Inspection on 01/06/05 for Norlington Care Home

This inspection was carried out on 1st June 2005.

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

Norlington Care Home 10/09/09

Norlington Care Home 19/09/07

Norlington Care Home 15/05/07

Norlington Care Home 03/10/06

Norlington Care Home 18/05/06

Norlington Care Home 14/11/05

Norlington Care Home 11/02/05

Norlington Care Home 22/06/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Norlington Care Home 19 Stourwood Avenue Southbourne Bournemouth Dorset BH6 3PW Lead Inspector Chris Gould Unannounced 1 June 2005 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 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. Norlington Care Home D55 S55350 Norlington Care Home V230127 010605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Norlington Care Home Address 19 Stourwood Avenue Southbourne Bournemouth Dorset BH6 3PW 01202 422064 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) Norlington Care Limited Ms Mary Bloomfield CRH N - Care Home With Nursing 37 Category(ies) of OP - Old Age (37) registration, with number of places Norlington Care Home D55 S55350 Norlington Care Home V230127 010605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. No more than 20 service users in need of nursing care may be accommodated. Date of last inspection 11 February 2005 Brief Description of the Service: The Norlington Care Home is registered to provide both personal and nursing care for older people. It can accommodate a maximum of 20 people with nursing needs. Mrs June Tempany and her son Mr Gary Tempany own the home. Mrs Mary Bloomfield, a first level registered nurse is the registered manager and is in day-to-day charge of the home. Norlington Care Home is situated on the edge of Southbourne and is close to local shops and amenities such as libraries, churches etc. and also to the sea and cliff top walks. There are single and double rooms on the ground, first and second floors. A lift provides level access to all areas of the home. There is a large lounge and lounge/dining area in the original part of the home. At the rear of the home, on the ground floor, is a small quiet lounge and a conservatory that can be used as a dining area. The building is well maintained and rooms are decorated and furnished to a good standard. Norlington Care Home D55 S55350 Norlington Care Home V230127 010605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over eight and a half hours on one day in June 2005. The inspection assessed 19 standards and the outstanding requirements from the previous inspection. A tour of the premises took place and three staff files and three residents care records were inspected. Eight residents, seven visitors to the home and the staff on duty were spoken with during the inspection. Due to poor physical and mental health a number of residents were unable to engage in conversation with the inspector. The registered manager was unavailable but Mrs June Tempany and Mr Gary Tempany were present in the home throughout the inspection. The occupancy of the home on the day of inspection was thirty five older people with eighteen requiring nursing care. What the service does well: People considering moving into the home are provided with clear information to assist them when trying to decide if the Norlington Care Home is the right home for them. All residents have a detailed assessment and care plans are in place to ensure that their health and care needs are met. Residents enjoy a varied and well balanced diet in surroundings of their choice. Comments from residents included ‘food is good’, ‘food okay’ and ‘dinners quite nice but would like meals hotter’. The levels of staffing and the staff training provided meet the needs of the residents and appropriate checks are being undertaken prior to the member of staff commencing employment to ensure residents are supported and protected. Norlington Care Home D55 S55350 Norlington Care Home V230127 010605 Stage 4.doc Version 1.30 Page 6 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. Norlington Care Home D55 S55350 Norlington Care Home V230127 010605 Stage 4.doc Version 1.30 Page 7 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 Standards Statutory Requirements Identified During the Inspection Norlington Care Home D55 S55350 Norlington Care Home V230127 010605 Stage 4.doc Version 1.30 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 3, The home is not providing intermediate care at the present time therefore standard 6 is not applicable. The systems in place ensure that the resident knows that the home they are moving into provides suitable facilities and that their care needs will be met. EVIDENCE: Norlington Care Home has a service user guide providing comprehensive detail of the homes provision and services. The information is given to all prospective residents. This was confirmed by residents and visitors to the home. Mrs Tempany said that a copy is to be placed in all bedrooms. Individual records are maintained for each of the residents. Inspection of three residents records contained a detailed pre admission assessment of care needs including information from professionals previously involved in providing their care. Discussion with staff confirmed that they were aware of the resident’s needs at the time of their admission. Norlington Care Home D55 S55350 Norlington Care Home V230127 010605 Stage 4.doc Version 1.30 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10 All residents have individual care plans to meet their health, personal and social needs. Residents’ health care needs are fully met and they are treated with respect and their right to privacy is upheld. Systems are in place for dealing with medicines but these are not consistently reflected in the home’s care practices potentially placing residents at risk. EVIDENCE: All residents have individual plans of care based on a pre-admission assessment of need. The three residents care records inspected had been reviewed at least monthly. The care plan provided a clear record of the resident’s needs, the expected outcome and the action plan to meet the assessed needs. The records included input from health care services including General Practitioners, opticians, chiropodist and the Community Psychiatric Nurse. The optician was visiting on the day of inspection. A resident spoken with had recently been provided with a pressure relieving mattresses and cushion to meet their changing needs, this was reflected in their care plan. Norlington Care Home D55 S55350 Norlington Care Home V230127 010605 Stage 4.doc Version 1.30 Page 10 The Medication Administration Records had not been signed on a number of occasions. An audit trail for medicines not in the Monitored Dosage System (MDS) blister packs has still to be implemented and handwritten entries have not been countersigned. Creams to be stored at below 25degrees centigrade were observed in a service user’s room on a windowsill that on a bright day would be in full sunlight. Staff induction includes respecting residents privacy and dignity. This was confirmed when speaking with staff. Staff were seen knocking on doors and waiting for an answer before entering residents rooms. Residents spoken with said that they were always addressed in the way they had requested. Norlington Care Home D55 S55350 Norlington Care Home V230127 010605 Stage 4.doc Version 1.30 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13, 14 and 15 Residents are able to maintain contact with their family and friends as they wish. Residents are not consistently provided with a choice in their lives. Residents receive a varied and well balanced diet in surroundings of their choice. EVIDENCE: The book in the reception area contained the names of residents’ visitors to the home and relatives spoken with said that they are made very welcome at any time. One resident goes out most days either to visit family or to the shops. Residents that were able to express an opinion said that they choose the time they get up and go to bed. Menus are provided at breakfast time for residents to choose their lunch and supper for that day. The morning hot drink was seen being served from a trolley containing a pot of tea and an uncovered plastic jug containing ready mixed strong coffee. A container of hot water was not available to alter the strength of the tea and the only milk available to add to the coffee was cold. The residents had no choice regarding the strength of their drink and the coffee was not being kept hot. One biscuit was taken from a tin by the member of staff and placed on the saucer before taking the drink to the resident in their room. One resident Norlington Care Home D55 S55350 Norlington Care Home V230127 010605 Stage 4.doc Version 1.30 Page 12 commented that they ‘drink what is brought’. Discussion with the chef and inspection of the menus evidenced that the choice available provides a balanced diet including the provision of five pieces of fruit and vegetables a day. Comments from residents included ‘food is good’, ‘food okay’ and ‘dinners quite nice but would like meals hotter’. Residents choose to either eat in the dining area or in their own rooms. Norlington Care Home D55 S55350 Norlington Care Home V230127 010605 Stage 4.doc Version 1.30 Page 13 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 The systems in place provide residents with the confidence that their complaints will be listened to and acted upon. Arrangements for protecting residents from abuse are not satisfactory placing them at possible risk of harm. EVIDENCE: The home has a detailed complaints procedure that is included in the service user guide. One complaint has been received by the Commission for Social Care Inspection since the last inspection. This was passed to the home for investigation that has not yet been completed. One resident said that they had a number of grumbles when first moving into the home but they were listened to and things changed. The home has an adult protection procedure but this is not in line with the local multi agency ‘No Secrets’ guidance. The procedure the home would follow if an alleged abuse was reported is not clearly stated. Staff confirmed that they have received training on the prevention of abuse. Norlington Care Home D55 S55350 Norlington Care Home V230127 010605 Stage 4.doc Version 1.30 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 22, and 26 The standard of the environment is good providing the residents with a comfortable and well maintained place to live. Fire safety recommendations need to be fully implemented to ensure residents live in a safe environment. Residents have the specialist equipment they require to maximise their independence. The home is clean and pleasant and there are systems in place to ensure the home is hygienic although these are not consistently reflected in the home’s care practices. EVIDENCE: During a recent visit by the Dorset fire and Rescue Service in May 2005 a number of unsatisfactory items were noted. The home is working towards addressing the issues identified. The home has not received an assessment by a suitably qualified person including an occupational therapist. This needs to be undertaken in order to fully meet this standard. A passenger lift enables residents to access all parts of the building and there are rails in the corridors and all WCs are suitable for Norlington Care Home D55 S55350 Norlington Care Home V230127 010605 Stage 4.doc Version 1.30 Page 15 people with disabilities. A number of mobile hoists and slings are available for residents requiring such aids to facilitate movement/transfer as documented in their care plans. Residents were observed