Inspection on 16/10/08 for Morton Close

This inspection was carried out on 16th October 2008.

CSCI found this care home to be providing an Adequate service.

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

Morton Close 22/08/09

Morton Close 01/11/07

Morton Close 17/12/06

Morton Close 27/06/06

Morton Close 09/02/06

Morton Close 22/11/05

Morton Close 31/08/05

Morton Close 07/10/04

Morton Close 05/05/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Morton Close Morton Lane East Morton Keighley BD20 5RP     The quality rating for this care home is:   one star adequate 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: Sughra Nazir     Date: 1 6 1 0 2 0 0 8 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. the things that people have said are important to them: They reflect 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 © (2008) 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Morton Close Morton Lane East Morton Keighley BD20 5RP 01274565955 01274510392 mortonmanager@adlcare.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Tracy Diane Hodgson Type of registration: Number of places registered: Barleyglow Limited c/o ADL plc care home 40 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 physical disability Additional conditions: Date of last inspection Brief description of the care home Morton Close Care Home is a large detached property set in substantial grounds. The original building was a former mill owners house. The large extension is now the only part of the building in use, with the original building closed. The home is situated in the Cross Flats area of Bingley, approximately two miles from the town centre. The home is registered to provide personal care only for up to 40 people with physical disabilities over the age of 65 years. Accommodation is on three floors with single and some double rooms available; the communal lounges and dining areas are all situated on the top floor. The home is well served by public transport. There is level access into the home and one passenger lift. There are mature garden areas around the home. Information about the fees and any additional charges was not available at the time of writing this report. The Statement of Purpose and Service User Guide providing information about the service are available from the home. The pre-inspection 0 Over 65 40 Care Homes for Older People Page 4 of 24 Brief description of the care home questionnaire had not been returned to the office in time to allow the information requested to be used. 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: one star adequate 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: We looked at information we have received about the home since the last key inspection. We asked for information to be sent to us before the inspection, this is called an annual quality assurance assessment. We sent surveys to people living in the home. We carried out an unannounced visit to the home We talked to people, their relatives staff and the manager. We checked some of the records, policies and procedures the home has to keep. Care Homes for Older People Page 6 of 24 We concentrated on the key standards and what the outcomes are for people living in the home, as well as issues which were raised at the last inspection. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. 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.csci.org.uk. You can get Care Homes for Older People Page 8 of 24 printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 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 10 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. People have the information they need to decide whether the service is right for them. By carrying out a through assessment the home can be sure that staff will be able to meet peoples needs. Evidence: Information booklets for people who use the service have now been changed and show more details about the home, its management, staff and services. This helps people to check whether the home is right for them and whether they are getting the care that should be provided. The document the home sent us tells us that they carry out a full assessment of peoples needs. The files we looked at each contained an assessment of that persons needs. Care Homes for Older People Page 11 of 24 Care Homes for Older People Page 12 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care people receive is based on the principles of respect dignity and privacy. Staff need more detailed information that tells them about peoples abilities and needs. Evidence: The home use preprinted care plan forms. These list a series of tasks that are ticked to show what help people need. The format helps to identify what peoples needs are but staff need more information that tells them what peoples abilities are and how care should be provided to meet individual preferences. Some plans showed that additional information has been handwritten alongside to give staff more information. This included recording preferred bedtimes which shows that peoples routines are flexible and choice is accommodated. We saw that on one file there was a record of a GP visit requested due to a display of aggressive behaviour from a person. Approximately 6 weeks later there was another incident reported during the night. But there was no care plan in place for recognising Care Homes for Older People Page 13 of 24 Evidence: the signs of distress or dealing with difficult or challenging behaviour. One file showed that the last recorded weight for one person was in August this year. The selfassessment the home carried out shows that they are aware that there are gaps in recording and care planning documentation. Care files show that people have regular contact with healthcare professionals. Medication practice has improved. The procedures have been changed to make sure that staff always sign the charts as they give medication out. We did not see a record to show the usual signatures for staff who give medication. The manager is addressing this. A relative told us that staff are respectful from what they have seen. Care Homes for Older People Page 14 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have access to some activities and meals that meet their needs. Widening the choice of meals and activities will ensure that the home meets more peoples individual needs. Evidence: An activity plan is displayed this tells people what the planned activities are for the week. People told us they enjoyed the entertainers visit. I thought he was very good. He has a quiz and does a bit of a dance around himself. They told us at other times the choice can be limited to dominoes or watching tv. The selfassessment tells us that the service knows that a programme of individual activities needs to be put in place and that additional resources for activities would help