Inspection on 23/02/06 for Morris Care Centre

This inspection was carried out on 23rd February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Morris Care Centre 06/11/08

Morris Care Centre 21/11/06

Morris Care Centre 07/07/05

Morris Care Centre 24/03/05

Morris Care Centre 05/11/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Maple Lodge

Polesworth Group 32 Station Road

Heathlands

Aston Court Nursing Home

Polesworth Group 70 Long Street

Breme

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

CARE HOMES FOR OLDER PEOPLE Morris Care Centre Holyhead Road Wellington Telford Shropshire TF1 2EH Lead Inspector Pat Scott Unannounced Inspection 23rd February 2006 11:45 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Morris Care Centre DS0000022283.V268720.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Morris Care Centre DS0000022283.V268720.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Morris Care Centre Address Holyhead Road Wellington Telford Shropshire TF1 2EH 01952 245521 01952 245523 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) www.morriscare.co.uk Morris & Co Limited Mrs Andrea Emma Kathleen Heath Care Home 77 Category(ies) of Learning disability (5), Old age, not falling registration, with number within any other category (51), Physical of places disability (15), Terminally ill (6) Morris Care Centre DS0000022283.V268720.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home must comply with the Staffing Notice as issued by Shropshire Health Authority dated 14/01/02. The Home may accommodate a maximum of 77 Service user`s of whom there can be a maximum of 5 Younger Adults with a Learning Disability, 58 Older People 15 Younger Adults with a Physical Disability and 6 people suffering from a terminal illness. 7th July 2005 Date of last inspection Brief Description of the Service: The Morris Care Centre Wellington is registered with the Commission for Social Care Inspection to provide accommodation, personal and nursing care for 77 people Wrekin Court and Wellington Court make up the care centre at Wellington, which is one of a group of nursing homes run by Morris Company Care Division. The home is situated on the outskirts of Wellington with local bus services close by. The home has two shared rooms and seventy three single occupancy bedrooms all with en suite facilities. The communal areas are spacious, tastefully decorated and well furnished. The garden areas are easily accessible for service users and are well maintained. Ample car parking spaces are available at the front and side of the premises. Morris Care Centre DS0000022283.V268720.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 23rd February 2006 over the lunch time period. The National Minimum Standards for Care Homes for Older People focus on achievable outcomes for service users – that is the impact on the individual of the facilities and services of the home. Evidence was looked for that the standards were being met and a good quality of life enjoyed by service users through: • Discussions with service users, families and friends, staff and managers. • Observation of daily life in the home • Scrutiny of written records The statement of purpose was used to assess how far the home’s objectives to be able to meet service user requirements and expectations were being met. Reports regarding an overview of the conduct of the home are sent to CSCI on a monthly basis by a representative of Morris Care. These, as well as the risk assessment from the last inspection were taken into account to determine the core standards focused on and depth of inspection. This inspection concentrated on the service provided for those receiving end of life care and intermediate care. The Commission does not currently have any concerns regarding this home. What the service does well: Staff are trained to give medication to service users admitted for intermediate care. Procedures are in place to ensure the wrong drug is not administered. The manager recognises the importance of providing palliative care for service users in the terminal phase of their illness and continues to develop staff skills and expertise within this area. The manager and staff in working with other health care professionals have provided sensitive and professional palliative care for service users at the end of their life. The home participates in the nationally recognized approaches to palliative care as below, and enhance the quality of end of life care provided. • The Liverpool Care Pathway (LCP); and • Gold Standard Framework. Morris Care Centre DS0000022283.V268720.R01.S.doc Version 5.1 Page 6 The LCP format transfers the hospice model of care into the care home setting and will facilitate multi-professional communication. It provides guidance on the different aspects of care required, including comfort measures, anticipatory prescribing of medicines and discontinuation of inappropriate interventions. Psychological, spiritual care and family support is included. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Morris Care Centre DS0000022283.V268720.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Morris Care Centre DS0000022283.V268720.R01.S.doc Version 5.1 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 the following standard(s): 6 Multi-disciplinary communication in this home is very good ensuring that the intermediate care service is reviewed and used efficiently to achieve good outcomes for service users admitted for rehabilitation. EVIDENCE: Dedicated accommodation and staff are provided to care for individuals admitted for rehabilitation. Evidence to meet this standard is considered in the whole of this report. Morris Care Centre DS0000022283.V268720.R01.S.doc Version 5.1 Page 9 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 the following standard(s): 7,9,11 The medication at this home for people receiving intermediate care and palliative care is well managed promoting good health. Personal and healthcare support in this home is offered in such a way as to promote and protect service users’ dignity and privacy in their daily life and at the end of life. EVIDENCE: People who are admitted for intermediate care have secure storage for their medicines in their rooms. Records are kept of their receipt. The staff conduct a risk assessment which determines whether a service user is able to self medicate or need prompting to take their medication. Monitoring of the effect of and changes in medication for service users is recorded in their care plan. Medication training has been provided for the intermediate care staff. Morris Care Centre DS0000022283.V268720.R01.S.doc Version 5.1 Page 10 There is anticipatory prescribing of medicines for Service users requiring end of life care. An example of a care plan seen showed that symptoms had been appropriately assessed and a drug regime implemented to alleviate them. Morris Care Centre DS0000022283.V268720.R01.S.doc Version 5.1 Page 11 