Inspection on 14/12/06 for Norewood Lodge

This inspection was carried out on 14th December 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 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 12/01/06

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 Patricia Hellier Unannounced Inspection 14th December 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.V316272.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. Norewood Lodge DS0000020308.V316272.R01.S.doc Version 5.2 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.V316272.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. May accommodate up to 48 persons aged 65 years and over who require nursing care of which 6 may be aged 50 - 65 years or above. 2 named residents of the 6 are aged between 45 - 50 years. 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 Brief Description of the Service: Norewood Lodge is a purpose built home providing 48 beds for residents requiring nursing care. The category of registration is for 46 persons over 50 years of age, and for 2 young physically disabled persons. It is situated in an urban area and surrounded by attractively maintained grounds. The building and décor is of a high standard providing a comfortable and homely environment. Accommodation is provided in both single and double rooms over three floors, with a passenger lift giving easy access to all floors. There are 36 single rooms, and 6 double rooms, all with ensuite facilities. All rooms have a call bell system. There is a large open dining area and two comfortable lounges. One lounge area can be used for receiving visitors or for family celebrations. Provision is made within the home for a variety of activities and outings which also enable close links with the local commumity to be maintained. A minibus is available to take residents to the local shops, or for trips to Potishead or the surrounding countryside. The provider makes information available through a company leaflet and service specific booklet about the home. CSCI reports are displayed in the entrance to the home and available for all to read. The fess range from £550 - £850 per week with additional charges being made for hairdressing, chiropody, newspapers, escorts, toiletries, use of minibus and social therapy entrance fees. This information was provided in October 2006. Norewood Lodge DS0000020308.V316272.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection took place over 7.5 hours with the manager present throughout. Before the inspection the information about the home was received from the pre inspection questionnaire and comment cards received from relatives, residents, and Health Care Professionals that visit the home. The last inspection report was reviewed and all correspondence since the last inspection. The accumulated evidence for this report comes from the above and also fieldwork that included the following: - discussions with 10 residents, 4 relatives and 7 staff; observation of practices, tour of the premises, review of documents relating to care, recruitment, health and safety; review of policies; inspection of medication records and storage. Of the 7 resident surveys sent 5 were returned and all were satisfied with the care they received. All said the home is clean and fresh, and that they would know who to speak to if they were unhappy. One of the 5 felt the staff were sometimes very busy, and thus there was a delay in call bells being answered. From the 10 relatives’ surveys sent, 7 were returned. All 7 felt welcomed at the home and that they were consulted regarding their relatives care and needs. 5 of the 7 stated they were satisfied with the overall care of their relatives; saying ‘very happy with the care and support provided’, ‘a friendly and caring atmosphere’, ‘staff listen and are responsive to comments’. 1 respondent was not satisfied at all with the care given. The manager was concerned by this and was sorry that the respondent had not made their concerns known to the home as well as to CSCI. Another felt there is poor nutritional monitoring. 2 of the respondents said they felt there is a lack of staff at times. One relative said ‘I am satisfied with the care, but angry about the fees’. Surveys were sent to 8 Health Care Professionals that visit the home and 1 was returned. The respondent felt that the care given is good, and had not received, or heard, any complaints about the home. All residents and staff spoken with told the inspector that the home was very good and the staff very kind. Comments received were “it is very homely and comfortable”; “I would recommend it to anyone”, “my care needs are well met”. Norewood Lodge DS0000020308.V316272.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Provide a clearly documented breakdown of fees showing how the free nursing care contribution fits into the charges. Review, and implement changes to the medication receipt, administration, storage, recording and disposal of medicines for the safety of residents. Norewood Lodge DS0000020308.V316272.R01.S.doc Version 5.2 Page 7 Pay greater attention to detail in record keeping ensuring that all details are clearly recorded for the safety and benefit of residents, including signatures for purposes of agreement and accountability of records made. When recruiting staff make sure that all the required safeguards and documentation required have been obtained before employment for the protection of residents. Provide a formal system of supervision for staff every 2 months to ensure that they have the skills and knowledge to meet residents’ needs. 