Inspection on 26/03/09 for Norton House

This is the latest available inspection report for this service, carried out on 26th March 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.

Other inspections for this house

Norton House 15/01/08

Norton House 26/04/07

Norton House 26/04/05

Norton House 30/09/04

Norton House 07/06/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

CARE HOMES FOR OLDER PEOPLE Norton House 10 Arneway Street London SW1P 2BG Lead Inspector Wynne Price-Rees Key Unannounced Inspection 26th March 2009 10:30 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 Norton House DS0000010862.V374622.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. Norton House DS0000010862.V374622.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Norton House Address 10 Arneway Street London SW1P 2BG 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) 020 7976 7681 susan.evans@anchor.org.uk keri.sherwood@anchor.org.uk Anchor Trust Manager post vacant Care Home 39 Category(ies) of Old age, not falling within any other category registration, with number (39) of places Norton House DS0000010862.V374622.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Registered Person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: 2. Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 39 25th April 2008 Date of last inspection Brief Description of the Service: Norton House is registered to provide care and accommodation for 39 older people. Currently there are 38 people using the service. The home is situated in a quiet cul-de-sac, off Horseferry Road, in Victoria and is close to local shops. The Anchor Trust operates the service, with all placements being made by Westminster City Council. Norton House DS0000010862.V374622.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. The inspection was unannounced and took five and a half hours to complete during one day, on 25/03/09. During the course of the inspection people who use the service were spoken with to get their views of the service they receive. The Care Manager and staff were also spoken with, care practices observed, records and procedures checked and a premises tour undertaken. All key standards were inspected and this information was triangulated with that gathered since the previous key inspection to give the new quality rating. The home previously provided a self-assessment AQAA and the available information was compared to the inspection findings. An AQAA is a self-assessment document that is filled in by the home to show how it is performing against the minimum standards. Six files of people who use the service were case tracked from all floors registered. What the service does well: The people who use the service feel they receive a good service, in safe and pleasant surroundings that is provided by a friendly, caring and efficient staff team. The care plans are up to date, person focused and people who use the service confirmed they are involved in planning their own care. The plans included all the areas required by the standards. The records inspected are well kept, accessible and easy to follow. The home is clean, tidy, odour free and well maintained. There is a very good range of activities provided. Norton House DS0000010862.V374622.R01.S.doc Version 5.2 Page 6 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. Norton House DS0000010862.V374622.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 Norton House DS0000010862.V374622.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 and 6. People who use this service experience good quality outcomes in this area. People who use the service are fully assessed to establish that their needs and wishes can be met before being given the opportunity to visit so that they can decide if they want to move in. This judgement has been made using available evidence including a visit to this service. EVIDENCE: “I visited before moving in”. “I read the last CSCI inspection report to help decide if the home might be suitable for my dad”. Norton House DS0000010862.V374622.R01.S.doc Version 5.2 Page 9 We inspected a sample of two case files from each floor that contained preadmission assessments as well as care plans and other information. The information shows us that the written assessment procedure enables the home to identify if the particular needs of people can be met and it is a suitable place for them to live. The assessments take place where people live and they fully participate in the process. They then visit the home to have a look around, meet people who use the service and staff who work there to help decide if they would like to move in. They can visit as many times as they like to help decide if they want to move in. The home also offers intermediate care using the same assessment procedures. Currently there is no one at the home receiving intermediate care. The Care Manager said that quite often people who use the service move in permanently, when they feel they can no longer live at home, having previously experienced the home by using it for intermediate stays. The Care Manager, Deputy or a Team Leader carries out the assessments. Norton House DS0000010862.V374622.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 and 10. People who use this service experience good quality outcomes in this area. The care plans are comprehensive with information in place that shows how staff are supporting the people who use the service with their social, health, cultural, emotional, communication and independent living needs. People using the service are treated with respect and their dignity observed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: “I am involved in my care plan”. “I decide what I want to do and when to do it”. The case files sample shows that everyone has an up to date, easy to use care plan that covers all the areas needed but is still focused on the individual. This Norton House DS0000010862.V374622.R01.S.doc Version 5.2 Page 11 includes needs and wishes of people regarding activities and stimulation as well as health care. The plans are broken down into specific goals and action required to achieve them by staff and people who use the service that is clearly identified. They are underpinned by risk assessments and progress made is identified in daily report sheets. The entries in the contact sheet have numbers that correspond to the care plans to make things clearer and easier to understand. The care plans and risk assessments are reviewed monthly and fed by information contained in the contact sheets. Although the risk assessments are reviewed