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Inspection on 07/06/05 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 7th June 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 homely and clean environment for residents who live here. Residents and visitors 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. Those care workers formally interviewed were found to have a good working knowledge of the care needs of residents. Meals are varied, well balanced and served plated to the resident. Information relating to service users dietary needs are available in the kitchen so that the cook is aware of any allergies.

What has improved since the last inspection?

The home has produced a service users guide, which has been placed in residents` rooms and is also given to prospective residents giving them the information they need when choosing where to live.

What the care home could do better:

The home needs to ensure that all prospective residents are informed in writing that the home can meet their care needs. The home must also implement a policy relating to the intimate care of service users and ensure that this is included in the homes initial training programme for new care workers. The homes policies and procedures for administration of medication must be followed to ensure that appropriate records are kept at the time when residents take their medication or otherwise.

CARE HOMES FOR OLDER PEOPLE Morton Court Nursing Home Ashby Avenue Lincoln LN6 OED Lead Inspector Doug Tunmore Unannounced 7 June 2005 9:00 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 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 C53 CO4 S2614 Morton Court V231546 070605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Morton Court Nursing Home Address Ashby Avenue Lincoln LN6 OED Telephone number Fax number Email 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 with Nursing 25 Category(ies) of OP Old Age - not falling within any other registration, with number category of places Morton Court Nursing Home C53 CO4 S2614 Morton Court V231546 070605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 15 March 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 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 C53 CO4 S2614 Morton Court V231546 070605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and started at 10.40 am. The main method of inspection used was called case tracking, which involved selecting two residents and tracking the care they receive through the checking of their records, discussion with them, the care staff and observations of care practice. Five visitors were also seen during the course of the inspection. A partial tour of the premises took place. What the service does well: What has improved since the last inspection? What they could do better: The home needs to ensure that all prospective residents are informed in writing that the home can meet their care needs. The home must also implement a policy relating to the intimate care of service users and ensure that this is included in the homes initial training programme for new care workers. The homes policies and procedures for administration of medication must be followed to ensure that appropriate records are kept at the time when residents take their medication or otherwise. Morton Court Nursing Home C53 CO4 S2614 Morton Court V231546 070605 Stage 4.doc Version 1.30 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 C53 CO4 S2614 Morton Court V231546 070605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Morton Court Nursing Home C53 CO4 S2614 Morton Court V231546 070605 Stage 4.doc Version 1.30 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 standard(s) 1 & 3 The service users guide gives residents the information they need when choosing where to live. The home undertakes a full care needs assessment but does not confirm in writing to prospective residents that the home can meet their needs. EVIDENCE: A tour of the home found that the residents guide was available to residents. Five relatives confirmed that they had been given a copy of the homes service users guide. The home has a detailed admission procedure, which identifies the needs of residents coming into the home. Two residents files also showed that social workers had completed ‘Easy Care’ assessments for the home relating to the care needs of residents. Those two residents being case tracked were not able to give a considered view of the care they receive due to their age and those infirmities that come with old age. Visitors confirmed that their relatives had been assessed either in the care home/hospital or in their own home before admission. Files seen showed that neither resident had been written to confirming that the home could meet their needs. Morton Court Nursing Home C53 CO4 S2614 Morton Court V231546 070605 Stage 4.doc Version 1.30 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 standard(s) 7,8,9 &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 not sufficient and need to be reviewed. On the day of the inspection medication was not administered appropriately. EVIDENCE: All residents have detailed care plans, which describe their health and welfare needs. Care plans outlined risk assessments, nutritional and dependency assessments. Care plans also evidenced that six weekly post-admission reviews had taken place and residents, relatives and social workers had attended. Care plans seen had not been signed by the residents or their representatives confirming that they agree with the care provided. Individual care plans evidenced that accidents are recorded in the homes’ accident book and in the residents daily notes. The home currently does not use body maps for the mapping of any cuts or abrasions to residents. One accident form was checked through the homes accident procedures and it was found that an abrasion to a resident had been recorded appropriately. Files seen confirmed that health care professionals visit the home when required by the residents. Visitors confirmed that their relatives have seen the GP and felt Morton Court Nursing Home C53 CO4 S2614 Morton Court V231546 070605 Stage 4.doc Version 1.30 Page 10 that their relative’s health care needs were being met. One resident’s file recorded his wishes to be covered at all times to ensure his dignity. Visitors confirmed that the home is mindful of their relative’s request to be covered at all times. One visitor said that ‘staff are very patient with my mother and are sensitive to her needs’. Two carers were aware of the intimate care needs of residents and both had National Vocational Qualifications level 2 & 3 in caring for residents. However, the homes intimate care policies were seen and found not to be sufficient and needs to be reviewed. Lunchtime medication given to residents