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Inspection on 25/07/05 for Morton House Nursing & Rest Home

Also see our care home review for Morton House Nursing & Rest Home for more information

This inspection was carried out on 25th July 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.

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

The home is well managed by a committed staff team that are able to deal with the complex nursing needs of the residents. Each shift pattern allows for a staff thirty minute handover period, which ensures any problems are passed from shift to shift and care needs are not compromised. Staff have a good relationship with residents. Residents said the home was good and they felt it was like home; they have access to the grounds which are flat, well maintained and wheelchair accessible.

What has improved since the last inspection?

The home had addressed many of the requirements from the last inspection. Specialised training sessions were arranged for staff.

CARE HOMES FOR OLDER PEOPLE Morton House Nursing and Rest Home Morton House Droitwich Road,Fernhill Heath Worcester WR3 7UR Lead Inspector Chrissy Presley Unannounced 25 July 2005 - 11.50am 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 House Nursing and Rest Home E52 S4126 Morton House V239185 250705.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Morton House Nursing and Rest Home Address Morton House, Droitwich Road, Fernhill Heath, Worcester, Worcestershire WR3 7UR 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) 01905 754489 01905 754489 Mrs Narinder Sanghera Mrs Sheila Janette Silk Care Home with Nursing 32 Category(ies) of DE(E) Dementia over 65 (17) registration, with number OP Old age (32) of places PD(E) Physical disability over 65 (32) Morton House Nursing and Rest Home E52 S4126 Morton House V239185 250705.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may accommodate a maximum of 24 people for nursing care. Date of last inspection 12 January 2005 Brief Description of the Service: Morton house is a Georgian property that has been converted for use as a private nursing and rest home.The detached property is surrounded by 2.5 acres of well-stocked mature gardens, and is located on the main A38 between Droitwich and Worcester. It is close to open countryside and yet convenient to the M5 via Worcesters Northern Link Road, making travel from the Midlands and surrounding areas easy.The registered manager is Mrs Silk Morton House Nursing and Rest Home E52 S4126 Morton House V239185 250705.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place during the lunchtime period. Policies and procedure documents were examined, care plan documentation and a tour of the premises was undertaken. The inspector spoke to five staff members, the registered provider, two visitors and eight residents. What the service does well: What has improved since the last inspection? The home had addressed many of the requirements from the last inspection. Specialised training sessions were arranged for staff. Morton House Nursing and Rest Home E52 S4126 Morton House V239185 250705.doc Version 1.40 Page 6 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 House Nursing and Rest Home E52 S4126 Morton House V239185 250705.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 House Nursing and Rest Home E52 S4126 Morton House V239185 250705.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) 3 All residents were assessed prior to admission. The documentation used ensured residents needs could be met on admission. EVIDENCE: Four care plans were inspected and the assessment of need document was located within these. Residents were assessed prior to admission by one of the registered nurses. The document had information about all aspects of care needs of a future resident and had enough information to formulate a care plan. Further assessment was carried out on admission. Morton House Nursing and Rest Home E52 S4126 Morton House V239185 250705.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 & 10 Despite care plan documentation not always being up to date, residents were well care for by experienced staff and have their individual needs met. EVIDENCE: Residents said they were well looked after and made a number of positive comments about the home and staff. Staff were observed interacting with residents in a positive and inclusive manner. Four care plans were inspected, information contained in these was concise, however identified risks need further development within the care plan. One care plan examined did not evidence a monthly review. There was no evidence of resident or family involvement in the care plans examined. Morton House Nursing and Rest Home E52 S4126 Morton House V239185 250705.doc Version 1.40 Page 10 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) 12 &15 A stimulating programme of activities, which ensured inclusively for all residents, was offered, together with a well managed varied and nutritious diet. EVIDENCE: Records for activities were seen but these had not been updated for the month of July. Staff spoken to said the activities co-ordinator offered a wide range of activities for all residents of varying ability, a recent fish and chip supper had taken place. Residents said they enjoyed the food and were offered a choice. The meal served on the day of inspection looked wholesome and nutritious and was well presented. Morton House Nursing and Rest Home E52 S4126 Morton House V239185 250705.doc Version 1.40 Page 11 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 policies and procedures for complaints and protection of Vulnerable Adults was not robust, however staff were aware of their responsibilities in protection of residents. EVIDENCE: Staff had received training on dealing with suspicion of abuse of the vulnerable adult and were aware of their responsibilities in protecting. The policy and procedure file needed to be updated and policies needed to reflect current practice as set out by Worcestershire protection of the vulnerable adult guidelines. Morton House Nursing and Rest Home E52 S4126 Morton House V239185 250705.doc Version 1.40 Page 12 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 & 26 Residents safety is compromised due to environmental