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Inspection on 09/01/07 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 9th January 2007.

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 service provides a high standard of personal and health care for those who live there. A health care professional has stated that; `The quality of nursing and holistic care is always (and consistently) of a high standard` Another said; The home itself is very friendly & welcoming environment. Relatives consider that they are always welcome, are kept well informed and consulted when appropriate. Staff are well recruited and trained and the residents say they are kind and courteous. The residents say they enjoy their food and a range of activities is provided for groups and individuals. The local vicar visits the home and those who wish can take Holy Communion. Bedrooms are pleasant and residents have their personal possessions around them.

What has improved since the last inspection?

Following the last inspection sixteen areas were identified for improvement. Only eight of these had been addressed within the timescales that were set. Some medication matters had been addressed, catering records had been improved and health and safety had improved regarding fire doors and wheelchairs.

What the care home could do better:

Documentary information should always be available to help people make decisions when seeking a place in a care home. Assessments of people`s care needs are being made and care records are being reviewed. However the detail and frequency of this needs to increase and involve the resident, or with their consent their representative, in line with good practice guidance so that staff have up to date information to help them care for the residents. There are still areas that need to be improved to ensure safety in the administration of medication. Staff need to consider how to sensitively obtain the information they need from residents or their representatives concerning residents` end of life wishes and death. It is acknowledged that this is a sensitive subject but without the knowledge staff cannot take the action the individual wishes. Staff training for qualifications and supervision need to increase to ensure they have the knowledge and support that they need to provide the service the residents need.

CARE HOMES FOR OLDER PEOPLE Morton House Nursing & Rest Home Morton House Droitwich Road Fernhill Heath Worcester Worcestershire WR3 7UR Lead Inspector Yvonne South Unannounced Inspection 9th January 2007 09:00 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 & Rest Home DS0000004126.V324234.R01.S.doc Version 5.2 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 & Rest Home DS0000004126.V324234.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Morton House Nursing & Rest Home Address Morton House Droitwich Road Fernhill Heath Worcester Worcestershire WR3 7UR O1905 754489 F/P 01905 754489 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) Mrs Narinder Sanghera Mrs Sheila Janette Silk Care Home 32 Category(ies) of Dementia - over 65 years of age (17), Old age, registration, with number not falling within any other category (32), of places Physical disability over 65 years of age (32) Morton House Nursing & Rest Home DS0000004126.V324234.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may accommodate a maximum of 24 people for nursing care. 9th December 2005 Date of last inspection Brief Description of the Service: 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 3 communal bathrooms and toilets, which are fitted with special aids to assist the less mobile, 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 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. The registered manager stated on 18.01.07 that the current fees were between £1516 and £1976 per month. Additional charges are made for newspapers, hairdressing, private chiropody and massage therapy at market prices. Morton House Nursing & Rest Home DS0000004126.V324234.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection therefore the focus was on the key standards and the sixteen requirements that arose out of the previous inspection. Evidence was gathered from information provided to the Commission for Social Care Inspection (CSCI) since the previous inspection, which took place on 12.12.05. A pre-inspection questionnaire was sent to the manager by the Commission for Social Care Inspection on 13.12.06. She was asked to complete this and return it. She was also asked to distribute questionnaires to residents, relatives and health care professionals seeking their views of the service provided. By 18.01.07 seven responses had been received from residents, ten from relatives and eight from health care professionals. The pre-inspection questionnaire had not yet been returned. A site visit took place on 09/01/07, which extended over 10 hours during which the inspector talked to three residents and five staff, undertook a partial tour of the building and assessed a range of documents. The inspector was assisted principally by the Registered Manager. What the service does well: The service provides a high standard of personal and health care for those who live there. A health care professional has stated that; ‘The quality of nursing and holistic care is always (and consistently) of a high standard’ Another said; The home itself is very friendly & welcoming environment. Relatives consider that they are always welcome, are kept well informed and consulted when appropriate. Staff are well recruited and trained and the residents say they are kind and courteous. The residents say they enjoy their food and a range of activities is provided for groups and individuals. The local vicar visits the home and those who wish can take Holy Communion. Morton House Nursing & Rest Home DS0000004126.V324234.R01.S.doc Version 5.2 Page 6 Bedrooms are pleasant and residents have their personal possessions around them. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Morton House Nursing & Rest Home DS0000004126.V324234.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Morton House Nursing & Rest Home DS0000004126.V324234.