Inspection on 27/04/05 for Morley House

This inspection was carried out on 27th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Morley House 16/08/06

Morley House 16/11/04

Morley House 11/05/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Morley House 1 & 2 Morley Square Bishopston Bristol BS7 9DW Lead Inspector Sam Fox Unannounced 27 April 2005 09:15 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 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Morley House D56_26542_222069_Morley_Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Morley House Address 1 & 2 Morley Square Bishopston Bristol BS7 9DW 01275 372109 01275 373151 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Freeways Trust Ltd Mr Jason Sanders-Harding PC Care Home 13 Category(ies) of LD Learning Disability (13) registration, with number of places Morley House D56_26542_222069_Morley_Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: May accommodate persons aged 21-64 years. Date of last inspection 16 November 2004 Brief Description of the Service: Morley House is operated by Freeways Trust Limited and is registered to provide personal care and accomodation for up to thirteen people who have a learning difficulty. The house is situated in a residential area and blends in well with the immediate environment. It is built over four storeys and has a basement area where the laundry is located. The premises would not be suited to residents who have long term mobility difficulties as the floors are only accesible via staircases. Morley House is located close to local amenities and shops which are regularly used by residents. They also have a minibus, the use of this, however, is limited due to a shortage of qualified drivers. Morley House D56_26542_222069_Morley_Stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, the purpose was to follow up on requirements and recommendations made at the last visit and to ensure that the environment was maintained to a satisfactory standard. Evidence was gathered through the homes records, consultation with staff and residents and observation. What the service does well: What has improved since the last inspection? What they could do better: There were a number of shortfalls and errors made in relation to the storage and administration of medication which could compromise the safety of Morley House D56_26542_222069_Morley_Stage4.doc Version 1.30 Page 6 residents. The manager must question all staff to ensure that they are competent to give out medication to minimise the risks. Standards of cleanliness within bedrooms also need to be improved. It is apparent that residents need more support with this aspect of their lives so that they can benefit from a cleaner environment. 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. Morley House D56_26542_222069_Morley_Stage4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Morley House D56_26542_222069_Morley_Stage4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4 and 5 The admissions procedure is robust and residents can be assured that they will be given enough information to make an informed choice about their future care needs. This also means that they can be confident that the home will have the resources and expertise to meet their assessed need. EVIDENCE: The manager has recently updated the home’s Statement of Purpose and this is now a comprehensive document which gives good detail of the services and facilities provided at the home. This is also accompanied by a service user guide, which is written with the use of pictures and symbols. This is a more accessible document which enables prospective new residents and their advocates to learn more about the home. One resident has recently moved to Morley House. She said that she was able to visit the home on several occasions and that she was able to make friends with residents before moving in which made her feel less anxious about going there. In addition to this there was a letter of commendation from the resident’s family who were pleased with the sensitive way in which the move was handled. There were also detailed assessments in her records written by both her social worker and other health care professionals. It was clear from these that they home had sought the appropriate information prior to making a decision that they would be equipped to meet her needs. Morley House D56_26542_222069_Morley_Stage4.doc Version 1.30 Page 9 There were updated contracts available. Morley House D56_26542_222069_Morley_Stage4.doc Version 1.30 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7 and 9 Care plans and associated records continue to be improved which enables the home to provide consistent and sensitive support that is based on residents needs. Staff make strenuous efforts to ensure that residents are fully involved in this process which means they have more choice and can dictate their daily routines. EVIDENCE: The personal files of two residents were examined in detail. These contain up to date care plans, which highlight individual needs and how these are to be met with the support of staff. They are written by key workers who are named members of staff who play more of a central role in co-ordinating the service that residents receive. In addition to this they write monthly reports which provide a good overview of progress made and changes in support that may be needed. All those seen at the time of this visit were up to date and written to good detail. Opportunity was taken to speak with one member of staff in depth and to discuss the care plan and associated records for one of her key residents. It was evident that she had a clear understanding of her role and she displayed a comprehensive knowledge of their needs. She also displayed a commitment to Morley House D56_26542_222069_Morley_Stage4.doc Version 1.30 Page 11 respecting and protecting residents’ rights. It was clear from records and discussion with her that the home provides a holistic service that takes into account emotional, social and physical needs. Care plans provide a means through