Inspection on 31/08/06 for Morven House

This inspection was carried out on 31st August 2006.

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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Morven House 25/08/09

Morven House 15/05/08

Morven House 29/05/07

Morven House 01/11/05

Morven House 20/06/05

Morven House 16/09/04

Morven House 06/04/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Morven House The Causeway Potters Bar Hertfordshire EN6 5HA Lead Inspector Jeffrey Orange Key Unannounced Inspection 31st August 2006 08:00 Morven House DS0000019475.V305511.R01.S.doc Version 5.2 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 Morven House DS0000019475.V305511.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 Adults 18-65. 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. Morven House DS0000019475.V305511.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Morven House Address The Causeway Potters Bar Hertfordshire EN6 5HA 01707 662755 01707 663634 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) www.caretech-uk.com Care Tech Community Services Limited Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Morven House DS0000019475.V305511.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: There are none Date of last inspection 1st November 2005 Brief Description of the Service: Morven House is part of Care Tech Community Services. The building is owned by the National Trust and leased to Care Tech. It is located within several acres of parkland and gardens, which are accessible to residents. It is within walking distance of Potters Bar shops and town centre and is convenient for pubic transport links. Morven House provides residential services to 12 young adults with learning disabilities. The house has been divided into two units, one eight bedded unit for residents requiring higher staff input and a four- bedded unit for more independent residents. All bedrooms are for single occupancy and each unit has access to its own communal areas. The layout of the building makes it unsuitable to residents with reduced mobility. There is a service folder, which includes a copy of the latest Commission for Social Care Inspection report and other information concerning the service, readily available in the home. Fees vary according to the unit concerned, ranging on average from just over £1000 per week to £1500 per week, this information was correct at 31.08.06. Personal toiletries, newspapers, dentistry and chiropody services where these are not free are all charged at additional cost, as are some day care services. Morven House DS0000019475.V305511.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection site visit took place over five and a half hours, which provided an opportunity to speak to some service users and staff, including the senior on duty, the deputy manager and manager. The morning routine of the home was observed and some key records, including those relating to medication and residents’ money were spotchecked. A tour of the premises and grounds was also undertaken with the manager. This report also draws on any information received by the CSCI since the last inspection in November 2005. A series of survey questionnaires to a sample number of service users, their relatives or representatives and some of the community health services associated with the home have been sent out. Any issues arising from these will be addressed with the home and reported on in the next report. What the service does well: What has improved since the last inspection? The management team have either addressed or are in the process of addressing all the requirements and recommendations made in the previous report; for example bathrooms have been refurbished and the kitchen flooring has been supplied, although not yet fitted. A major benefit to residents this year has been the way the impressive greenhouse has been put into use. This provides not only a leisure and social interest for residents, but also has the benefit of providing fresh, homegrown produce for use in the home. Morven House DS0000019475.V305511.R01.S.doc Version 5.2 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. Morven House DS0000019475.V305511.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Morven House DS0000019475.V305511.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 Quality in this outcome area is good. This judgement has been made using available evidence, including a site visit to this service. Before they move into Morven House, prospective residents’ needs are fully assessed and their aspirations and preferences taken into account in order to make sure that the home is the right one for them. EVIDENCE: Care plan documentation was seen to include a comprehensive assessment and review process, involving service users. It is understood that expert advice has been sought to review the home’s Service User’s Guide and Statement of Purpose, so as to make them more readily accessible and user friendly for prospective residents. Progress with this will be monitored at the next inspection. Morven House DS0000019475.V305511.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 679 Quality in this outcome area is good. This judgement has been made using available evidence, including a site visit to this service. Residents’ care plans are individually focussed and provide an up to date record of resident’s needs and goals, how they may be changing and how they will continue to be appropriately met. This makes sure that the way residents live reflects their changing ability and needs within a person centred, risk assessment framework, that is designed to build and maintain independence. EVIDENCE: Detailed person centred care plans were seen which included evidence of regular review and development, in line with changing circumstances. This process included the active involvement of residents and those responsible for them. Morven House DS0000019475.V305511.R01.S.doc Version 5.2 Page 10 There is a robust system of risk assessment in place, which enables residents to take reasonable risks as they seek to maintain and develop independent lifestyles. Staff were seen to provide residents with choices and then to support them in a non-directive way to put their decisions into action. Morven House DS0000019475.V305511.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 15 16 17 Quality in this outcome area is good. This judgement has been made using available evidence, including a site visit to this service. Residents take part in a varied range of activities based upon their individual needs and choices and are supported appropriately by staff to use local community facilities. EVIDENCE: Individual care plans contain records of the likes and dislikes of residents. There are details of activities undertaken and these are discussed and reviewed with the residents regularly. Residents are involved in the planning of menus and mealtimes can be flexible to accommodate activities outside of the home. Details were provided of recent trips and visits by residents, both locally and further away and this was confirmed in conversation with residents. Morven House DS0000019475.V305511.R01.S.doc Version 5.2 Page 12 During the inspection visit, residents left the home, supported by staff, to attend day care and access community health services. A resident indicated that they enjoyed a part time job in the community. In most cases care plans include evidence of the involvement of family and other interested parties, including advocates. Morven House DS0000019475.V305511.