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (an intermediate service is not offered therefore standard 6 is not relevant) Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Information about the home was not always readily available. Therefore some people might not be offered the information that could help them make a decision regarding the home. The pre-admission assessment of needs is limited. Therefore the home cannot be sure the service can provide all the care the individual requires. EVIDENCE: Copies of the Statement of Purpose and Service Users’ Guide for the home were not available. The manager believed that they were in the process of being up dated. Copies should be sent to the CSCI when available. Morton House Nursing & Rest Home DS0000004126.V324234.R01.S.doc Version 5.2 Page 9 The care records of three residents were assessed during the fieldwork. It was observed that initial information was recorded in a hard backed book. Good records were maintained of the progress of the inquiry that included contacts and visits made and received and the initial information obtained regarding the prospective residents’ need. Some files contained a community care assessment and hospital information that assisted the home’s assessment. A form titled an ‘Assessment of the Patient’s Condition’ was then completed. However this did not contain all the necessary information required. It was recommended that the form be developed to include all topics listed in National Minimum Standards 3.3. If the information is not available prior to admission this should be noted and obtained as soon as possible if the admission goes ahead. Morton House Nursing & Rest Home DS0000004126.V324234.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans provide staff with detailed information to provide the identified care needed. However needs, care plans and risk assessments are not reviewed frequently enough to ensure plans continue to address them. EVIDENCE: Care plans had been drawn up in good detail that provided information to advise and guide the staff in the delivery of individual care. A detailed care plan was not available for one person who had specific needs regarding mouth care. Morton House Nursing & Rest Home DS0000004126.V324234.R01.S.doc Version 5.2 Page 11 There was little evidence in the records that were assessed of the residents’ involvement in planning their care although some relatives confirmed that they were kept well informed. It was recommended that this communication be recorded. The records demonstrated that the assessment form was updated every three months and clearly demonstrated progress or deterioration. Risk assessments had also been made but not adequately reviewed. Although daily entries were made regarding the implementation of each care plan the quarterly assessment review was the main review. However it did not cover all care topics identified in the National Minimum Standards (NMS). The NMS indicates that it is good practice that care plans should be reviewed monthly or more often if needed. A requirement regarding the necessary increase in the frequency of reviewing was made in previous reports. Daily records indicated that personal and health care needs were being addressed and the residents, relatives and health care professionals commended the standard of work. Health care professionals stated; They (the trained nurses) provide a very high standard of person centred care & are proactive in assessing and managing the health care needs of residents. Nursing Staff are an excellent team of highly experienced trained professionals. They deliver individual designed care plans which actively involve the service user/carers/relatives/multi disciplinary Team. Documentation and accountability is a high priority for the team & I’ve never had any course for concern over many years. Medication was generally well managed. However it was observed that hand written entries had not been double signed to ensure accuracy and some administrations had been acknowledged by ‘ticks’ rather than signatures. A requirement had been made concerning the administration records following the last inspection. This had not been met. The home was supported by Boots The Chemist whose representative visited the home regularly. It was recommended that the pharmacist be asked to label the tubes and inhalers instead of, or as well as, their boxes as the boxes are inclined to disintegrate or become separated from their contents leaving ownership of the medicine unidentified. There was no information regarding the residents’ wishes relating to their care at the end of the lives and when they died. It is acknowledged that this is a sensitive subject. However without the information the care required cannot be given. Morton House Nursing & Rest Home DS0000004126.V324234.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The activities organiser provides a range of group and individual activities to interest and stimulate residents. Relatives and religious representatives are always welcome and provide residents with support and links to the community. Residents are able to choose foods they enjoy. EVIDENCE: Six residents completed and returned questionnaires to the Commission for Social Care Inspection. In these three stated that they considered that there were always suitable activities provided. Two people said that there sometimes were and the sixth said that there never were. Comments from residents included; Would like a few more, with notification a week before of roughly what is planned and what time. At the moment the activities are or appear to be a little ad hoc. (a programme of activities). Morton House Nursing & Rest Home DS0000004126.V324234.R01.S.doc Version 5.2 Page 13 This is my biggest bug bear. I am bored. Not enough activities. A resident who spoke to the inspector also said that she was bored. Two others said that they were happy with the provision of activities. Residents’ records indicated that they had family but not the extent of the contact and support. Social interests were not recorded in the assessment and care plans. However a separate record was made of each residents’ personal participation that was then entered in their daily records. The entries were detailed and indicated that a good