Inspection on 10/11/08 for Norfolk House

This inspection was carried out on 10th November 2008.

CSCI found this care home to be providing an Good service.

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

Norfolk House 25/03/08

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Norfolk House 34 Norfolk Street Wigan Lancashire WN6 7BJ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Judith Stanley     Date: 1 0 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Norfolk House 34 Norfolk Street Wigan Lancashire WN6 7BJ 01942495777 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Sharon Marie Macinson Type of registration: Number of places registered: Mr Megraj Jingree,Mrs Premila Jingree care home 18 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The registered person may provide the following categories of service only: Care Home only - Code PC To people of either gender, whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP The maximum number of people who can be accommodated is: 18. Date of last inspection Brief description of the care home Norfolk House is a privately owned care home that offers personal care and support for 18 older people. Norfolk House is a large converted semi detached property situated in the Springfield area of Wigan and is a short drive away from Wigan and Standish town centres. Local amenities are close by including shops, local church, library and health centre. The home offers 10 single rooms and 4 shared rooms, there are no rooms with en suite facilities, however all rooms have a hand basin and bathrooms and toilets are within close proximity to bedrooms and communal areas. There are bedrooms on both floors; the first floor is accessible by passenger lift. There are car-parking facilities at Care Homes for Older People Page 4 of 27 Over 65 18 0 Brief description of the care home the front of the Home and a large enclosed private garden to the rear. At the time of the inspection the weekly fee charged ranges from 322:65 pounds to 360:51 pounds there is no top up fee incurred. Additional charges were made for hairdressing, magazines and toiletries and private chiropody. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection was unannounced and was carried out over a six hour period on one day. The homes manager was available to assist with the inspection. Part of the time was spent in the office looking at information the home holds on residents (care plans) and other records the home needs to keep to ensure the home is being properly run. The inspector spoke with staff and residents during the course of the day and looked around the home. Prior to the inspection the manager was sent an Annual Quality Assurance Assessment (AQAA) form to complete, this tells us what the home does well at and in what areas they need to improve and develop. Comment cards were also sent to staff and residents asking their views and opinions of the home and the services provided. Care Homes for Older People Page 6 of 27 Although their were no added comments on the returned surveys, residents indicated overall satisfaction with the care and support they received. One residents spoken with said, I have no complaints, its a good home and the staff are very kind and caring. Staff comments were positive about the home and one wrote, We keep the residents well and happy and try to meet all their needs. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 27 Care Homes for Older People Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A full assessment is carried out prior to any new resident moving in to the home to ensure that staff can meet their individual care needs. Evidence: The home has a statement of purpose and a service users guide. This information tells people about the home, the staffing structure and the range of facilities and services it offers. This is available to prospective residents and to residents already living at the home. The information is kept in the hallway along with the last CSCI inspection report. We selected two residents care plans to work with during the course of the inspection. We checked the contracts for those residents. Both had a written contract in place. Some of the supplementary information needs to be amended as it refers to the Care Homes for Older People Page 11 of 27 Evidence: National Care Standards Commission and not the Commission for Social Care Inspection. It also indicates that the home will be visited twice a year by inspectors, this is not necessarily the case. Before any new resident moves in to the home the manager carries out a pre admission assessment. This is done at the most convenient place for the prospective resident, either at their home home or at the hospital. The assessment covers residents personal details such as full name, date of birth, next of kin, details of doctors, past medical history, routines of day living, diet, allergies, communication, health and personal care etc. The home is currently offering care to some residents with a dementia related illness. To ensure that staff have the skills to offer the right care for those residents most staff had undertaken training in this specialised area. The manager of the home had recently completed a more advanced course in dementia care and is waiting for her file to be assessed and finalised. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans are clear and provide staff with the information they need to meet the needs of individual residents. Evidence: We continued to work with the two residents files selected. Each resident has two files. One contains the contracts and the administrative records of the resident and the other is the working file that contains the day to day care needs of the residents. Included in the file was personal details such as name, address, next of kin, date of birth, date of admission in to the home, name of doctor etc. The care needs of residents are drawn up from the initial assessment and includes: personal care and hygiene, breathing, communication, elimination, mobility, nutrition, skin tact, rest and sleep patterns and social interests and hobbies. Risk assessments were in place for moving and handling, bathing and nutrition. Risk assessments are regularly reviewed and changes made as required. Supplementary information includes records of bathing and weights. Daily progress notes are also maintained. The full care Care Homes for Older People Page 13 of 27 Evidence: plans were seen