if there are no changes to be made, staff have not been signing and dating them. We chose one care plan objective from each case file from different areas such as health care, personal hygiene and activities. We followed them through from identification, recording in the daily sheets, review and if risks were assessed. For example one person has identified attending keep fit sessions once a week, whilst someone else likes to have regular showers and another person needs to monitor their weight to stay healthy. The daily report sheets and reviews showed us that these were happening and people who use the service confirmed this. During the inspection we observed how staff treated people who use the service and how they treat staff. We saw that everyone was being treated with mutual respect and their dignity observed whilst maintaining a friendly and humorous atmosphere. Staff receive core induction training regarding maintaining privacy and maintaining someone’s dignity and this was reflected in the way they conducted themselves. Most people are registered with a GP attached to the home although they can keep their own GP if they wish. They also have access to community based health care services when needed. These include chiropodists, opticians and dentists. The medication administration records were checked for all people who use the service. The records were generally up to date and correctly completed although there were three gaps present. The gaps were identified at the weekly audit although the rear of the sheets had not been filled in with an explanation and if the medication had been administered. The person doing the audit established this by checking the tablet count. This told us the written medication policy and procedure was generally being followed. Norton House DS0000010862.V374622.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 and 15. People who use this service experience good quality outcomes in this area. People who use the service have their preferences observed and their social, cultural, religious and recreational needs and interests met, meaning they have fulfilling lifestyles. They are encouraged to maintain contact with friends and relatives as they wish to enhance their social lives. This judgement has been made using available evidence including a visit to this service. EVIDENCE: “There is a good range of activities”. “They provide the things I like to do”. “I go out for a walk most days by myself or with staff depending on how far and where I am going”. Norton House DS0000010862.V374622.R01.S.doc Version 5.2 Page 13 “I would like more outings but the trouble is when they are provided a lot of people don’t bother”. The home employs an activities co-ordinator who provides a wide range of activities for people who use the service to choose from. “I enjoy the mobility sessions”. Activities range from group that everyone can join in with to individual sessions such as memory joggers based on the person’s social history and games. “I think the activities are excellent”. The activities are not confined to within the home and a number of trips have taken place to destinations such as museums, theatres, concerts, Westminster Abbey, two boat trips to Greenwich and the Blue water shopping mall. Local amenities are also available with things like pub visits. One person said at one mealtime their preference had run out and they didn’t fancy the alternative so staff took them out for something to eat. The home provides in-house activities daily including bingo and quizzes. During the inspection a baking session was taking place. The activities are not confined to the daytime and there are a number of evening activities available and outside entertainers visit to put on performances. A schedule of special activities has been planned up to November 5th and there are also weekly schedules flexible to meet people’s needs. Special events that have already taken place include St Patrick’s Day, Valentine’s Day dinner and last year the Beijing Olympics was celebrated by staff wearing Chinese costume and serving Chinese food. An international day also took place where people wore traditional dress from various countries around the world. Everyone’s birthday is celebrated with a party if they wish. “The food is pretty good”. The home has a new chef manager who joined recently and people said they enjoyed the food. One person said sometimes there was a problem with his food arriving cold because instead of taking the order for one table staff took the orders individually making more work for themselves and taking more time. He suggested they take orders by table, which they are now doing, and there is no longer a problem. People who use the service entertain visitors when they wish and there were friends and family visiting during the inspection. Norton House DS0000010862.V374622.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 and 18. People who use this service experience good quality outcomes in this area. People who use the service are listened to, complaints investigated with outcomes and they are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a comprehensive complaints policy and procedure that people who use the service and staff confirmed they have seen and understand. This was on display. “If I had a complaint I would talk to staff or directly to the manager”. “I’m not clear who I need to talk to when I want something done”. One person moved in quite recently and wasn’t really clear who they needed to talk to. We explained that generally their main point of contact is their key-worker and floor team leader although they can talk to any member of staff. They were unclear because a key-worker is still being identified as they are just coming to the end of their six-week moving in period. Any complaints made are recorded with outcomes. There are three complaints recorded since the random visit in January that have been resolved. There are no current Pova issues. Pova is the protection of vulnerable adults. The complaints records are checked as part of quality assurance to identify any emerging patterns. Norton House DS0000010862.V374622.R01.S.doc Version 5.2 Page 15 “I feel safe living here”. There is an adult protection policy and procedure that staff confirmed they have understood and all staff has received adult protection as part of induction with annual refresher courses except two who are currently on maternity leave. They are also CRB checked before starting work. CRB is the Criminal Records Bureau. There is a whistle-blowing procedure that staff confirmed they have access to and know how to use. Norton House DS0000010862.V374622.