Inspection on 21/05/07 for Norewood Lodge

This inspection was carried out on 21st May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Norewood Lodge 27/11/07

Norewood Lodge 14/12/06

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 21st May 2007 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.V335954.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.V335954.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 maddalena@tiscali.co.uk 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.V335954.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 14th December 2006 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 65 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 that also enable close links with the local community to be maintained. A minibus is available to take residents to the local shops, or for trips to Portishead 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 £575 - £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 April 2007. Norewood Lodge DS0000020308.V335954.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 5hours on two days. Manager, Mrs Maddalena, was present throughout. The Registered Before the inspection the information about the home was received from the pre inspection questionnaire and comment cards received from 3 residents and 9 relatives. 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 9 residents, 3 relatives, and 3 staff; observation of practices, tour of the premises, review of documents relating to care, recruitment and health and safety; review of policies; inspection of medication records and storage. Of the 12 resident surveys sent 3 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. Comments from residents were “the staff are very friendly and kind”, “the response to the call bell is sometimes slow”. All relatives spoken with felt welcomed at the home and that they were consulted regarding their relatives care and needs. Comments included “the staff are very friendly and welcoming”, “the staff’s kindness and care help my relative to settle in”. Of the 13 relatives surveys sent 9 were returned and all felt that their relatives were well cared for by competent staff. Comments from relatives were “they make the conditions as near home as possible”; “the staff are friendly and caring and the building never smells”; “ we are generally happy with things”. Eight relatives felt they were kept up to date with important issues. Comments about the food provided were variable from “good” to “unimaginative”. 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”; “my care needs are well met”; “it’s a good staff team and we try to provide care that takes account of residents wishes and preferences”. What the service does well: The staff work well as a team and ensure the well-being and comfort of the residents’ and treat them with great respect and kindness. For example 3 residents spoken with said, “the home is lovely, the staff are kind and caring, Norewood Lodge DS0000020308.V335954.R01.S.doc Version 5.2 Page 6 and the food is good.” There is a good rapport between staff and residents and occupancy level are consistently high. Residents live in a very comfortable and homely environment. It is decorated and furnished to a high standard and there are many homely touches. There is strong team spirit and work ethic at the home. Meeting residents’ needs is given priority. There are good communication systems and staff training is encouraged. Residents feel that if they had something to complain about they would speak to a member of staff. Four residents spoken with said they had nothing to complain about. Three residents said ‘the home is very nice’. What has improved since the last inspection? What they could do better: Review, and implement changes to the medication receipt, administration, storage, recording and disposal of medicines for the safety of residents. The home currently has a two-part homely remedies policy to be found in two different areas of the home. It is recommended that these be brought together to ensure that all staff have access to the full information to ensure appropriate administration and safeguard residents. 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. The environment is well maintained, but attention to detail is needed in relation to the small Health and Safety issues around the home, e.g. risk assessments for free standing fans; the use of signs in areas where oxygen is being used and stored. When recruiting staff make sure that all the required safeguards and documentation required have been obtained before employment for the protection of residents. Norewood Lodge DS0000020308.V335954.R01.S.doc Version 5.2 Page 7 The fire training records did not show that all staff have received Fire training at least six monthly. This training should be provided for all staff and clearly documented to evidence attendance. 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.V335954.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.V335954.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 1,2,3,4,5 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. All of the residents’ surveys returned stated 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 Norewood Lodge DS0000020308.V335954.R01.S.doc Version 5.2 Page 10 who are publicly funded receive a copy of the Terms and Conditions document which forms a contract of agreement. The provider is now supplying new residents with clear information about the breakdown of fees, outlining the contributions to be made and by whom, to make up the weekly chargeable amount. 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. One resident who had been recently admitted said that the care was “excellent.” “The staff are very attentive, kind and caring and fully meet our needs”. 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.V335954.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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. 