Inspection on 28/04/05 for Norlin House

This inspection was carried out on 28th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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

Norlin House 20/01/09

Norlin House 13/02/07

Norlin House 23/02/06

Norlin House 22/09/04

Norlin House 02/06/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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 PO1 5RH Lead Inspector Ian Craig Unannounced 28 April 2005 8:00 th 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 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 Stationary 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 H55-H03 S12002 Norlin House V219913 280405.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Norlin House Address 31 Ewart Road, Kingston, Portsmouth PO1 5RH Telephone number Fax number Email 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) Ltd Mrs Linda Janice Walsh Care Home 3 Category(ies) of Learning Disability registration, with number of places Norlin House H55-H03 S12002 Norlin House V219913 280405.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Service users may only be accommodated between the age of 18 - 55 years Date of last inspection 22/9/04 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. Norlin House H55-H03 S12002 Norlin House V219913 280405.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place from 0830 to 1230. One of the two residents was present during the visit. Assistance was given by the registered manager, Mrs. L. Walsh, as well from staff on duty. What the service does well: What has improved since the last inspection? The kitchen units, as well as hob and oven, have been replaced. There is a new kitchen floor. The rear courtyard garden has also been improved. The lounge three-piece suite has been replaced. Care plans have improved considerably, and include details of residents’ activities that involve an element of risk and how that risk is minimised. Staffing levels have increased. Recruitment procedures for new staff were found to be thorough. A system of assessing potential resident’s needs has been devised. Norlin House H55-H03 S12002 Norlin House V219913 280405.doc Version 1.30 Page 6 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. Norlin House H55-H03 S12002 Norlin House V219913 280405.doc Version 1.30 Page 7 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 Standards Statutory Requirements Identified During the Inspection Norlin House H55-H03 S12002 Norlin House V219913 280405.doc Version 1.30 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 and 5 The home utilises a system of assessing needs before admission. The home had not promoted the residents’ rights by ensuring that contractual arrangements with a purchasing agency are clear. EVIDENCE: The home has not admitted any new residents since the last inspection. A pre admission assessment pro forma has been devised, which includes the following: biographical information, physical health and well being, self care ability, assessment of emotional well being, lifestyle choices and preferences, intellectual assessment, assessing risks, assessment overview and medication. This document had been completed for the most recent person admitted to the home. Copies of the home’s contract were available. Contracts with the purchasing agency/local authority were available for only one of the two residents. There was a lack of clarity regarding the purchasing agreement for the second resident. This person was not receiving benefits and personal allowance. This situation needs clarifying so that the resident receives a personal allowance. Norlin House H55-H03 S12002 Norlin House V219913 280405.doc Version 1.30 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 and 9 Progress has been made to improve the system of assessing needs and care plans demonstrated that resident’s care needs as well as their preferences were being met. Residents’ safety is addressed in risk assessments showing that independence is promoted. EVIDENCE: Since the last inspection the written care plans have been improved to reflect the care needs of residents. These also detail the domestic and daily routines of the individual as well as the social interests, relationships, finances, etc. Assessments had been completed for activities where there was an element of risk to the resident. This included the use of kitchen equipment and going out. The home has revised the care planning documents to include the above details. A revised plan had been recorded for one resident and for the second resident the revision was partially completed. It was noted that the care plans had not been signed or dated by the person completing them. The manager agreed to address this. There was no evidence in the care plans that the residents’ had taken part in the completion of the care plans. However, a resident was directly involved in the decision-making process regarding holidays and day trips; the resident was also able to confirm that his/her needs were reflected in this process. Norlin House H55-H03 S12002 Norlin House V219913 280405.