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. Norewood Lodge DS0000020308.V316272.R01.S.doc Version 5.2 Page 8 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.V316272.R01.S.doc Version 5.2 Page 9 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): 1,2,3,4,5 (6) does not apply Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Statement of Purpose and Service User Guide is comprehensive and provides prospective residents with information to make an informed choice. The home’s assessment process is thorough and ensures that it is able to meet residents’ needs. Prospective residents and relatives are encouraged to visit the home to assess suitability. EVIDENCE: Residents are provided with a comprehensive Service User Guide containing the Statement of Purpose and all the information required to ensure they or their relatives have access to the relevant information at all times. 1 of the 5 resident surveys returned stated they had not received a contract of residency, and 2 did not know if they had received a contract of residency. Resident files inspected showed that all privately funded residents receive a contract of Conditions of Admission and Terms of Business, and those who are Norewood Lodge DS0000020308.V316272.R01.S.doc Version 5.2 Page 10 publicly funded receive a copy of the Terms and Conditions document which forms a contract of agreement. While fees are mention in these documents the breakdown of fees, outlining the contributions and by whom, to make up the weekly chargeable amount, are not clearly stated. This is recommended as outlined in the recent ‘Fair Price for Care’ report. Care needs are well met through a full assessment process and the completion of a care plan from this information. The assessment includes all the elements listed in the standard. A comprehensive assessment was seen for 2 relatively new residents to the home. The residents when spoken to said, “the staff are wonderful, they look after me well”. “The staff are very helpful and have accommodated my requests for a different room.’’ “I am very happy here and couldn’t ask for more”. Social services care plans had been obtained where relevant. Care practices observed showed that staff were fully aware of the residents needs as stated in their assessments. Norewood Lodge DS0000020308.V316272.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents benefit from care plans that are well formulated and give information to enable staff to meet residents’ health and social care needs. Personal and environmental risks are well managed. The systems in place for the management of medicines are good. Respect and dignity are well maintained by kind and caring staff. EVIDENCE: Individual records are kept for each of the residents, which sometimes include a social history. Four care plans were inspected and 2 reflected clearly current identified health and social care needs. Two care plans did not have social histories thus making it difficult for care staff to fully understand and meet resident’s social care needs. The manager said that obtaining this information from relatives can be difficult. None of the care plans had a record to show if the resident suffered from any allergies, or not. One care plan contained good records and forms for pressure sore / wound monitoring, however the dimensions of the wound were not recorded making it difficult to clearly document improvement or further breakdown. All care records inspected had Norewood Lodge DS0000020308.V316272.R01.S.doc Version 5.2 Page 12 gaps in documentation and attention to detail in recording information is recommended, to ensure well informed, person centred care is delivered. Clear actions to met identified needs were recorded and regular evaluation noted. Two of the four care plans showed resident involvement. This practice needs to be extended to all residents or their relatives. All care plans contained well-formulated risk assessments for Manual Handling and falls. Other personal and environmental risk assessments were present to ensure the safety of the resident while promoting independence as able. Daily records were up to date and written in a respectful manner. Care practices observed showed caring interactions and good communication skills from staff. Choices and preferences were observed being discussed and offered. One resident said ‘they always do things the way I like, and if I want to get up later they let me’. Regular audits of Medication Administration Record charts are undertaken since the last inspection. The most recent ‘in house’ audit, completed at the end of November, showed that there were stock discrepancies and it has not been possible to clearly trace all medication received, administered and disposed of, in the home. This is poor practice and potentially puts residents at risk. No homely remedies were seen on the Medication Administration Record Sheets or in the drug book entries sampled. The Homely Remedies policy is clear, but is not dated for review purposes, and was not signed by the local GP’s to demonstrate their agreement with it. However the manager has informed the inspector