Inspection on 13/09/05 for Morton Grange

This inspection was carried out on 13th 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.

Other inspections for this house

Morton Grange 17/08/06

Morton Grange 08/02/06

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Morton Grange Stretton Road Morton Alfreton Derbyshire, DE55 6HD Lead Inspector Ivan Barker Unannounced 13 September 2005, 9.00am th 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 Grange C02 C52 S2066 Morton Grange v248599 130905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Morton Grange Address Stretton Road Morton Alfreton Derbyshire DE55 6HD 01246 866888 01246 861757 enquiries@mortongrange.co.uk Inverhome Limited 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) Doreen Teanby Care home with nursing 66 Category(ies) of Terminally Ill registration, with number Physical Disability of places Older People Dementia Morton Grange C02 C52 S2066 Morton Grange v248599 130905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 15/03/05 Brief Description of the Service: The home is located in the village of Morton with shops, pubs and other amenities near by. The home consists of 2 buildings. The Beeches unit is a converted building and The Poplars and The Willows units are purpose built. There are 9 day / quiet rooms overall. 54 of the home’s bedrooms are single accommodation with 20 of these providing en suite facilities. 6 of the bedrooms are double accommodation with 2 of these providing en suite facilities. 2 passenger lifts are provided. There are extensive gardens that are well maintained and easily accessible. Car parking space is to the front of the building. Morton Grange C02 C52 S2066 Morton Grange v248599 130905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Only a limited number of the National Minimum Standards were examined at this inspection (with emphasis on several of the ‘key standards’). The persons present at the inspection were: Mr M Rye, Director (Register person) Mrs J Rye, Company Secretary Mrs D Teanby, Manager. Within this inspection, which occurred over a six and half hour period, the inspector toured the building, spoke to service users, a relative and staff and examined the care plans and other documentation. He spoke with 7 service users, 1 relative and 6 staff during the inspection. At the feedback to the inspection, the registered person discussed his previous inspection reports with the inspector. He identified that he had received a number of scores of 4 and that he had used the inspection report very much as a incentive tool / morale booster for the staff to show them that they were doing a good job and that outside agencies recognised this fact, and that he expected consistent 4’s from this inspection. The inspector informed the director that the scoring system had been shown to have anomalies, and the reasons given for this was, the difference evidence which was seen at the inspections, and also the inspector’s professional judgement and their knowledge base, could affect the scoring. Mr and Mrs Rye expressed their commitment to the provision of quality care to the inspector. The inspector will examine their quality assurance systems on the next inspection. The inspector has received verbal assurance from Mr and Mrs Rye that all issues raised within this report will be acted upon. The inspector would wish to thank Mr and Mrs Rye and Mrs Teanby, the staff, service users and relative for their full co-operation and warm welcome extend to the inspector, during the inspection. Morton Grange C02 C52 S2066 Morton Grange v248599 130905 Stage 4.doc Version 1.40 Page 6 What the service does well: What has improved since the last inspection? 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 Grange C02 C52 S2066 Morton Grange v248599 130905 Stage 4.doc Version 1.40 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 Grange C02 C52 S2066 Morton Grange v248599 130905 Stage 4.doc Version 1.40 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) 6 Standard 6 was not applicable. EVIDENCE: The manager advised the inspector that no intermediate care was provided. Morton Grange C02 C52 S2066 Morton Grange v248599 130905 Stage 4.doc Version 1.40 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 Accurate care plans contribute to the delivery of care. EVIDENCE: Whilst touring the building and whilst speaking with service users the inspector observed that a considerable number of service users within the home had a dementia type illness. Also there were a considerable number of very physically frail individuals being nursed on constant bed rest. On examination of 6 care plans (nursing and personal care service users). The care plans were up to date, and had been evaluated at monthly intervals. The service user or relative had signed the documents. The documentation within the plans contained communication records with the GP and relatives, risk assessment, and other relevant documents. On closer examination of the Waterlow scoring system, the inspector established that within the six care plans wherever a high Waterlow score was indicated then a care plan had been produced. Morton Grange C02 C52 S2066 Morton Grange v248599 130905 Stage 4.doc Version 1.40 Page 10 Regarding standard 9, the home had previous requirements relating to this section. All requirements had been met. On examination of the storage, and administration of medication at this inspection, all areas were satisfactory. The inspector was informed by the service users and a relative that the home delivery a good standard of care. Morton Grange C02 C52 S2066 Morton Grange v248599 130905 Stage 4.doc Version 1.40 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) 15 An alternative choice of meals was available to the service users. The quality of meal was commended by the service users. EVIDENCE: The meal at dinner was displayed on a menu board, on each unit of the home. The meal, at the day of the inspection, was chicken, potatoes and vegetables. On discussing the choice and quality of the meal with the service users, they informed the inspector that, ‘The food was always excellent, good and nice’. ‘They give us what we like’. As part of monitoring the provision of meals, the inspector visited the kitchen, where he was shown a diary, which contained information regarding the fridge, freezer temperature records, menu, and cleaning records. The director expressed his satisfaction of the kitchen provision and commended the catering staff, and particularly the head cook who had been with the company for many years. Morton Grange C02 C52 S2066 Morton Grange v248599 130905 Stage 4.doc Version 1.40 Page 12 The inspector discussed the provision of alternative meals at dinner. The head cook advised the inspector that she had a white board in the kitchen, which identified service users likes and dislikes and preferences. She then explained to the inspector that although only one meal was displayed in the dining rooms she had prepared 8 different types of meals that morning. From the information giving by the service users and staff the inspector accepted that a choice was available to the service users. The inspector did discuss with the director and manager, the benefits of recording such choices. Whilst the inspector was