Inspection on 04/11/05 for Morton House Nursing Home

This inspection was carried out on 4th November 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 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 House Nursing Home 04/09/08

Morton House Nursing Home 22/05/07

Morton House Nursing Home 25/09/06

Morton House Nursing Home 07/03/06

Morton House Nursing Home 28/02/05

Morton House Nursing Home 17/02/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Morton House Nursing Home Morton House 12-14 Lewisham Park Lewisham London SE13 6QZ Lead Inspector Ornella Cavuoto Unannounced Inspection 4th November 2005 09:15 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 House Nursing Home DS0000007035.V258679.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 House Nursing Home DS0000007035.V258679.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Morton House Nursing Home Address Morton House 12-14 Lewisham Park Lewisham London SE13 6QZ 020 8314 1075 020 8690 3419 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) Mission Care Mr Terence Anthony O`Connor Care Home 27 Category(ies) of Old age, not falling within any other category registration, with number (0), Physical disability (0) of places Morton House Nursing Home DS0000007035.V258679.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 16 patients, frail, elderly persons aged 60 years and above (female) and 65 years and above (male). 11 patients, who require intermediate care aged 55 years and above both male and female. 28th February 2005 Date of last inspection Brief Description of the Service: Morton House is a care home providing nursing care and accommodation for 27 older people. It is owned by Mission Care, which is an inter-denominational Christian registered charity. The organisation has five other homes in South East London and the head office is in Bromley. The home looks out over Lewisham Park and is close to buses and to Ladywell railway station. There are some local shops nearby and Lewisham centre with all its transport and shopping facilities is approximately ½ mile up the road. The home, which is a modern building, opened in 1991 and consists of three storeys. It has recently been decorated. All the bedrooms are single and none have en-suite facilities. There is a passenger lift. The home has parking and a small garden to the rear of the property. Morton House also provides intermediate care for up to 11 service users and there is a portakabin extension at the rear of the property to provide additional facilities for those individuals receiving intermediate care. The home works in close partnership with Lewisham Intermediate Care team comprising of physiotherapists, occupational therapists and social workers and there is at least one member of the team on site at all times. Morton House Nursing Home DS0000007035.V258679.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was an unannounced visit that was carried out over two days. The inspection included speaking to six service users, one visitor and three staff members. The registered manager was also spoken to and present for the duration of the inspection. Other inspection methods included a tour of the premises and inspection of records. What the service does well: What has improved since the last inspection? The service has recently introduced a new format for service user plans which are aimed at being more accessible to service users and easier for them to understand. Morton House Nursing Home DS0000007035.V258679.R01.S.doc Version 5.0 Page 6 There have been some improvements to the rear garden to make it more attractive for service users. What they could do better: The home needs to ensure that a statement of purpose and service user guide is produced that includes all the information that is required under regulation. The service needs to ensure that all service users are issued a contract on admission outlining the terms and conditions of their stay within the home. For those service users referred to the home through care management arrangements it needs to be ensured that a copy of the care management assessment is obtained. Although service user plans do cover heath, personal and social care needs there is not sufficient information to ensure that service users’ needs in these areas are being met comprehensively. Furthermore, there needs to be regular monitoring and reviews held to ensure the plans reflect service users’ changing needs and progress. Risk assessments also need to be more specific and detailed. Despite service user plans being written as if the service user had written it themselves there was no evidence that service users, or their relatives where appropriate, had been involved in the drawing up of plans, as they were not signed. Service users’ ability to self administer medication needs to be looked at as part of the service user plan and risk assessment to ensure that those that can administer their own medication are encouraged to do so in order to maintain their independence. Also, in respect to medication, improvements need to be made in respect to administration, handling and storage. The home does provide a good variety of group activities for service users but there needs to be more consideration given to the development of activities for those service users who are unable to leave their rooms or find it more difficult to join in the group activities. Also, to