to be a few days overdue for the next review. The manager confirmed this would be immediately addressed. The services of opticians, dentists and chiropodist were accessed either at the home or in the community as and when necessary. There was information recorded of doctors and the district nurse and other outside community services. Information on returned residents comments cards confirmed they always received medical support when needed. We looked at the medication for the two residents whose files we were working with. Both residents had been given medication as prescribed and the individual drugs sheets were correct. Medication was securely stored in a locked drugs trolley and any controlled drugs at the home are kept in a proper controlled drugs cabinet. Senior staff administer medication and have undertaken appropriate training in this area. During the inspection, staff were observed to treat residents with respect and consideration. There was a friendly rapport between residents and staff noted. Residents were seen to be clean and well dressed in nicely laundered clothes. For residents in shared rooms privacy screening was available. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The range of activities meet the expectations and capabilities of the residents living in the home. Residents enjoyed the meals and food is nourishing and presented in a way that meets their needs. Evidence: On the day of the inspection, the routines of daily living were observed. It was observed that some residents like to have a lie in where others are up and were having breakfast. Some residents, after meals like to return back to their own rooms and enjoy their own company reading, watching television or listening to music. There are two lounges, however residents have clearly made preferences where they wish to sit and with whom they want to spend their day with. The home has a activities coordinator, who with the help of residents plans a varied range of activities and outings. Some residents are more mobile than others and can walk out to the shops and library, whereas others require more assistance. The ladies said they liked it when the activities coordinator brings her dog in to the home and the recent arrival of a rabbit has proved to be popular with most residents. Other activities include dominoes, bingo, reminiscence and quizzes etc. Activities records are kept for Care Homes for Older People Page 15 of 27 Evidence: all residents. On the day of the inspection one resident was going away on holiday with a friend for a few days. Staff encourage and support residents to maintain links with family and friends and the local community. The home welcomes visits from the local churches. Representatives from the Church of England were at the home on the day of the inspection to offer communion to those who wished to partake. Residents religious preferences were documented in the care plans. The home has groups coming in to entertain. A visit from the Salvation Army and singers from Derian House are planned for the Christmas festivities. Visitors are welcome to visit at any time. On looking at the visitors signing in book it was evident that people visit during the day and evening. There were no visitors to speak with the inspector during the day, however no complaints had been raised by relatives to the home. The menus were available for inspection, which offered a varied choice of nutritional food. Residents have the choice of hot and cold breakfast dishes including: choices of cereal, toast and preserves, cooked breakfast, tea or coffee. Lunch is the main meal of the day and the main choice was corned beef hash, with green beans followed by rice pudding. Alternatives are available at every meal time. As this is a small home the cook will offer a selection of food if residents dont fancy what is being offered. A lighter afternoon tea is served, again choices are available. A choice of hot and cold drinks and snacks are available during the day and residents are offered a choice of supper and drink before retiring. Information on returned comments cards indicated satisfaction about the quality and quantity of the food served. One resident spoken with said, The food is very good, I have complaints. The dining room was comfortable and the owner had recently put down new flooring. Tables were nicely set with appropriate crockery and cutlery, napkins and condiments. Staff were on hand to assist any resident that needed help. The staff know the residents well and know residents like and dislikes, who has a good appetite and who only requires small portions. Care Homes for Older People Page 16 of 27 Care Homes for Older People Page 17 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Protection policies, procedures and effective staff training are in place to ensure that residents are protected from abuse in any of its forms. Evidence: The home has a complaints system in place which gives details of how any complaints or concerns will be dealt with and what the outcomes were. The home has a complaints file where any issues would be logged. There have been no complaints made to the home or to the CSCI since the last inspection. Adult protection policies and procedures were in place. The home has a copy of the local councils adults safeguarding procedure for staff to refer to if needed. All staff at the home had undertaken training in the protection of vulnerable adults, this is updated as required. There had been no safeguarding referrals made since the last inspection. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The standard of the decor within the home is good making this a homely place for residents to live in. Evidence: Norfolk House is well maintained internally and externally. The home has two lounge areas one with an adjoining the dining area. The communal areas are well furnished and well equipped with a television, DVD player and a music centre. The dining/lounge area had recently been fitted with new flooring. Several bedrooms were looked at and were seen to be clean, comfortable and tidy. It was evident that rooms had been personalised with residents own photographs and mementos brought with them from home. On the day of the inspection, which was a cold day, the main lounge area was cold and residents said they felt chilly. We appreciate that the layout of the room is difficult to change, however the big radiator is behind all the residents chairs and a wall unit is in front of the other radiator, therefore blocking the heat from circulating around the room. The boiler had also been turned down, which the manager immediately addressed. All rooms that residents have access to should be heated to the recommended guidelines of 70 degrees Fahrenheit. At the last inspection of March 2008 we asked for the heater in the conservatory to be turned off, removed and Care Homes for Older People Page 19 of 27 Evidence: replaced as this was dangerously hot and could have resulted in someone being burned. At this inspection the conservatory could not be used as no heat was available. The owner is required to provide appropriate heating as this is an area that residents like to use for quiet reflection or private time to spend with their families when they visit. On checking the laundry area, it was discussed that both the washer and tumble dryer had both broken that week. The manager confirmed that the owner was aware of this and had sent for quotes to repair or replace them. All washing was currently being taken to the owners other home, washed, dried and promptly returned as an interim measure. Good hygiene procedures were in place to reduce the risk of cross infection, staff were seen wearing different protective clothing for different tasks. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels were satisfactory ensuring consistency of care for people living at the home. There are enough staff working in the the home to make sure that safe and appropriate support is provided to residents. Evidence: On the day of the inspection staffing levels were sufficient to meet the needs of the residents. A written rota is maintained to show which staff are on duty and at what time of the day or night. Most of the staff group had worked together for a number of years under the same manager. Staff morale appeared good and the staff were happy to help one another out, they seemed happy in their work. The atmosphere in the home between staff and residents is friendly and relaxed, which is evident on entering the home. Domestic staff and catering staff support the care team. Two members of staff cover a waking night shift. The home meets the standard of having at least 50 of care staff qualified to NVQ level 2 or above. Other staff training such as moving and handling, fire awareness, protection of vulnerable adults and food hygiene is completed and updated as required. Care Homes for Older People Page 21 of 27 Evidence: The files of two staff employed were looked at and these were found to contain a written application form, two written references, Criminal Records Bureau (CRB ) check and other forms of identification. It was discussed with the manager that the application form needed to be amended to allow more space for a full school/college and qualification and employment history. Although two written references were on file, the names and address of the referees needs adding to the application form to correspond with the references of the file. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Norfolk House is well run by an experienced, suitably qualified manager and a dedicated staff team that ensures residents needs are fully met and there is an inclusive approach to making the service better. Evidence: The manager has worked at Norfolk House for a number of years and has extensive experience in managing the home. The manager is receipt of NVQ level 4, registered managers award and regularly updates her own skills and training. There is a clear line of accountability in the home which residents and staff are aware off. The manager knows every resident in the home and knows how their needs are to be met. It was observed that residents and staff had no hesitation in approaching her if they had anything to discuss. Internal and external quality assurance systems are in place. Regular staff and residents meetings take place and these are minuted. The home has satisfaction Care Homes for Older People Page 23 of 27 Evidence: questionnaires and is also inspected by an external company RDB who award a star rating, ( RDB has no connection to the CSCI). The owner of the home visits on a regular basis, however the monthly written report he is required by regulation to keep have not been done since August 2008. We have written to the owner requiring him that the monthly report must be available at the home for inspection and for the next six months a copy must be submitted to the CSCI. This was a requirment at the last inspection of March 2008 Some residents have handed over small amounts of money to the manager for safekeeping. We checked the money of the two residents files we had worked with and found that monies were held in separate wallets and balanced with the written records. Health and safety policies and procedures were in place. Equipment and systems used in the home are serviced and maintained and records kept. At the last inspection in March 2008 we checked certificates for the gas, electric, lift and hoists etc, these were seen to be up to date and valid. Certificates will be looked at during the next inspection. The manager works well with the CSCI and informs us of any accidents, incidents or injuries that affect the well being of the resident. Any accidents were properly recorded and kept in the resident care file. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action 1 25 23 The heater in the conservatory must be removed as this was extremely hot to touch and could result in people receiving severe burns. A suitable replacement is required to ensure the temperature in the conservatory is maintained to approximately 70(F. 25/03/2008 2 33 26 The registered provider must 30/04/2008 carry out unannounced monthly visits to the home and compile a written report of his findings. These must be on site and available for inspection. Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action 1 25 23 You must provide heating suitable for residents in all parts of the home which are used by residents. To ensure that all areas of the home are warm and comfortable. 12/12/2008 2 33 26 The Registered Person must complete a monthly written report in accordance with this regulation. To monitor was goes on within the home and to ascertain resident and staff views and opinions. 12/12/2008 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 26 of 27 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - 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!