range of stimulation was made available, for example it was observed that a choir had visited the home, manicures had been undertaken and residents had enjoyed, crosswords, quizzes, a bonfire party and individual time with the activities organiser. The three records assessed indicated that the residents belonged to the Church of England and they were able to attend services and receive Holy Communion in the home if they wished. The manager said that to her knowledge there were currently no residents with unmet needs regarding their race, religion or sexuality. Relatives confirmed that they were always welcome in the home and it was observed that they were relaxed and confident when relating to the staff. In the six residents’ questionnaire responses three residents stated that they always liked their food and others said that they usually did. One person said that sometimes a ‘high tea’ would be appreciated. One resident told the inspector that the food was acceptable but there was no choice, another confirmed that although she had difficulties the staff and her daughter kept trying foods to tempt her appetite. One resident said that he ‘loved everything’. The manager said that records were maintained of foods provided for residents on special diets. Personal likes and dislikes were known and alternatives were always available for those who did not care for the menu. A relative commented in the questionnaire that; The staff of Morton House are very warm, caring professional and attentive. I am very impressed with the quality of the food and the cleanliness of the facility. Morton House Nursing & Rest Home DS0000004126.V324234.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected as people raise their concerns and they are investigated and addressed. EVIDENCE: Since the last inspection the CSCI received an allegation concerning the abuse of residents. The allegations were investigated and the two staff concerned were dismissed and referred for inclusion on the Protection of Vulnerable Adults register. (People who have their name on this registered are not legally permitted to work with vulnerable people.) No further issues have been raised with the CSCI or in the home. All relatives who completed and returned questionnaires stated that they were aware of the complaint procedure and only one had ever made a complaint. Morton House Nursing & Rest Home DS0000004126.V324234.R01.S.doc Version 5.2 Page 15 The six residents who completed questionnaires indicated that staff always listened to them, they knew who to speak to if they were unhappy and knew how to make a complaint. This was also confirmed by a resident who spoke to the inspector. Relatives commented; I am impressed with the quality of care, which was been given to my mother for the last fifteen months. The staff are kind and friendly both to her and me. Discussions with staff indicated that although they knew how to respond to complaints not all staff had received recent training to recognise and respond to abuse concerns. Morton House Nursing & Rest Home DS0000004126.V324234.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides the accommodation and facilities that residents need. Systems and equipment are in use to manage the risks of cross infection. EVIDENCE: A partial tour of the home was undertaken by the inspector. The general décor appeared ‘tired’ and dark in places although the communal rooms were light and spacious and the bedrooms well maintained and personalised. Some carpeting appeared worn. One dining area appeared functional and unattractive. Morton House Nursing & Rest Home DS0000004126.V324234.R01.S.doc Version 5.2 Page 17 At the bottom of an unused staircase a storage project had been commenced and then abandoned leaving unsightly bare woodwork. There were no offensive odours and the residents indicated that the home was always fresh and clean. The laundry was well-maintained and liquid soap, disposable towels and personal protective equipment were readily available. Systems were in place for the disposal of clinical waste and staff confirmed that they had received training in infection control. Morton House Nursing & Rest Home DS0000004126.V324234.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care staff are well recruited and trained so that they are able to care for the residents. The time pressure on the nursing staff is considerable especially when they work alone. This means that it is difficult to keep administrative, monitoring and reviewing tasks up to date and the risk of out of date communication increases and may compromise care. EVIDENCE: The inspector spoke to five staff, interviewed three of them and assessed their records. Staff indicated that they had experienced an acceptable recruitment process and their records demonstrated that appropriate interviews and checks had been made. Training was undertaken and training in ‘End of Life Care’ was in progress on the day the inspector visited. Other training opportunities were advertised on the notice board. Morton House Nursing & Rest Home DS0000004126.V324234.R01.S.doc Version 5.2 Page 19 Some staff needed to update their training in the protection of vulnerable adults although they were aware of the correct action to take should they have concerns. Some staff had National Vocational Qualifications (NVQ) and others were undertaking courses. The manager said that seven staff had indicated an interest in starting NVQ courses in January. Data has not yet been received from the home that identifies the percentage of trained care staff in the home. A training matrix was not available during the fieldwork. Staff considered that levels were generally acceptable although it was said that the lack of administrative staff put a considerable strain on the trained nurses. When there were two nurses on duty it was ‘alright’ but when there was only one on duty it was a ‘nightmare’. There had been a shortage of domestic staff but this had recently been addressed. Residents, relatives and health care professionals were complimentary concerning the quality of care that was provided and the kindness of staff. A relatives stated in a questionnaire response; The staff are very caring and have helped my step mother settle in well despite her lack of mobility and inability to speak, apart from a very few words. Another said; We are pleased with the care and attention given to our mother. Morton House Nursing & Rest Home DS0000004126.V324234.