ensure that generally service users have more time spent with them on an individual basis. Improvements needs to be made in recruitment and training of staff ensuring that all appropriate documents are in place and checks have been carried out prior to staff working within the home and that staff receive a full induction and ongoing training. Quality assurance needs to be improved ensuring that there is regular selfmonitoring and the results of surveys that are carried out with service users, relatives and other stakeholders are compiled and feedback in a report that is made accessible. Morton House Nursing Home DS0000007035.V258679.R01.S.doc Version 5.0 Page 7 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 House Nursing Home DS0000007035.V258679.R01.S.doc Version 5.0 Page 8 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 House Nursing Home DS0000007035.V258679.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3 5 &6 Service users do not presently have all the information they need to make an informed choice about where to live. Service users do not have a written contract/terms or conditions with the home. A copy of the care management assessment was not available for all service users. Generally prospective service users, relatives and friends have an opportunity to visit the home. Service users in intermediate care are helped to maximise their independence and return home. EVIDENCE: In respect to the statement of purpose it was reported that this was in the process of being updated. A copy was seen but this was not fully completed. Consequently, the previous requirement that the statement of purpose should contain more detailed information about therapeutic techniques used and arrangements for their supervision particularly in relation to care offered in the intermediate care beds remains unmet. However, a separate leaflet specifically outlining details about the services offered within intermediate care for service Morton House Nursing Home DS0000007035.V258679.R01.S.doc Version 5.0 Page 10 users and relatives was seen. Also, although a general information guide was examined that had been produced by Mission Care for service users, relatives and carers relevant to all Mission Care homes, one was not available that was specific to Morton House. Therefore, a requirement is to be stated in this report that a statement of purpose and service user guide are produced that contain all the information as required by regulations 4 and 5 and within Schedule 1 of the Care Standards Act. Six service user files were inspected including those of permanent and intermediate care service users. None included evidence of a contract outlining the terms and conditions of service users stay within the home. Subject to a previous requirement this is to be restated in this report. In addition, although there was evidence that all service users had a detailed assessment of need that had been carried out by the home a copy of the care management assessment was not available on three of the files examined. This needs to be obtained to ensure the care needs of the service user can be adequately planned for and met by the home. Subject to a requirement. It was reported that for service users who are to move into the home on a permanent basis that the home insists upon a trial visit and if the service user themselves cannot visit then a relative is invited to visit on their behalf. They are asked to stay for lunch to chat to residents and staff. Service users spoken to confirmed this. Intermediate care is offered for up to eleven service users. All of the bedrooms on the ground floor and part of the corridor on the first floor have been dedicated to these service users. In addition, the home has good facilities and links with specialised staff to ensure that the needs of the service users are well met ensuring their independence is maximised to enable them to return home. Morton House Nursing Home DS0000007035.V258679.R01.S.doc Version 5.0 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10&11 Service users health, personal and social care needs are set out in an individual plan but there is insufficient detail to ensure that service users are being fully supported in these areas. Records indicate that service user’s health care needs are not being fully met. The home has robust procedures for dealing with medicines but these are not being adhered to. Also service users are not being encouraged, where appropriate, to take responsibility for their own medication. Service users are treated with respect and privacy. More consultation is required with service users, family or friends around their personal wishes and instructions at the time of death. EVIDENCE: Six service user plans were inspected. These are kept in service users bedrooms. The home has very recently introduced a new care plan format for service users living at the home. The plan aims to address daily living needs including service users personal and social care needs. Health care needs were included in a clinical plan. It was reported that the aim of changing the format was to make them more person -centred and easier for service users to understand. Although, the plans do contain useful information and the plans are written as if the service user had written it themselves, the information Morton House Nursing Home DS0000007035.V258679.R01.S.doc Version 5.0 Page 