issues being identified, however the home was clean, homely and free from malodours. EVIDENCE: During a tour of the premises a number of environmental issues, which compromised the health, and safety of residents were noted and have become requirements of this report. Morton House Nursing and Rest Home E52 S4126 Morton House V239185 250705.doc Version 1.40 Page 13 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 There were enough staff on duty during a twenty four hour period to meet the needs of the residents. EVIDENCE: The home had a committed staff team some of whom had worked in the home for a number of years and knew the residents well. Staff interviewed said at times another member of staff in the morning would be helpful, trained nurses interviewed including the deputy manager said this was kept under review. The home allocated a thirty-minute handover time during each shift, this was to enable all staff to raise any concerns about resident care. Care staff undertook domestic duties during the weekend. Morton House Nursing and Rest Home E52 S4126 Morton House V239185 250705.doc Version 1.40 Page 14 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) 37 & 38 The home was managed well by the registered manager who was experienced and knowledgeable. EVIDENCE: The registered manager Mrs Silk who is a first level nurse acted as the health and safety officer and managed the home. There was a first aid trained member of staff on duty at all times. Shortfalls were noted in mandatory training such as moving and handling, food hygiene and fire training. Records of service contracts were seen and appeared in order. There did not appear to be an environmental risk assessment in place. Morton House Nursing and Rest Home E52 S4126 Morton House V239185 250705.doc Version 1.40 Page 15 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 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 2 x x x x x 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 2 x 2 x x x x x x 2 2 Morton House Nursing and Rest Home E52 S4126 Morton House V239185 250705.doc Version 1.40 Page 16 yes 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 OP7 Regulation 13 &15 Requirement For those residents at risk of developing pressure sores a waterlow or similar scoring tool to identify risk must be reviewed at least monthly. Care plans must be reviewed monthly Risk assessments must be carried out on all activities of daily living including falls Care plans must reflect current care needs Prescribed creams must be only used for named residents and must be kept secure at all times. Records of food given to residents must be kept Fridge and freezer temperatures must be taken at least once daily. The complaints procedure must be amended to include information about the stages of and the timescales for an investigation and must include accurate information regarding referring a complaint direct to the Commission Procedures for responding to suspicion or evidence of abuse or neglect (including whistleTimescale for action Immediate 2. 3. 4. 5. 6. 7. 8. OP7 OP7 OP7 OP9 OP15 OP15 OP16 15 13 15 13 (2) 17 13 22 Immediate Immediate Immediate Immediate Immediate Immediate 30/08/05 9. OP18 12,13 30/08/05 Morton House Nursing and Rest Home E52 S4126 Morton House V239185 250705.doc Version 1.40 Page 17 10. 11. OP19 OP19 23 23 12. 13. 14. 15. 16. OP19 OP19 OP19 OP19 OP24 15 23 13 13 16 17. 18. OP24 OP37 12,13 26 19. 20. OP38 OP38 13 13 21. OP38 13 blowing) must be drawn up in accordance with the Public Interest Disclosure Act 1998 and the Department of Health No secrets Emergency lighting must be tested at least monthly There must be evidence to show that staff have received fire training at least every three months. Items of furniture belonging to residents must be recorded in the care plan Fire doors must not be wedged Wheelchairs must be fitted with footplates whenever in use by residents The clinical room must be locked at all times All of the items of furniture specified in standard 24.2 must be provided in rooms occupied by residents. If the provision of any item poses an unacceptable risk to the resident or they decline the provision, details of the discussions and decision about this should be recorded in the assessment of the residents needs. Residents must be provided with keys to their room unless a risk assessment proves otherwise Visits by the registered provider must take place at least once a month in accordance with the requirements of Regulation 26 An environmental risk assessment must be undertaken The registered manager must ensure all staff have received updated training in first aid, moving and handling, infection control, food hygiene and fire All bathrooms must have a lockable cabinet where immediate immediate 30/08/05 immediate immediate Immediate 30/08/05 30/08/09 30/08/05 30/08/05 30/08/05 Immediate Page 18 Morton House Nursing and Rest Home E52 S4126 Morton House V239185 250705.doc Version 1.40 22. 23. 24. OP19 OP27 OP38 16 17 13 hazardous cleaning products can be stored and must be locked at all times. Carpets identified during the inspection must be cleaned or replaced. The home must continue to seek and employ domestic cover over the weekend Water temperatures must be recorded weekly 30/09/05 30/08/05 Immediate 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. 2. Refer to Standard OP18 OP18 Good Practice Recommendations The policy and procedure file should be reviewed. A policy and procedure should be developed and implemented regarding residents money and financial affairs, ensuring residents access to their personal records, safe storage of money and valuables, consultation on finances in private, advice on personal insurance and preclude staff involvement in assisting in the making of or benefiting of wills. It is recommended valences are fitted to beds. 3. OP24 Morton House Nursing and Rest Home E52 S4126 Morton House V239185 250705.doc Version 1.40 Page 19 Commission for Social Care Inspection The Coach House, John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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 and Rest Home E52 S4126 Morton House V239185 250705.doc Version 1.40 Page 20 - 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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