Care Home: Moulsham Home

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What the care home does well Moulsham provides a homely, relaxed environment for the residents, which is both clean and tidy. From evidence over several inspections the home provides a consistently good standard of care. The home benefits from an established, stable and experienced staff team, who are well supported by the manager. What has improved since the last inspection? Only one requirement was made at the last inspection, and this has now been met. All records of new staff currently in post were inspected and found to hold the required checks and information i.e. criminal record disclosure and references. What the care home could do better: The manager must ensure that all complaints, however minor are investigated and recorded. The manager usually complies, but at this inspection one complaint had not been fully recorded. The home currently uses a set format for assessing people with dementia prior to admission. Whilst this is a good judgement tool it is mainly a tick box style of assessment. The home should develop their own format for recording information. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Moulsham Home 116/117 Moulsham Street Chelmsford Essex CM2 0JN     The quality rating for this care home is:   two star good 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: June Humphreys     Date: 0 3 0 8 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 24 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 24 Information about the care home Name of care home: Address: Moulsham Home 116/117 Moulsham Street Chelmsford Essex CM2 0JN 01245350750 F/P01245350750 npvjgardener@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Miss Nicola Pedita Victoria Jason Gardener Name of registered manager (if applicable) Miss Sharon Stubbings Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The registered person may provide the following categories of service: Care Home CRH To service users of the following gender: Both 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 The maximum number of service users who can be accommodated is: 19 Date of last inspection Brief description of the care home Moulsham Home is an adapted detached domestic style property situated close to the centre of Chelmsford and all local amenities. The home is currently registered to accommodate 19 elderly people (over 65 years), including 8 places for people diagnosed as suffering with dementia. Care Homes for Older People Page 4 of 24 care home 19 Over 65 0 19 19 0 Brief description of the care home There are twelve single and three shared bedrooms on two floors. A shaft passenger lift is available to provide access between levels. Communal space comprises an L shaped lounge and dining room on the ground floor, as well as a fully separate quiet/visitors room at the rear of the dining area. All prospective residents are provided with a combined Statement of Purpose and Service User Guide that gives them up to date information on the home. Fees range from £710.00 to £750.00 per week and there are additional charges for hairdressing, chiropodist, newspapers and dry cleaning. The home has a rear garden with an accessible patio area. Off street parking is available at the front and rear of the property. Care Homes for Older People Page 5 of 24 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: two star good 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 2 stars. This means that people who use this service experience good quality outcomes. This was a routine unannounced inspection, which included a visit to Moulsham on the 3rd of August 2009. One inspector undertook the site visit, and all of the key national minimum standards were addressed. Opportunity was taken to speak with residents, relatives, staff, and the registered Manager. Care Homes for Older People Page 6 of 24 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. 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 7 of 24 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 8 of 24 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. Prospective residents are provided with clear information about what the service can offer in an easy read format , and will only be admitted to the home if their needs can be met. Evidence: Sufficient information is available to potential residents to assist them in deciding if Moulsham is a home that they may like to consider. This includes a statement of terms and conditions, and a service users guide that has uptodate pictures of the home. The manager stated that prospective residents are encouraged to visit the home prior to any move. Several residents were spoken to about their move to the home, and both were complimentary. One person said I was welcomed, and made to feel at home by the staff and residents at the home. This has helped me settle, and feel it was the right decision. Care Homes for Older People Page 9 of 24 Evidence: All residents are assessed prior to moving into the home, and these are undertaken by the manager or the proprietor. The current format used is a specialist assessment, BASOLL (Behavioral assessment scale of later life) which is beneficial for use with people who suffer from dementia. Two were looked at as part of this inspection, and would benefit from more in depth information in relation to the persons needs and level of care support required. The manager has agreed to update the form to ensure it is personalized, and demonstrates how peoples needs will be met. The home currently provides intermediate care, and the assessment clearly outlined the care that would be provided whilst the person was staying at the home. It also had a review date to ensure the assessment and care plan was reviewed at regular intervals. Care Homes for Older People Page 10 of 24 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. Residents can be assured that both health care and personal support is provided in a manner that they prefer. Evidence: Two care plans were looked at as part of the inspection. They were personalized, and contained good detail of individual needs. The care plans had been updated, and were easy for staff to access. Residents spoken with reported that staff gave them the level of support and assistance they required and provided care in the way that they preferred. One resident said There is usually someone to help me, and I am pleased with the care and support I receive. The Manager spoke of good working relationships with all health care professionals, and evidence of regular visits from Opticians, dentists and chiropodists were recorded on a regular basis. The home had recently had a number of admissions from hospital and had contacted the district nurse service immediately when there were concerns on admission. The manager regularly checks that medication is adequately stored and recorded. She Care Homes for Older People Page 11 of 24 Evidence: has also been involved in ordering and checking prescriptions. Two residents medication was checked thoroughly and found to be correct, this included current controlled drugs. Residents spoken with commented on how good staff were, and how well they were treated. Residents knew most of the staff, has several had been in post for a number of years. The staff were able to talk about residents individual preferences,and quick to identify any health issues, which could then be acted upon. Staff interaction with residents was observed to be good, and confirmed that they were polite when assisting residents with their daily activities. Care Homes for Older People Page 12 of 24 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. The service provides flexible routines, and a lifestyle that enables residents to make choices, and to engage in their individual interests. Evidence: The provision of activities within the home is good, with a range of different opportunities for residents to chose to participate in. Feedback from many of the residents was very positive, especially in relation to the outside entertainers that regularly visit the home. Staff has continually reviewed residents activities as part of the residents meetings. The Manager stated in the AQAA that