7,8,9,10 Residents benefit from care plans that are well formulated and give clear information to enable staff to meet residents’ health and social care needs. Risks to residents are assessed and actions to minimise these planned, for the safeguarding of residents. The system in place for the management of medicines is poor and potentially puts residents’ at risk. Respect and dignity are well maintained by kind and caring staff. EVIDENCE: Individual records are kept for each of the residents, which include a social history. Three care plans were inspected and all reflected clearly, current identified health and social care needs. Clear actions to meet identified needs were recorded and regular evaluation noted. Two of the three care plans showed resident or relative involvement. This practice needs to be extended to all residents or their relatives. Eight of the nine relatives who returned surveys said they felt “the home communicated well with them”. Visits by the Norewood Lodge DS0000020308.V335954.R01.S.doc Version 5.2 Page 12 dentist, chiropodist and optician were recorded in all of the care plans inspected. In one of the care plans the information about allergies given on the front of the plan did not agree with information given inside the plan, potentially putting the resident at risk. All care plans contained well-formulated risk assessments for Manual Handling, Falls, Nutrition and in two of the care plans for Pressure areas. One of the care plans did not contain information relating a current pressure sore, mentioned in the communication sheet. There was no written plan of care for the treatment of this sore, however staff were overheard, and observed, taking appropriate action to assist in the healing of this. One of the wound care plans did not contain all the relevant information, e.g. size of wound. Attention to detail in recording information is recommended, to ensure well informed, person centred care, is delivered. All other identified risks had been translated into the care plans to meet the needs identified, and reduce the risk. Daily records were up to date and written in a respectful manner. All residents spoken with said, “the staff are lovely”, “I am well looked after”, “I can do what I want when I want”; “they are usually there when I need them”. Two residents said, “staff are sometimes slow to answer the bell”; and one resident felt that staff were not always respectful in their manner of speech to residents. Care practices observed showed caring interactions and good communication skills from staff. Choices and preferences were observed being discussed and offered. Regular audits of Medication Administration Record charts are not undertaken and it is not possible to clearly trace all medication received, administered and disposed of, in the home. An example of this was seen where there was a discrepancy between the number of tablets supplied, administered and disposed of and the number left in the bottle. This is poor practice and potentially puts residents at risk. The home currently has a two-part homely remedies policy to be found in two different areas of the home. It is recommended that these be brought together to ensure that all staff have access to the full information to ensure appropriate administration and safeguard residents. Residents who are self medicating had not signed a form to take responsibility for this. No evidence was available to show how the resident’s competency to self medicate was assessed, for their safety. Norewood Lodge DS0000020308.V335954.R01.S.doc Version 5.2 Page 13 The area where medication is stored is in the centre of the building. Daily temperature checks of the medication fridge are not always recorded to ensure that medication is safely stored. Recent temperature recordings showed them to be within the acceptable range. The temperature of the storage room for medication during the inspection was very warm and a room thermometer showed the temperature to be 27°C. This temperature is above the recommended safe storage temperature, rendering the medication potentially unsafe for residents. It is required that the necessary action is taken to maintain the temperature below 25°C for the correct storage of medicines and the protection of residents. Most products are marked with the date of opening at the time of opening. Hand transcribed prescriptions were seen and these had not been signed by two members of staff when written, thus not providing the recommended safeguard for residents. Stock levels inspected showed poor management with excess for some residents, and ‘out of stock’ for others indicating doses of medication had been missed. Some unexplained gaps on the Medication Administration Record charts were seen. Variable dose prescriptions do not always show the dose administered at any one time. The above practices potentially place residents at risk. Actions to rectify these poor practices are required for the protection of residents, as stated in the last report. All residents spoken with felt that kind and caring staff respected their dignity and privacy. Two residents stating, “they always knock on the door”; and another said they always ask what I would like”. 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.V335954.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 12,13,14,15 Residents are offered the opportunity to participate in a range of activities and enabled to maintain as much independence as possible. 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 home employs two part-time social activity organisers who they share with another nursing home belonging to the company. They collate the current residents preferences regarding activities and incorporate these, where possible, into a program of events. Aiming to ensure that all residents have access to some form of activity if they wish. Residents said that they were able to arrange their day as they saw fit. Spiritual needs are catered for and local clergy visit as requested. resident said they would like more church services to join in. One Norewood Lodge DS0000020308.V335954.R01.S.doc Version 5.2 Page 15 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 most said the food ‘is good’. As can be seen from the survey results in the summary section however there was a mixed response to this important aspect of daily life. One resident on the day was describing to the inspector their perception of the poor food and another said they liked that meal. Another resident praised the meal provided during the inspection. The meal was well presented and appeared well balanced and appetising. In discussions with the manager and cook they are aware of some residents discontent with the food and are in the process of having meeting with residents and reviewing the menus to meet all tastes and preferences. This good practice is to be commended. 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. Norewood Lodge DS0000020308.V335954.