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Inspection on 27/09/05 for Morton Court Nursing Home

Also see our care home review for Morton Court Nursing Home for more information

This inspection was carried out on 27th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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

This home provides a pleasant and clean environment for residents. Those residents spoken to expressed their satisfaction about all aspects of the care provided. The care staff are a competent team who were observed to be kind and polite when speaking to residents. The manager and staff have are good at developing positive relationships with each resident. The home also has a training profile for all care workers detailing which staff have undertaken training.

What has improved since the last inspection?

All requirements made at the last inspection have been addressed by the home. Those care plans seen had been signed by residents or their relatives agreeing to the plan of care offered by the home. All prospective residents are assessed prior to admission and a letter is written to residents confirming that the home can meet their needs.

What the care home could do better:

CARE HOMES FOR OLDER PEOPLE Morton Court Nursing Home Ashby Avenue Lincoln Lincs LN6 0ED Lead Inspector Mr Doug Tunmore Unannounced Inspection 27th September 2005 09:00 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 Court Nursing Home DS0000002614.V251451.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 Court Nursing Home DS0000002614.V251451.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Morton Court Nursing Home Address Ashby Avenue Lincoln Lincs LN6 0ED 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) 01522 689400 LACE Housing Limited Mrs M E Waterer Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Morton Court Nursing Home DS0000002614.V251451.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7 June 2005 Brief Description of the Service: Morton Court is a care home that provides both nursing and personal care for persons who are 65 years of age or over. Morton Court is a purpose built home that is sited to the south of the City of Lincoln. There is limited car parking facilities to the side of the building but street parking is available. Accommodation for residents is provided in single rooms with en-suite WC, wash hand basin and shower. Facilities are on the ground floor and the first floor, which is accessed by a passenger lift. Morton Court is one of a group of homes owned and operated by a voluntary organisation, LACE Housing. The day-to-day management of the home is the responsibility of the registered manager. Morton Court Nursing Home DS0000002614.V251451.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and started at 9.00 am. The main method of inspection used was called case tracking, which involved looking at policies and procedures relating to maintaining the safety and general welfare of residents. Residents were spoken to as well as visitors, the manager and care staff and observations were made of care practices. A tour of the home took place. What the service does well: What has improved since the last inspection? What they could do better: Files seen showed that only one member of care staff has undertaken an annual appraisal and none have had supervision which needs to be formalised, addressing all those aspect required for the supervision and recording of this process. The homes décor is now in need of attention with two lounges, one dining room and five bedroom carpets now needing to be replaced. Staff commented that they struggle at the busiest times of the day to deliver the care required by some residents. Morton Court Nursing Home DS0000002614.V251451.R01.S.doc Version 5.0 Page 6 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 Court Nursing Home DS0000002614.V251451.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 Court Nursing Home DS0000002614.V251451.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): 3 The home undertakes a full care needs assessment and writes to prospective residents informing them that the home can meet their needs or not. EVIDENCE: The home has a detailed admission procedure, which identifies the needs of residents coming into the home. One resident’s file showed that the home had visited and carried out a care assessment of his needs. A visiting Access and Reviewing Coordinator from the Primary Care Team (PCT) confirmed that assessments are carried out by their team and that the home also carries out their own admission assessments. Files seen showed that residents had been written to confirming that the home could meet their needs. Morton Court Nursing Home DS0000002614.V251451.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): 8,9 & 10 There is good care planning in this home, which helps ensure that the general health and welfare of residents is addressed. Procedures relating to the delivery of personal care are sufficient and help maintain the dignity of residents. Nursing staff are trained and proficient in administering medication. EVIDENCE: The home has a personal care policy, which gives guidance to care workers when undertaking intimate care tasks with residents. One care worker who was spoken to was sensitive to the more personal care needs of service users and described the best practice in ensuring that service users dignity is maintained when bathing or toileting. She also stated that she had read the homes policy on giving personal care to residents. The inspector observed during the inspection that staff gave support to residents and were sensitive in maintaining their dignity. Residents stated that ‘ all staff are very good and very kind’. Individual care plans evidenced that accidents are recorded in the homes’ accident book and in the resident’s daily Morton Court Nursing Home DS0000002614.V251451.R01.S.doc Version 5.0 Page 10 notes. However, one accident had not been recorded on the resident’s body map, which is used for the mapping of any cuts or abrasions. Files seen confirmed that health care professionals visit the home when required by residents that, they have placed in this home. The visiting Access and Review Coordinator confirmed that she or nurses from the (PCT) visit the home regularly to ensure that residents health care needs were being met. A nurse administering medication stated that she is mindful of maintaining residents dignity when undertaking invasive treatment, such as administering eye drops. She also said that, when giving medication to residents, she ensures that they take it before signing their medication sheets. The pharmacist inspected the home on the 13/09/05 and recorded that storage and administration records of medication is carried out appropriately and no recommendations were made. Morton Court Nursing Home DS0000002614.V251451.R01.S.doc Version 5.0 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): The key outcomes were assessed at the last inspection. EVIDENCE: Morton Court Nursing Home DS0000002614.V251451.R01.S.doc Version 5.0 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): The key outcomes were assessed at the last inspection. EVIDENCE: Morton Court Nursing Home DS0000002614.V251451.R01.S.doc Version 5.0 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): 19 & 26 The home is clean, comfortable and pleasant. Some parts of the home were in reasonable condition; other parts were in need of redecoration and refurbishment. EVIDENCE: A tour of the home found that two first floor lounge carpets, five bedroom carpets and the dining room carpet looked worn and stained, needing to be replaced. The décor of the home in some areas looked shabby, with corridors, doorframes and a number of rooms needing painting. The home employs three cleaners two who work in total work forty hours a week. A tour of the home found that it was clean and tidy, having a pleasant odour. One cleaner stated that she had undertaken Hygiene control training and had also NVQ (National Vocational Training) training level 1. Morton Court Nursing Home DS0000002614.V251451.