activities are arranged by management, but chosen by residents. The residents minutes showed the changes made, and information was also documented as part of residents reviews. Relatives can visit residents at anytime, and several visitors were seen visiting during the inspection. Two relatives were spoken to, and said staff were approachable and supportive. The home has a varied menu offering varied styles of cooked breakfast daily. The food seen on the day of inspection was of a good standard with a number of choices. Care Homes for Older People Page 13 of 24 Evidence: Specialist dietary needs are noted in individual care plans. Several residents were spoken to about the quality of food, and one person said food here is good. The other person said every effort is made to provide what you prefer. Care Homes for Older People Page 14 of 24 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. Residents and their relatives are encouraged to make their concerns and complaints known to enable individuals feel safe, and protected. Evidence: The homes complaints procedure is provided to all residents at the point of admission to the home. The complaints procedure is also on display in the home. Residents have regular contact with their allocated key worker, and concerns are addressed immediately wherever possible. Keyworker contact sessions are recorded which provided evidence of staff actively seeking the views of those people they assist/ support. Residents spoken to did know how to make a complaint, and staff said that they actively encouraged residents to speak out. Several family members were asked for their views and they said, if they had a complaint they would have no hesitation in speaking to the manager, and felt that she would listen to them and try to resolve things. The last recorded complaint was in November 2008. The record book had not been kept uptodate, as stated it should be in the current complaints policy. One relative said that they had made a complaint, but there was no recorded evidence of this. The Care Homes for Older People Page 15 of 24 Evidence: manager advised that this was a verbal complaint and that she had dealt with the concern raised. Policies and procedures relating to the protection of vulnerable adults were in place with appropriate guidelines for staff to follow, should a complaint of abuse be made or they observe an incident of abuse taking place. The manager has attended comprehensive training, and ensures new staff are trained as part of induction. All staff are updated of any changes in policies and procedures, and staff spoken to were aware of how to use the homes procedures, and the Whistle Blowing policy Care Homes for Older People Page 16 of 24 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. The home provides a safe well-maintained environment, which meets the needs of the residents who live there Evidence: The home is comfortable and domestic in scale and style. The general cleanliness of the home was maintained to a high standard. Bedrooms were personalized, reflecting individual style. Communal areas were seen to be well maintained, comfortably furnished and odour free. Residents spoke highly of the dedicated manner in which the staff maintain the cleanliness of the home and of the speed and efficiency with which their laundry is returned to them, our clothes rarely get lost, and care is given to all of our clothes There is a maintenance programme within the home, and since the last inspection a number of bedrooms have been re-decorated, with flooring also being replaced. Care Homes for Older People Page 17 of 24 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. The home provides staff in sufficient numbers, and with suitable skills and experience, to ensure that residents needs are met. Evidence: On the day of the inspection, there was three staff on duty, throughout the day and early evening. The staff rota for the day was accurate and few changes had been made. Staff on duty had a good understanding of residents assessed care needs. Staff were informative and very helpful. Several staff spoken to stated that whilst staffing levels were adequate some residents did require two staff in relation to manual handling tasks. This was discussed with the manager who advised that they often helped, at busy periods. Three residents who were spoken to during the inspection stated that there were always staff around when they needed them, and a relative said that staff came promptly when they pressed a call buzzer. Two staff files were looked as part of the inspection. All staff files identified the training staff had undertaken. The homes mandatory training i.e. first aid, manual handling, safeguarding and medication administration, had been completed by staff. Staff felt that they had good access to relevant training opportunities, and new staff undergo a thorough induction programme. Part of this familiarizes staff with the policies, procedures and routines of the home. Care Homes for Older People Page 18 of 24 Evidence: The records of all of new staff currently in post were inspected and found to hold all of the required checks and information i.e. criminal record disclosure and references. Care Homes for Older People Page 19 of 24 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed, and residents benefit from the knowledge, ethos and experience of the manager, who is committed to ensuring the home, is run in the best interests of residents. Evidence: The registered manager is an experienced manager and has completed the Registered Managers award (NVQ 4 in management) The manager demonstrated a good awareness of the needs of older people, and a positive approach to promoting independence and fulfillment for the people living in the home. Staff spoken to said the manager was approachable, although firm in providing guidance, especially in matters of care practice. Residents and relatives spoke highly of the manager of the home, and felt there was good communication. One staff member who provided feedback stated that they enjoyed working at the home, and felt that the home is managed well. All of the records required by regulation are kept correctly. The home had a clear Care Homes for Older People Page 20 of 24 Evidence: health and safety policy, and staff interviewed was aware of the policies and procedures and felt confident that the manager would update them when necessary.The homes training records showed that the majority of staff had current moving and handling, and fire safety training, and that staff had also attended other relevant health and safety training e.g. COSHH, food hygiene, first aid, health and safety. New staff had dates scheduled for training. Records looked at showed that appropriate servicing and checks were carried out on facilities and equipment. The fire log provided evidence that regular fire alarm checks, extinguisher checks and emergency lighting checks took place. Records of money spent on residents behalf were looked at as part of the inspection. Any items that residents would like are purchased by the home and itemized on a monthly invoice which is received by residents or their relatives. Two records were looked at and both were easy to read, and recording accurate. The home does not have a current annual development plan. The proprietor completed an Annual Quality Assurance Assessment (AQAA) for 2009, but it did not demonstrate an ability to evaluate the service, and to identify areas for improvement. The manager must ensure that the AQAA provides all the necessary requested information. Care Homes for Older People Page 21 of 24 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 22 of 24 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 3 The registered manager should develop an assessment format to record information, other then the BASOLL which is currently used, to ensure that all prospective residents, social and personal needs are assessed prior to admission. All complaints should be accurately recorded, to ensure residents are listened to, and their requests acted on. 2 16 Care Homes for Older People Page 23 of 24 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. 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