12 contained in the plans is not very detailed and some sections had been left blank. This is despite the fact that the home carries out a very detailed and comprehensive assessment of need and a “Life Review” form is also used to gather more detailed information on service users to help address social care needs. Furthermore, the plans did not allow for any additional information to be recorded to evidence that service users needs are being effectively monitored and evaluated to ensure that changing needs or progress made is reflected. This potentially could result in service users needs being overlooked or not being adequately addressed. For example, in relation to health care needs, one service user whose care plan was inspected despite it being recorded that they are required to attend a warfarin clinic every 2-3 weeks for this medication to be reviewed there had been no follow up to indicate the outcome and if any changes were to be implemented. Subject to previous recommendations, a new requirement is to be stated in this area. Also, subject to a previous requirement that systems should be in place to maximise service user participation in monthly and annual reviews this was not able to be fully assessed. Since the introduction of the new care plans in September there have not been any care plan reviews and previous to this there had not appeared to be any care plan reviews carried out since May. Only one service user had had a recent annual care management review. In addition, care plans were not signed to evidence that service users had been involved in the care planning process. Subject to a new requirement. In respect to health care needs, as well as information contained in care plans being limited, gaps in weight monitoring were identified. For one service user, despite the fact that they had lost weight they had not been weighed for 3 months. One service user had pressure sores and there was evidence of appropriate intervention with photographs taken and involvement of the tissue viability nurse. However, evidence of liaison with other healthcare professionals such as chiropodists and dentists and opticians was limited. In terms of fall risk assessments although care plans did specify assistance required in terms of moving and handling, for one service user who was prone to not asking for assistance and so was at a high risk of falls this was not clearly addressed within the care plan or in a risk assessment. Subject to a requirement. For intermediate care service users additional information was included in their care plans by LINC (Lewisham Intermediate Care team) such as a timetable of therapy from the physiotherapist and occupational therapists. Subject to a previous requirement that there needs to be more integration between the LINC team’s intervention and the home’s care provision in order to fully maximise the support available to service users, some progress has been made in this area. A folder is now in place in which the home’s care staff record daily notes and provide a brief daily review of individual care plans. This is accessible to the LINC team. However, the services do remain largely autonomous from each other and a closer working partnership between them Morton House Nursing Home DS0000007035.V258679.R01.S.doc Version 5.0 Page 13 still needs to be developed. Therefore, although this requirement has been partially met it is to be restated in this report. In addition a recommendation is to be made that a member of the LINC team where possible attend handover meetings to further facilitate a more integrated approach to provision of care to intermediate care service users. The home has robust policies and procedures for dealing with medication. Trained staff administer all medication. However, a sample of Medication Administration Records (MARS) charts were inspected and errors were found. These included MARS sheets not being signed where medication had clearly been administered, medication which had not been given but that had been signed for and stocks of tablets not corresponding to MARS sheets with medication that was not in use being kept in the medication cabinet. This potentially could lead to errors. Subject to a new requirement. The home has a robust policy on self- administration of medication and all service users in intermediate care have lockable cabinets. However, risk assessments to identify how service users can be supported to administer their own medication had not been completed. Subject to a new requirement. Service users spoken to said that generally staff do respect their privacy and knock before entering their rooms. It was also reported by service users that they receive their letters unopened and are able to see visitors privately in their rooms. Service users were observed as being well dressed and well groomed and staff interaction with service users was warm and respectful. In respect to issues of death and dying, the home has a policy and procedure in place. Yet, of those care plans looked at only one service user had had their wishes in respect to death and dying recorded. Subject to a recommendation. Morton House Nursing Home DS0000007035.V258679.R01.S.doc Version 5.0 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13 &15 The home provides a good range of activities for service users but there needs to be more individualised activities particularly for service users