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 15 and 17 Residents have opportunities to develop independent living skills and are able to pursue their own interests, hobbies, college courses and social life. The home promotes healthy eating and provides a balanced diet. Residents are supported in personal relationships and family matters. EVIDENCE: A resident was able to confirm that his/her specific preferences for daily activities and leisure were catered for. This included consideration of holidays, day trips and how the person spends an ‘ordinary’ day. A resident was observed helping him/herself to breakfast. All residents are relatively independent and do not require staff intervention with personal care other than monitoring and occasional supervision. Residents are supervised in developing independent living skills such as preparing food, cooking and housework. Educational college courses are attended by residents, as well social activities and holidays. Staff are aware of the residents’ family background and other relationships. One resident is involved in a local theatre and drama group, which promotes the rights of people with a learning disability. The theatre group perform at local theatres. Norlin House H55-H03 S12002 Norlin House V219913 280405.doc Version 1.30 Page 11 The home involves the residents in devising the menu plan and encourage a healthy diet. The home has achieved considerable success in weight management. There was fresh fruit on the dining table. A resident confirmed that the meals are “good.” A resident was observed helping him/herself to breakfast, describing how much he/she enjoyed cereals. Norlin House H55-H03 S12002 Norlin House V219913 280405.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 and 19 The home makes arrangements for appropriate healthcare for the residents. Residents are supported with personal care routines. EVIDENCE: Care plans detail the personal support needs of the residents. The home has been successful in promoting healthy eating and weight management. Arrangements are made for routine health checks such as eyesight, foot care, and dental care. This was demonstrated by records, which also showed that more specialist health professionals are involved when necessary, including asthma nurse, Consultant Psychiatrist and community nursing team. The resident interviewed confirmed that there is support from health professionals, such as doctors and community nurses. Norlin House H55-H03 S12002 Norlin House V219913 280405.doc Version 1.30 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23 Procedures for dealing with resident’s finances are not secure and the home has not ensured that resident’s receive benefits that they are entitled to. EVIDENCE: Procedures for the handling of resident’s finances were examined. Accurate records are maintained, but there was a lack of security in access to funds held in a bank account. Funding for one resident is complicated as the placement is exclusively funded by the local health trust. This person did not receive a personal allowance and there was no contract from the health trust to detail exactly what was being purchased and what allowances the person received. The home’s manager explained that social services would not involve themselves in this matter due to the involvement of the health trust, and that the resident had been refused any funding from income support. The home has recently referred a staff member for possible inclusion on a nationally held record of those unsuitable to work with vulnerable persons, known as the Protection of Vulnerable Adults (POVA). This person has left the employment of the home. The manager stated that there has been no response from POVA to this referral. It was identified that staff need to receive training in adult protection, and in dealing with aggressive behaviour on the part of residents, although staff are aware of how to deal with resident’s exhibiting this behaviour. One staff member has attended training accredited by the British Institute for Learning Disabilities in dealing with challenging behaviour, entitled, Strategies for Crisis Intervention Prevention (SCIP). Care plans also detail how staff should respond to aggressive and challenging behaviour. Norlin House H55-H03 S12002 Norlin House V219913 280405.doc Version 1.30 Page 14 Personal alarms are given to residents for safety when going out alone. A resident was able to talk about safety issues when going out alone and showed the inspector how the alarm worked. Norlin House H55-H03 S12002 Norlin House V219913 280405.doc Version 1.30 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27, and 30 The home’s physical environment has been improved since the last inspection and reflects the character of the residents. Aspects of the environment do not meet the current national minimum standards, but are permitted as they were agreed with the previous registration authority. The home is not suitable for those with a mobility need. The home is clean and hygienic. EVIDENCE: The kitchen has been completely refurbished and looks attractive and modern. The flooring has also been replaced. There is a dining area at one end of the kitchen. The ground floor contains a lounge, which has a television and video cassette recorder. The 3-piece suite in the lounge has been replaced since the last inspection. Bedrooms are personalised with ornaments, items for hobbies, posters, etc. Bedrooms do not have wash hand basins. This was agreed with the previous registration authority. There is a bathroom on the first floor, which has a shower, toilet and wash hand basin. There is a further toilet on the ground floor. A resident described how he/she enjoyed living at the home as it was near local shops. This person also stated that he/she is satisfied with his/her bedroom. Norlin House H55-H03 S12002 Norlin House V219913 280405.doc Version 1.30 Page 16 The layout of the home is such that it is not suitable for those with a mobility need. All areas of the home were found to be clean. All staff have completed training in infection