which they can maintain a consistent approach. Morley House D56_26542_222069_Morley_Stage4.doc Version 1.30 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 16 and 17 Residents are encouraged to make choices about every aspect of their daily routines. They are supported by staff to pursue activities which they enjoy and which enables them to have interesting lifestyles and which are tailored to individual preferences and need. EVIDENCE: A number of residents explained what they liked to do throughout the week. Some of them attend Leigh Court resource activity centre which is operated by Freeways Trust. They said they enjoyed the courses that they did there and it was apparent that they had friends at Leigh Court who they enjoyed seeing on a regular basis. Other residents have part time employment. In addition to the above residents pursue many hobbies and interests. This was confirmed through discussion with them and through the décor in their bedrooms. They also explained that they were due to go on two holidays in the forthcoming year, including a trip abroad which they were excited about. Daily records also provided confirmation that many residents are encouraged to maintain positive links with their families. It was noted that some residents Morley House D56_26542_222069_Morley_Stage4.doc Version 1.30 Page 13 travel long distances on public transport to visit their relatives. The manager needs to develop risk assessments in relation to this to ensure that this is appropriate and safe practice. There is currently an issue with one resident who has been unable to go out due to safety reasons for a number of weeks. This is to be the subject of separate correspondence between the CSCI and the home. Morley House has a mini bus. The manager explained that they have been recruiting for a driver so that they can make more use of this, for which they have had partial success. Members of staff said the house has good relations with their neighbours and there was a letter confirming that they had just joined a local residential committee. Residents explained that they spend one day at home each week during which time that are supported to do their cleaning and washing. Household chores are shared amongst them. This was observed at the time of the inspection. They also said that they do cook although some residents are better at it than others. They commented positively about the quality and quantity of the food provided. Morley House D56_26542_222069_Morley_Stage4.doc Version 1.30 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 20 Errors are being made with the administration and recording of medication and these shortfalls have the potential to place residents at risk. Health care needs are monitored effectively and action is taken promptly to address concerns so that residents can be assured that their physical and emotional health needs are met. EVIDENCE: The home operates a monitored dosage system for the administration of medication which is supplied at weekly intervals by the local pharmacist. Records held in relation to this were inspected and found to have the following shortfalls: • • • • There were no records to evidence that tablets had been checked and then booked on to the premises Stock checks of medication given on an as and when basis were inaccurate There was one occasion when medication had been administered and not signed for One resident had been given medication prescribed for them on an as and when basis for anxiety. There was no indication on daily records to indicate the reasons for this and it was not clear, on two occasions, whether this had been administered appropriately. D56_26542_222069_Morley_Stage4.doc Version 1.30 Page 15 Morley House A number of requirements are made in relation to the above and improvements must be made to the existing system to make it safer. The manager was also asked to re-asses all staff in their competency to give out medication. Four residents explained that they have regular check ups with the dentist and opticians. Records provided evidence that they are supported to see the relevant health professionals as and when necessary. Staff also said that they have good relations with their local GP surgeries. Morley House D56_26542_222069_Morley_Stage4.doc Version 1.30 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and23 There is an open atmosphere within the home and residents are encouraged to air their views. They can therefore be assured that they will be listened to and that their concerns will be dealt with promptly. EVIDENCE: There have been four complaints by residents that have been recorded in the home’s logbook. Action has been taken by the manager to resolve these. Residents spoke openly in front of staff about what it was like to live at the home and they did not appear to be afraid to air their views. They said that they have regular residents meetings during which time they are asked what they would like, if they have any complaints and are kept informed of new developments. This was confirmed through detailed minutes of these meetings. Freeways Trust has an established complaints procedure which includes timescales for action and the contact number of the CSCI to whom concerns can also be made. Information in relation to this is given to all residents. There have been no complaints received by the CSCi regarding Morley House. Members of staff said they have had training about protecting vulnerable adults and there was information about how to report suspected abuse in the office. Morley House D56_26542_222069_Morley_Stage4.doc Version 1.30 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25,26,27,28 and 30 Improvements have been made to the décor throughout the home and this means that residents benefit from a homely and comfortable environment. Some areas of the house, however, are not clean enough and routines need to be improved so that residents can benefit from a cleaner environment. EVIDENCE: Opportunity was taken to inspect the whole premises, including all the bedrooms. The home has a rolling programme