Inspection on 24/02/09 for Norfolk House

This inspection was carried out on 24th February 2009.

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

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

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Norfolk House Etnam Street Leominster Herefordshire HR6 8AQ     The quality rating for this care home is:   one star adequate 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: Michael Moloney     Date: 2 4 0 2 2 0 0 9 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. that people have said are important to them: They reflect the things 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 Adults (18-65 years) 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 Adults (18-65 years) Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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 Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Norfolk House Etnam Street Leominster Herefordshire HR6 8AQ 01568610663 01568610663 wilhelmina.tymensen@midlandheart.org.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Midland Heart Limited care home 4 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 4 The maximum number of service users to be accommodated is 4. The registered person may provide the following category of service only: Care Home Only (Code PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning Disability (LD) 4 Date of last inspection Brief description of the care home Flat 13 Norfolk House is situated in the Herefordshire market town of Leominster. It is part of a sheltered housing complex that is within easy reach of the town centre shops and other local facilities. The home is situated on the ground floor of the building and each person living there has a bedroom to themselves. There is no outside space available to the people who live in this home other than the car park. It is run by Midland Heart Ltd and is currently without a permanent manager. This home is registered to care for four people with a learning disability. Care Homes for Adults (18-65 years) Page 4 of 26 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: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: A range of evidence was used to make judgements about this service. This includes: information from the provider which included a self assessment document that they are required by law to complete, records kept in the home, medication records, discussions with the staff team, tour of the premises, previous inspection reports and talking with as well as observing the care experienced by people using the service. Care Homes for Adults (18-65 years) Page 5 of 26 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 Adults (18-65 years) Page 6 of 26 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 7 of 26 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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. People who may want to live in this home and their representatives have the information needed to choose a home, which will meet their needs. They have their needs assessed and a contract which clearly tells them about the service the will receive. Evidence: The home was seen to have a Service User Guide that contained the information that people may want if they are thinking about arranging for someone to live there. This is information that must be available by law. The records of a person who had come to live at the home since the last inspection were looked at and these showed that a full assessment of her needs had been carried out before the home manager had decided that it would be a suitable place for her to live. She had then been able to visit for a trial period before it was decided that this home Care Homes for Adults (18-65 years) Page 8 of 26 Evidence: would be somewhere she would like to live. Talking to the person concerned confirmed that this process had taken place. Care Homes for Adults (18-65 years) Page 9 of 26 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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. People who live in this home are involved in decisions about their lives and play an active role in planning the care and support they receive. Evidence: It was seen that the care of the of the two people whose records were looked at had been reviewed on a regular basis. This was confirmed by talking with both the manager and the staff. The care plans were seen to cover a variety of areas of need ranging from self help skills to past-times and interests. These had been identified individually and talking to the people who were in the home at the time of the inspection confirmed that they had been part of that identification and review process. Talking with one of the people who live in the home in particular showed that staff talk to her on a regular basis about what she wants to do each day. Care Homes for Adults (18-65 years) Page 10 of 26 Evidence: Risk assessments and behavioural management programmes were seen to have been developed for a number of the activities so that people could take part in them in as safe a manner as possible. Care Homes for Adults (18-65 years) Page 11 of 26 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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. People who live in this home are able to make choices about their life style and are supported to develop their life skills. Social, educational, cultural and recreational activities meet individuals expectations. Evidence: The records of two of the service users were looked. They were both seen to have detailed care plans that had been developed in a Person Centred style and contained the likes, dislikes and wishes of each individual. Talking to the staff and the manager confirmed that these had been developed by observing which activities the person liked or disliked or asking other people such as friends or relatives for input. Each individual person had been asked and they were able to respond in different ways depending on their communication skills. Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: Weekly activity sheets were also seen in each persons file and looking at these showed that activities take place that are to the liking of the person concerned. These showed that activities arranged by the local authority were attended during the day and at other time attending church as well as discos was also arranged. The home was seen to have a minibus with a tail-lift with which they could transport the people who live in the home to their different activities. During the inspection one of the people who live in this home returned from a holiday in Burnham-on-Sea. Two of the staff had been with him to ensure that his needs were met and he could enjoy himself. Two more staff came in later in the day and they were to take another person away on a similar basis. During the inspection it was seen that each persons daily notes recorded which activity they had taken part in and where appropriate their reactions had been noted. These same daily sheets were seen to contain records of what each person had eaten. Checking these records against individual support plans and talking to the service users showed that people are being offered food that they are known to enjoy and meet their cultural needs. Throughout the inspection staff were seen to treat everyone with