control and the prevention of MRSA. Norlin House H55-H03 S12002 Norlin House V219913 280405.doc Version 1.30 Page 17 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34 and 35 The home has increased its staffing levels since the last inspection and recruitment procedures were found to be satisfactory. Staff demonstrated a good comprehension of the needs of those with a learning disability, but need to attend formal training in adult protection and challenging behaviour. EVIDENCE: All the staff employed in the home were spoken to, and demonstrated a thorough knowledge of the resident’s individual needs. Staff also showed a commitment to ensuring that people with a learning disability have access to a wide range of services. The staff group consists of only three, which promotes communication between staff as well as with the residents. Recruitment procedures were examined for a member of staff who has recently started work in the home. These were found to be satisfactory and included two written references being obtained plus a criminal record bureau check. An induction programme had been completed for this staff member. Staffing levels have been increased since the last inspection, from 60.5 to 94.5 hours for the week. At least one staff member is on duty at any given time. There are significant periods when both residents are out. Night time staffing consists of one sleep in person. Staff (not including the manager) are trained to either NVQ level 2 or 4. All staff have completed training in the following: manual handling and lifting, Norlin House H55-H03 S12002 Norlin House V219913 280405.doc Version 1.30 Page 18 infection control, prevention of MRSA, basic food hygiene and first aid. Staff have attended training in working with those with a learning disability, but this needs to be extended to include adult protection and challenging behaviour/managing aggression. A resident described the staff as helpful. The inspector observed a genuine warmth in the interaction between the staff and the residents. Norlin House H55-H03 S12002 Norlin House V219913 280405.doc Version 1.30 Page 19 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,39, 41 and 42 Progress has been made in various areas of the home’s management, although the security of records needs to be improved. The manager needs to take a more proactive role in ensuring that the residents receive benefits that they are entitled to. Health and safety in the home is satisfactory. EVIDENCE: The manager is in the process of completing NVQ level 4 and the Registered Manager’s Award. As referred to in Standard 23, the manager must take steps to safeguard resident’s monies and to ensure they receive benefits that they are entitled to. Staff records need to be securely stored. The home uses a questionnaire to obtain the views of residents about the service provided by the home. These confirmed that the residents are satisfied with life at the home. The environmental health officer visited the home on 25/10/04 and provided a ‘satisfactory’ report on the home’s health and safety. Service records showed that a qualified person checks wiring and portable electrical appliances. A landlord’s gas safety certificate was not available. Norlin House H55-H03 S12002 Norlin House V219913 280405.doc Version 1.30 Page 20 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x 1 Standard No 22 23 ENVIRONMENT Score x 1 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 x 3 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Norlin House Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 3 x x x 2 x 2 H55-H03 S12002 Norlin House V219913 280405.doc Version 1.30 Page 21 no 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 5 Regulation 5(3) Requirement The home must obtain a copy of the agreement with the health trust for the placement of a resident. This must specify a breakdown of what is being purchased including the residents personal allowance. A copy of this must be forwarded to the Commission. The home must take steps to ensure that a resident receives a weekly personal allowance. Referral and involvement of a welfare rights advocate should be used if necessary. Written confirmation of the results of this must be forwarded to the Commission. Staff must receive training in the following: adult protection and challenging behaviour/managing aggression. The latter should be from a trainer accreditted with the British Association of Leaning Disability (BILD). The home must follow up the referral made to the POVA. Written confirmation of the result of this must be sent to the Commission. Staff records must be kept Timescale for action 28th. August 2005 2. 5 and 23 12 (1)(a) 28th. August 2005 3. 23 and 35 12 (1) (a) (b) and 18 (1) (c) 28th. September 2005 4. 23 13 (6) 28th. July 2005 5. 41 17 (1)(b) 28th. June Page 22 Norlin House H55-H03 S12002 Norlin House V219913 280405.doc Version 1.30 securely in the home. 6. 7. 42 23 23 (2) 13(6) A copy of a landlords gas safety certificate must be forwarded to the Commission. The home must review the arrangements for residents accessing their bank accounts. 2005 28th. June 2005 28th. June 2005 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 Good Practice Recommendations Norlin House H55-H03 S12002 Norlin House V219913 280405.doc Version 1.30 Page 23 Commission for Social Care Inspection 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 0845 015 0120 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 H55-H03 S12002 Norlin House V219913 280405.doc Version 1.30 Page 24 - 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!