that individual letters regarding this are available. The lunchtime medication routine observed was safe and complied with the guidance. Residents who are self medicating had signed a form to take responsibility for this. In the policy file a competency assessment form was seen, but this did not show how the resident’s competency to self medicate was assessed, for their safety. The assessment form requires review and updating for the safety of residents. All residents spoken with felt that kind and caring staff respected their dignity and privacy. Three residents stating, “they always knock on the door”. The home has an Equality and Diversity policy that recognises the cultural and social needs and differences that are present in society. In discussion with the manager and staff these issues have not yet arisen within the service provision. Both management and staff demonstrated clear knowledge and desire to meet cultural and diversity needs as and when they should arise. Norewood Lodge DS0000020308.V316272.R01.S.doc Version 5.2 Page 13 Resident’s wishes following death were well recorded, and staff interviewed showed knowledge of residents’ wishes. There is a clear policy in place to protect resident’s wishes while maintaining professional duties. Norewood Lodge DS0000020308.V316272.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The quality outcome in this area is good. Social activities and meals are both well managed, creative and provide daily variation and interest for people living in the home. Residents right to choice and control over their lives is well respected, and encouraged. Autonomy and personal choice is promoted via advocacy services helping residents to maintain independence. Friendly staff always welcomes relatives and visitors EVIDENCE: An excellent range of activities is provided with posters displaying information of forthcoming events throughout the home. Residents spoken with said, “we have plenty of choice and variety”. One resident said, “the activities are marvellous”. The activities organisers work hard to provide a varied programme with activities that will appeal to all. Resident survey responses showed that most people feel that there are usually, or always, activities arranged that they could take part in. Norewood Lodge DS0000020308.V316272.R01.S.doc Version 5.2 Page 15 One area of the main lounge is being set up with a computer for residents’ use. The home plans to help residents that wish, to set up an e-mail account for them so that they can receive news and photographs from relatives that live some distance away. The home is to be commended for this idea in enabling residents’ social interactions. Spiritual needs are catered for and local clergy visit as requested. Several visitors were seen coming and going during the inspection. Relatives spoken with said they could come any time and felt that their relatives were well looked after by friendly staff. One relative said, “the staff are so patient and residents never look untidy or uncomfortable”. A number of people living in the home were spoken to about the food and all said the food ‘is good’. Many said they “ like the meals, and the choices offered”. At lunchtime choices of both main course and desert were seen being offered, and meals tailored to resident’s preferences. Menus showed a varied, healthy and nutritious diet. Good practice was observed in staff assisting residents with their food. Staff should be aware of how they describe this assistance, to maintain respect and dignity for residents. E.g. staff were overheard saying, “she needs feeding”, rather than ‘helping with her food’. Written records also showed this disrespectful language. The kitchen is clean, tidy and well organised. A recent inspection by the Environmental Health Officer (Food) deemed the home to be of good standard. The dining room is homely and tables well presented. Good practice was observed in the dining room where care staff were helping residents with their meal. Norewood Lodge DS0000020308.V316272.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are confident that they are listened to and their requests acted upon. Knowledgeable and competent staff protect residents. EVIDENCE: The home has a comprehensive complaints procedure and all residents receive a copy on admission. All relatives and residents spoken with were aware of the complaints policy. There has been one complaint since the last inspection, which is recent and is currently being investigated by the manager. All residents stated that if they were not happy about anything they would speak to the manager. The resident who made the recent complaint said she felt confident that it would be sorted out. Staff and residents spoken to, say the manager is very approachable and understanding. One service user said ‘I’ve nothing to complain about, it’s a lovely home”. A record of complaints received, with actions taken and outcomes is kept to show residents are responded to, and the information used to inform the running of the home for the residents’ benefit. The home has a copy of the North Somerset ‘No Secrets’ guide and a local abbreviated policy/procedure for the home specifically for responding to allegations of abuse. Staff said they had never seen any signs of abuse in the home and demonstrated a good understanding of what abuse is. Staff have