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 and 26. People who use this service experience good quality outcomes in this area. A homely, clean and safe environment is provided for people who use the service to live in. This judgement has been made using available evidence including a visit to this service. EVIDENCE: “I like living here”. “The rooms are a little small but that’s because of the way the building is and I like have an ensuite”. We walked around the building and found the home provided a comfortable, warm and safe environment to live in that matched its statement of purpose. It is well decorated and maintained. Everyone has their own bedroom that they are encouraged to personalise by bringing in personal possessions from home with ensuite shower. Norton House DS0000010862.V374622.R01.S.doc Version 5.2 Page 17 The floor communal areas are comfortable and about the right size to make them cosy. People who use the service also have access to a pleasant garden area. There are ample toilets and bathrooms that are easily accessible to people who use the service and people generally preferred to use their own showers. The home was clean, tidy, hygienic and odour free. Norton House DS0000010862.V374622.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 and 30. People who use this service experience good quality outcomes in this area. There are suitably trained, competent and diverse staff employed in suitable numbers to meet the needs and wishes of people who use the service. Staff are properly vetted. This judgement has been made using available evidence including a visit to this service. EVIDENCE: “The staff are friendly and helpful”. “The staff are very nice”. The home’s staff rota shows there are ample numbers of well trained staff on duty to meet needs of people who use the service at all times and this was reflected by the number of those on duty when we visited, number of activities taking place and positive way that staff support and encourage people who use the service. One person who uses the service had a continuous banter running with one of the staff that they were both obviously thoroughly enjoying. Other staff were observed chatting with people in a friendly manner that showed staff and people who use the service treat each other as equals. Norton House DS0000010862.V374622.R01.S.doc Version 5.2 Page 19 The home has a thorough recruitment policy and procedure that four staff files sampled showed meets equal opportunities legislation, the requirements of standard 29 and means people who use the service are safe and their needs professionally met. All staff are interviewed, have CRB and POVA first checks carried out before starting work and must provide references that are checked. CRB checks are renewed after three years. Staff are required to successfully complete workbooks as part of induction training and have access to a rolling training programme. This includes mandatory training in basic food hygiene, health and safety, fire and manual handling. Over 50 of staff currently holds NVQ level 2 awards. NVQ is the national vocational qualification. Weekly work planning workshops also take place. Supervision takes place every six to eight weeks and these meetings are partly used to identify training needs. Team leaders supervise care staff and the Care Manager supervises the team leaders. Norton House DS0000010862.V374622.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 and 38. People who use this service experience good quality outcomes in this area. The home is well managed in the interests of those who use the service and the quality assurance system is effective. Health and safety is well managed meaning that people who use the service live in a safe environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Care Manager is the same as at the last random inspection, currently undertaking NVQ level 4 in management, has been in post for six months and has extensive previous experience as a Deputy. The improved performance of activities provided, records seen, professional caring staff team and Norton House DS0000010862.V374622.R01.S.doc Version 5.2 Page 21 observation of care practices suggest people who use the service benefit from good quality management that has their interests first. The quality assurance system is thorough and robust. It contains identifiable performance indicators and action trigger levels. There is an annual business plan with set objectives and internal audits are carried out. These include monthly, unannounced regulation 26 visits with accompanying reports. Regulation 26 visits check that required quality service levels are met and are carried out by the provider’s representative. Westminster City Council also undertakes quality-monitoring visits. Surveys of people who use the service are undertaken about specific service areas. These include catering and personal care. There are also questionnaires and regular residential meetings. The home also returns annual self-assessment AQAAs. Comprehensive health and safety checks take place throughout the building and are fully documented. Any problems are recorded, reported and there are two designated health and safety officers. The fire fighting equipment is tested and serviced a minimum annually, fire alarms are tested monthly and fire drills take place weekly. PAT tests take place six monthly or when electrical appliances are introduced to the home and fridge and freezer temperatures tested and recorded daily. PAT tests are tests of electrical appliances to make sure they are safe. Norton House DS0000010862.V374622.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 X X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X 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 3 X 3 X X 3 Norton House DS0000010862.V374622.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 12 (1) (a) Requirement The risk assessments must be signed and dated when the monthly reviews take place. Timescale for action 01/05/09 2. OP9 13 (2) The home must record the 26/03/09 reason for any gaps and if a person who uses the service has been administered medication on the rear of the MARR sheets. 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 Standard Good Practice Recommendations Norton House DS0000010862.V374622.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 Norton House DS0000010862.V374622.R01.S.doc Version 5.2 Page 25 - 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. 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