dignity and respect and explained what they were doing as they did it. The people that they were talking to gave the impression that they were used to this and expected it. Care Homes for Adults (18-65 years) Page 13 of 26 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: The records looked at showed when each person had either visited or been visited by a healthcare professional, what for and what the outcome was. On the day of the inspection an extra member of staff was on duty to take one of the people who live in the home for their regular treatment at a hospital some distance away. The arrangements for the storage and administration of peoples medication were looked at. Storage was seen to be appropriate and records correctly maintained. No controlled drugs were found to be kept at the home. Staff said that they receive training in the safe handling of medication before they are allowed to give them to people and their records confirmed this. Care Homes for Adults (18-65 years) Page 14 of 26 Care Homes for Adults (18-65 years) Page 15 of 26 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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. People who live in this home are able to express their concerns and have access to a robust, effective complaints procedure, are protected from abuse and have their rights protected. Evidence: The manager confirmed that the home has received no complaints. A copy of the homes complaints procedure was seen and this contained the information someone would need if they wished to raise a problem with the home or its owners. The manager also confirmed that one issue had been referred into the local procedures that are designed to protect vulnerable adults. This had not been related to any problem at this home. Although the level of some of the disabilities of the service users means that they are unlikely to be able to access these formal policies, observation of the staff talking with them and each other indicated that they, the staff, would be aware of any dissatisfaction expressed and it was seen that a whistle blowing policy is available to be used. The manager also explained that some of the service users monies are managed by the home. Full records were seen to be kept outlining any transactions. Care Homes for Adults (18-65 years) Page 16 of 26 Care Homes for Adults (18-65 years) Page 17 of 26 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical design and layout of the home enables people who use the service to live in a safe and well maintained environment but it does not encourage independence. Evidence: This home is an annex at the rear of a sheltered accommodation block called Norfolk House. It was seen to be clean, tidy and odour free. There is no outside communal space other than the car park which staff say is busy and often full as on the day of the inspection. The flat is on the ground floor and has a lounge and a small dining room which contains a small chest freezer and a door to the car park. There are four bedrooms and a small but fully equipped kitchen. This home is equipped with shower rooms, not bathrooms. The home has access to a laundry room which is not in the flat but across the hallway in Norfolk House with whom they share the facility with each organisation having their own machines. Care Homes for Adults (18-65 years) Page 18 of 26 Care Homes for Adults (18-65 years) Page 19 of 26 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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. Staff in the home are trained, skilled and in sufficient numbers to support the people who use the service, in line with their terms and conditions and to support the smooth running of the service. Evidence: At the start of the inspection there were 2 staff on duty as well as the manager. During the inspection others came in to escort people to such things as hospital appointments and holidays. Talking to the staff on duty and looking at the rota showed that this is the usual throughout the day with extra staff being made available as necessary and with one on duty at night. One member of staff had only just started working at the home and she was able describe what training she had been offered and undertaken. She was able to describe her induction as well as foundation training and the mandatory safety training that is necessary for someone working in this type of establishment. All of the staff spoken to said that they have access to a good range of professional training that is chosen to meet the identified needs of the service users. This was confirmed by looking at the training records. Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: By talking with the staff and looking at their records it was also possible to establish that over 50 of the staff team had achieved at least National Vocational Qualification level 2 with a number of them exceeding this. Recruitment files were seen as part of a recent visit to the providers local office and these were seen to contain all of the pre-employment checks that that are designed to show that people wishing to work with vulnerable people are fit to do so. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Management support for this home does not ensure that the needs of the people who live there are met. While checks that ensure the safety of the people who live in this home are carried out there is no record of the proprietor checking this and any other issues. Evidence: This home does not currently have a manager who is registered with the Commission for Social Care Inspection. It is being overseen by a registered manager who runs two other homes within Leominster. The law says that a senior member of the owners staff must carry out formal inspections of the home every month. No record of any visits of this kind could be found within the home. The staff stated that they were only aware of one such visit taking place and that was thought to be in August 2008. Incident records were seen to be kept on each persons file so that managers can look Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: at them to see if there are any trends that could be a cause for concern. A variety of records were seen that showed that safety issues are constantly monitored. Records of such things as fridge freezer temperatures, fire equipment tests, gas safety tests, hot water temperatures and portable appliance testing were seen to have been maintained. Hazardous materials were seen to have been stored in a locked cupboard. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R 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 Care Homes for Adults (18-65 years) Page 24 of 26 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 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 1 39 To make sure that people who live in this home are looked after in a way that they like regular visits by the providers senior managers should focus on how they feel that their needs are being met. These findings should be recorded and available to those people who could use that information to improve the service. Care Homes for Adults (18-65 years) Page 25 of 26 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 © (2009) 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 Adults (18-65 years) Page 26 of 26 - 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!