Inspection on 06/09/07 for Morton Cottage Residential Care Home

This inspection was carried out on 6th September 2007.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Morton Cottage Residential Care... 15/01/09

Morton Cottage Residential Care... 17/07/08

Morton Cottage Residential Care... 30/01/08

Morton Cottage Residential Care... 19/07/06

Morton Cottage Residential Care... 04/12/05

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Morton Cottage Residential Care Home 210 Wigton Road Carlisle Cumbria CA2 6JZ Lead Inspector Diane Jinks Unannounced Inspection 6th September 2007 10:00 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.V342141.R01.S.doc Version 5.2 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.V342141.R01.S.doc Version 5.2 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.V342141.R01.S.doc Version 5.2 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) Date of last inspection 19th July 2006 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. The property is a large detached house 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. The home produces a guide to the services and facilities provided by the home and this is available on request from the manager. The scale of charges range from £373.00 to £434.00 per week (September 2007). Morton Cottage Residential Care Home DS0000064307.V342141.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The assessment of this service took place over several weeks and included a visit to the home. The home was assessed against the National Minimum Standards for care homes. During the visit people living at the home were spoken to. Some people and their relatives were sent questionnaires in order to obtain their views of the service. Questionnaires were also sent to health and social care professionals. The discussions and questionnaires help to provide information about the home. The manager also completed an Annual Quality Assurance Assessment; this helped to verify information throughout the inspection of this service. What the service does well: What has improved since the last inspection? What they could do better: People living at the home have an individual plan of their care needs and requirements. These documents do not contain sufficient information to ensure that people have all their care and support needs met in the most appropriate way. Improvements could be made to these plans. Social and leisure activities do not take place at the home. Some of the people living at the home said that they would like activities and outings to take place sometimes. Comments and suggestions received included ‘‘I would like to see Morton Cottage Residential Care Home DS0000064307.V342141.R01.S.doc Version 5.2 Page 6 more activities in the home – art therapy, simple crafts. I also feel a more secure outside area would be beneficial or an area inside the home with a view of the garden with perhaps bird tables/feeders which would be of interest to the residents.’’ Some improvements have been made to the general environment at the home. The home does not have an annual development and maintenance plan in place to ensure that refurbishment, décor and general upkeep of the home is carried out in a planned and organised manner. 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. The summary of this inspection report can be made available in other formats on request. Morton Cottage Residential Care Home DS0000064307.V342141.R01.S.doc Version 5.2 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.V342141.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1 and 3. Standard 6 is not applicable. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home obtains information about the health and social care needs of people thinking about using this service, prior to them moving in. This helps to ensure that the home will be able to support and care for them appropriately. EVIDENCE: The home has produced a brochure and Statement of Purpose. This document provides prospective residents with information about the home. It includes details of how to access the home and the assessment process. The document would benefit from a review to ensure that it reflects and acknowledges equality and the diverse needs of people who use or may use this service. The document should also accurately reflect the amenities and facilities that the home states it can provide, for example access to leisure and social activities. A sample of four care files was looked at during this visit. Where appropriate an assessment or care planning document has been obtained from social services, prior to the person’s admission to the home. The manager also undertakes pre-admission assessments. This document provides brief Morton Cottage Residential Care Home DS0000064307.V342141.R01.S.doc Version 5.2 Page 9 information in respect of the persons needs, abilities and level of independence. The home has an admission process to help ensure that the needs and expectations of prospective residents will be able to be met. People are able to visit the home for tea or for a day and are offered a six-week trial period. This helps them to decide if they like the home and if it will be suitable to meet their requirements. Morton Cottage Residential Care Home DS0000064307.V342141.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7,8,9, and 10. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The care plans in place at the home do not consistently include sufficient details regarding individual needs. This means that people using this service may not always be supported appropriately. EVIDENCE: Care files indicate that people using this service and their relatives, where appropriate, are involved in the development and review of their care plan. Care plans include information about the type and level of support each person requires and acknowledgment is given to promoting and encouraging independence. Nutritional assessments and mobility assessments form part of the care plan, which help identify the level of potential risk for each person. They do not consistently provide strategies for staff to follow in order to manage any risks adequately. Risk and handling assessments are undertaken and reviewed frequently. Copies are kept on the individual’s personal file and also in their room. This helps to ensure that care staff are aware of any special instructions regarding the use of equipment, risks and the mobility of people using this service. Morton Cottage Residential Care Home DS0000064307.V342141.R01.S.doc Version 5.2 Page 11 Sufficient details are not always recorded and this could place people using the service and staff at risk from injury. Where people may be at risk from falling, this is recorded and some arrangements have been put in place to help reduce the risks. This has not been done with any consistency and care plans have not always been reviewed and updated when a person has fallen. Some people living at the home have behaviour that can become challenging at times. This is reflected in care plans and assessments. There are no clear strategies recorded to help staff manage such situations to ensure that people living at the home are safe and protected from harm. There are indications that the manager has sought help from the community mental health team but this support has been limited at times. Daily records show that people using this service generally have access to a variety of health care professionals including their doctor, community nurses, dentists, opticians and podiatrists. However, the sample of daily notes looked at record concerns about the health and well-being of people using this service. Information has not been consistently recorded to evidence or confirm that these matters have been followed up with the relevant people such as doctors and social workers. The shortfalls noted in care plans place people living at the home at risk from harm and potentially compromises their health and well-being. There are procedures in place at the home in respect of the administration of medication. Staff with responsibility for administering medication have received training on this subject. This helps to make sure that people are supported with their medication in a safe manner. People living at the home are able to take responsibility for their own medication. This is subject to an assessment being carried out so that any risks are minimised. A secure, lockable storage space for medication, is available in the person’s own room. A sample of medication records and prescriptions were looked at during the visit. It was the first day of a new cycle of medication. All the records seen have been completed accurately and correspond with the amount left in the dosette boxes. A photograph of individuals is attached to their medication box. This provides a further identification check during the administration of medicine. Medication is generally stored safely and medication requiring cold storage is kept in a designated fridge. Two prescribed items had been left in one of the communal bathrooms in a basket of toiletries. This matter was discussed with the manager. Staff at the home treat the people living there with respect and dignity and many examples were observed. Where people wanted to go to the toilet, assistance was provided discreetly. People living at the home were spoken to politely and staff knocked on their doors before entering bedrooms and bathrooms. There is a friendly atmosphere between staff and people living at the home. Many of the people spoken to during the visit said that the staff are ‘very kind and helpful’. Where people had visitors, including health care professionals and relatives, they were assisted to their own rooms so that they could see them in private. One relative commented that ‘there is a genuine caring atmosphere in place in the care home. The staff are friendly.’ Morton Cottage Residential Care Home DS0000064307.V342141.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. People living at this home are not encouraged to enjoy a full and stimulating lifestyle. This means that people are restricted in their choices about how they live their lives and maintain their interests, hobbies and contact with the local community. EVIDENCE: The activities co-ordinator employed at the home has recently left. There were no activities seen on the day of the visit to the home. The television was on and music was playing in another room. Some people living at the home were able to entertain themselves with knitting, magazines, newspapers and reading books. Generally, people were sitting around with very little stimulation. Some people living at the home were spoken to during the visit. They say that there are very few opportunities to take part in activities both in and outside of the home. Some people said that they would like to go out occasionally, for a short walk, but felt that this was not encouraged. There is a garden area at the home and people are generally able to access this when they want to. At the bottom of the garden a shed has been erected and is the designated smoking area for people who wish to smoke. People living at the home are able to receive visitors whenever they wish, although prior arrangements may need to be made for people wishing to visit Morton Cottage Residential Care Home DS0000064307.V342141.R01.S.doc Version 5.2 Page 13 in the late evening. Visitors may be seen in one of the communal areas or in the privacy