Inspection on 13/02/07 for Norlin House

This inspection was carried out on 13th February 2007.

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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Norlin House 20/01/09

Norlin House 23/02/06

Norlin House 28/04/05

Norlin House 22/09/04

Norlin House 02/06/04

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Dalewood Respite Care

Orchard,The

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Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

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

CARE HOME ADULTS 18-65 Norlin House 31 Ewart Road Kingston Portsmouth Hampshire PO1 5RH Lead Inspector Nick Morrison Unannounced Inspection 13th February 2007 10:00 Norlin House DS0000012002.V327533.R01.S.doc Version 5.2 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 Norlin House DS0000012002.V327533.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 Adults 18-65. 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. Norlin House DS0000012002.V327533.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Norlin House Address 31 Ewart Road Kingston Portsmouth Hampshire PO1 5RH 02392 717040 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) Independent Care (Portsmouth) Limited Mrs Linda Janice Rosa Walsh Mrs Linda J R Walsh Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Norlin House DS0000012002.V327533.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users may only be accommodated between the age of 18 - 55 years 23rd February 2006 Date of last inspection Brief Description of the Service: Norlin House provides accommodation and care for up to three adults with a learning disability, aged between 18 - 55 years. The home is a terraced property situated in a residential area of Portsmouth, and is close to local amenities and bus services. The home has a small rear courtyard garden. All bedrooms are single and the communal areas consist of a ground floor lounge and kitchen/diner. The bedrooms do not have wash hand basins; this was agreed with the previous registration authority, Hampshire County Council Social Services department Registration and Inspection Unit. The registered person rents the property on a lease basis from a landlord. The physical layout of the home is such that it is not suitable for those who may have mobility needs. At present there are only two people living in the home. Norlin House DS0000012002.V327533.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report represents a review of all the evidence and information gathered about the service since the previous inspection. This included a site visit that occurred on 13th February 2007 and lasted four hours. During this time the Inspector toured the premises, looked all service users’ files and met with both service users. All records and relevant documentation referred to in the report was seen on the day of inspection. The Inspector spoke with the Manager and one member of staff. What the service does well: What has improved since the last inspection? What they could do better: 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. Norlin House DS0000012002.V327533.R01.S.doc Version 5.2 Page 6 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Norlin House DS0000012002.V327533.R01.S.doc Version 5.2 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from having their needs assessed prior to moving into the home. EVIDENCE: All the service users files contained initial assessments that had been completed prior to admission and updated since. The assessments had been used in devising each person’s care plan. Norlin House DS0000012002.V327533.R01.S.doc Version 5.2 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users benefit from having clear individual plans in place and from support to take decisions and risks appropriate to their development. Service users would benefit further from having their care plans and risk assessment regularly reviewed. EVIDENCE: Files showed that all service users had individual plans in place. Staff spoken with were clear about the plans for each person and services users understood the planning system. There had been a requirement from that previous inspection that care plans must be reviewed, where possible, with the service user, at least every six months. The home was still in the process of addressing this requirement, but they had devised a new system for reviewing the care plans with service users. Norlin House DS0000012002.V327533.R01.S.doc Version 5.2 Page 9 Staff and service users spoken with were very clear that service users made their own decisions about their own lives and the Inspector observed staff supporting service users to make their own choices. Risk assessments were in place for service users where specific risks had been identified. Staff spoken with understood these. There had been a requirement form the previous inspection that risk assessments must be reviewed, where possible, with the service user, at least every six months. The home had made some progress in this, along with the care plans, but had not yet fully met the requirement. Norlin House DS0000012002.V327533.R01.S.doc Version 5.2 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from being part of the community and involved in varied activities. They also benefit from regular contact with their friends and families and from a healthy diet. EVIDENCE: A visitors’ policy was in place and service users were encouraged to have visits from friends and families at any time. Visitors were only discouraged where their presence might have a negative impact on other people living in the home. During the inspection visit the Inspector observed staff interacting with service users and they behaved in a respectful way and were aware of the rights of service users and staff respected their privacy. Service users spoken with confirmed that staff were always respectful towards them. Staff interaction with service users was positive throughout the inspection. Norlin House DS0000012002.V327533.R01.S.doc Version 5.2 Page 11 Staff observed during the inspection were very effective in communicating with service users and showed a caring and supportive approach to their work. Formal menus were not used, but service users were supported to choose what they were going to eat and shop for it accordingly. Records of food consumed demonstrated that the diet was varied and nutritious. Individual preferences and dietary needs were fully considered. Service users were happy with the food at the home. Staff had put a lot of time into supporting service users to try different foods and to choose foods that were healthy. Shopping lists kept in the home demonstrated that fresh food was used throughout the menus. Service users were also able to choose unhealthy options, such as take-aways, on occasions but to make sure this was in the context of an overall healthy diet. Service users are very independent and organise their own social activities. Norlin House DS0000012002.V327533.R01.S.doc Version 5.2 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are protected by the home’s medication policy and practices and benefit from having their health and support needs met appropriately. EVIDENCE: Service users had been involved in their own care planning and were able to comment on how they received care. Each service user had a health profile in place and their healthcare needs were clearly and closely monitored. The Manager of the home was concerned for the health needs of service users and ensured that they were supported to attend medical appointments as necessary. Service users were also encouraged to take control of their own health and to make attend appointments independently where possible. The home had an effective medication policy in place and staff were clear about their responsibilities within this. All staff involved in administering medication had received training. Medication records were all up-to-date and medication was appropriately stored. All medication coming into and going out of the home was accounted for. There had been two requirements from the Norlin House DS0000012002.V327533.R01.S.doc Version 5.2 Page 13 previous inspection relating to medication. One was that all medication administered should be signed for and the other was that the medication cupboard be secured to the wall. Both of these requirements had now been met. Norlin House DS0000012002.V327533.