Inspection on 07/04/05 for Mornington Hall

This inspection was carried out on 7th 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

Mornington Hall 13/06/08

Mornington Hall 20/09/07

Mornington Hall 18/12/06

Mornington Hall 09/05/06

Mornington Hall 21/07/05

Mornington Hall 01/11/04

Mornington Hall 01/04/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Mornington Hall 76 Whitta Road Manor Park London E12 5DA Lead Inspector Sarah Greaves Unannounced Inspection 7th April 2005 at 12.00pm 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 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. Mornington Hall Version 1.10 Page 3 SERVICE INFORMATION Name of service Mornington Hall Address 76 Whitta Road, Manor Park, London, E12 5DA 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) 020 8478 7170 020 8478 6793 BUPA Care Homes Limited Ms Patience Ajayi Care Home 120 Category(ies) of Dementia (60), Old age, not falling within any registration, with number other category (60) of places Mornington Hall Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st November 2004 Brief Description of the Service: Mornington Hall is a registered care home for older people, owned by BUPA Care Homes Ltd. The home is divided into four separate units; residential care, residential care for people with dementia, nursing care and nursing care for people with dementia. The home is located in Manor Park, within a short walking distance of an overground station and bus routes. There is car parking facilities for visitors within the grounds of the home. Mornington Hall Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection visit was conducted over one day. The inspector spoke in detail to eight service users and two relatives. Many other service users were spoken to during the course of the inspection and all of the service users views have been incorporated into this report. Detailed discussions were conducted with the registered manager, the two activities organisers, the departmental head of care and a unit manager. Other staff were spoken to during the course of the inspection. What the service does well: What has improved since the last inspection? The standard of the written care plans for service users was noted to have improved. The care plans contained newly introduced documentation, which enabled staff to plan individualised care in a more focused manner. The new risk assessments possessed a wider scope of clinical information for staff to consider, hence promoting a more comprehensive and safe approach to ensuring that potential and actual risk factors are identified and appropriately met. It was noted that there were some documents within the care plans that required more detailed attention by staff Mornington Hall Version 1.10 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Mornington Hall Version 1.10 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 Standards Statutory Requirements Identified During the Inspection Mornington Hall Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 3 and 5. In order for service users to be provided with sufficient information, the service needed to ensure a more rigorous approach to the provision of accurately written Service Users Guides. In addition, the low number of service users who have viewed the home prior to moving in needs to be addressed by the registered manager. EVIDENCE: A requirement was issued in the previous inspection report for the home to amend the information contained in the Statement of Purpose and the Service Users Guide. The inspector found that this requirement had been satisfactorily met; however, a potentially confusingly- worded statement relating to the qualifications of the care managers of the two residential units was brought to the attention of the registered manager. The inspector found a Service Users Guide in the bedroom of a service user, which still referred to the home being regulated by the local health authority. The registered manager was advised to ensure that an audit was undertaken of all copies of Service Users Guides distributed within the home to ensure that they contain updated and accurate information. The Service Users Guide and the Statement of Purpose did not contain a recorded date for the next review. Mornington Hall Version 1.10 Page 9 Via discussion with service users and their relatives, the inspector found that service users were not consistently being offered the opportunity to visit the home prior to moving in, although their relatives and / or friends visited the home on their behalf before admission. The care plans contained appropriate assessments of the holistic needs of the service users. Requirements have been issued in relation to Standards 1 and 5. Mornington Hall Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8 and 9. The care plans (inclusive of risk assessments) had generally improved. At the time of the inspection, none of the service users had a pressure sore and documentation within the care plans demonstrated a good and methodical approach to meeting individual health needs. The need for on-going staff training in the administration of medication was identified. A requirement has been issued in relation to Standard 9. EVIDENCE: The care plans (inclusive of risk assessments) were found to have improved since the last inspection. There was greater attention by staff to ensuring that relevant information was recorded and updated as required. The inspector observed some areas for improvement. 1. The activities undertaken by service users were not properly recorded in the care plans. On one of the units, staff tended to record on the activities document that service users were either in the lounge or in their bedroom. 2. The documentation to address the personal care needs (bowel activity) of service users on one of the residential units required additional information to be recorded by staff for service users who independently managed this aspect of their care. The concerns of the inspector relating to the current method of documentation were explained to the registered manager at the inspection. Mornington Hall Version 1.10 Page 11 3. An assessment for a service user’s skin integrity was found to be incomplete; this was pointed out to the unit manager at the time of the inspection. The inspector case-tracked specific health needs of individuals via the documentation within the care plans. It was generally found that recorded observations of any discomfort or other symptoms experienced by an individual were promptly forwarded for medical attention as necessary, or treated via nursing care as necessary. The inspector found that a medication administration record had not been properly completed by a staff nurse. The staff nurse informed the inspector that they had not received appropriate training in how to complete a medication administration record. The registered manager stated that training had been provided. The inspector was aware of previous medication training within the home; however, this incident has identified the need for the registered manager to provide ‘refresher’ training and respond to the individual training/developmental needs of staff, as identified through supervision sessions and appraisals. Mornington Hall Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 15. The provision of activities was found to be good; however, the staff need to be trained and encouraged to creatively consider other ways of involving service users in fulfilling and stimulating activities, beyond the structured programme. EVIDENCE: The inspector met the