of the person’s own room. The clergy makes visits from both the Catholic Church and the Church of England each week. People living at the home may attend the service if they wish. At the time of the visit to the home, the kitchen was in the process of being replaced. A temporary kitchen has been sited at the front of the home. The menus at the home are varied and include fresh fruit and vegetables and at least two choices of main course and dessert at each meal time. Although new dishes have been included, the menus have not been reviewed and developed as recommended at the last inspection. People living at the home have not been consulted for their views and ideas about meals and food choices. The service of the lunchtime meal was observed. The dining rooms had been nicely laid up ready for the meal. When people gathered for their lunch, friendly conversations and interaction took place, making the lunchtime pleasurable and homely. Where people required assistance with eating their meal, staff provided this in a sensitive and caring manner, taking their time to talk to people and offering drinks or assistance where required. Improvements need to be made to the way in which soft diets are presented. Soft diet meals are pureed altogether and therefore there is no variety in taste and texture for the people eating this type of meal. After lunch staff were observed talking to people about the menu choices for the following day. Explanations were given to help people decide on what they would like to eat. Some of the people spoken to during the assessment of this service said that the food was ‘beautiful’ and ‘very good.’ People indicated that despite the main kitchen being out of action there had been no noticeable differences to the quality of the meals. Morton Cottage Residential Care Home DS0000064307.V342141.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager understands the need for complaints and safeguarding adults procedures. This helps to ensure that people living at the home are safe and protected from harm. EVIDENCE: The home has a complaints process. This is included in the Statement of Purpose and is on display in the home. The procedure makes reference to complaints being forwarded to the social service department or the local Ombudsman and consideration should be given to including the full contact details of these agencies. People at the home know who they should direct complaints and comments to and feel that they will be listened to and taken seriously. The manager has not received any complaints during the last 12 months. However, one person raised issues that were dealt with under safeguarding adults procedures. The manager responded appropriately and involved the necessary agencies such as social services and the Commission for Social Care Inspection. Detailed records of the investigation and progress of the matter were kept by the manager. Some initial difficulties were experienced in contacting social services but once contact had been made the matter was dealt with quickly and appropriately. Staff training records indicate that staff are provided with a basic awareness of adult abuse and how to deal with complaints. These subjects have also been discussed at staff meetings and within supervision sessions, with staff attention being drawn in particular to the whistle-blowing policy in place at the home. Morton Cottage Residential Care Home DS0000064307.V342141.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 and 26 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Maintenance and renewal at the home is not approached in a planned and structured way. This means that the quality of life for people using this service is compromised by the environment they are living in. EVIDENCE: On the day of this visit the kitchen was closed and was in the process of being replaced. A mobile kitchen had been obtained. It was seen to be in good order and tidy, although there is limited work space available. The manager indicated that the food safety officer at the local city council had been consulted on the temporary kitchen and the plans for the new kitchen. The main staircase is in the process of re-decoration and is closed off to people living at the home and staff in order to ensure safety. Several areas of the home have been re-decorated and the improvements are very noticeable. This includes the top corridor. A new carpet has been ordered for this area and the Morton Cottage Residential Care Home DS0000064307.V342141.R01.S.doc Version 5.2 Page 16 home is awaiting delivery and fitting. Where ceilings have been damaged previously by leaking water, they have been re-papered and painted. The home has recently had an inspection by the local fire authority. The fire officer made recommendations and the manager indicates that these have started to be addressed. There are three communal bathrooms at the home, two of which have bath chairs to help less mobile people access the bath. The bathroom on the ground floor is in need of refurbishment and the bath seat needs replacing. The seat was found in a stained and corroding condition and this poses a risk of cross infection. There was also a basket of toiletries, including some prescribed items in this bathroom. This indicates that toiletries may be for communal use and that people living at the home are not able to choose their own bath products. The bath taps in this room are constantly trickling and do not turn off. Communal bathrooms and toilets have some aids and adaptations to help people with limited mobility but further equipment could be provided after consultation with an occupational therapist. Consideration should be given to this when bathrooms are up-graded. The lounge and dining