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Inspection on 04/02/09 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 4th February 2009.

CSCI found this care home to be providing an Good service.

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

Morton House provides 24-hour nursing care to older people with physical and/or memory problems. Before people move in, staff make sure they know what care the person will need. The care people need is written down and kept up to date, and people who use the service are involved with this. People say staff help them to make their own decisions and live comfortable lives. Staff help them to do so as safely as possible and allow people to take risks in their normal day-to-day living activities. Daily life is not restrictive. The home provides a good variety of food and caters well for special diets. People like the food. Staff help people to keep healthy and to feel secure. They look after medication safely. Staff are open to listening to any concerns. People feel comfortable with raising concerns and say the home acts on them.

What has improved since the last inspection?

Management and staff have worked extremely hard to introduce more robust risk assessments within care documentation, and includes the individual or their representative within the care process. There has been greater emphasis placed on promoting equality and diversity issues through staff training, and there has been investment within the fabric of the building through redecoration which improves the visual appearance of the building. There continues to be emphasis placed on people`s rights - particularly in relation to the `Mental Capacity Act` and the `Deprivation of Liberties Safeguards`.

What the care home could do better:

The only area of criticism regarding the service is in relation to the decorative standard of some areas within the physical environment. However, the proprietors plan to continue with on-going decoration, upgrade and improvement as and when finances become available.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Morton House Nursing & Rest Home Morton House Droitwich Road Fernhill Heath Worcester Worcestershire WR3 7UR     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Nick Richards     Date: 0 4 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Morton House Nursing & Rest Home Droitwich Road Morton House Fernhill Heath Worcester Worcestershire WR3 7UR O1905754489 01905754489 asanghera@mortonhouseproperties.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Narinder Sanghera care home 32 Number of places (if applicable): Under 65 Over 65 0 32 0 dementia old age, not falling within any other category physical disability Additional conditions: 17 0 32 The maximum number of service users who can be accommodated is: 32 The registered person may provide the following category of service only: Care Home with Nursing (Code N) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) 32 Dementia (DE) 17 Physical disability (PD) 32 Date of last inspection Brief description of the care home Morton house is a Georgian property that has been converted for use as a nursing and residential care home. There are 23 single bedrooms of which 3 have ensuite facilities and 4 double rooms none of which have ensuite facilities. In addition there are 2 communal bathrooms, 1 shower room and toilets, which are fitted with special aids to assist the less mobile, Care Homes for Older People Page 4 of 28 Brief description of the care home two lounges and a conservatory and two dinning rooms. There is a shaft lift between floors and handrails are fitted to assist the residents. The detached property is surrounded by 2.5 acres of well-stocked mature level 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 Worchester?s Northern Link Road, making travel from the Midlands and surrounding areas easy. The registered manager is Mrs Silk who is a first level registered nurse. Mrs Narinder Sanghera is the registered provider. The home is registered to provide care for a maximum of thirty-two older people of either sex who have personal and health care needs. A maximum of seventeen people may have needs relating to a dementia illness and a maximum of twenty-four people may have nursing needs. For details about the range of fees charged along with what is, and what is not included within the fee, please contact the home. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The visit was carried out over one day - the home did not know we were going to visit. This was the homes first key inspection since February 2008. A key inspection is where we look at those areas that we, the commission, consider to be important when providing quality care. The focus of inspections we, the commission, undertake is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, minimum standards of Care Homes for Older People Page 6 of 28 practice and focuses on aspects of service provision that need further development. Prior to the fieldwork visit taking place a range of information was gathered to include notifications received from the home. This included surveys completed by the people living there, staff working within the home and professional people who visit the home. We also looked at the information submitted to us by the home in the form of an AQAA. This stands for Annual Quality Assurance Assessment. An AQAA is a document that the home has to send to us, and helps them to assess their home, identify what they do well, identify the things they are not so good at, and it tells us what they are going to do to help improve things within the home. Three people who live in the home were case tracked. This involves establishing individuals experience of living in the care home by meeting or observing them, discussing their care with staff, looking at care files, and focusing on outcomes. Tracking peoples care helps us understand the experiences of people who use the service. The people who live at the home, the manager and the staff were spoken to. Time was spent observing care practices, interactions and support from staff. We looked at the premises during a walk around the home, and we also looked at care, and health and safety records. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who want to move into the home can be confident that their needs will be comprehensively assessed prior to moving into the home, and their rights will be safeguarded after they move into the home. When people are admitted as an emergency admission, the home makes sure peoples rights are safeguarded. Evidence: During our visit we looked at the way the home gives information to people who want to move into the home, and the arrangements made to assess people before a decision is made as to whether the home is suitable for the individual. People that we spoke to all said that somebody from the home came to meet and assess them before they moved into the home. This is important because the home can decide whether they feel they can meet the needs of people before a decision is made to move in. We talked to several people about their experiences when they Care Homes for Older People Page 10 of 28 Evidence: moved into the home. Each person was very happy about their experience of being introduced to, and moving into the home. People told us that either they, or their relatives visited and experienced the home before they moved in. This helped people to get to know other people who use the service and get a feel about the service before they decided whether or not they wished to move in. The homes management had undertaken pre-admission assessments before people moved into the home. This gives the home the chance to look at peoples needs and decide whether they can offer a service to people that will meet their assessed needs. The pre-admission assessments were comprehensive and provided information that allowed staff to start planning for the persons care before they are admitted into the home. On some occasions, people had been admitted as an emergency, and the home did not have the opportunity to gather a lot of information about the people who were to come to live at the home. On these occasions, management had assessed the person and had gathered all the relevant information shortly after they had been admitted. This means that the home was able to provide the right care for people who had been admitted as an emergency. People using the service confirmed that the homes management had visited them before they moved into the home and talked to them about their needs and expectations. People also told us that they had been given a copy of the homes Service User Guide (hereafter referred to as the Guide). The Guide provides people with important information about the home and the service it aims to provide. The Guide is available to each person, and is held in their bedroom for reference purposes. We looked at both the Guide and the Statement of Purpose. Both documents were easy to understand, and contained the information people would need to help them make a decision about whether they would want to move into the home. The only piece of information missing from the Statement of Purpose and the Guide was the range of fees charged. We talked to management about this and were told that the fees would be included within both documents. Each persons representative had been given a copy of the contract to sign. The home had experienced some problems with contracts being signed and returned, but had made the necessary arrangements to try to encourage people to sign and return them. This is important as a signed contract provides legal protection for both the person using the service and the service itself. The contracts specified what was and what wasnt included in the fees, but needed to be altered to include more fully the items and services that were additional to the fees charged (for example, private healthcare). This was discussed with the proprietors at the time of our visit, and they agreed to make the necessary changes. Care Homes for Older People Page 11 of 28 Evidence: Healthcare professionals spoke very highly about the care within the home. One person said, Skilled and experienced nursing staff oversee the work of carers, plan care for residents and evaluate it appropriately. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements ensure that the personal and healthcare needs of individuals are met so ensuring their health, well being and dignity. Evidence: During our visit the people we saw had been well supported with their personal care and clothing. They looked very smart. All the people living there were well dressed in individual styles that were reflective of their age, their cultural background, the weather and the activities they were doing. Records sampled showed that people had been regularly weighed to ensure they were not gaining or losing a significant amount of weight, which could be an indicator of an underlying health need. Records sampled showed that each person is registered with a local general practitioner, who visits them if they are unwell. Where appropriate health professionals, such as psychiatrists, dentists, audiologists, chiropodists and community Care Homes for Older People Page 13 of 28 Evidence: nurses are involved in the care of individuals. People using the service told us The doctors visit and always return to check you if you need it. The dentist calls at the home (one person told us that they had received new dentures) and the chiropodist visits as well. The outcome of any health appointments are recorded and records showed that staff follow the advice given to ensure individuals health and well being. One visiting healthcare professional returned a survey to us and confirmed that staff within the home seem very aware of their abilities and seek advice from other professionals as they require it. (There is a) high level of skilled nursing care in evidence. (They) manage a sometimes complex caseload. Several people who use the service confirmed that their physical and emotional health needs were being very well met - rating the quality of care as 10 out of 10. The care records examined were of a really good quality and clearly documented the actual care provided in detail thereby allowing staff to know whats being done, why its being done and how to do it. This helps to promote consistency and ensures that good quality care is maintained throughout the 24-hour period - thereby safeguarding people who use the service. The service works well to promote equality and diversity within the home. Each person is respected as an individual and staff work hard to ensure that their wishes are upheld or promoted. The vast number of staff within the home are female and the majority of people using the service are female. The home has ensured that peoples preferences about the gender of staff providing care has been sought and respected. Within the home, registered nurses help people who use the service to take their prescribed medication. All medication is administered in accordance with the homes policies and procedures. At the time of our visit, the medication policy was being rewritten, and was in the final draft stages. We looked at the policy, which appeared to be appropriate, safe and comprehensive. Staff were adminsitering medication in accordance with the safe principles documneted within the new medication policy. This helps to ensure that people receive their prescribed medication safely. When people receive their medication, the care staff sign a drug