using equipment to enable them to walk within their room and the home. Walking around the home it was observed that since the last inspection the programme to provide radiator guards as assessed appropriate has been completed to prevent residents from burning themselves. On the day of inspection the home was clean and no malodours were noted. An infection control procedure is in place and all staff have received training. This was confirmed in discussion with staff. A member of staff was observed not using appropriate infection control procedures when dealing with clinical waste. All residents and visitors spoken with commented positively about the laundry service and the cleanliness of the home. Norlington Care Home D55 S55350 Norlington Care Home V230127 010605 Stage 4.doc Version 1.30 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30 The levels of staffing and the staff training provided meet the needs of the residents and appropriate checks are being undertaken prior to the member of staff commencing employment to ensure residents are supported and protected. EVIDENCE: The duty rota demonstrated that there are a sufficient number of registered nurses, health care assistants and ancillary staff on duty to meet the staffing notice issued by the previous regulator, the Dorset Health Authority. Residents spoken with all agreed that there was always someone there when you needed them. One resident commented that when they need help the carers ‘will come very quickly’. Four staff files were inspected and they all contained the relevant documentation and checks required including a satisfactory enhanced Criminal Records Bureau or POVA first check. Five care assistants are at present undertaking NVQ level 2. When the five staff have completed their training 50 of the care assistants at Norlington would have achieved an NVQ level 2 in care or equivalent. Norlington has a continuous plan for enabling all care staff to have the opportunity to achieve an NVQ level 2 in care. This was confirmed in discussion with care staff. Norlington Care Home D55 S55350 Norlington Care Home V230127 010605 Stage 4.doc Version 1.30 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 38 Systems are in place to ensure that the welfare of residents is promoted and protected. Systems are not in place to ensure that the home is run in the best interests of the residents. EVIDENCE: A service user survey was completed prior to the last inspection in February 2005 but the results have not been collated or action taken to address any issues identified. Records demonstrated and staff confirmed that they have received training in moving and handling, fire safety, first aid, food hygiene and infection control. Norlington Care Home D55 S55350 Norlington Care Home V230127 010605 Stage 4.doc Version 1.30 Page 18 Records viewed evidenced that all gas installations, central heating, electrical wiring and appliances and equipment used to meet service user needs has been checked. Policies and procedures are available relating to health and safety, Control of Substances Hazardous to Health (COSHH), infection control, manual handling and first aid. Accidents are recorded and evaluated monthly. Norlington Care Home D55 S55350 Norlington Care Home V230127 010605 Stage 4.doc Version 1.30 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 2 15 3 COMPLAINTS AND PROTECTION 2 x x 3 x x x 2 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x x 2 x x x x 3 Norlington Care Home D55 S55350 Norlington Care Home V230127 010605 Stage 4.doc Version 1.30 Page 20 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 9 Regulation 13(2) Timescale for action The registered person shall make 30th arrangements for the recording, September handling, safekeeping, safe 2005 administration and disposal of medicines receved into the care home. The registered person shall make 30th arrangements, by training staff September and implementing robust 2005 procedures to prevent residents being harmed or suffering abuse or being placed at risk of harm or abuse. The matters in the Fire Safety 30th Officers report dated 26 May September 2005 must be addressed. 2005 The registered person shall make 30th suitable arrangements to prevent September infection, toxic conditions and 2005 the spread of infection at the care home. Effective quality assurance and 30th quality monitoring systems, September based on seeking the views of 2005 service users, must be put in place to measure success in meeting the aims, objectives and statement of purpose of the home. Timescale of 31-05-05 not met Version 1.30 Page 21 Requirement 2. 18 13(6) 3. 4. 19 26 13(4) 23(4) 13(3) 5. 33 24 Norlington Care Home D55 S55350 Norlington Care Home V230127 010605 Stage 4.doc 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 9 Good Practice Recommendations It is recommended that the home should have a clear audit trail for medicines not in the Monitored Dosage System (MDS) blister packs e.g. dating packs when they are started or entering a carry forward balance on the MAR chart and this should be monitored to ensure medicines are given correctly. It is recommended that the present method of providing mid morning drinks and snacks is reviewed to ensure service users are provided with choice and the drinks are served from appropriate containers. It is a recommendation that suitably qualified persons including a qualified occupational therapist with specialist knowledge of the client group that the home caters for make an assessment of the premises and facilities. 2. 14 3. 22 Norlington Care Home D55 S55350 Norlington Care Home V230127 010605 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Unit 4 New Field Business Park Stinsford Road Poole Dorset BH17 0NF 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. 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