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a clear complaints policy and were protected by the home’s abuse policies and practices. EVIDENCE: There was a clear complaints policy in place, which was available to each service user. Service users were encouraged to highlight any issues they were not happy with and these were recorded and responded to. Records were kept of any complaint made. Service users spoken with said they did not have to complain much about the service because there were only two of them living in the house and things were organised to suit them. They were clear about the home’s policies on the rights of people living there and felt that staff supported their rights. The home has adequate policies in place regarding responding to issues of potential or suspected abuse. Staff at the home had had adult protection training. There had been a requirement from the previous inspection visit that the Manager should follow up on a previous referral made under the Adult Protection Procedures. This had not been addressed as the Manager reported that she had had some difficulty in getting a response to this from the Adult Services team. The home had a good system in place for supporting service users with their money. Service users were encouraged to be as independent as possible with their money and records were kept of all transactions where staff were involved in supporting them. It was clear from discussions between service Norlin House DS0000012002.V327533.R01.S.doc Version 5.2 Page 15 users and the manager during the inspection visit that service users felt in control of their own finances, but could ask for help when they felt they needed it. Norlin House DS0000012002.V327533.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from living in a comfortable, safe and clean home. EVIDENCE: Service users are encouraged to be involved in housework, according to their wishes and staff ensure the cleanliness of the home. Infection control procedures were in place and the home was clean throughout whilst remaining comfortable and homely. Service users spoken with felt that the home was clean and presentable, but that they were supported to make themselves comfortable and there was no pressure on them to keep their rooms tidier than they wanted them to be. They felt that staff were supportive but not directive about keeping the home clean and tidy. Service users also had a good understanding of hygiene issues and of the potential harm from poor hygiene. This was particularly evident in discussion with them about food hygiene procedures. Norlin House DS0000012002.V327533.R01.S.doc Version 5.2 Page 17 There had been requirements from the previous inspection visit concerning the roof being repaired and the shower being fixed. Both of these have now been fully addressed. Norlin House DS0000012002.V327533.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from being supported by competent, trained staff and are protected by the home’s recruitment policies and practices. EVIDENCE: Staff training records were clear and demonstrated that there is a commitment to ensuring that staff are well equipped for their role. Staff spoken with confirmed that the training available is very good and that they did not have any outstanding training needs that were not being dealt with. Staff files were well-kept and demonstrated that staff did not begin working in the home before all necessary checks had been undertaken. Staff had a clear induction when they began work and this was welldocumented. Staff spoken with confirmed that their induction programme was useful gave them a good understanding of their role as well as covering basic training issues. Service users spoken with felt that staff were competent in their roles and said they felt there was sufficient staff available to meet their needs. Norlin House DS0000012002.V327533.R01.S.doc Version 5.2 Page 19 Norlin House DS0000012002.V327533.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from living in a well run home and they are protected by the home’s Health and Safety policies and practices. They would benefit further from workplace risk assessments being in place. EVIDENCE: The home is well managed around the needs and wishes of service users. The Manager has the necessary skills, experience and qualifications to manage the home and roles and responsibilities within the home are made clear. Service users were able to contribute to the running of the home in a number of ways, including input into their own care plans, private meetings with keyworkers and they both had regular access to the manager. All policies in the home were reviewed annually, the last time being in October 2006. Norlin House DS0000012002.V327533.R01.S.doc Version 5.2 Page 21 Health and safety within the home was mostly well managed. Up-to-date records were kept of all servicing for equipment, including electrical equipment and the gas boiler. Staff training, including their induction, covered health and safety issues and there were good records to support this. Staff spoken with were clear about their health and safety responsibilities. Fire equipment in the home was regularly checked and records were up-to-date. Service users and staff spoken with did not highlight any health and safety concerns. There had been a previous requirement that workplace risk assessments must be put in place. The home has still not addressed this issue, although a member of staff had recently been on a training course to be able to complete workplace risk assessments. The Manager reported that workplace risk assessments will be given a high priority and will be put in place without delay. Norlin House DS0000012002.V327533.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 2 3 Norlin House DS0000012002.V327533.R01.S.doc Version 5.2 Page 23 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA6 YA9 Regulation 15 Requirement Care plans and risk assessments must be reviewed, where possible, with the service user, at least every six months. The home must follow up the referral made to POVA. Written confirmation of the result of this must be sent to the Commission. Workplace risk assessments must be put in place. Timescale for action 30/04/07 2. YA23 13 30/04/07 3. YA42 23 30/04/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Norlin House DS0000012002.V327533.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Norlin House DS0000012002.V327533.R01.S.doc Version 5.2 Page 25 - 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. 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