obtaining the views of the service users, the director visited the kitchen. On meeting up with the inspector, he informed him that he could see the inspector point of view, regarding the menu display, however he had established that the cook was offering fish that was poached, boiled or fried, fishcakes and other non fish based meals, and this was clearly not reflected upon the menu board on display in the dining rooms, that such a variety of meals was provided by the home. Each unit had a kitchenette, which contained a fridge, microwave and hot water heaters, which was available for staff, visitors etc. The inspector discussed with the director and manager the possible dangers of the water heaters. The director informed the inspector that he understood the inspector’s comments, but the home had not experienced any problems. It was agreed that the use of the heaters should be managed under a health and safety risk assessment. A score of 4 was award to this section as clearly the service users were offered more than an alternate meal. Morton Grange C02 C52 S2066 Morton Grange v248599 130905 Stage 4.doc Version 1.40 Page 13 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) 0 EVIDENCE: These standards were not assessed, at this inspection. Morton Grange C02 C52 S2066 Morton Grange v248599 130905 Stage 4.doc Version 1.40 Page 14 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) 22, 24,26 Specialist equipment, which included adjustable beds, had been provided to meet the service user’s needs. The environment, relating to room 12, had not been maintained to the required standard. EVIDENCE: On touring the building, at this inspection, the following was found: The furnishing and décor were to a high standard. Wallpaper was on the wall rather than paint. The home was well maintained. During the inspection the inspector observed several members of the housekeeping staff throughout the home, who appeared to be doing a through job of maintaining the cleanliness of the home. Morton Grange C02 C52 S2066 Morton Grange v248599 130905 Stage 4.doc Version 1.40 Page 15 There was a considerable amount of specialist equipment within the home to meet the needs of the service users. This equipment included pressure relieving mattresses, pressure pads, specialist chairs, and adjustable beds. The registered person had clearly invested in the provision of adjustable beds, as there was a considerable number within the home. On discussing the number of adjustable beds, the manager informed the inspector although some service users did not require such sophisticated beds at this time, the beds were available should the service users needs change. Also the beds were popular with both the service users and staff, and contributed considerably to assisting in providing the care. There was no lockable storage space or locks on the bedroom doors, controlled by keys as referred to within Standards 24.5, 24.6 and 24.7. The bedroom doors had locks, which had a ‘turn buckle’ on the inside and a slot mechanism on the outside rather than a key. The inspector discussed with the registered person and the manager the rights of service users to be able to secure their own valuable and belonging and to hold a key to their room. The manager advised the inspector that the service users were assessed on admission and often this assessment indicated that they could not be responsible for a key, and this was recorded within the care plan. The registered person and manager agreed that should a service user or family request a door lock or lockable storage then locks with keys would be provided. Within room 12 there was an offensive odour, at the point of inspection it could not be established where the odour was coming from. However immediately after the inspection the registered person contacted the inspector and informed him that the carpet was omitting the odour and that it would be replaced with an appropriate floor covering. The store room containing cleaning substances and other chemicals was found to have been left unattended and unlock. This will be address in Standard 38. The scores of 4 within this section were awarded for the provision of specialist equipments, including the amount of adjustable beds. Morton Grange C02 C52 S2066 Morton Grange v248599 130905 Stage 4.doc Version 1.40 Page 16 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) 27 Current staffing levels in place would appear to meet the current dependency needs of service users, accommodated within the home. EVIDENCE: On examination of the duty rotas of care staff and discussion with the manager, the inspector established the following: On the am shifts, there were 3 qualified nurse and 9 care assistants. On the pm shifts, there were 3 qualified nurse and 9 care assistants. On the night shifts, there were 1 qualified nurse and 5 care assistants. Providing care to 62 service users over the 3 units. In addition there was the manager, who was supernumerary, and an activities co-ordinator who worked 10.00 to 18.00, 5 days a week. The director also brought it to the attention of the inspector that there was a receptionist / administrator situated at the entrance to the home to deal with visitor telephone calls etc, which relieved the manager and care staff of these duties during the busy times of the day, and that this service was not provided in some other care homes. Morton Grange C02 C52 S2066 Morton Grange v248599 130905 Stage 4.doc Version 1.40 Page 17 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) 38 Substances hazardous to health were not secured and could place service users at risk. EVIDENCE: As previously stated a store-room containing cleaning substances and other chemicals was left unattended, unlocked with the substances available to service users. On raising the issue with the registered person and manager, the manager immediately went to find the key from the housekeeping staff, and locked the room. The inspector informed the registered person and manager that staff should be made aware of the fact that the room containing the substances should be locked. Morton Grange C02 C52 S2066 Morton Grange v248599 130905 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 4 COMPLAINTS AND PROTECTION x x x 4 x 4 x 2 STAFFING Standard No Score 27 3 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 x x x x x x x x x x 2 Morton Grange C02 C52 S2066 Morton Grange v248599 130905 Stage 4.doc Version 1.40 Page 19 no 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 26 Regulation 23 Requirement The registered person must replace the floor covering in room 12, that he has identified as the cause of the odour. The registered person must ensure that cleaning substances and chemicals are stored correctly. Timescale for action 13/12/05 2. 38 COSHH 13/10/05 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 Good Practice Recommendations Morton Grange C02 C52 S2066 Morton Grange v248599 130905 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection South Point, Cardinal Square Nottingham Road Derby DE1 3QT 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 Grange C02 C52 S2066 Morton Grange v248599 130905 Stage 4.doc Version 1.40 Page 21 - 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. 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