection of vulnerable adult clearance before they work in the home. Also, satisfactory employers references are taken up to ensure they are suitable and have the experience and qualifications needed to work in the home. We looked at the training records and found that mandatory training for staff is continuous. New staff receive induction training and shadow experienced staff when first employed. Care staff we spoke with told us they have National Vocational Qualifications in care. Those staff who work with people who have dementia have attended a training course to help them understand dementia and how people who have dementia should be supported. Some of the staff have attended a course on the Mental Capacity Act and Deprivation of Liberty Safeguards to give them an Care Homes for Older People Page 19 of 25 Evidence: understanding of best practice and how to ensure peoples rights and freedom will be supported and protected in the home. In a staff survey received we were told that the training and management support in Moss View are satisfactory and that checks and references were taken up before taking up their post. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service was well run and a high level of consultation with people who use the service meant they (and their representatives) could contribute to its development. Evidence: The manager is qualified and experienced and has worked in Moss View for several years. She has worked hard with the staff to make sure that the standard of care being provided is good, that record keeping is good and that staff are all aware of the policies and procedures for the home. She provides good leadership to make sure that the diverse and individual needs of the people who live in the home are met with respect and dignity. There are good management systems in the home and information was easy to access and follow during our visit. We found that the management systems include ways by which people living in the home and their families will be consulted about the service. There was evidence of this in quality monitoring systems, residents meetings and Care Homes for Older People Page 21 of 25 Evidence: through regular reviews of peoples care. It was also evident that peoples opinions are valued and acted upon, as improvements have been made to meet their stated preferences. A visitor to the home confirmed this to be the case, telling us that suggestions she made for improvements to her relatives comfort were listened to and acted upon by staff. For some people, small sums of money are held in safekeeping so that they can buy personal items and services (such as hairdressing) as they need them. We looked at how peoples personal allowances are managed in the home. We found that people have access to their money as they need it, and good records are kept of any transactions on each persons account with receipts retained for any services paid for. Regular audits of accounts are carried out by the home manager and staff from the providers regional office. In this way, personal allowances are managed in peoples best interests and their money is accounted for. We looked at how peoples health and safety is promoted and supported by looking at records of checks on the building and equipment and these were found to be up to date. There are regular health and safety meetings and the minutes give evidence of how best practice in health and safety is monitored and planned (examples seen were for planning in the event of a flu pandemic and promotion of safe use of bed rails). There are good systems for recording and monitoring accidents and for moving frail people safely through provision of equipment and relevant training for staff. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 19 Remedial work should be carried out to make the kitchen flooring even to avoid a tripping hazard which could cause accident and injury to people who work in the kitchen. All parts of the home (including storage areas) should be maintained to good standards of hygiene to avoid contamination. 2 26 Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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