by nurses was left on the tables with medication sheets being completed before the medication was taken or not. Intrusive practices such as administering eye drops was also seen at lunch when residents were eating. The homes policies and best practices must be followed to ensure the dignity of residents and that medication is given and recorded appropriately. The pharmacist inspected the home on the 23/05/05 and recorded that storage and administration records of medication is carried out appropriately and no recommendations were made. Morton Court Nursing Home C53 CO4 S2614 Morton Court V231546 070605 Stage 4.doc Version 1.30 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 standard(s) 13 & 15 Relatives and friends of residents are made welcome in this home. Meals are well managed and reflect the dietary needs of residents. EVIDENCE: Visitors said that they were made very welcome at the home and that the home had a friendly atmosphere. Nine relatives comment cards recorded that staff welcome them to the home. The homes signing in book was seen and recorded that relatives visit the home at various times of the day. The manager and staff confirmed that in the summer months residents go to Hartsholme Park, with most trips undertaken by residents using wheelchairs. Barbeques are held in the homes grounds in the summer and communion takes place in the home on a monthly basis. The inspector joined two residents for lunch and found the meal provided to be hot and delicious. Residents said that they have a choice of meals. One visitor commented that ‘if my mother misses a meal due to being asleep the kitchen staff cook her an omelette’. Menus were inspected and found to be balanced, with flexible mealtime arrangements. However, two care assessments seen had not been completed in areas relating to the likes and dislike of residents and had not been signed or dated by the person carrying out the assessment of need. The cook keeps a record of those residents who require specialised diets. Morton Court Nursing Home C53 CO4 S2614 Morton Court V231546 070605 Stage 4.doc Version 1.30 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 standard(s) 16 & 18 The home takes the issue of addressing complaints very seriously and has a comprehensive complaints policy. Staff are aware of how to respond to a complaint or an adult protection allegation. EVIDENCE: The home has displayed the service users guide, which contains the homes complaint procedures in the main entrance. The home has a detailed complaints procedure, which is posted on the residents’ notice board. The homes complaints log was seen; no complaints had been made since the last inspection. The Commission has received a negative comment concerning the home in respect of the care provided to a resident requiring short-term care. The manager has responded in a satisfactory manner in writing to the Commission concerning the issues raised. Relatives confirmed that they felt confident in approaching the manager regarding complaints or concerns that they might have. The home returned nine relatives comment cards with eight confirming that they know about the homes complaints procedure. Thirteen residents comment card showed that 11 residents felt that that they are treated well and felt safe in the home. Two other residents’ cards recorded that they are usually treated well. Two care workers were aware of the homes ‘Whistle Blowing’ policy and spoke knowledgeably about abusive practices and what action she would take if this came to her attention. All staff received adult protection training as part of their induction process and further training was undertaken in April 2004. Morton Court Nursing Home C53 CO4 S2614 Morton Court V231546 070605 Stage 4.doc Version 1.30 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 standard(s) 19 The home is well maintained, the standard of the environment and its facilities are appropriate to the needs of residents. EVIDENCE: The home has a property standard document (refurbishment plan) which showed forthcoming maintenance and decoration to be carried out externally and internally at the home. A tour of the environment found that the home was well decorated clean and tidy. Those residents and visitors seen confirmed that the home is always clean and tidy. Two relatives comment cards recorded that the response time to the call buzzer is variable and another wrote that the ‘call buzzer cables are to short’. This was brought to the attention of the manager after the inspection who will undertake a survey and send the outcome to the Commission. Relatives commented that sometimes staff are busy, but generally they answer the call buzzer promptly. Morton Court Nursing Home C53 CO4 S2614 Morton Court V231546 070605 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) This standard was not inspected. EVIDENCE: Morton Court Nursing Home C53 CO4 S2614 Morton Court V231546 070605 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) This standard was not inspected. EVIDENCE: Morton Court Nursing Home C53 CO4 S2614 Morton Court V231546 070605 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x x STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x x x x x Morton Court Nursing Home C53 CO4 S2614 Morton Court V231546 070605 Stage 4.doc Version 1.30 Page 17 Are there any outstanding requirements from the last inspection? 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 3 Regulation 14(a) Requirement Timescale for action 15/08/05 2. 3. 3 3 14(d) 15(2)(c ) 4. 9 13(2) All assessements on prospective residents must be completed with likes and dislikes recorded and the assessemnt form signed and dated in order to formulate a care plan. All prospective residents must be 15/08/05 written to confirming that the home can meet their care needs. The home must ensure that 15/08/08 residents care plans are signed either by the resident or their representatives agreeing to the plan of care offered by the home. The home must record and 15/08/05 administer medication as per the homes policies and be mindful of residents dignity. 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 8 Good Practice Recommendations The home should incorporate the use of body maps to record all cuts and bruises to residents as part of the C53 CO4 S2614 Morton Court V231546 070605 Stage 4.doc Version 1.30 Page 18 Morton Court Nursing Home 2. 10 accident and adult protection procedure. The home should update its intimate care policies and advise all staff trough training and the homes induction process. Morton Court Nursing Home C53 CO4 S2614 Morton Court V231546 070605 Stage 4.doc Version 1.30 Page 19 Commission for Social Care Inspection Unit House, The Point Weaver 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. 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