who are unable to leave their rooms or are unable to engage with group activities. Relatives and friends are able to visit freely so service users are able to maintain relationships that are important to them. Service users receive a wholesome, appealing and balanced diet. EVIDENCE: The home’s activities co-ordinator left in June and has not been replaced. Instead care staff are encouraged to get involved in the weekly schedule of activities that is provided. These include bingo, music and movement, reminiscence, board games, what the papers say, crafts, shopping, baking, cooking and a beauty day for female service users where they have their nails manicured and can be pampered. During the inspection a staff member was observed playing dominoes with several service users in the dining room/lounge. The home has an activities folder in which a summary of the activities that take place and those service users and staff members who were involved are recorded. Activities are discussed and evaluated with service users at resident meetings. Morton House Nursing Home DS0000007035.V258679.R01.S.doc Version 5.0 Page 15 In addition, to activities that occur in the home regular outings are arranged for service users to a variety of places of interests including art galleries such as the Tate Modern, museums, parks and the cinema amongst others. Service users spoken to clearly enjoy these trips. An audit of trips and who attended is maintained. A local school has also visited the home to perform a concert for service users as well as another locally- based orchestra. Individual ‘s interests and preferences are noted within care plans. However, there does need to be more individualised activities particularly for those service users who are unable to leave their rooms or are not able to participate in the group activities. Subject to a requirement. In terms of religious observance, church services are held within the home at weekends. It was also reported that locally based church organisations visit the home. Relatives were observed visiting service users during the inspection. It was reported that visitors and family contact is encouraged. A relative who was spoken to expressed that they were always made to feel welcome by staff and feedback from service users was that they receive regular visits. Feedback from service users about the food was very positive and service users were very satisfied with the menu, which is varied and offers a lot of choice including catering for the cultural needs of service users. Lunchtime was observed and service users appeared to enjoy the food. It was also very relaxed and unhurried with service users being given time to eat. Also, assistance was given to service users where required in a sensitive and appropriate manner. Morton House Nursing Home DS0000007035.V258679.R01.S.doc Version 5.0 Page 16 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): 16 Complaints are acted upon and dealt with appropriately. EVIDENCE: The home has a robust complaints policy and complaints process including details to contact Care) if service users are not satisfied with how dealt with is placed within service users files that a form outlining the home’s CSCI (Commission for Social their complaint dealt is being are kept in their bedrooms. Complaints records were examined. The home did have an adult protection investigation earlier this year which resulted in the staff member who was involved being dismissed. There have no further adult protection incidents. Low-level complaints have been recorded and have been addressed appropriately. Morton House Nursing Home DS0000007035.V258679.R01.S.doc Version 5.0 Page 17 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): 19,20,21,23,24&25 Service users live in a safe, well-maintained environment. There is access to safe and comfortable indoor and outdoor communal facilities but the communal lounge dedicated to intermediate care service users needs to be made for attractive. Service users have sufficient and suitable lavatories and washing facilities. 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. EVIDENCE: The location and layout of the home is suitable for its stated purpose. It is accessible, safe and well maintained having recently been decorated. The lounge and dining area on the ground floor is spacious and the furnishings are of a good quality and domestic in character. The garden at the rear of the property is small but attractive and well maintained. There are plans to have work done to extend the patio area to Morton House Nursing Home DS0000007035.V258679.R01.S.doc Version 5.0 Page 18 provide more space for service users to sit out in the garden. A previous requirement that the garden needed to be made more attractive has now been met. There is a small communal area on the first floor that is dedicated to intermediate care service users but the room is presently being used to store belongings of residents who have died and an old mattress was also being stored there. Furnishings were also not very comfortable. Therefore a requirement is to be stated in this report that the room is cleared and is made more attractive for use by service users. The home has sufficient toilet, washing and bathing facilities to meet the needs of service users. All bedrooms are single rooms which are very spacious are furnished to a high standard and are suitably personalised. All