increase choice. One person told us that they would like to go out for more walks. Some care files now identify what peoples social interests are. Staff told us that one person enjoys photography and that they are hoping to work with them to develop this further. The home has acquired a personal computer for peoples use via Age Concern and will be looking at ways this can be used. Care Homes for Older People Page 15 of 24 Evidence: We observed lunchtime. Tables were nicely set, with a range of condiments and people were asked which of the two choices they wanted for their main course. The meal we saw was roast pork or chicken with vegetables. Sometimes the two choices offered are very similar for example two types of meat stew. This should be looked at so that people have a proper choice. People who needed help to eat were given it in a respectful way. Some staff did not make the most of this opportunity to speak to people. We asked people their views about the food. One person said the meat can be difficult to chew. Other people told us, as far as I am concerned it is very pleasant to eat. seem to accommodate choices the food is very very nice A relative told us that the food is good and nutritious and that staff will make her relative something if she doesnt like what is on the menu. Meals are served from a kitchenette located off the dining area. The previous inspection reported that there is no dishwasher or hot water boiler for drinks. Staff may lose care time if their time is taken up by boiling kettles and washing by hand. The main kitchen was given a 4 star rating by the local Environmental health department this tells us that there are good systems in place to maintain hygiene. Care Homes for Older People Page 16 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are protected by a robust complaints and protection procedure and can be confident that their concerns will be listened to and acted upon. Evidence: There is a complaints procedure displayed and this tells people who to speak to if they are unhappy. The manager keeps a record of complaints and this includes what action has been taken. There have been no complaints to the Commission since the last inspection. The manager has now attended a two day course for managers about protecting people from abuse. Most staff have had internal training that tells them about looking for abuse. More staff need this training so that they can help keep people safe and protected from abuse. We saw that there were 4 instances where matters were referred to the local safeguarding team. This shows that any concerns raised are acted upon. The selfassessment states that there is no policy in place on whistleblowing. This would give staff information and confidence to report any concerns they see. Care Homes for Older People Page 17 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a safe clean and comfortable environment. Evidence: All shared spaces we saw were clean. Some individual bedrooms needed attention. A relative said always clean, never any bad smells. A handyman is employed to carry out maintenance and small repairs. The self-assessment submitted by the home states that there is a rolling programme of refurbishment. The manager confirmed that people are consulted about changes to the environment. A safety certificate has now been obtained in respect of gas safety. The company are still looking into individual controls for radiators in bedrooms. Externally there are plans in place to undertake some tree felling and create a safe walkway for people All staff have undertaken in-house training on infection control. Care Homes for Older People Page 18 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. Peoples needs are met by staff who are trained and qualified. Evidence: Staffing levels have been reviewed. There are now 4 care staff on duty in the mornings, 3 staff in the afternoon and 4 staff again between 4 till 6pm. Staffing levels are consistent over weekdays and weekends. We saw that there are staff available at peak times such as meatimes. The information the home sent us tells us that there is a staff development programme in place. More than half of the care staff have a National Vocational Qualification at level 2. This means that they are trained ro provide care and support. We checked three staff files and found that all the required checks had been carried out. The manager told us that they make sure that any gaps in employment history are explored andd recorded on interview notes. This helps the home make sure that the people they employ are safe to work with vulnerable people. 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 with good recordkeeping and people can be confident that their comments will be acted upon. Evidence: The manager has now registered with the Commission. This helps to reassure people that the service is managed by someone who is trained and qualified to do the job. We sent out a selfassessment and this was returned within the agreed timescale. The selfassessment was brief. More detail would help us gain an understanding of how the service operates, what it does well and how planned changes are to be implemented. We saw minutes of meetings that show that the staff at the home ask people about their views. We saw surveys that the home had sent out to people asking for their views. The survey results are collated and the information is displayed in charts and tables on the notice board. We discussed other ways of communicating the results back to relatives and interested parties. Care Homes for Older People Page 20 of 24 Evidence: The home does not handle peoples finances. Most of the records and policies have been reviewed in the past year. This tells us that the manager is keen to promote safe working practices that support peoples health and wellbeing. 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 7 The care files for people should continue to be improved to show their specific need and preferences. This will help staff to make sure that they provide care that meets peoples individual needs and takes accounts of peoples abilities. A record showing the usual signatures of staff who administer medication should be available. This will help the manager to monitor and track medication administration. An increased range of activities including those that take place on an individual basis will help maintain peoples wellbeing. All staff should have training on adult protection. This will help them identify abuse and act upon any concerns raised. A whistleblowing policy should be in place to give staff the confidence to report any concerns. 2 9 3 12 4 18 Care Homes for Older People Page 23 of 24 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) 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. Care Homes for Older People Page 24 of 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!