activities organisers and spoke to service users to find out how the home met the recreational needs of individuals. The activities programme was varied and interesting; service users participated in pub lunches, shopping trips, a visit to Hackney Empire Music Hall and a quiz at another BUPA Care Home. The home provided internal entertainments such as visiting musicians, bingo, arts and crafts, ball games, sherry mornings and make-up parties. A requirement issued at the previous inspection for the home to provide a sensory/ recreational room in the residential unit for older people was observed to having been progressed at this inspection. The inspector observed that the nursing and care staff did not appear to engage service users in meaningful activities, for example, chatting or encouraging service users with an expressed interest in housekeeping and safe mobility to become involved in the laying of tables (alternatively, tasks such as folding napkins could be offered to service users with limited mobility). The menu plan stated that homemade cakes were offered at teatime. On the day of the inspection, service users were offered tea and biscuits. Via Mornington Hall Version 1.10 Page 13 discussion with a service users and their visitor, the inspector was informed that homemade cakes were not provided at teatime, unless it was for a service users birthday. This was confirmed to the inspector by the home’s Head of Care. A recommendation has been issued in relation to Standard 12 and a requirement has been issued in relation to Standard 15. Mornington Hall Version 1.10 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 The management of complaints was found to be satisfactory; service users and their representatives were assured of a service which responded to promptly and methodically to their concerns. EVIDENCE: The inspector was informed of two complaints received by the home since the last inspection. One of the complaints was in regard to the quality of the food service and had been resolved by the home. The second complaint was in relation to a notice displayed in communal areas; a relative of a service user notified the CSCI of their concerns that the home was withdrawing staff escort services for service users who have a hospital appointment. This notice has now been withdrawn and has been replaced with guidance for service users and their families, which confirms that support is provided. Via the reading of Regulation 37 notifications and discussion with the registered manager, the inspector confirmed that there have not been any allegations of abuse. Mornington Hall Version 1.10 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21 and 26. The home was well maintained and suitable for its purpose. The registered manager needs to ensure that service users are offered a choice of communal areas to relax in, including quiet and smoke free facilities. EVIDENCE: The inspector visited all of the four units, which were found to be generally clean, comfortable and free from any offensive odours. The units contained two communal lounges. The inspector noted that both the television and a music system were being broadcast simultaneously in a combined lounge and dining area. A service user informed the inspector that they found this combination of noise to be disruptive. The radio was switched on in one of the smaller communal areas and was broadcasting a contemporary, urban music station aimed at a much younger audience. The small lounge on the general residential unit was for service users to smoke in, hence it’s suitability as a ‘quiet area’ was limited. The home offered an appropriate adapted range of bathing/ showering facilities, which were viewed at this inspection visit. A requirement has been issued in relation to Standard 20. Mornington Hall Version 1.10 Page 16 Mornington Hall Version 1.10 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 30. The staffing levels and training was found to be satisfactory in order to provide a service that met the assessed needs of the service users. EVIDENCE: The rotas viewed demonstrated that a satisfactory number of staff were allocated on each shift. The inspector found that a sufficient number of staff were on duty during the inspection. The inspector found that the home had provided relevant training for staff, including falls prevention and the prevention/ treatment of leg ulcers and pressure sores. The need for staff (who have a responsibility to administer medication) to receive ‘refresher’ medication training has been previously identified in this report. Mornington Hall Version 1.10 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 and 38. The home demonstrated satisfactory systems for consulting with service users. The health and safety of service users was maintained. EVIDENCE: Via discussion with service users, the inspector was pleased to find that service users felt that their individual needs and preferences were identified and met. Service users confirmed that they were consulted regarding the time that they wished to get up in the morning and the time that they wished to retire for bed. The home undertook annual surveys to ascertain service users (and their representatives) views and conducted meetings. The inspector viewed the following health and safety practices, which were found to be satisfactory (1) Portable electrical appliances testing (2) Refrigerator and freezer temperatures and (3) Professional annual maintenance of fire equipment. Thermometers were provided in each bathroom with written guidance for staff, stating the importance of checking the water temperature even though the home had installed temperature regulation apparatus. Mornington Hall Version 1.10 Page 19 Mornington Hall Version 1.10 Page 20 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 X 3 X 2 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 2 COMPLAINTS AND PROTECTION 3 2 3 X X X X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 X X X X 3 X X X X 3 Mornington Hall Version 1.10 Page 21 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 1 Regulation 5 (1) (a) (b) Requirement The registered manager must ensure that the Service User Guide is updated to inform service users of the correct regulatory authority. The registered manager must ensure that the Statement of Purpose and the Service User Guide are regularly reviewed. The registered manager must promote the entitlement of prospective service users to visit the home before moving in for a trial visit. The registered manager must ensure that staff receive ongoing training in the administration of medication. The registered manager must ensure that service users are provided with the food stated on the daily menu plan. The registered manager must ensure that service users are provided with quiet communal areas and are not exposed to simultaneous broadcasts of television and music. Timescale for action 15/06/05 2. 1 6(a) and (b) 12(2) 15/06/05 3. 5 15/06/05 4. 9 18(1) (c) 31/07/05 5. 15 16(2) (i) and 17 (2) (13) 23(2) (a) and (f) 15/05/05 6. 23 31/08/05 Mornington Hall Version 1.10 Page 22 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 OP12 Good Practice Recommendations Staff should be encouraged to promote informal activities fir service users, taking into account their assessed needs and interests. Mornington Hall Version 1.10 Page 23 Commission for Social Care Inspection Gredley House 1-11 Broadway London E15 4BQ 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 Mornington Hall Version 1.10 Page 24 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!