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Inspection on 01/12/06 for 30 Norbins Road

Also see our care home review for 30 Norbins Road for more information

This inspection was carried out on 1st December 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 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

The home provides a high level of support to service users within a small homely environment. Staff have a good knowledge of individual service users` needs. Service users are encouraged to exercise choice and are able to participate in a range of activities. Staff use British Sign Language, symbols, and pictures to communicate with service users, depending upon their specific needs. Service users each have a spacious bedroom, which has been decorated to reflect their personal tastes and preferences. All service user rooms have en suite facilities. Care plans are detailed and reviewed on a regular basis. The home follows good practice in relation to the recording and administration of medicines.

What has improved since the last inspection?

Staff have worked to support service users through changes in the staff team. The Registered Manager who had been at the home for a number of years left, and Jo Pearse who had previously been a Senior Support worker at the home was appointed as Manager. Further care staff and senior workers have also been employed at the home. Considerable work has been completed to improve the environment at Norbins House and Bungalow. Specialist advice has been sought from the MultiSensory Impairment Specialist employed by SENSE, and many areas of the home have been re-decorated. A new vehicle is being purchased to provide increased opportunities for service users to access the community. Staff recruitment files have been well organised and contain all documentation required. The home has operated a robust recruitment procedure. Appropriate action has been taken to address all requirements made at the last inspection.

What the care home could do better:

It is recommended that foot operated flip top bins be provided in toilets, en suite and communal bathrooms, to reduce the risk of cross infection.