areas are pleasant, warm and furnished to a reasonable standard. Many of the windows look out onto the garden areas surrounding the home. Some of the bedrooms were looked at during this visit. Most of them were clean and tidy and others were waiting for the domestic to visit. People living at the home are able to personalise their own rooms with ornaments, pictures and furniture. All of the bedrooms have an en-suite toilet and wash basin. The people spoken to during this visit indicate that they are happy with their rooms and confirm that they have brought personal items and possessions with them to help create a more homely environment in their own room. The home does not currently have a programme to ensure that it is kept in a good state of repair and well maintained. The manager has recently purchased a recording and auditing system, which will assist with the development of a plan for the continued renewal and maintenance of the home. A handy man has been employed recently too. Morton Cottage Residential Care Home DS0000064307.V342141.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has staff recruitment and training processes in place. These help to ensure that people using this service are supported and cared for by suitable staff. EVIDENCE: There were sufficient staff on duty on the day of the visit. Staff were kept very busy throughout the day. This was partially due to the disruptions caused by the fitting of the new kitchen and alternative arrangements that had been made in respect of dining areas and lounge space. Staff are friendly and polite and there appears to be a good rapport between staff and people living at the home. The people spoken to on the day of the visit were very complimentary about the staff. They said that they were ‘kind and helpful’ and ‘lovely, they will do anything for me’. The handyman is the most recently appointed member of staff at the home. There was no application form on his record but a Criminal Record Bureau (CRB) check and a Protection of Vulnerable Adults (POVA) check had been undertaken. References have also been obtained. These checks help to make sure that people using this service are protected from people who may be unsuitable to work in a care home. The files of two members of the care staff were also looked at. Both have been employed at the home for more that a year. The manager has obtained proper checks and references prior to their employment at the home. Morton Cottage Residential Care Home DS0000064307.V342141.R01.S.doc Version 5.2 Page 18 The manager has not yet developed a staff training plan. Records are kept of courses attended and evidence was seen to confirm that staff attend specialised training courses to help them understand and meet the needs of the people they are caring for. Staff training records show that staff undertake induction training but these records are not dated. Other training provided to staff includes; administration of medication, manual handling, dementia care, first aid, infection control, food hygiene, safeguarding adults and National Vocational Qualifications (NVQ). The home uses a variety of training methods including external training providers and staff obtain nationally recognised qualifications. Over half of the care staff employed at the home have obtained NVQ at least at level 2 in care or health and social care. Although the home provides staff with training in respect of manual handling, some poor care practices regarding manual handling techniques were observed during the visit to this service. The matter was brought to the attention of the manager. Morton Cottage Residential Care Home DS0000064307.V342141.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 36 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The manager is aware of the need to promote and protect the health and safety of people working and living at the home. Health and safety matters are not always dealt with appropriately and this potentially places people at risk from harm. EVIDENCE: The manager is experienced in the management of the care home. She has gained a National Vocational Qualification in care management and continues to undertake the registered managers award to help ensure that she keeps her skills and knowledge up to date. The record keeping at the home is generally up to date and accurate, although there are some gaps in the care records and recruitment procedures. Morton Cottage Residential Care Home DS0000064307.V342141.R01.S.doc Version 5.2 Page 20 The manager has recently purchased a system to help develop a quality assurance system within the home. Some of the documentation has started to be completed. This will help the manager to produce a plan for the improvement and development of the home. There is little evidence to demonstrate that staff are supervised and have their practice assessed on a regular basis. Staff meetings are held and minutes are kept but again these are not held frequently. Staff at the home are provided with health and safety training including first aid, manual handling, infection control and food hygiene. This type of training helps to ensure the safety of both people living at the home and staff employed in the home. A visit by the fire authority has been made recently. Some areas have been identified as needing attention and the fire authority are monitoring the progress of these matters. The home does not have a maintenance plan or a business development plan and areas of the home are in need of attention. Some of the areas that have been overlooked by the manager include the checking of electrical circuits at the home, the portable electrical equipment, gas appliances and the central heating system. The manager indicated that a