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staff confirmed that it was a happy home to work in and residents and their relatives told the inspector that they were happy and pleased with the care. Staff described the manager as approachable and supportive. Relatives confirmed that communication was good. Health care professionals were most complimentary. Morton House Nursing & Rest Home DS0000004126.V324234.R01.S.doc Version 5.2 Page 21 The registered manager was well trained and experienced. Due to the needs of the residents she was having considerable difficulty in undertaking all of her management duties. This was apparent as completion of the pre-inspection questionnaire was delayed and progress to meet the requirements made following the previous inspection had not been met in full. The requirement to implement a quality assurance system had not been complied with. Personal monies were held for some residents. One person’s was checked and found acceptable. Records were maintained however it was recommended that receipts were given for all income received as well as being retained as evidence of expenditure. With residents’ consent copies of their accounts may be given to named relatives but the originals should not leave the home. Staff supervision was not being undertaken and recorded six times a year which is the frequency recommended in the National Minimum Standards. There were concerns regarding the management of health and safety. A requirement for an environmental health and safety risk assessment was made over twelve months ago. This could not be found at the time of the fieldwork. A requirement was made in the previous report that emergency lighting be tested each month. The records demonstrated that the practice of testing every three months had not been changed. Evidence of fire safety training was not complete and sufficient to meet the requirement that had been made in the previous report. Past Hereford and Worcester Fire Authority guidance was that all staff receive fire safety training every three months and participate in at least one fire drill a year. It would be good practice to comply with this guidance. The manager confirmed that staff had received training in health and safety related subjects and this was confirmed by the staff that spoke to the inspector. However it was not possible to assess the progress of the whole team to meet the requirement for this training as the matrix was not available. Routine checks of fire safety systems and equipment and the water supply were being maintained. Morton House Nursing & Rest Home DS0000004126.V324234.R01.S.doc Version 5.2 Page 22 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 X 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 X 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 1 X 3 X x 2 Morton House Nursing & Rest Home DS0000004126.V324234.R01.S.doc Version 5.2 Page 23 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 4 (2) Requirement A copy of the Statement of Purpose shall be supplied to the Commission and copies of it be made available on request for inspection by every service user and any representative of a service user. Arrangements must be made for the recording, handling, safe keeping, safe administration and disposal of medicines received into the care home. Outstanding from the previous inspection report. A system must be established and maintained to review at appropriate intervals, and improve the quality of care provided. Outstanding from the previous inspection report. After consultation with the Fire Authority arrangements should be made for persons working in the home to receive suitable training in fire prevention and ensure by means of fire drills and practices at suitable DS0000004126.V324234.R01.S.doc Timescale for action 28/02/07 2 OP9 13 09/01/07 3 OP33 24 01/06/07 4 OP38 23 09/02/07 Morton House Nursing & Rest Home Version 5.2 Page 24 10. OP38 13 intervals that the persons working in the care home and so far as is practicable, service users, are aware of the procedure to be followed in case of fire, including the procedure for saving life. Outstanding from the previous inspection report. The registered manager must ensure all staff have received updated training in first aid, moving and handling, infection control, food hygiene and fire Outstanding from the last inspection The training matrix was not available to confirm that this had been complied with. 01/02/07 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 OP3 Good Practice Recommendations The pre-admission assessment format should be developed to included all aspects listed in National Minimum standard 3.3 Care plans and risk assessments should be reviewed with the resident, or with their consent their representative, at least monthly and updated to reflect changing needs. The residents’ wishes concerning terminal care and arrangements after death should be discussed and carried out. 2 OP7 3 OP11 Morton House Nursing & Rest Home DS0000004126.V324234.R01.S.doc Version 5.2 Page 25 4 5 6 OP28 OP36 OP38 A minimum of 50 of care staff should have a National Vocational Qualification at level 2 or above. Care staff should receive formal supervision (1:1 support) at least 6 times a year. In order to ensure that all parts of the home are maintained and operate with due attention to health and safety a risk assessment for the premises should be available. It is recommended that previous guidance given by the Fire Authority relating to staff training for registered homes be followed. 7 OP38 Morton House Nursing & Rest Home DS0000004126.V324234.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John ComynHowever the manager said in the response to the Perdiswell Park, Droitwich Road Worcester WR3 7NW National Enquiry Line: 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 © 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 & Rest Home DS0000004126.V324234.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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