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): 27,28,29 & 30 Residents are protected by robust recruitment practices. Residents benefit from a staff team who are well trained and work well together and complement each others skills. EVIDENCE: Two personnel file seen contained CRB checks (Criminal Record Bureau), references and application forms. All care workers have seen The General Social Care Council Codes of Practice, which sets out their responsibilities as care workers looking after vulnerable adults. The home has twenty two care workers, five nurses, two kitchen assistants, two cooks and a maintenance man two days a week. The homes training record was seen which showed that, ten care workers had NVQ (National Vocational Qualifications) level 2, with three of these having NVQ 3, two workers are currently awaiting to undertaking NVQ level 2 training. Five care workers have undertaken the National Training for Social Care (TOPSS) induction training. One carer commented that she had undertaken TOPSS induction and the homes initial induction training. Two kitchen assistants have NVQ 1 & 2. The registered manager successfully completed the Registered Managers Award in 2004. Statutory training such as fire training (now due), moving and handling and first aid are undertaken at this home. Other training undertaken included; continence update, tissue viability, falls and prevention and food hygiene. Morton Court Nursing Home DS0000002614.V251451.R01.S.doc Version 5.0 Page 15 One care worker demonstrated a clear understanding of her role and responsibilities. She stated that she will be undertaken training in March 2006 to become a nurse. The home meets the standard for 50 of staff to be trained to NVQ level 2 by 2005. The rota showed that adequate staffing levels are available during the night but the registered manager and a care worker identified that the early morning shift requires one more carer as this is the busiest time of the day. Comments received during this inspection from the visiting Access and Review Coordinator were that ‘ never noticed a big turner over of staff at this home and there appears to be enough staff on duty during my visits’. One resident said that ‘when we use the call buzzer, they (the staff) come quite quickly’. Morton Court Nursing Home DS0000002614.V251451.R01.S.doc Version 5.0 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, 36 & 38 Records seen show that residents’ health and general welfare and safety are promoted. The home ensures that the residents have the opportunity to voice their views and opinions. Accurate records are kept of residents’ monies. All care workers have not had annual appraisals undertaken or supervision. EVIDENCE: Comments from staff, visitors and residents were that the manger has a visible presence in the home and is approachable. A resident stated that the ‘matron is very nice’. The home conducted its last quality assurance questionnaire on 04/11/03. An analysis of this report has not been made available to residents or relatives/visitors. The minutes of the last residents meeting held in August 2005 showed that residents are encouraged to voice their views and are actively involved in issues relating to the running of the home. Morton Court Nursing Home DS0000002614.V251451.R01.S.doc Version 5.0 Page 17 The home only deals with personal allowances of residents, which are kept safe. All other monies relating to funding are paid into the homes bank account on a standing order by relatives. Residents’ personal allowances were seen and it was found that an accurate record is kept and receipts are available for any monies spent, with signatures made by the registered manager or the deputy manager. A resident commented that her daughter dealt with her monies. Supervision of care staff has not been undertaken in 2005, nor has the registered manager carried out appraisals of nursing staff or care staff. One carer confirmed that supervision her supervision had been undertaken in 2004. There are a range of policies and procedures available in the home relating to fire safety and fire risk assessments. There was also evidence that fire alarm, fire drill and emergency lighting checks have been undertaken. Certificates were available showing that the shaft-lift and bath hoists had been serviced. All wheelchairs seen on the day of the inspection had footplates, which were in use. Morton Court Nursing Home DS0000002614.V251451.R01.S.doc Version 5.0 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 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 2 9 3 10 11 2 x x x x x x 3 STAFFING Standard No Score 27 2 28 29 30 3 x 4 3 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 3 2 x 3 Morton Court Nursing Home DS0000002614.V251451.R01.S.doc Version 5.0 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. 1 Standard OP8 Regulation 12(a) Requirement The home must record all accidents appropriately including completing of body maps if residents have a bruise or abrasion. The registered person must maintain the fabric of the home to a good standard, by replacing old carpets and also improve the décor of the home where required. The home must ensure that persons working in the care home are in such numbers as are appropriate for the health and welfare of residents. The home must undertake regular quality assurance monitoring based on seeking the views of residents so as to measure the success in meeting the homes aims. The outcome must also be posted on the notice board for the information of residents and relatives. The home must carryout annual appraisals on all staff as per their policies and procedures. The home must carryout DS0000002614.V251451.R01.S.doc Timescale for action 12/12/05 2 OP19 16(2) 15/03/06 3 OP26 18(a) 12/12/05 4 OP33 24 12/12/05 5 6 OP36 OP36 18(2) 18(2) 15/02/06 15/02/06 Page 20 Morton Court Nursing Home Version 5.0 appropriate formal supervision of all care workers at least six times a year. 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 OP36 Good Practice Recommendations The home should have a formalised supervision form addressing all those aspects required for the supervision and recording of this process. Morton Court Nursing Home DS0000002614.V251451.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Morton Court Nursing Home DS0000002614.V251451.R01.S.doc Version 5.0 Page 22 - 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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