service engineer has been contacted regarding the central heating and gas appliances and she is awaiting confirmation of a start date. The electrical circuits are to be checked next week when the new kitchen is re-wired. The manager has purchased the equipment needed to check the portable electrical equipment and the handyman is awaiting training in order to use the equipment and carry out the checks safely. The accident/incident book was looked at during the visit to the home. These records have not been kept as accurately as they should be. Some incidents recorded in care files had not been recorded in the book. Additionally, evidence shows that CSCI are not always notified as required about events and occurrences, which may adversely affect the well-being and safety of people living in the home. Morton Cottage Residential Care Home DS0000064307.V342141.R01.S.doc Version 5.2 Page 21 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 2 X 2 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 2 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X X 1 X 2 Morton Cottage Residential Care Home DS0000064307.V342141.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? YES. Morton Cottage Residential Care Home DS0000064307.V342141.R01.S.doc Version 5.2 Page 23 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 OP19 Regulation 13 23 Requirement The registered person must review the maintenance and renewal plan for the home to ensure that the areas requiring refurbishment and redecoration are attended to as a priority. Timescales for action must be included in the plan. (Previous timescale of 30/09/06 and 01/05/07 not met). The registered person must ensure that a system is established and maintained for reviewing and improving the quality of care provided by the home, including an annual development plan for the home. (Previous timescale of 30/09/06 and 01/05/07 not met). A detailed plan of care must be developed for each person using this service, taking into account the needs and risk assessments. This will help ensure that people using this service are supported safely and the care needs and outcomes identified are being met properly. Where health concerns have been identified, people using this service must have access to DS0000064307.V342141.R01.S.doc Timescale for action 31/10/07 2. OP33 24 01/12/07 3. OP7 15 12 13 31/10/07 4. OP8 12 13 30/09/07 Morton Cottage Residential Care Home Version 5.2 Page 24 health care professionals. This will ensure that all aspects of the person’s health care needs are met appropriately. 5. OP9 13 Medicines, including creams and ointments must be kept secure at all times and given or used for the people for whom they are prescribed. This will ensure the health, safety and welfare of people using this service. 30/09/07 6. OP12 16 People using this service must be 31/10/07 consulted about their social and recreational activities and interests. A programme of suitable and stimulating activities at the care home must be available for people living at the home. Bathrooms and bathing equipment must be kept clean, hygienic and free of hazards at all times. This will help to minimize the risks that they present to people living in the home. The records required to be kept by regulation, including accident and incident records, must be maintained accurately and kept up to date. The Commission for Social Care Inspection must be notified of any event, which adversely affects the well-being or safety of any person using this service. 31/10/07 7. OP26 13 23 8. OP37 17 37 30/09/07 Morton Cottage Residential Care Home DS0000064307.V342141.R01.S.doc Version 5.2 Page 25 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 OP22 Good Practice Recommendations It is recommended that the registered person obtain an assessment of the premises and facilities by a suitably qualified person (e.g. Occupational therapist) to ensure that service users have the specialist equipment and environmental adaptations required to meet their needs. The Statement of Purpose and brochure for the home should be reviewed and updated. These documents provide information to people who use or may use this service and should accurately reflect the service to enable people to make an informed choice. It is recommended that care needs assessments be reviewed so that they clearly identify the care needs and reflect the preferences and choices of people using this service. People requiring liquidised meals should have their food presented in an appealing manner so that they receive a variety of textures and flavours. This will help ensure their appetite and nutrition is maintained. It is recommended that the menu be reviewed to clearly identify the daily choices available. This will help to promote individual choice. It is recommended that a comprehensive staff training and development programme be in place at the home. This will help ensure that staff are able to fulfil the aims of the home and meet the changing needs of people living in the home. Staff employed at the home should be supervised and have their care practices monitored on a frequent basis. This helps to make sure they are working to the policies and procedures in place at the home as well as identifying any training and development needs they may have. 2. OP1 3. OP3 4. OP15 5. OP15 6. OP30 7. OP36 Morton Cottage Residential Care Home DS0000064307.V342141.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP National Enquiry Line: 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 © 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 Morton Cottage Residential Care Home DS0000064307.V342141.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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