CARE HOME ADULTS 18-65 Norbins House and The Bungalow 30 Norbins Road Glastonbury Somerset BA6 9JF Lead Inspector Sally Murphy Unannounced Inspection 1 December 2006 10:30 st Norbins House and The Bungalow DS0000016299.V305646.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 Norbins House and The Bungalow DS0000016299.V305646.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. Norbins House and The Bungalow DS0000016299.V305646.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Norbins House and The Bungalow Address 30 Norbins Road Glastonbury Somerset BA6 9JF 01458 833004 01458 830212 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) SENSE South West Joanne Pearse Care Home 4 Category(ies) of Sensory impairment (4) registration, with number of places Norbins House and The Bungalow DS0000016299.V305646.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Three places in 30 Norbins Road One place in The Bungalow Date of last inspection 17th January 2006 Brief Description of the Service: 30 Norbins Road is small residential home situated within walking distance of Glastonbury town centre. Accommodation is provided for 3 people within the large Victorian house, whilst a fourth person lives more independently within the self-contained bungalow located at the rear of the property. The home is registered with the Commission for Social Care Inspection to provide care for up to four people who have a sensory impairment. The service users residing at this service also have additional care and support needs as a result of learning disabilities. The Registered Manager is Jo Pearse and the Registered Provider is SENSE. Fees at this home range from £69,000 to £95,000 per year. The cost of hairdressing, toiletries, clothes, magazines and bedding is not included in the fee. Norbins House and The Bungalow DS0000016299.V305646.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was completed as part of the planned programme of inspection. The inspection was unannounced and was completed by one inspector over one day. The previous inspection was also unannounced and was completed on 17th January 2006. On the day of the inspection there were four service users residing within the home. During the course of the visit service users, staff members and the Registered Manager were spoken with. Care practice was also observed, records examined and a tour of the premises was made Prior to the inspection comment cards (surveys) were sent to health and social care professionals who have contact with the home. Two cards were received by CSCI, both of which provided positive feedback on the home. One of the cards received stated that it was an ‘excellent, well-run home’. What the service does well: What has improved since the last inspection? Staff have worked to support service users through changes in the staff team. The Registered Manager who had been at the home for a number of years left, and Jo Pearse who had previously been a Senior Support worker at the home was appointed as Manager. Further care staff and senior workers have also been employed at the home. Considerable work has been completed to improve the environment at Norbins House and Bungalow. Specialist advice has been sought from the MultiNorbins House and The Bungalow DS0000016299.V305646.R01.S.doc Version 5.2 Page 6 Sensory Impairment Specialist employed by SENSE, and many areas of the home have been re-decorated. A new vehicle is being purchased to provide increased opportunities for service users to access the community. Staff recruitment files have been well organised and contain all documentation required. The home has operated a robust recruitment procedure. Appropriate action has been taken to address all requirements made at 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. Norbins House and The Bungalow DS0000016299.V305646.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 Norbins House and The Bungalow DS0000016299.V305646.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): 1. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users and their families are provided with appropriate information regarding the home. EVIDENCE: The home has a Statement of Purpose and Service User Guide that provide details of the services and facilities offered at the home. These documents have been updated in to reflect the change in Manager. A copy of the revised Statement of Purpose was sent to CSCI. The Service User Guide is available in a format that is accessible to service users residing at the home. Pre-admission assessments were not assessed at this inspection. The home is fully occupied at present and there have been no admissions for several years. Norbins House and The Bungalow DS0000016299.V305646.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): 6,7,8,9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has developed an appropriate care plan for each service user. Service users are supported to make choices regarding their life. Staff demonstrated a good knowledge of individual service users’ communication needs. Appropriate records are maintained in relation to service users’ finances. Records relating to service users are stored securely. EVIDENCE: Care plans are maintained for each service user. Two care plans were examined in detail during this inspection. Care plans provided details of service users needs, daily routines and preferences. Staff also maintain daily records addressing service users’ living skills, daily activities, exercise, communication, personal care and diet. Care plans included communication Norbins House and The Bungalow DS0000016299.V305646.R01.S.doc Version 5.2 Page 10 and behavioural guidelines. Risk assessments had been completed as required. The Core workers file provided a useful audit to ensure that service users needs were being met appropriately. Those care plans seen had been regularly reviewed and updated as necessary. Service users are supported in preparing for care reviews through a variety of methods including pictures and photographs to ensure that they can participate fully in the review. Service users are encouraged to exercise choice regarding their daily routines. There is a board displaying which staff will be on duty. None of the current service users have advocates. There is a circle of support for each service user. The home will keep money securely for any service user that wishes them to. Records are maintained of all transactions involving service user finances and are supported by receipts and staff signatures. The Regional Financial Officer acts as Appointee for some service users at the home. Norbins House and The Bungalow DS0000016299.V305646.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): 11,12,13,14,15 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are provided with a range of activities that are appropriate to their individual needs, and are supported in accessing the local community. Service users are involved in planning menus, and a choice is offered for each meal. Independence is promoted. EVIDENCE: A range of activities is available to each service user. Those activities that service users choose to participate in include: DVDs, keyboard, music, yoga, exercise bike, massage, hair and beauty, cookery and daily living skills. Norbins House and The Bungalow DS0000016299.V305646.R01.S.doc Version 5.2 Page 12 Service users are also supported in accessing the local community and enjoy blind club, horse riding, going for walks and visiting local cafes. Clear guidelines have been produced to assist staff when walking with one service user. A new vehicle has been purchased for the home, which will provide increased opportunities to access the local community. Service users also attend courses at Strode College. Two service users enjoyed a holiday in Minehead this year. A third service user decided not to go away on a planned holiday. One service user regularly goes to Spain to visit their family. There are further breaks planned for the forthcoming year. Staff support service users in maintaining contact with family and friends. Visitors are welcomed at the home. Staff use a variety of methods to communicate with service users, including British Sign Language, symbols, and the pictorial exchange communication system. Care plans include clear guidelines to staff to ensure consistent communication and the promotion of independence of service users. Service users are involved in planning menus each week. A choice is provided at each meal. Specialist kettles have been provided to promote service users independence in preparing hot drinks. Service users are involved in food shopping and the preparation of meals as appropriate to their individual needs. Norbins House and The Bungalow DS0000016299.V305646.