Inspection on 29/11/06 for Norfolk House

This inspection was carried out on 29th November 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Norfolk House 26/07/06

Norfolk House 02/06/06

Norfolk House 31/10/05

Norfolk House 25/04/05

Norfolk House 23/11/04

Norfolk House 07/06/04

Norfolk House 15/01/04

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Norfolk House 39 Portmore Park Road Weybridge Surrey KT13 8HQ Lead Inspector Mavis Clahar, Lesley Garrett Key Unannounced Inspection 29th November 2006 09:00 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 Norfolk House DS0000017628.V321829.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. Norfolk House DS0000017628.V321829.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Norfolk House Address 39 Portmore Park Road Weybridge Surrey KT13 8HQ 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) 01932 820300 Ashbourne Homes Limited Mrs Elizabeth Werrett Care Home 76 Category(ies) of Old age, not falling within any other category registration, with number (76), Physical disability over 65 years of age (3) of places Norfolk House DS0000017628.V321829.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 52 beds providing nursing care for elderly people from the age of 60 years. 24 residential beds including up to three service users in the category PD(E). 1 person aged 56 years or above may be admitted for short term convalescent residency at any time. 26th July 2006 Date of last inspection Brief Description of the Service: Norfolk House is a purpose built home situated in central Weybridge, providing nursing and personal care to seventy-six older people. Accommodation is provided over three floors, with six spacious lounges and, three dining rooms. The majority of the bedrooms are single with a few double rooms. All bedrooms have en-suite facilities. Passenger lifts and stairs serve the first and second floors. The home is served by good transport system, the railway station is close by, and the home is easily reached from junction 11 of the M25. The home has its own transport in the form of a mini bus in which service users can enjoy visits to many of the local attractions such as Hever Castle, Polsden Lacey and Gamshaw mill. To the rear of the property is a large garden with patio area, whilst the front of the property is laid out for car parking. Fees at this home are in the range of £635.00 to £950.00 per week. Norfolk House DS0000017628.V321829.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced site visit, which forms part of the home’s key inspection was undertaken by Mrs Mavis Clahar and Mrs Lesley Garrett regulation inspectors, on 29th November 2006. The site visit lasted for seven and three quarter hours, commencing at 08:35 hours and concluding at 16:20 hours. The first part of the visit was spent in discussion with the new manager who has been in post since 10/10/06. The format of the inspection was discussed and agreed, followed by discussion and clarification of information contained in the pre inspection questionnaire. The second part of the inspection was spent visiting and discussing with service users and staff, observing care workers and service users interaction, and observing the lunch time activities. Service users were enthusiastic about their home and some said they had seen an improvement in staffing and care since the new manager has been in post. Service users said they enjoyed their lunch and care workers were observed to be attentive providing assistance where needed but not being intrusive. A tour of the home and gardens was undertaken and it was pleasing to see the service users bedrooms were kept in very good condition. The rear garden is laid mainly to lawn with seating strategically placed for the use of the service users. All records sampled were up to date with care plans being signed by the service user/relative The inspectors would like to thank all the service users, care workers who made the visit so productive and pleasant on the day. What the service does well: The home has completed the requirements and recommendations made on the last inspection. Service users and care workers spoke highly of the care and support provided by the home. They all said they could see an improvement since the new manager has been in post. One service user said, “The manager listens to what we have to say and then she speaks with the top people”. Service users spoken to on the day of the inspection rated the personal care they receive at the home as very good. Service users unanimously said, “We are treated with respect”. They said the staff team are friendly. Service users were complimentary about the level, quality and amount of activities the home supplied. They informed the inspectors that they have an Norfolk House DS0000017628.V321829.R01.S.doc Version 5.2 Page 6 activities co-ordinator but she is not on duty today. The homes’ manager and the duty roster supported this statement. The manager informed the inspectors that suitable activities were planned for the day and the care workers would undertake these with the service users. The home has strong links with the Church f England (C/E) Church and the Roman Catholic (R/C) Church. Services of both denominations are held regularly and some service users mostly from the residential part of the home attend church in the local community. Service users commented positively on their meal. What has improved since the last inspection? What they could do better: A recommendation was made to ensure all service users have the appropriate tools to aid good dietary intake. Norfolk House DS0000017628.V321829.R01.S.doc Version 5.2 Page 7 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. Norfolk House DS0000017628.V321829.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 Norfolk House DS0000017628.V321829.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): 3.6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good information was obtained from prospective service users prior to their admission into the home, which ensured needs, were fully assessed and identified Skilled and competent staff at the home carries out all pre admission assessments Standard six does not apply to this home. EVIDENCE: Where the assessments have been undertaken through care management arrangements the manager stated the she insists on receiving a copy of the Norfolk House DS0000017628.V321829.R01.S.doc Version 5.2 Page 10 care plan. This allowed for care workers and service users to make informed decisions regarding the planning and delivery of care. Random sampling of service users files, care plans and daily work sheet, and along with selected case tracking has demonstrated the homes ability to assess service users needs. This was supported by discussions with the manager, the key worker and the service user themselves. Discussions with care workers have shown that they have the knowledge suitable to meet the care needs of the service users in their care. Norfolk House DS0000017628.V321829.