for decoration and as such three bedrooms and the lounges have been re decorated since the last inspection. This has resulted in a significant improvement to the environment. The manager said he is soon to purchase new dining room furniture and a sofa for the lounge which will also contribute to this progress. Residents’ bedrooms are personalised and reflect their individual tastes – indicating that choice and independence are promoted. Residents said that they are fully involved in choosing colours. One bedroom has stained paintwork and is in need of urgent re decoration. In addition to this one room had a broken bed headboard and broken radiator guard which could be a safety risk. Requirements were made about this at the time of the inspection. Morley House D56_26542_222069_Morley_Stage4.doc Version 1.30 Page 18 Whilst all the communal areas were found to be cleaned to a good standard a number of the bedrooms were dusty and required a deeper clean. Action must be taken by staff to improve this and routines should be reviewed so that adequate standards can be maintained. Requirements made at the last inspection relating to the environment have been met. These included, replacing the patio, a stained carpet and reducing odours in two areas of the home. Morley House D56_26542_222069_Morley_Stage4.doc Version 1.30 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35 and 36 There are many opportunities for training and residents can therefore be assured that they will receive advice and support from qualified staff. They work well as a team and benefit from a supportive and strong management team which allows them to deliver a consistent service. EVIDENCE: Opportunity was taken to talk with three members of staff. All spoke enthusiastically about their jobs and displayed a good understanding of their roles and responsibilities. There appears to be a good team spirit which has improved due to recent staff meetings. It was also evident that there is a robust formal supervision system in place which staff value and which enables them to develop their skills. Training records and discussion with staff confirmed that there are effective systems in place for induction, including both formal training provided by Freeways Trust and in- house. In addition to this steady progress is being made by staff to obtain their national vocational qualifications. Members of staff said they were satisfied with the training and support provided by the organisation. Morley House D56_26542_222069_Morley_Stage4.doc Version 1.30 Page 20 Residents spoke warmly about the staff team and it was observed that relationships between the two are respectful and friendly. They said that there was always two staff on duty and this was confirmed through rotas. Morley House D56_26542_222069_Morley_Stage4.doc Version 1.30 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,41 and 42 The home is well run and progress continues to be made to record keeping systems. There are effective procedures in place to maintain good standards of health and safety which minimises the potential risks to residents. EVIDENCE: Members of staff said that they felt supported and listened to by their manager. Progress continues to be made in relation to care plans and other associated records and significant positive developments have been made over the past six months. This enables the home to more clearly demonstrate that it is providing a consistent service which is tailored to individual needs and enables them to further evidence that they are meeting national minimum standards. All records seen at the time of this inspection were up to date, sensitively written and meaningful. Morley House D56_26542_222069_Morley_Stage4.doc Version 1.30 Page 22 There are robust systems in place for the maintenance of health and safety. A number of polices were available and the fire logbook indicated that the relevant tests and checks are being made of the system at the appropriate intervals. In addition to the above there were up to date health and safety risk assessments. Members of staff said that they had received statutory training in relation to first aid, manual handling, fire and food safety. They also confirmed that they have re fresher training at regular intervals. Morley House D56_26542_222069_Morley_Stage4.doc Version 1.30 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 2 3 3 x 2 Standard No 11 12 13 14 15 16 17 x 3 2 x x 3 3 Standard No 31 32 33 34 35 36 Score x x 3 x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Morley House Score x 3 1 x Standard No 37 38 39 40 41 42 43 Score 3 x x x 3 3 x D56_26542_222069_Morley_Stage4.doc Version 1.30 Page 24 NO Are there any outstanding requirements from the last inspection? 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 13 Regulation 13 (4)(b) Requirement Develop risk assessments for residents who visit their relatives independently using public transport Maintian acurate records for the safe adminstration of medication Record reasons for the administration of medication given on an as and when basis The competencies of all staff trained to give out medication to be re-assessed Ensure that broken headboard and radiator guard are fixed Take action to improve standards of cleanliness in bedrooms Re decorate bedroom Timescale for action 27 May 2005 27April 2005 27 April 2005 27 May 2005 3 May 2005 27 April 2005 27 May 2005 2. 3. 4. 5. 6. 7. 8. 20 20 20 26 30 26 13 (2) 13(2) 13 (2) 13(4)(a) 23(2)(d) 23 (2)(d) 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. Morley House D56_26542_222069_Morley_Stage4.doc Version 1.30 Page 25 Refer to Standard Good Practice Recommendations Morley House D56_26542_222069_Morley_Stage4.doc Version 1.30 Page 26 Commission for Social Care Inspection 300 Aztec West Almondsbury South Glos BS32 4RG National Enquiry Line: 0845 015 0120 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 Morley House D56_26542_222069_Morley_Stage4.doc Version 1.30 Page 27 - 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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