administration record. This allows people to know that their medication has been managed safely, it also shows when, and why, medication has not been given to people. People using the service said that staff always help them with their medication, while one visiting healthcare professional said that the registered nurses have good drug knowledge and awareness. Four people who use the service described the management of their healthcare as either excellent or fantastic. We looked at the care one person is receiving in the final stages of their life. Staff Care Homes for Older People Page 14 of 28 Evidence: respond quickly and appropriately, and contact relevant healthcare professionals in response to the persons changing needs, along with the individuals next-of-kin. One person told us Soon as you ring the bell theyre there - in fact they come without you ringing the bell. Staff make sure that the person is kept comfortable and they also maintain the persons dignity. Care Homes for Older People Page 15 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are encouraged and supported to engage in social and recreational activities that refelect their individual preferences. Relatives and visitors are welcomed into the home and daily routines are unrestrictive. A good range of food is supplied, and the home caters well for peoples individual and collective dietary needs. Evidence: People we talked to said that they were happy with the daily routine. They said that they were free to get up an go to bed whenever they chose. They also said they were satisfied with the range of social and leisure activities provided in the home. These included music and movement sessions, hand massage, holy communion and trips out which include themed lunches at local pubs. Aromatherapy and manicure sessions are also arranged, and we saw staff helping several ladies with their nails at the time of our visit. We concluded that the ladies concerned enjoyed this activity and the banter they engaged in with the staff members. The home employs an activities co-ordinator for 24 hours each week, and she works to organise and arrange leisure, social and recreational activities for people using the service. Care Homes for Older People Page 16 of 28 Evidence: People using the service said that they were satisfied with the range of social, recreational and leisure activities and opportunities afforded to them. Several people went out with their family and friends, and we saw people visiting during our visit - all of whom were very complimentary about the home. One person described the service as brilliant. We were told that one family member visits their relative during the late evening period, and staff are always polite and greet them hospitably. The home employs two cooks who provide nutritionally balanced home cooking. None of the meals provided were fast or convenience foods. The food provided centres around the preferences of people using the service and alternatives are always provided. The record of food provided showed that food was nutritionally balanced and varied. On the day of our visit, the lunchtime meal was bacon, croquette and mashed potatoes, mushrooms, tomatoes and baked beans. People were seen enjoying the lunchtime meal, and confirmed this during conversation. One person said (I) had a lovely lunch - quite different. People using the service and staff use mealtimes as a social event, which was unhurried. Some people prefer to eat their meals in there bedrooms and staff respected this choice. One person described the food as fabulous, and another person said Oh yes - very good. In fact Im having too much, while another five people who we spoke to all said that the food was good. Weight records confirmed that people were getting enough food as there was no evidence of any unintentional weight loss. Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are supported to express concerns, and are safeguarded by the homes open culture, complaints procedure and investment in staff training. Evidence: Each person living at the home has been given a copy of the homes complaints procedure, which is simple and easy to understand. It includes timescales within which people can expect a response from the home. This was confirmed in the survey responses from people who use the service and their relatives. There havent actually been any complaints raised with the Commission or at the home since the last inspection. The culture within the home is open and allows and supports people to raise concerns. People that we spoke with said that if they had any concerns they would raise them with the manager. This was clearly supported by the record of concerns and complaints retained by the home. Concerns are used by management to learn and adapt practice. One person who visits the home said that they have never needed to raise any concerns. Staff we spoke to all confirmed that they were aware of safeguarding procedures, and the home has a training programme that includes training about the Protection Of Care Homes for Older People Page 18 of 28 Evidence: Vulnerable Adults (POVA) and the Deprivation of Liberties Safeguards (DOLS). The training is being provided by an external agency who specialise in staff training. The home has copies of the local authoritys safeguarding protocol. This ensures that, should the home have need to raise a concern about safeguarding, they know the correct procedures to follow. People using the service have the information and support they need to raise any concerns they may have in the confident expectation of a fair hearing and response. New staff are carefully checked to be sure they will be suitable to work with vulnerable adults. Appropriate action is taken, when necessary, to protect people from harm. Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean, homely, safe and well maintained and meets the needs and expectations of those people living there. Evidence: There has been a lot of work done since the last inspection to improve the physical environment at the home. For example, the main entrance area has been re-decorated to a very good standard and surfaces made good, and new aids and equipment have been purchased. The home can demonstrate its ability to maintain and improve the quality of the environment through effective quality monitoring and an improvement plan. The providers have carefully counterbalanced the needs of the service with effective financial planning and management. For example, the floor of the main dining room would benefit from replacement but, having considered the needs of people using the service and taking into account finances available, the homes management had decided to invest in pressure-relieving mattresses as this would help to safeguard the needs and interests of people