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 visit to this service. Service users are provided with appropriate assistance to meet their personal care needs. The home supports service users in accessing healthcare services, and ensures that specialist advice is sought when required. The management of medication follows safe practice. EVIDENCE: Service users are provided with assistance to undertake personal care tasks as required. There had been an increased incidence of challenging behaviour from one service user. The Registered Manager had sought specialist advice and consulted fully with the service users family members. The care plan for this service user has been regularly reviewed and updated as necessary. SENSE has a detailed policy regarding the administration, recording and storage of medication. Staff at the home receive medications training. A competence-based assessment is completed, and regularly reviewed for each Norbins House and The Bungalow DS0000016299.V305646.R01.S.doc Version 5.2 Page 14 staff member involved in the administration of medications. Medication Administration Records include a photograph of the service user, details of any allergies, and clear guidelines regarding the administration of ‘as required’ medication. The home has followed good practice in relation to the recording and administration of medication. Norbins House and The Bungalow DS0000016299.V305646.R01.S.doc Version 5.2 Page 15 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 visit to this service. The home has appropriate policies and procedures in place to safeguard vulnerable adults. EVIDENCE: The home has a complaints procedure that includes details of external agencies that may be contacted, including CSCI. It is a policy at homes owned by SENSE that the complaints procedure is explained to each service user, in a format that is suitable to them on a three monthly basis. Those care plans seen evidenced that this had taken place. The Registered Manager has responded appropriately to any complaints or concerns raised. Records have been maintained, and any appropriate actions taken. The home has a Protection of Vulnerable Adults and whistle blowing policy. Norbins House and The Bungalow DS0000016299.V305646.R01.S.doc Version 5.2 Page 16 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): 24,25,26,27,28,29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has been decorated and furnished to a good standard. Appropriate actions have been taken to address the environmental requirements made at the last inspection. Service user rooms have been personalised to reflect individuals’ tastes. There are sufficient communal areas and bathing facilities to meet service users’ needs. The home was found to have a high standard of cleanliness. EVIDENCE: Since the last inspection, considerable work has taken place to improve the environment at Norbins House and Bungalow. This has included repainting the lounge, stairwell, landing, sleeping- in room, and office. The Registered Norbins House and The Bungalow DS0000016299.V305646.R01.S.doc Version 5.2 Page 17 Manager has worked with the Multi-Sensory Impairment Specialist from SENSE to ensure that the improvements being made will meet service users needs. The home is domestic in style. Communal areas comprise of a lounge, dining room, and sensory room. There is a enclosed garden at the rear of the property is accessible to service users. All service user rooms have en suite facilities. Service users have been involved in choosing colour schemes and furniture for their rooms, and all rooms have been personalised to reflect individuals’ tastes and preferences. Since the last inspection, repairs have been completed as necessary and new carpets provided for some rooms. There are two bathrooms within the home, and additional toilets available close to communal areas. Liquid soap and paper towels have been provided in toilets, and bathrooms. It is recommended that foot operated flip top bins are also provided to reduce the risk of cross infection. The Bungalow is situated at the rear of the Norbin’s house. Work has taken place to address those issues identified in the last inspection report, and the lounge has been re-painted in a colour chosen by the service user. The laundry is sited at the rear of the home. This has been re-painted since the last inspection. Norbins House and The Bungalow DS0000016299.V305646.R01.S.doc Version 5.2 Page 18 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): 31,32,33,34,35 & 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels are appropriate to meet service users’ needs. Staff are provided with the training and support required to undertake their role. The Registered Manager has operated a robust recruitment procedure. Staff are provided with regular supervision. EVIDENCE: Duty rotas are maintained. There is a notice board in the kitchen displaying which staff members will be on duty each day. Newly appointed staff are provided with in-house induction training, and an Induction course provided by the company. Staff are encouraged to attend further training, and comprehensive training records are maintained. Staff are provided with infection control, health and Norbins House and The Bungalow DS0000016299.V305646.R01.S.doc Version 5.2 Page 19 safety, food hygiene, CPI, risk assessment, manual handling, care of medicines and BSL induction training. Recruitments files were examined for two recently appointed staff members. These included an interview record, two references, a POVA First check, proof of identity and a record of mandatory training. The files were well organised and contained all required documentation. This good practice and provides evidence that the home is operating a robust recruitment procedure. The home has monthly staff meetings where policies and care practices are reviewed. Staff confirmed that they are provided with regular supervision. Norbins House and The Bungalow DS0000016299.V305646.R01.S.doc Version 5.2 Page 20 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): 37,38,39,40,41 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run. The Registered Manager provides good leadership to the staff team. There are appropriate strategies in place to obtain feedback from service users and their families. Records relating to service users are stored securely. The Registered Manager has taken appropriate actions to promote the health and safety of staff and service users. EVIDENCE: Norbins House and The Bungalow DS0000016299.V305646.R01.S.doc Version 5.2 Page 21 The Registered Manager is Jo Pearse. Ms Pearse has worked at the home for five years prior to being appointed as manager. Ms Pearse has obtained the NVQ Level 3 qualification and is working towards the NVQ Assessors Award. There was a relaxed atmosphere within the home. Interaction between the Manager, other staff members and service users was observed to be friendly and respectful. The registration certificate is displayed, and the home has appropriate Employers Liability insurance. Business and financial plans were not seen at this inspection. Due to the needs of the service user group, feedback is sought from service users on an informal basis. The home has appropriate policies and procedures in place to safeguard vulnerable service users. All records relating to service users are stored securely in accordance with the Data Protection Act 1998. Fire safety records were examined. Fire equipment had been serviced and tested as required. Emergency lighting had been tested on a monthly basis. Staff had been provided with appropriate updates in fire safety training. The electrical hardwiring, gas safety and portable appliances had been tested appropriately. Accidents had been recorded and reported as necessary. Norbins House and The Bungalow DS0000016299.V305646.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 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 3 2 N/A 3 N/A 4 N/A 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 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 N/A 3 3 3 3 3 3 x Norbins House and The Bungalow DS0000016299.V305646.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action 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 YA30 Good Practice Recommendations Norbins House and The Bungalow DS0000016299.V305646.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Norbins House and The Bungalow DS0000016299.V305646.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. 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!