rooms have locks but it was reported that not all service users want to have a key to their room. The home is well ventilated throughout. Rooms are centrally heated; radiators have low temperature surfaces and can be individually regulated. Evidence that water temperatures are checked and recorded monthly to prevent risks from scalding was not available on the day of the inspection. Subject to a previous requirement this is to be restated in this report. Morton House Nursing Home DS0000007035.V258679.R01.S.doc Version 5.0 Page 19 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): 29 &30 The home’s recruitment policy and practice is not presently supporting and protecting service users. Staff are not receiving sufficient training to ensure they are competent to do their jobs. EVIDENCE: A check of eight staff recruitment files was carried out. Not all contained the necessary documents as specified under Schedule 2 of the regulations. Two of the files only had one written reference instead of the required two. Also, on three of the files there was no evidence of appropriate identification documents such as a birth certificate or a passport. All the files inspected had evidence of Criminal Bureau Record Checks (CRBs). However, a number were photocopies of CRB’s that had been accepted from a previous employer. It was also evident that PoVA First checks had not been carried out. An immediate requirement was issued immediately following the inspection specifying that CRBs are not portable and that new CRB applications and a PoVA First check be carried out straight away on all those staff members where portable CRBs had been accepted. It was reported that all new staff do receive an induction. However, four of the staff files inspected had no evidence of an induction process. In addition, although there was some evidence that some of the staff had received training recently in palliative care, medication awareness and pressure ulcer management there was no indication that staff were having mandatory training Morton House Nursing Home DS0000007035.V258679.R01.S.doc Version 5.0 Page 20 and that this was being regularly updated. A training plan was not available. Subject to requirements. Morton House Nursing Home DS0000007035.V258679.R01.S.doc Version 5.0 Page 21 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 The home is run and managed by a manager who is fit to be in charge and is of good character. However, the NVQ in management and care has not been obtained. There needs to be improvements in the quality assurance systems used by the home to ensure that the home is run in the best interests of service users. EVIDENCE: The registered manager is experienced and committed to running the home to a good standard. He is a qualified nurse and holds an MSc in Inter Professional Health and Community studies. The manager has not completed the NVQ in management and care as he considers his qualifications are equivalent to this. Subject to a previous requirement the manager was expected to provide evidence to the Commission that his qualification is equivalent to NVQ Level 4. However, to date this has not been made available. Therefore, this is to be re stated in this report. Morton House Nursing Home DS0000007035.V258679.R01.S.doc Version 5.0 Page 22 In relation to quality assurance there was evidence that an independent audit had been carried out on the home that was based on looking at various aspects of the care standards. It was reported that statistics are maintained and regularly updated and monitored in relation to intermediate care. Regular resident meetings are held. Relatives are invited to attend but it was reported that generally there is not a good response. Minutes of the meetings were seen. These cover a range of different topics including catering, outings and activities and other general concerns and comments from service users. It was clear from the minutes that service users participate and their views are heard and acted upon. However, monthly provider reports have not been carried out regularly. Also, there was no evidence of a formal system to gather information from service users, relatives and other stakeholders involved in the service. There was also no evidence of an annual development plan for the home. It was reported that customer satisfaction surveys have been issued and that an external independent agency is responsible for collating and feeding the results back and this is still ongoing. Subject to a previous requirement this has been partially met but as evidence was not available on the day of the inspection this is to be restated as a requirement in this report. Morton House Nursing Home DS0000007035.V258679.R01.S.doc Version 5.0 Page 23 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 2 2 X 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 2 3 X 3 3 3 X STAFFING Standard No Score 27 X 28 X 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X X X X X Morton House Nursing Home DS0000007035.V258679.R01.S.doc Version 5.0 Page 24 Are there any outstanding requirements from the last inspection? Yes 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 OP1 Regulation Requirement Timescale for action 28/02/06 2. OP2 3. OP3 4. OP7 4&5 & Sch The registered person must 1 ensure that a statement of purpose and service user guide are drawn up for the home that include all the information required by