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 16,18 Residents are confident that they are listened to and their requests acted upon. Residents are protected from abuse by knowledgeable and competent staff EVIDENCE: The home has a comprehensive complaints procedure that is well displayed and all residents have a copy of. There has been 1 complaint since the last inspection that was resolved satisfactorily by the home. The complaint investigation showed a clear focus on the outcome for the resident and meeting their needs. Staff and residents spoken to, say the manager is very approachable and understanding. Four residents said ‘I’ve nothing to complain about” another resident said, it’s the best home I’ve been in”. A clear record of complaints received with actions taken and outcomes is kept. A comprehensive policy and procedure for responding to allegations of abuse is available, together with the Local Adult Protection (No Secrets in North Somerset) guidelines. The home also has a Whislteblowing policy and staff said they would report any concerns to the manager. Staff said they had never seen any signs of abuse in the home and demonstrated a good understanding of what abuse is. Staff said they have received training in the recognition and handling of abusive situations for the safeguarding of residents. This was verified during inspection of training records. Norewood Lodge DS0000020308.V335954.R01.S.doc Version 5.2 Page 17 Care plans inspected showed that consent for the use of bedrails had been obtained from residents or relatives thus safeguarding choice. Consent for photographic recording of wounds had not been obtained. All residents spoken with said ‘the staff are very kind’; ‘they take time to help me’; ‘I can’t fault them’. Norewood Lodge DS0000020308.V335954.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 19,22,24,26 Residents are provided with homely, safe and comfortable surroundings. The home is clean and well presented throughout The home has suitable equipment to maximise resident independence. Robust Infection Control practices are followed. 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. Environmental risk assessments for free standing fans observed in the corridors of the home were not available. These potentially pose a risk to residents and staff need to be aware of the actions to take to minimise risk. Norewood Lodge DS0000020308.V335954.R01.S.doc Version 5.2 Page 19 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 for the comfort of residents. 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. The home was clean and free from offensive odours throughout. The laundry facilities were well organised. 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.V335954.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 27,28,29,30 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: Copies of two weeks staffing rosters were supplied to the inspector. Staffing levels rostered were sufficient to meet residents’ needs. Most 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”. Four residents said that staff were “usually available” however there are times when you have to wait a bit for staff to answer the bell. Relatives in the survey responses also raised this as a concern. The manager should keep the staffing levels under review against the changing needs of the residents. A sufficient team of ancillary workers supports care 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”. Norewood Lodge DS0000020308.V335954.R01.S.doc Version 5.2 Page 21 Recruitment procedures are not always robust. One of the three files inspected showed that a member of staff had been working unsupervised prior to the return of her Criminal Record Bureau check. The member of staff when interviewed verified that this had been the case. This potentially puts residents at risk. 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. The home has recently commenced using the Common Induction Standards. The home provides in house mandatory training with clear records of attendance and renewal dates. Records inspected showed that 2 members of staff had not received training within the requisite period. Staff should receive fire training every 3-6months. Staff interviewed spoke of regular fire training and drills to ensure their ability to deal with the situation should it occur. Four residents told the inspector they “feel safe with the staff”. what they are doing”. They know Norewood Lodge DS0000020308.V335954.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 31,32,33,35,36,37,38 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.V335954.R01.S.doc Version 5.2 Page 23 Quality assurance processes are in place and ongoing audits of aspects of the homes quality are completed. The results are fed back to residents and relatives at meetings where they are discussed and used to inform the ongoing service provision. 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 and all receipts were present, to enable a full audit of monies received and spent on behalf of residents. Staff interviewed spoke of regular supervision every 2 months to ensure they have the knowledge and skills to meet resident’s needs. . Records inspected indicated regular safety and fire checks are carried out. Staff spoken to confirmed that regular fire instruction and drills had taken place. There were no signs displayed to show that one resident’s room contained an oxygen cylinder. It is recommended that an international sign is obtained and displayed. 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. Recommendations raised by these professionals are responded to in a timely manner. Norewood Lodge DS0000020308.V335954.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 3 4 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 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 4 17 X 18 2 3 X X 3 X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 3 3 Norewood Lodge DS0000020308.V335954.R01.S.doc Version 5.2 Page 25 YES 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 Requirement The arrangements for the management of medicines recording, handling, safekeeping, safe administration and disposal of medicines received into the care home must be reviewed to provide a safe system for the protection of residents. Previous timescale of 31/01/07 not met. An Immediate Requirement notice was issued. Timescale for action 14/06/07 2 OP9 13.2 Residents who are self25/06/07 administering medications should be assessed as competent to do this, and sign to take responsibility. 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 Norewood Lodge DS0000020308.V335954.R01.S.doc Version 5.2 Page 26 1 OP7 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. Hand transcribed medication to be verified by two signatures to safeguards residents and provide accountability. To obtain consent from residents for photographic records of wounds. To provide environmental risk assessments for all potential hazards to residents within the home. To ensure that all relevant checks are completed, and recorded, prior to staff commencing employment. To ensure attention to detail in all record keeping for the provision of clear and full information, to residents, relatives and staff. 2 OP9 3 4 5 OP18 OP19 OP29 6 OP37 Norewood Lodge DS0000020308.V335954.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Taunton Local Office 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.V335954.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!