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a good and clear care plan in place for service users, which also includes appropriate risks assessments. This forms the basis for care based on the agreed care needs of the service users and demonstrated that health and personal care needs were met. Care staff receives training to meet the assessed care needs of the service users ensuring that competent staff supports service users and their health and care needs are met. The home’s medication policy on receiving, storing and administering and return of medication was in place and being adhered to thereby ensuring the safety and protection of the service users. Care workers are aware of the need to treat service users with respect and to maintain their dignity and privacy when delivering personal care Norfolk House DS0000017628.V321829.R01.S.doc Version 5.2 Page 12 EVIDENCE: The randomly selected care plans which were reviewed regularly were clear and easy to read, identifying risks to service users. The daily work sheet along with discussion with service users demonstrated that service users care needs are met according to the agreed plan of care. The inspector observed the administration of medicines to service users in accordance to the homes policy on administration of medicines, the Medicines Act 1968 and the Nursing and Midwifery Council (NMC) Standards for administration of medicines. One service user at the time of inspection was responsible for their medication and there was suitable risk assessment in place for this service user. Good clear records are kept of medication received, stored and returned. A list of care workers trained and considered competent to administer medication was available for review. Service users spoken to on the day of the inspection rated the personal care they receive at the home as very good. Service users unanimously said, “We are treated with respect”. They said the staff team are friendly and they attend all appointments by the home’s transport and is always accompanied by their carer unless their relatives are accompanying them. Norfolk House DS0000017628.V321829.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users lifestyles matched their needs and preferences and where possible they are able to maintain contact with family, friends and the local community. Service users are able to make choices in accordance with their abilities and were provided with balanced diet in pleasant surroundings and in an unhurried way. EVIDENCE: The home employs an activities co-ordinator who provides a full programme of activities on a one to one basis, in small groups of two or four and in larger groups, thereby enabling every one to pursue their chosen activity. Service users lifestyles matched their needs and preferences and where possible they are able to maintain contact with family, friends and the local community. The C/E Vicar holds regular monthly services at the home, and those service users who are able attends Church in the community. Norfolk House DS0000017628.V321829.R01.S.doc Version 5.2 Page 14 Although on the day of the visit the inspector did not meet with any relatives or visitors to the home but a review of the visitors’ book indicated the home regularly has visitors to service users. Service users spoken to on the day of the visit were complementary about their home, the care they receive and their lifestyles in the community and the choices and variety of meals. During the June 2006 inspection one service user expressed a wish for more vegetables and this was discussed with the Chef, who promised to purchase vegetable tureens for each table so that service users in the residential part of the home could help themselves. The inspectors were informed that this has not happened. In discussion with the manager of the home, she has indicated that the catering arrangements were currently under review and this aspect of care would be given high priority. Service users said they enjoyed the meal, and in discussions with the Chef it was apparent she was knowledgeable about the dietary needs of the service users and prepared their food to their tastes. There is always a choice of two hot meals per day at lunchtime, or a salad, or the service users can choose their own food such as an omelette. It was observed that both dining rooms were appropriately laid out for the mid-day meal, and that service users were in appropriate seats. Each service user in both dining rooms were offered napkins, and where it was necessary food guards and suitable cutlery and utensils were available and used by the service users. However, it was observed that one service user being served their meal in their bedroom was not offered napkins or suitable utensils to ensure service user could eat their meal in comfort. A recommendation was made on this standard. Norfolk House DS0000017628.V321829.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints policy and procedure and training in place that evidenced that service users and relatives concerns are listened to and acted upon. Robust Safeguarding adults’ policies are in place to protect the service users from abuse. EVIDENCE: CSCI Eashing office has received one complaint about this home since the last inspection. Some matters of concern have been pursued under the local authority safeguarding adults’ procedures and appropriate actions have been taken by the service provider to promote the safety and welfare of service users. Complaints received at the home are logged with their outcomes. This demonstrated that service users and relatives complaints are taken seriously and are dealt with within the company/s time frame. Service users spoken to said they knew how to complain if there was a need to do so. Random sample of staff training files and discussion with staff evidenced that staff are being trained to recognise and report any act or suspicion of abuse to service users. The manager supported this by the production of the staff training matrix which evidenced that staff receive yearly training in the Norfolk House DS0000017628.V321829.R01.S.doc Version 5.2 Page 16 safeguarding of adults (protection of vulnerable adults) to remind them of their duty of care to the service users living at the home. The home had a number of compliment cards and letters from service users’ relatives thanking the staff for the care their relative received whilst being at the home. Norfolk House DS0000017628.V321829.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a well-maintained environment, which provides aids and equipment to meet the care needs of the service users. It is a pleasant and safe place to live with a good standard of hygiene evident. EVIDENCE: The home operates within its planned programme of refurbishment and maintenance. The manager stated that bedrooms are redecorated as soon as they become vacant. The dining rooms have been redecorated with new flooring in place. The home presents as comfortable with good ventilation. There is good wheel chair and pedestrian access to the garden, which is laid mainly to lawn with seating available. One service user said, “I try to go out as much as possible weather permitting. We tend to use the garden mostly when the weather is good. Not too hot”. It was observed that service users were able to Norfolk House DS0000017628.V321829.R01.S.doc Version 5.2 Page 18 personalise their bedrooms with small items of furniture, paintings hanging on the wall and many family photographs. Water temperatures were regularly tested by the service provider to ensure they were in a safe range. Generally, the home presented as clean, safe, pleasant, hygienic and free from offensive odours. Norfolk House DS0000017628.V321829.