who may be at risk of developing sore skin when they lie in bed. We were told that the home intends to replace the flooring in the dining area, but this would be at a later stage when further finances are available. Many bedrooms have been redecorated to a nice standard and people have been encouraged to bring their own possessions and furnishings (whenever possible) into Care Homes for Older People Page 20 of 28 Evidence: the home. This helps people to personalise their rooms and helps people gain and maintain their own identity. It is acknowledged that, as the building is a period building, it was not initially designed to be a care home and, therefore has some design limitations. The proprietor has worked well to try to limit the impact of the environmental restrictions, while several people said that they liked the uniqueness of the building. People told us, The home is lovely, Its like being in a home from home, I couldnt imagine being anywhere nicer and Id recommend it to anybody, its lovely. All areas of the home were clean and tidy, and people using the service said that Every day it is cleaned. (Its a) nice place to stay, His room is always clean, not always tidy but thats his fault!. There are enough cleaning staff available to keep the home nice, tidy and fresh. staff have received the necessary training to make sure that cross infection does not occur, and we saw evidence to confirm that when somebody develops an infection, it does not spread around the home. Care Homes for Older People Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home can be confident that there are suitable staff employed in sufficient numbers to effectively and safely meet peoples assessed needs. Evidence: We looked at how the needs of people living at the home were met through the provision of appropriately skilled staff. We talked to people using the service and the staff working at the home, and looked at staff records, training records and duty rotas. Morton House provides waking registered nurse cover throughout the 24-hour period. This means that people using the service have access to a registered nurse at any time of the day or night. There are also waking care staff working in the home throughout the 24-hour period in numbers that are consistent with the needs of the people using the service. Care staff are flexible and work various shifts including, for example, 8am to 2pm, 2pm to 8pm, 8pm to 8am. The flexibility in staffing allows the home to respond flexibility to peoples needs. We talked to several staff, and we were told that there are always enough staff on duty to meet the needs of people using the service, but the home could do with more staff to deal with details. This was described as meaning activities such as hanging up Christmas cards. We were also told that the Care Homes for Older People Page 22 of 28 Evidence: staff provide a high quality care. People using the service praised the staff, telling us They all work together, when I was ill recently the care was as always very good, they strike a good balance of personal/pastoral care and the staff are very good. People told us how quickly staff responded if they need them. We were told you dont have to wait for anything. Theyre very kind and also sometimes unforeseen circumstances cause a slight delay but staff always come as quickly as possible. The home kept full and up to date records of staff training. These records showed that basic training took place in a range of topics, including Protection of Vulnerable Adults, Moving and Handling, Infection Control, Health and Safety, Food Hygiene, First Aid, Fire Safety, Dying, Death and Bereavement and Dementia Awareness. This means that staff working within the home are well equipped to meet the needs of the people using the service. We looked at how well people are protected through the homes recruitment process. The staff files we examined all proved that the home is taking the correct steps to ensure that only people who are suitable to work with vulnerable adults work at the home. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management arrangements ensure that the people living at Morton House benefit from a well run home and their views are considered. The health, safety and welfare of the people living there is promoted and protected so ensuring their safety and well being. Evidence: The management arrangements within the home are unique as the owner, Mrs Sanghera, and her son play an active part in the day-to-day running of the home. Mrs Silk is the registered manager of the service and is suitably qualified and experienced to manage the service. She has extensive nursing experience and qualifications along with a National Vocational Qualification at level 4 in management and care. Since the time of the previous inspection, fairly radical changes have taken place that aim to enhance the management arrangements within the home. Mrs Sangheras son has now taken responsibility for quality assurance and administration, and is currently Care Homes for Older People Page 24 of 28 Evidence: reviewing policies and procedures. This has taken a large amount of pressure off Mrs Silk - allowing her to consolidate her focus on the management of nursing and care provision. This has helped to enhance the quality of service provided to people at the home. This point is best demonstrated by the feedback we received from a visiting healthcare professional who said, (they) provide an excellent standard of skilled nursing care. Very competent nurses who liaise well with their medical colleagues to achieve the best outcomes for their residents. people using the service expressed praise of the homes management team. Comments included Theyre wonderful, ever so kind, (you) couldnt ask for better and Matrons very nice. Shes extremely nice. The managers were considered to be very approachableand all staff spoken to were happy with their support. Mrs Silk has started to implement a formal system of one-toone staff supervision because as this can help to ensure that performance issues are addressed effectively. The home has up-to-date records detailing how its responsibility to ensure the health and safety of people using the service has been met. Risk assessments are conducted on a specific basis for each person using the service and there are generic risk assessments available within the home. All accidents and incidents are monitored closely and action is taken to prevent further accidental occurences happening when or should an accident occur. This helps to ensure that people are protected from avoidable harm, but they are also allowed and supported to take risks which promote their independence. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - 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!