Inspection on 12/01/06 for Norewood Lodge

This inspection was carried out on 12th January 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.

Other inspections for this house

Norewood Lodge 27/11/07

Norewood Lodge 21/05/07

Norewood Lodge 14/12/06

Norewood Lodge 15/09/05

Norewood Lodge 17/03/05

Norewood Lodge 18/08/04

Norewood Lodge 16/02/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Norewood Lodge 72 Nore Road Portishead North Somerset BS20 8DU Lead Inspector Carolle Wise Scanlan Unannounced Inspection 12th January 2006 09:30 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 Norewood Lodge DS0000020308.V275203.R01.S.doc Version 5.1 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. Norewood Lodge DS0000020308.V275203.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Norewood Lodge Address 72 Nore Road Portishead North Somerset BS20 8DU 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) 01275 818660 01275 818660 Belmont Care Limited Mrs Judith Maddalena Care Home 48 Category(ies) of Old age, not falling within any other category registration, with number (46), Physical disability (2) of places Norewood Lodge DS0000020308.V275203.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. May accommodate up to 48 persons aged 50 years and over. Of the 48 persons, up to 2 Young Physically Disabled Persons may be accommodated. Staffing Notice dated 15/10/2001 applies Manager must be a RN on parts 1 or 12 of the NMC register Date of last inspection 15th September 2005 Brief Description of the Service: Norewood Lodge is registered to provide nursing care for up to 48 people. The category of registration is for 46 persons over 50years of age and for 2 young physically disabled persons. The home is a purpose built property set in large attractively maintained grounds. Accommodation is provided in both single and double rooms over three floors. The home provides communal areas of a dining rooms and lounges with a spacious reception area. Norewood Lodge DS0000020308.V275203.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection. The inspector spent a total of 6 hours in the home. During this time the inspector spoke to six of the residents individually, and chatted with others in the communal areas of the home. The inspector received positive feedback following discussions with two visitors to the home. Staff were not consulted formally, but observed and consulted with as they went about their work. Mrs J Maddalena, the homes Matron, was on sick leave when the inspection took place. Feedback on the inspection findings was given to the Group Operations Manager, Gill Lee. What the service does well: What has improved since the last inspection? What they could do better: Consent for the use of bed rails must be specific to the individually named resident. Recording of whether medication has been administered to a resident must be made and insulin medication dosage prescribed should be auditable. Norewood Lodge DS0000020308.V275203.R01.S.doc Version 5.1 Page 6 Care plan records on the first floor of the home to be kept securely when not in use. Fire safety training must be undertaken in accordance with Avon Fire Brigade guidance, however it was noted that training had been booked for 24/1/06. 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. Norewood Lodge DS0000020308.V275203.R01.S.doc Version 5.1 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 Norewood Lodge DS0000020308.V275203.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5 (6 does not apply) Residents are able to make a choice about living here based on the information provided and visiting the home. Resident’s needs are effectively assessed. EVIDENCE: The homes service user guide and statement of purpose has been subject to review and contains the relevant details required. Prospective residents are encouraged, where able, to visit the home and meet the staff and other residents prior to making their decision to move in. All residents have a month’s trial period. One recently admitted resident said that when she needed to move into a Nursing home, a friend suggested that she look at Norewood Lodge. She and her family visited the home, and met staff before she made a decision to stay. She said that during this visit, she discussed her care needs with the staff. This lady felt she had been welcomed and has since settled well. She felt confident that staff had the skills and knowledge to give her the assistance she required. Norewood Lodge DS0000020308.V275203.R01.S.doc Version 5.1 Page 9 Norewood Lodge DS0000020308.V275203.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Care records demonstrate a person centred approach. Residents feel that they receive a good standard of care. They get on well with the staff. Medication administration is generally robust however further improvement is needed in recording medications administered. EVIDENCE: Care plans are in place for all residents. These are reviewed on a monthly basis and drawn up where possible with the resident’s involvement. The staff and home continue to make improvements in their care plans and risk assessments. Care plans for residents suffering with dementia needed further person specific detail. Residents consulted during the inspection said they were very happy with the standard of care provided at Norewood Lodge. There was evidence of a good rapport between staff and residents. Norewood Lodge DS0000020308.V275203.R01.S.doc Version 5.1 Page 11 Several of the residents had rails fitted to their beds. Their use was recorded in the care records and there was evidence to confirm that permission had been sought for their use. In one instance however, there was an incomplete form, as it did not specify the name of the resident to which consent had been sought. Medication procedures in the home need to be further improved. All medicines must be signed for once administered. Should medication not be administered the key on the Medication Administration Record (MAR) followed. One record of prescribed insulin did not have a clear auditable trail of the dosage required. Norewood Lodge DS0000020308.V275203.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 Residents are offered the opportunity to participate in a range of activities. EVIDENCE: The home employs two part-time social activity organisers. Their responsibilities include collating the current residents preferences regarding activities and incorporating these, where possible, into a program of events. The aim is to ensure that all residents have access to some form of activity. Several residents choose not to attend the social activities arranged by the home and make their own arrangements with family friends or attend local community events or day care facilities. One younger resident commented that a ‘holiday’ was on the ‘wish’ list, but needed to find funding. This ‘wish’ was not recorded in the residents care notes but was known to the staff. Residents said that they were able to arrange their day as they saw fit. The home has a good range of communal lounges and dining rooms. The activity organisers regularly take groups of residents out in the homes mini bus however it accommodates only one wheelchair user so can be limiting. All those consulted including visitors to the home said that family and friends were actively encouraged to visit. During the inspection, there was a steady stream of visitors to the home. Norewood Lodge DS0000020308.V275203.R01.S.doc Version 5.1 Page 13 Norewood Lodge DS0000020308.V275203.