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 19 20 Quality in this outcome area is good. This judgement has been made using available evidence, including a site visit to this service. Personal care is provided for residents in a way that meets their needs and takes account of their own preferences and expressed choice. Residents have access to the health services they need and where they require assistance with medication this is done in a way that should ensure their safety. EVIDENCE: Care plans were seen to include full details of the care needs of residents and how they should be met in ways that the residents prefer. There was ample evidence of the involvement in resident’s care of a range of health professionals and one resident was being accompanied to a medical appointment on the day of the inspection visit. Medication records were spot checked and found to be satisfactory. The manager confirmed that residents would be encouraged and enabled to selfmedicate where this was appropriate and could be done safely. Morven House DS0000019475.V305511.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 23 Quality in this outcome area is good. This judgement has been made using available evidence, including a site visit to this service. Policies and procedures are in place to protect residents from abuse, neglect and self-harm. Residents’ views are regularly asked for, listened to and wherever possible acted upon. EVIDENCE: A comprehensive complaints policy and procedure is in place and is well publicised to both residents and those responsible for them. Staff receive training in issues and procedures around the protection of vulnerable adults. The complaint received by the Commission for Social Care Inspection referred to in the previous inspection report, was only partly upheld. Action has been taken by the home to address any shortcomings identified. Morven House DS0000019475.V305511.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although the building provides a very special environment for residents, it also poses considerable challenges for Care Tech in maintaining it to an acceptable standard. Whilst the overall effect is comfortable and attractive, there are areas of concern that affect the safety of residents and the time taken to address routine maintenance and refurbishment is unsatisfactory. EVIDENCE: Handles are missing from the pine dresser in the dining room, leaving screws exposed. The sofa bed in the small lounge is broken and needs replacing. The ceiling in the ground floor lounge needs attention following a leak and the French doors require repair and repainting. There is a hole in the ceiling in the ground floor entrance lobby. Morven House DS0000019475.V305511.R01.S.doc Version 5.2 Page 16 Although floor covering has now been obtained for the kitchen, this has not been fitted. Whilst some remedial work has been done to the home’s bathrooms, further refurbishment is still required. Morven House DS0000019475.V305511.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 33 34 35 Quality in this outcome area is good. This judgement has been made using available evidence, including a site visit to this service. The recruitment policy and practice of the home provides adequate safeguards for residents to make sure that any new members of the staff team are suitable to work with them and care for them. A well-trained staff team supports residents, with the skills needed to meet their assessed needs. There are not always sufficient suitably qualified relief staff available to cover unplanned staff absence at short notice. EVIDENCE: Recruitment records were seen in respect of recently recruited staff and the standard of practice demonstrated was satisfactory. Those members of the staff team spoken with during this inspection visit said that they were well supported with training and supervision. The training and supervision records seen confirmed this. On the day of the inspection visit the home’s driver and one other member of staff had not been fit for work and this had caused a period of uncertainty, Morven House DS0000019475.V305511.R01.S.doc Version 5.2 Page 18 which could potentially have affected the ability of some residents to attend day care. Morven House DS0000019475.V305511.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 39 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is a well developed system of quality assurance in place, which should help the home’s management assess areas of strength and weakness and provide them with information to enable them to improve the care experience for residents. The recent change in management has been well handled and any disruption to the service should be minimal, which will provide the consistency required by the residents. The arrangements for management cover and communication need to be reviewed to ensure that staff have access to appropriate management support at all times. Morven House DS0000019475.V305511.R01.S.doc Version 5.2 Page 20 EVIDENCE: The home was given a “Top Team” award for the period December 2005 to February 2006. The home were audited against Care Tech residential standards during January to June 2006 and achieved 99 A further audit was carried out in May 2006 and the findings are available to residents and other interested parties in the home. Staff reported that they felt well supported and although a change of manager can be stressful for staff, in general they felt this had been handled well and that care standards had not suffered for residents. There was some confusion in the home at the outset of the inspection visit as the duty senior could not contact the manager and there was a lack of accurate communication as to when he was expected to arrive. The deputy manager did however respond and came in early to assist. It is also acknowledged that an inspector arriving at a time when staff are trying to cover staff shortages can itself prove disruptive. The manager had not submitted an application for registration to the Commission for Social Care Inspection. (At the time of the inspection visit) Morven House DS0000019475.V305511.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 3 X X 2 X Morven House DS0000019475.V305511.R01.S.doc Version 5.2 Page 22 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA24 Regulation Requirement Timescale for action 30/11/06 2 YA37 3 YA42 23(2)(b&d) A maintenance audit of the home must be completed and a schedule, with detailed timescales, put in place to show how and when any issues indicated by the audit are to be dealt with. A copy of this schedule must be sent to the CSCI. 9 An application for registration as 30/09/06 manager must be made to the CSCI in order that fitness can be established through the registration process. 12 A review of communication and 31/10/06 management cover arrangement must be completed to ensure that these adequately meet the management needs of the home. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations DS0000019475.V305511.R01.S.doc Version 5.2 Page 23 Morven House 1 Standard YA33 The manager should review the emergency cover arrangements in respect of short notice absences of staff to ensure that it is as robust and effective as possible. Morven House DS0000019475.V305511.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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. 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