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Skilled and competent staff were observed to be on duty in sufficient numbers to meet the service users needs. The service recruitment policy is adequate and supports and protects the safety of service users Care workers are trained and competent to do their jobs. EVIDENCE: The staff rota demonstrated the number and grade of staff on duty to provide care and attention to service users for any twenty-four period was adequate to meet the assessed care needs of the service users. Over 65 of care workers have attained the National Vocational Qualification (NVQ) Level 2 qualification with two care workers achieving NVQ Level 3 and one is in the process of completing NVQ Level4 in care. The registered manager is in possession of the Registered Managers Award (RMA). Review of care workers files demonstrated that care workers had regular and up to date training to enable them to fulfil their roles. Norfolk House DS0000017628.V321829.R01.S.doc Version 5.2 Page 20 A random review of care workers files found that the home complied with the regulation regarding employment of staff to work in care homes. Records contained evidence that care workers attended all training offered. Recruitment to the home is through a process of equal opportunity, and in accordance with the code of conduct and practice set by the General Social Care Council (GSCC). All care workers have Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) checks prior to commencing employment, and they are in receipt of terms and conditions of employment as evidenced in their randomly selected files. There was evidence in the care workers files that they are supervised on a regular basis. All newly appointed care workers undertake an induction programme, and this was supported during discussions with a new member of staff. The home ensures that staff undertakes the mandatory training with yearly updates as necessary to maintain their competency to fulfil their duties. This was evidenced through discussion with the manager and care workers and by checking care workers’ training files. It was evidenced from notification of incidents sent to CSCI that a number of service users suffered falls, which are suitably managed. In discussion with the manager and operations manager they informed the inspectors that they plan to send one member of staff to the falls clinic to learn more about the management of falls, and that this member of staff would then share the information with the team. Norfolk House DS0000017628.V321829.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31 33 35 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager has the experience to run the home and works to continuously improve services and provide an increased quality of life for the service users. There is a strong ethos of being transparent and open in all areas of running the home and the views of service users and their relatives are actively sought. Service users financial interests are safeguarded by the home’s policies and procedures. The service provides training on health and safety issues for all staff and service users are involved in the running of the home. EVIDENCE: Norfolk House DS0000017628.V321829.R01.S.doc Version 5.2 Page 22 There have been substantial management changes since the last inspection of the home, including a new home manager, deputy manager and operations manager for the organisation. The new management arrangements have focused on a number of areas of concern that were raised and referred under the local authority safeguarding procedures and many improvements have been made as a result to the service provided for all service users. The management structure now includes one overall General Manager for the service, a deputy manager to support her in her role and a specific manager for the residential unit within the home. The new manager has demonstrated that she has kept herself updated on issues relating to care of service users and staff in her charge. She has acquired the Registered Managers Award (NVQ L4) in management, and is a Registered General Nurse with many years experience of nursing and management. In discussion with the manager it was evident she was knowledgeable about the care needs of the service users and the training needs of the care workers to meet the identified care needs of the service users. There are clear lines of accountability within the home; each member of staff spoken to on the day of the inspection was clear about their role and responsibilities. The majority of the service users are not able to be involved in the running of the home, but their relatives are encouraged to be as involved as their time will allow them to be. One service user said, “The manager listens to what we have to say and then she speaks with the top people”. Minutes of the residents meetings are kept on file for review. Management of service users’ personal account was not checked as the Administrator was away on the day of inspection. The manager informed the inspectors the home does not become involved with service users’ finance except for those service users who have asked for their spending money to be kept by the home. Review of documented records demonstrated that health and safety checks are routinely carried out at the home. All equipment examined on the day was properly maintained. Records indicated that fire drills, fire alarm, water temperature were regularly checked. Random sample of care workers’ training files demonstrated that up to date and relevant training were carried out by care workers to protect service users’ health, welfare and safety. In discussion with care workers it was evident that they had an understanding and implementation of appropriate procedures to safeguard service users, and they spoke about their understanding of promoting safe working practices based on their health and safety training. Norfolk House DS0000017628.V321829.R01.S.doc Version 5.2 Page 23 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 X X 3 X X x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 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 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Norfolk House DS0000017628.V321829.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP15 Good Practice Recommendations The manager should ensure that all service users have appropriate utensils to promote and support adequate food intake. Norfolk House DS0000017628.V321829.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Norfolk House DS0000017628.V321829.R01.S.doc Version 5.2 Page 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. 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