received training in the recognition and handling of abusive situations for the Norewood Lodge DS0000020308.V316272.R01.S.doc Version 5.2 Page 17 safeguarding of residents. Care plans inspected showed that consent for the use of bedrails and recliner chairs had been obtained from residents or relatives thus safeguarding choice. All residents spoken with said ‘the staff are very kind’; ‘they take time to help me’; ‘I can’t fault them’. Norewood Lodge DS0000020308.V316272.R01.S.doc Version 5.2 Page 18 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): 19,22,24,26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are provided with homely, safe and comfortable surroundings. Outdoor space is attractive and accessible for residents to enjoy. The home has suitable equipment to maximise resident independence. Robust Infection control practices are followed. EVIDENCE: The home is purpose built, light, airy and furnished to a good quality. It is arranged over three floors with a passenger lift to enable access. The property is well maintained, with homely and comfortable communal spaces. The living accommodation is well decorated and homely. Residents’ rooms are personalised and comfortable. All rooms are provided with ensuite facilities. The décor, fixtures and fittings are in excellent order. Maintenance and refurbishment plans and records are kept, to ensure the homes’ environment is maintained at a high standard. Norewood Lodge DS0000020308.V316272.R01.S.doc Version 5.2 Page 19 The home has grab rails situated at relevant points and a shaft lift that is easily used to assist resident mobility, and aid independence within the home. All resident rooms are provided with a lockable space for securing personal possessions, if desired, and door locks that are accessible to staff in an emergency. The home was clean and free from offensive odours throughout. The laundry facilities were well organised. The practice of keeping sealed laundry bags, with soiled linen, in a corridor in the home for up to 48 hours is not good infection control practice. It is recommended that this practice is reviewed and bags stored away from the residential area. Staff interviewed and observed demonstrated good understanding of Infection Control procedures and practices and maintained a clean and hygienic environment. The home has good facilities for ensuring that staff can maintain good hand washing practices, between caring for residents. Norewood Lodge DS0000020308.V316272.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s staffing levels are sufficient to manage the care needs of residents. The procedures for the recruitment of staff are not always robust to provide the safeguards required for residents’ protection. Staff access external training to ensure training is matched to the residents needs. EVIDENCE: Staff went about their duties in an unhurried manner and were observed spending time talking with residents. Residents reported, “staff make time for a chat when they can.” Staff approached residents with directness, openness and consideration. Each of the resident’s with whom the inspector spoke said, “how nice the staff are”. Copies of two weeks staffing rosters were supplied to the inspector. Staffing levels rostered were sufficient to meet residents’ needs. Half of the residents spoken with told the inspector “staff are always there when you need them”; “ you only have to ring the bell and they come”. The other half said that staff were, “usually available” however “there are times in the evenings and at weekends when you have to wait a bit for staff to answer the bell”. The manager should keep the staffing levels under review against the changing needs of the residents. A sufficient team of ancillary workers supports care Norewood Lodge DS0000020308.V316272.R01.S.doc Version 5.2 Page 21 and nursing staff to ensure the smooth running of the service. The home has a Key Worker system in place for all residents. Residents and staff were aware of the role and said, “it worked well”. A few of the staff team employed at the home are from overseas. Residents and staff said, “they fit into the team well”. The home supports staff from overseas to attend college, to develop their language skills. Recruitment procedures do not always ensure that all the necessary safeguards have been completed for the protection of residents. Of the four files inspected, one for a recent employee did not contain any references; another had references but these were not dated. All staff interviewed stated they had contracts of employment and job descriptions. Newly appointed staff confirmed they had completed an induction programme and evidence of this was seen in personnel files. The home employs a trainer to provide mandatory training. All induction training is provided ‘in house’ and specialist training, e.g. Care of the Elderly, Diabetes, is accessed from the local Primary Care Trust and outside providers. A training plan was seen, however written evidence of staff attendance at training, was not always present. Interviews with staff verified they had completed a wide range of courses, which correlated with the training plan. Norewood Lodge DS0000020308.V316272.R01.S.doc Version 5.2 Page 22 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): 31,32,33,35,36,37,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager provides clear leadership and guidance to staff to ensure residents receive consistent care in a safe environment. Quality assurance processes in the home are formal demonstrating that the home consults with residents, families and visiting professionals. Health and safety issues are monitored in the home to ensure that issues are identified and addressed where they arise. EVIDENCE: The manager gives clear leadership, guidance and direction to staff. Residents feel she is approachable, available and seeks to ensure all their needs are met. Staff interviewed stated that they felt well supported by an approachable manager. Norewood Lodge DS0000020308.V316272.R01.S.doc Version 5.2 Page 23 A formal quality assurance tool was available for inspection in order to demonstrate that the home consults with residents, and that comments from them are acted upon. Feedback to residents and relatives is provided through the displaying of results, and discussion of these at residents / relatives meetings. The results are also discussed at staff meetings to inform practice and implement changes for the benefit of residents’ health and well being. Residents and relatives told the inspector that they were always encouraged to express their view and “to air the grumbles”. One resident said “they always do something about a grumble if you tell them”. The management of resident monies by the home were inspected. Small amounts of cash are held for some residents for the purchase of toiletries and the hairdresser. Monies inspected tallied but not all receipts were present, to enable a full audit of monies received and spent on behalf of residents. This is recommended. For one resident the home holds a larger sum of money and this is paid into the company account. This is not in accordance with the regulations and an alternative arrangement should be made to safeguard the resident. Supervision for staff takes place on an ad hoc, informal basis during the year culminating in an appraisal. Staff interviewed said ‘supervision does take place every six months’, but were not aware of formal records. Records inspected for supervision were minimal. A more formal system of supervision, six times a year, should be implemented to ensure staff have received the knowledge and skills to meet residents’ needs. Staff interviewed confirmed that informal supervision takes place every 3-4 months when they are working with a senior member of staff. Records inspected indicated regular safety and fire checks are carried out. Staff spoken to confirmed that regular fire instruction and drills had taken place. A number of staff have received First Aid training. Records indicating regular maintenance to gas and water systems were seen, together with servicing records for all equipment. Norewood Lodge DS0000020308.V316272.R01.S.doc Version 5.2 Page 24 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 2 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 3 11 3 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 3 18 3 3 3 X 3 X 3 X 2 STAFFING Standard No Score 27 3 28 X 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 1 2 2 3 Norewood Lodge DS0000020308.V316272.R01.S.doc Version 5.2 Page 25 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 OP9 Regulation 13.2 Timescale for action The registered person shall make 31/01/07 arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. This relates to the need to have a clear audit trail of medicines entering and leaving the home. 31/01/07 The registered person shall not pay money belonging to any service user into a bank account unless(b) the account is not used by the registered person in connection with the carrying on all management of the care home. This relates to the one resident whose monies are paid into the company account Requirement 2 OP35 20.1 (b) Norewood Lodge DS0000020308.V316272.R01.S.doc Version 5.2 Page 26 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 OP2 Good Practice Recommendations Contracts of residency need to clearly state the fees to be paid, showing a breakdown of what is to be paid to make up the weekly rate, and by whom. All care records to contain a social history to enable residents’ current social care needs to be recognised and actions identified to meet these needs. Attention to detail in recording information on all care records to be sure that full and clear information is available to provide care that meets resident’s health and social care needs. A review of the self-medication assessment/consent form to demonstrate how competency assessment has been made. Respectful language should be used when referring to assisting residents with their food. Laundry bags containing soiled linen should be stored in a safe place away from residential areas of the home. To ensure that all relevant checks are completed, and recorded, prior to staff commencing employment. To ensure that supervision is formally provided six times a year and clearly documented. To ensure attention to detail in all record keeping for the provision of clear and full information, to residents, relatives and staff. 2 OP7 3 OP7 4 5 6 7 8 9 OP9 OP15 OP26 OP29 OP36 OP37 Norewood Lodge DS0000020308.V316272.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Norewood Lodge DS0000020308.V316272.R01.S.doc Version 5.2 Page 28 - 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!