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Inspection on 04/12/05 for Morton Cottage Residential Care Home

Also see our care home review for Morton Cottage Residential Care Home for more information

This inspection was carried out on 4th December 2005.

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home carries out an in-depth assessment prior to admission, to ensure the correct level of care can be provided. The senior on duty said that this assessment process is continued throughout the first month after admission to give an even clearer picture of the resident`s needs. There is an improved care planning system in place to provide staff with the information required to satisfactorily meet residents` needs. The health care needs of the residents are met through good working relationships with the local doctors and district nursing service. Efforts are made to ensure residents are offered a varied nutritious menu, with a choice at each meal.

What has improved since the last inspection?

The care planning system has improved since the last inspection with clear and concise information now available to enable staff to meet the assessed needs. The plans contain details of all the healthcare professional visits and healthcare needs. The registered manager reviews the plans at least once a month, more frequently if required.

What the care home could do better:

The owner and manager should ensure the care planning system is now kept up to date and ensure the staff continue to deliver a high level of care.

CARE HOMES FOR OLDER PEOPLE Morton Cottage Residential Care Home 210 Wigton Road Carlisle Cumbria CA2 6JZ Lead Inspector Mrs Margaret Drury Unannounced Inspection 4th December 2005 13.50 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 Morton Cottage Residential Care Home DS0000064307.V266152.R01.S.doc Version 5.0 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. Morton Cottage Residential Care Home DS0000064307.V266152.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Morton Cottage Residential Care Home Address 210 Wigton Road Carlisle Cumbria CA2 6JZ 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) 01228 515757 01228 521876 Morton Cottage Residential Care Home Ltd Mrs Amanda Jane Longford Care Home 32 Category(ies) of Dementia - over 65 years of age (6), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (1), Old age, not falling within any other category (32) Morton Cottage Residential Care Home DS0000064307.V266152.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 32 service users to include: up to 32 service users in the category of OP (Old age, not falling within any other category) up to 6 service users in the category of DE(E) (Dementia over 65 years of age) 1 service user in the category of MD(E) (Mental disorder excluding learning disability or dementia over 65 years of age) Two service users may share a bedroom of at least 16 sqm usable floor space only if they have made a positive choice to do so, and when a shared space becomes vacant the remaining service user must have an opportunity to choose not to share, by moving to a different home if necessary. The service must at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 4 May 2005 2. 3. Date of last inspection Brief Description of the Service: Morton Cottage is owned and operated by Mrs April Dixon with Mrs Amanda Longford as the registered manager. The home is registered to provide accommodation for up to 32 older people, 6 of whom may have varying forms of dementia. The property is a large detached house set back off Wigton Road on the outskirts of Carlisle. Accommodation for the residents is on two floors with a passenger lift accessing the first floor. There are 24 rooms for single occupation and 4 that can be shared by 2 people. All the bedrooms have en-suite toilet and washbasin facilities and there are communal toilet and bathing facilities throughout the home. There are three lounge/dining rooms and a quiet lounge on the ground floor. Residents are not permitted to smoke in the home but there is a sheltered area at the rear of the home available for those wishing to smoke. Morton Cottage Residential Care Home DS0000064307.V266152.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on a Sunday afternoon. The proprietor and manager were not available during the inspection but the senior in charge of the home assisted the inspector. Time was spent looking at staff records, care plans and records pertaining to the care of the residents and running of the home. Time was also spent speaking with residents and visitors and some parts of the home were looked at. The standards not assessed during this visit were assessed and met during the inspection that took place earlier in the year. What the service does well: What has improved since the last inspection? The care planning system has improved since the last inspection with clear and concise information now available to enable staff to meet the assessed needs. The plans contain details of all the healthcare professional visits and healthcare needs. The registered manager reviews the plans at least once a month, more frequently if required. Morton Cottage Residential Care Home DS0000064307.V266152.R01.S.doc Version 5.0 Page 6 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. Morton Cottage Residential Care Home DS0000064307.V266152.R01.S.doc Version 5.0 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 Morton Cottage Residential Care Home DS0000064307.V266152.R01.S.doc Version 5.0 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): 1, 2 & 5 The home’s statement of purpose provides residents with details of the services and facilities on offer at the home. This enables an informed choice to be made whether or not to move into the home. EVIDENCE: The home has a statement of purpose that is provided to all prospective residents and/or their families. This gives details of the facilities on offer and helps them to make an informed decision about moving in to the home. All residents have a contract with the home or Social Services, which acts as a safeguard for them and their families. Prospective residents and their families are encouraged to visit the home to meet the staff and to ensure the assessed needs of the resident can be met. Morton Cottage Residential Care Home