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Staff demonstrated a good knowledge base of adult abuse awareness. Residents, visitors and staff benefit from the homes clear complaints procedure. EVIDENCE: All those consulted said that they would have no hesitation raising concerns with the staff or the Matron. The home has a complaints procedure in place. Visitors to the home remarked that they had quick resolutions to minor issues they may raise. Staff receive ‘Adult Abuse awareness’ training and updates are planned in the next few months. Staff demonstrated knowledge and awareness of adult abuse issues and of where to locate the homes complaints and ‘whistle blowing’ procedures and policies. Norewood Lodge DS0000020308.V275203.R01.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 22, 24 & 26 An ongoing programme of refurbishment and redecoration helps to ensure that residents and their visitors are comfortable at Norewood Lodge. The home is clean and well presented throughout. EVIDENCE: Norewood Lodge is a large purpose built home. It is in a prime location overlooking Portishead with communal areas arranged to maximise residents’ enjoyment of the views afforded there. Staff have worked hard to reduce the impact the size of the home may have on residents by making it welcoming. Resident private rooms are arranged over three floors, two of which have their own communal lounges. Residents are able to choose which lounge area to use. The home has a large dining room and another communal room currently used as a separate, smaller, dining space. A passenger lift offers easy access to all areas of the home. Each room has access to the nurse call bell system. Norewood Lodge DS0000020308.V275203.R01.S.doc Version 5.1 Page 16 There was evidence of an ongoing programme of refurbishment and redecoration. On the day of the inspection a planned and agreed move for a resident to a larger bedroom was underway with the resident, maintenance and care staff all working together moving furniture and putting up shelving to achieve the look the resident wanted. Residents have lockable drawers in their rooms. One resident requested some form of extra lockable storage, which could be fixed to a piece of non-movable furniture. This request was discussed with the Group Operations Manager, who once aware of the request said that this request could be accommodated. The standard of the furniture and decoration is very good. The communal rooms are attractively decorated. Residents with high care needs had specialist mattresses and profiling beds. It was clear from conversations with residents and their relatives that they were comfortable and happy. The home has a good range of mobility aids and hoists. Norewood Lodge DS0000020308.V275203.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 Staffing levels meet the needs of the current residents. EVIDENCE: All the residents and relatives consulted said that the staffing levels were satisfactory. Staff said that they were kept busy, but that they were actively encouraged to spend time with the residents. Duty rotas showed some staff sickness which other permanent staff members ‘backfilled’ to ensure consistency of care. Several staff within the Belmont Care homes group work at the other homes when needed. At the time of the inspection the recent Deputy Matron vacancy had been advertised and arrangements for interviews in place. Norewood Lodge DS0000020308.V275203.R01.S.doc Version 5.1 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 37 Residents and relative’s views are valued and account made of when improvements are indicated. Records are held and maintained safely further account is needed regarding safe storage of care plans on the first floor of the home. EVIDENCE: Quality auditing within the home has included periodic resident questionnaires, security checks, catering and food auditing as well as housekeeping. The minutes of the last resident meeting could not be located during the inspection but these are held at least six monthly. Consultation with residents is included on the completed regulation 26 visits undertaken by one of the homes Directors, generally on a monthly basis. Feedback from residents and relatives about the homes services was positive on the whole. Norewood Lodge DS0000020308.V275203.R01.S.doc Version 5.1 Page 19 The majority of the records are held either within the administrator’s office or Matrons office, both of which are lockable. Care plan records held on the first floor of the home were behind the ‘nurses station’ area for staff to access. However, these records must, when not in use, be housed in a safe lockable area. A fire officer reviewed fire safety in August 2005. The last fire safety training according to the logbook kept was in July 2005. The Group operations manager advised that further training was booked for January. Although standard 38 was not reviewed fully, a portable heater seen on the first floor had not been recently Portable Appliance Tested (PAT). The inspector was advised that this would be taken out of use until it is tested. Norewood Lodge DS0000020308.V275203.R01.S.doc Version 5.1 Page 20 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 3 3 3 3 3 N/A 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 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X 3 X 3 X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X X X 2 X Norewood Lodge DS0000020308.V275203.R01.S.doc Version 5.1 Page 21 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 2 Standard OP18 OP9 Regulation Sch 3(3)(q) 13(2) Requirement Consent for the use of Bed rails must clearly indicate the resident’s name. Recording of whether medication has been administered to a resident must be made. Medication dosages prescribed should be auditable. Care plan records on the first floor of the home to be kept securely. Fire safety training must be undertaken and recorded in accordance with Avon Fire Brigade Guidance. It was noted that training was booked for 24/1/06. Timescale for action 12/03/06 12/03/06 3 4 OP37 OP38 17(1)(b) 23(4) 12/03/06 24/01/06 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 OP7 Good Practice Recommendations Care plans for residents with dementia need to be DS0000020308.V275203.R01.S.doc Version 5.1 Page 22 Norewood Lodge 2. OP38 developed to incorporate more detail. Portable heater to be out of use until noted as safe following a Portable Appliance Test. Norewood Lodge DS0000020308.V275203.R01.S.doc Version 5.1 Page 23 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. 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