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 the following standard(s): 15 Dietary needs of service users are well catered for with a balanced and varied selection of food available that meets service users tastes and choices. EVIDENCE: Service users admitted for intermediate care are enabled to regain their independence by assistance and guidance from staff to make their own breakfast and supper with appropriate aids. The main lunch of the day is taken as per the home’s menu from which they have a choice. Staff also work with service users to cook the ready frozen meals in preparation for discharge home. Service users in other areas of the home were observed to be assisted by staff in a sensitive and respectful manner. The home has the gold standard in healthy eating from the environmental health office. Service users receiving palliative care may have a reduced appetite that fluctuates daily and are provided with food that will meet their tastes. Morris Care Centre DS0000022283.V268720.R01.S.doc Version 5.1 Page 12 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 the following standard(s): 16,18 Staff are provided with induction and on-going training regarding adult protection. This provides staff with the relevant knowledge to safeguard service users from many types of abuse. The home has a complaint procedure that ensures complaints are dealt with promptly and effectively. Service users and their friends can be assured that what they say will be heard and dealt with. EVIDENCE: There have been two complaints since the last inspection, made to the home, relating to housekeeping. This had been dealt with in the time scales of the homes’ procedure and responded to in full. The quality team carries out an audit trail of all complaints in the home to identify any trends and to address any failings. The Chief Executive of Morris Care records a comment on each complaint seen. Staff induction and training contains information regarding adult protection. Morris Care Centre DS0000022283.V268720.R01.S.doc Version 5.1 Page 13 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 the following standard(s): 26 The domestic services are organised to ensure that the home is hygienic and that service users clothes are returned clean and fresh. EVIDENCE: The home was the subject of a Primary Care Trust infection control audit during February 2006. The registered provider intends to implement some of the salient points contained in the information produced following the audit. However, the home achieved an excellent result in several areas. All areas of the intermediate care accommodation were clean and hygienic. The sluice facilities have recently received a deep clean. Morris Care Centre DS0000022283.V268720.R01.S.doc Version 5.1 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 There is a good match of well-qualified staff offering consistency of care within the home. The home’s procedures provide a safe framework for the recruitment of staff that is followed consistently in order to protect service users. Staff receive training appropriate to their roles which ensures that residents needs can be met at all times. The arrangements for the induction and training of staff are good with the staff demonstrating a clear understanding of their roles. EVIDENCE: The staff recruitment files were seen of three of the most recent employees, being two care assistants and one registered nurse. References for one care assistant were incomplete and the RGN had only one reference back before commencing induction. The CRB checks had been received after the start date but the induction process is very thorough ensuring that no member of staff is left to work unsupervised. The actual CRB forms are held at head office and Morris Care Centre DS0000022283.V268720.R01.S.doc Version 5.1 Page 15 could not be examined. The dates of their return were not kept on file but the disclosure number was. Staff observed carrying out their duties on the intermediate care unit were seen to be responsive and understanding of individuals wishes and needs. The number of staff who hold an NVQ qualification has almost reached 100 . Specific training for intermediate care staff has been provided regarding mental health issues, medication and food hygiene. Specific palliative care training is provided on an annual basis which equips staff with the necessary skills to care for people at the end of life. Such training includes topics such as; care panning including the Liverpool care pathway, pain control and assessments, complimentary therapies and audit and research. Induction programmes were seen for the new recruits. Morris Care Centre DS0000022283.V268720.R01.S.doc Version 5.1 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 The manager is experienced and competent and management systems and practices ensure that the home is well run for the benefit of the residents. Service users views are regularly sought and they perceive them as having an effect in changing how the home is run. Service users personal monies are well managed so that their financial interests are safeguarded. Working practices are in place which ensure that the health and safety of staff and service users is protected. EVIDENCE: Morris Care Centre DS0000022283.V268720.R01.S.doc Version 5.1 Page 17 The manager was seen around the home talking to service users and was receptive to opinions that they had. She has achieved the relevant qualifications required by the standards. Quality assurance surveys are conducted and a record kept of the findings and how they were acted upon. Regular meetings take place where service users can air their views. Quality assurance was seen to take place throughout the inspection as staff were seen to be in conversations with service users and monitoring of their welfare. The monthly reports into the conduct of the home states that all records and health and safety checks are in place and up to date. At the time of this inspection it was considered that standard 38 was met and no potential hazards were identified. Morris Care Centre DS0000022283.V268720.R01.S.doc Version 5.1 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X 4 HEALTH AND PERSONAL CARE Standard No Score 7 4 8 X 9 3 10 X 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 3 Morris Care Centre DS0000022283.V268720.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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 2 Refer to Standard OP29 OP29 Good Practice Recommendations To record dates of CRB certificates on staff files for the purposes of inspection To ensure that references received are placed on individuals’ files. Morris Care Centre DS0000022283.V268720.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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 Morris Care Centre DS0000022283.V268720.R01.S.doc Version 5.1 Page 21 - 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. 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