DS0000064307.V266152.R01.S.doc Version 5.0 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, 10 & 11 Residents now benefit from a care planning system that gives sufficient information to enable the assessed needs can be met with privacy and dignity. EVIDENCE: The care planning system has been reviewed and improved since the last inspection. The inspector examined a sample of the care plans and found them to be informative and containing details of the health care needs and professional visits. The manager reviews them once a month, more often if required. Details of the review dates shown on the plans. Discussions with residents and visiting families evidenced that they were treated with respect at all times. Visitors said the staff were “very kind and really looked after the residents well”. Details of the residents’ wishes at death are now recorded on the care plans. Morton Cottage Residential Care Home DS0000064307.V266152.R01.S.doc Version 5.0 Page 10 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): 12 & 15 The meals in this home are good offering both choice and variety and catering for special dietary meals. EVIDENCE: Local clergy visit the home from time to time and one resident attends church twice a week. Activities are organised by staff for those wishing to join in and arrangements have been made for some residents to go to the local theatre later in the week. The inspector was able to speak to the weekend cook during the visit to discuss the 4-week menu. There is a choice at each meal and special diets are available when required. Residents and family members said the food “is very good and there is always plenty to eat”. Morton Cottage Residential Care Home DS0000064307.V266152.R01.S.doc Version 5.0 Page 11 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): 18 Staff have a good knowledge and understanding of adult protection issues, which protects residents from abuse. EVIDENCE: All of the staff that spoke with the inspector had a good understanding of adult protection issues and the different forms abuse can take. This subject is covered in the induction programme and the NVQ course. Staff were able to take part in an abuse training course earlier in the year. All these measures ensure that residents are protected at all times. Morton Cottage Residential Care Home DS0000064307.V266152.R01.S.doc Version 5.0 Page 12 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): 19, 21, 22, 23 & 24 The standard of the environment within this home is reasonably good providing the residents with a homely place to live EVIDENCE: The home is currently going through a period of refurbishment due to recent floods in the Carlisle area. One lounge/diner has been completed and new carpet laid. The affected bedrooms have all been redecorated and new carpets have been laid. The new furniture has been ordered and will be delivered shortly. There are other parts of the home that look in need of redecoration and the senior on duty said the owners are aware of these areas. There are assisted bathing and toilet facilities around the home to assist people with disability and handrails on the corridors to aid mobility. Discussions with the senior on duty evidenced that there is currently only one bathroom in use. The owner should ensure that, at least one of the other bathrooms in the home is made available as soon as possible. The inspector was able to examine some of the bedrooms and found them to be personalised with items from the residents’ own homes. Some were a little Morton Cottage Residential Care Home DS0000064307.V266152.R01.S.doc Version 5.0 Page 13 small but those residents who spoke with the inspector were happy with their accommodation. Morton Cottage Residential Care Home DS0000064307.V266152.R01.S.doc Version 5.0 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): 28 & 30 Residents benefit from a staff team that has a clear understanding of their roles and an awareness of their needs. EVIDENCE: The inspector was able to examine the training file, which contained details of all the staff training completed. This included, infection control, first aid, eye care and protection of vulnerable adults. Staff personnel files contained details of the checks completed prior to the staff starting work at the home, which contribute to the safety of the residents. On the day of the inspection there was sufficient staff to meet the residents needs and interviews with them demonstrated their commitment to delivering a high level of care. Visitors who spoke with the inspector spoke highly of the care given to the residents and all said they “would not consider any other home”. Morton Cottage Residential Care Home DS0000064307.V266152.R01.S.doc Version 5.0 Page 15 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, 32, 33 & 34 Residents benefit from an owner and manager that support the staff in the delivery of care to meet the assessed needs. EVIDENCE: Although neither the owner or the registered manager were in the home on the day of the inspection it was clear that both the visitors and staff were appreciative of their approach and support in ensuring there is a relaxed atmosphere in the home. All said that the home was run for the benefit of the residents and that the manager was always readily available for help and advice. Details of the home’s accounting procedures were not available on the day of the inspection but the senior in charge confirmed that no personal monies are held on behalf of the residents and that the administrator dealt with everyday finances. Morton Cottage Residential Care Home DS0000064307.V266152.R01.S.doc Version 5.0 Page 16 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 3 3 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 X 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 X 3 3 3 3 X X STAFFING Standard No Score 27 X 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 X X X x Morton Cottage Residential Care Home DS0000064307.V266152.R01.S.doc Version 5.0 Page 17 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. Refer to Standard Good Practice Recommendations Morton Cottage Residential Care Home DS0000064307.V266152.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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. 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