regulation and these are accessible for all prospective service users and those presently living within the home. 5 (1)(b) The registered person must ensure that every service user admitted to the home has a statement of terms and conditions that contains all the information required under this standard. (Previous requirement of 28/02/05 not met) 14(1)(a) The registered person must &(b) ensure that for those service users referred through care management arrangements that a copy of the care management assessment is obtained upon which the service user plan should be based and this should be kept on file. 12 & 15 The registered person must ensure that service user plans DS0000007035.V258679.R01.S.doc 28/02/06 30/04/06 30/04/06 Morton House Nursing Home Version 5.0 Page 25 5. OP7 12(1)(a) &(b) 6. OP8 13(4)(c) 15(1) 7. OP9 13(2) 8. OP9 13(2) 9. OP12 16 (m) set out in sufficient detail the action which needs to be taken by staff to ensure all aspects of service users health, personal and social care needs are met and that the plan is drawn up with the involvement of the service user and signed by the service user, relative or representative where appropriate and that service user plans are reviewed on a monthly basis as required. (Previous requirement of 28/02/05 not met) The registered person must ensure that further integration is developed between the LINC team’s interventions and the home’s care provision in order to fully maximise the support available to intermediate care service users. (Previous requirement of 28/02/05 partially met) The registered person must ensure that all health needs of service users are fully met and where risks are identified a risk assessment must be put in place specifying action and control measures to be taken to reduce the risk. The registered person must ensure that the systems in place for recording and monitoring the administration of medication are used consistently and effectively specifically that staff sign the medication administration records accurately. The registered person must ensure that where appropriate service users are able to take responsibility for their own medication if they wish within a risk management framework. The registered person must DS0000007035.V258679.R01.S.doc 30/04/06 30/04/06 28/02/06 28/02/06 30/04/06 Page 26 Morton House Nursing Home Version 5.0 10. OP20 23 (2) (g) 11. OP25 13 (4) (b) & (c) 12. OP29 19 & Sched 2 13. OP30 18 (1) (c) 14. OP31 10 (3) ensure that the social needs of those service users who are unable to leave their rooms and for those who are less able to engage with group activities are catered for. The registered manager must ensure that for intermediate care service users there is a separate communal space that is accessible and made more attractive for their use specifically that items stored in the space should be removed and more comfortable chairs/furnishings be placed there. The registered manager must ensure that water temperatures are checked on a monthly basis to prevent risks from scalding. (Previous requirement of 28/02/05 not met). The registered person must ensure that all required documents are obtained and all necessary checks are carried prior to staff being employed to work in the home. (Previous requirement of 28/02/05 not met). The registered person must ensure that all staff receive an induction to National Training Organisation (NTO) specifications when they commence working for the home and also receive training on a regular basis with mandatory training being updated. A training plan should be developed and a record of training undertaken by staff kept on staff files. The registered person must provide the CSCI with evidence that his qualification is equivalent to NVQ Level 4 in care and management. DS0000007035.V258679.R01.S.doc 28/02/06 28/02/06 31/12/05 28/02/06 28/02/06 Morton House Nursing Home Version 5.0 Page 27 15. OP33 24 &26 (Previous requirement of 28/02/05 not met). The registered person must ensure that there is evidence to demonstrate that as part of self monitoring regular consultation is being carried out with service users, relatives and other stakeholders involved with the home and that feedback on the results is given in the form of a report. Also, as part of quality assurance that monthly provider visits are conducted and copies of the report sent to CSCI. (Previous requirement of 28/02/05 partially met). 30/04/06 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 OP7 Good Practice Recommendations The registered manager should consider altering the format of the care plan to allow for additional information to be recorded reflecting changing needs and progress. The registered manager should consider arranging for a member of the LINC team to be involved in staff handovers whenever possible to facilitate an integrated approach between the LINC team’s interventions and the home’s care provision. The registered manager should try to consult with all service users on their wishes concerning death and dying and ensure these are recorded. 2 OP7 3. OP11 Morton House Nursing Home DS0000007035.V258679.R01.S.doc Version 5.0 Page 28 Commission for Social Care Inspection SE London Area Office Ground Floor 46 Loman Street Southwark SE1 0EH 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 House Nursing Home DS0000007035.V258679.R01.S.doc Version 5.0 Page 29 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!