Inspection on 19/09/07 for Norlington Care Home

This inspection was carried out on 19th September 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 but made no statutory requirements on the home.

Other inspections for this house

Norlington Care Home 10/09/09

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 01/06/05

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 Key Unannounced Inspection 19th September 2007 10:00 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 Norlington Care Home DS0000055350.V350556.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. Norlington Care Home DS0000055350.V350556.R01.S.doc Version 5.2 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 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) Norlington Care Limited Mrs Carolyn Mary Jolliffe Care Home 37 Category(ies) of Old age, not falling within any other category registration, with number (37) of places Norlington Care Home DS0000055350.V350556.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. No more than 20 service users in need of nursing care may be accommodated. 15th May 2007 Date of last inspection Brief Description of the Service: The Norlington Care Home is registered to provide personal care for up to 37 older people, 20 of whom can require nursing care. Mrs June Tempany and her son Mr Gary Tempany own the home. The Commission for Social Care Inspection has registered Carolyn Jolliffe as the manager. 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, are a small quiet lounge and a conservatory that can be used as a dining area. The fees for the home as provided to CSCI at the time of inspection range from £450 to £850. The fees for people requiring continuing care are negotiated on an individual basis. Additional charges include hairdressing, chiropody and newspapers. See the following website for further guidance on fees and contracts. http:/www.csci.org.uk/about_csci/press_releases/better_advice_for_people_c hoos.aspx Norlington Care Home DS0000055350.V350556.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second unannounced key inspection this year and took eight and half hours over two days in September 2007 to complete. A tour of the premises took place and three staff files, three residents care records and relevant documentation and policies and procedures relating to the running of the home were inspected. Eleven residents, two visitors to the home and the staff on duty were spoken with. Carolyn Jolliffe the registered manager, June Tempany and Gary Tempany were available during the inspection. What the service does well: What has improved since the last inspection? Since the last inspection all the residents assessments and care plans have been reviewed and it is now easier to access the information required relating to the care needs of the resident. The care plans now contain sufficient detail and reflect the care actually being provided including wound care. A care co-ordinator has now been appointed and a Map of Life introduced for each resident that can be added to as more information is gathered. The number and skill mix of the staff on duty has been reviewed since the last inspection and further recruitment has taken place. At the time of this inspection the staffing levels are meeting the needs of the residents. Norlington Care Home DS0000055350.V350556.R01.S.doc Version 5.2 Page 6 Bedrails are now only used after a full, documented risk assessment has been carried out to determine if their use is the most appropriate method of managing the risk for the individual resident. 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. Norlington Care Home DS0000055350.V350556.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Norlington Care Home DS0000055350.V350556.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Admissions only take place when the home is confident that they are able to meet the assessed needs of the prospective resident. EVIDENCE: Since the last inspection a new format has been developed and implemented to record a pre admission assessment. The care records for two recently admitted residents viewed contained a detailed pre admission assessment of care need using the new format. The assessment included 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. Copies of letters provided to the prospective resident advising them that following assessment the home is able to meet their needs were seen. Norlington Care Home DS0000055350.V350556.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 7, 8, 9 and 11 Residents’ benefit from care plans being developed through the assessment process, their health needs being met and a kind respectful staff team. Medication procedures and practices ensure that medicines are administered to residents safely. 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 records included input from health care services including General Practitioners and specialist nurses and therapists. Residents spoken with confirmed that appointments are made on their behalf as necessary if they require medical attention, a dentist, optician etc. Since the last inspection all the care plans have been reviewed and it is now easier to access the information required relating to the care needs of the resident. Staff spoken with agreed that the information relating to the individual resident was now much easier to read. Norlington Care Home DS0000055350.V350556.R01.S.doc Version 5.2 Page 10 Two files contained detailed care plans including the resident’s personal care needs such as washing, dressing and care of the hair, teeth and nails. Visiting and talking to the residents confirmed that the care records are up to date reflecting the actual care being provided. The third care plan did not contain any reference to the care of the resident’s teeth or hair and included statements such as ‘change position regularly’ with no indication of how often this should be. Between the first and the second day of the inspection the staff had commenced auditing the care plans to ensure that they are consistent and provide sufficient detail. Since the last inspection body mapping of all residents has been undertaken and wound care assessments and care plans have been put in place for all wounds regardless of whether they are long term or expected to be short term ‘minor’ wounds. Completed documentation including a photograph was seen in one resident’s file. A wound care analysis is undertaken monthly. Nutritional assessments were seen in the three care records viewed. Residents are weighed monthly and if there is any weight loss noted with no previously identified reason a food intake chart is commenced for five days and then reviewed. The care records for one resident identified recent weight loss and their food intake is now being monitored. Bed rail assessments are now in place as appropriate to the need of the resident. One resident had been having frequent falls from the bed. An assessment had been undertaken and as bed rails were not found to be appropriate other equipment including a bed that lowers to the floor has been purchased to assist with managing the risk. One resident said ‘they are all lovely they look after X very well’. The home has an administration of medicines procedure. A monthly written medication audit has taken place and any issues identified addressed. The Medication Administration Records (MAR) viewed had been correctly and fully completed. The maximum and minimum temperature of the medicines refrigerator is recorded daily. The care records viewed contained a medication care plan including the resident’s preference for taking medication. The care records did not always provide clear guidance to indicate when prescriptions marked ‘as needed’ or ‘prn’ should be given when the resident is unable to request the medication. One resident frequently refuses their medication and this is clearly recorded on the MAR chart and in the care documentation. 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 and the staff are very polite. The admission document includes the resident’s preferred form of address. Screens are provided in the bedrooms used by more than one resident. Norlington Care Home DS0000055350.V350556.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The flexibility of the home and the activities provided enable residents to retain control over their lives where feasible and take part in social activities that meet their expectations. EVIDENCE: Since the last inspection an activities co-ordinator has been appointed. The care records viewed included a Map of Life that can be added to as more information is gathered from the resident. Minutes were available of meetings held with residents and their relatives or representatives. A monthly newsletter is provided for all residents and available in reception listing the activities planned for the following month. August included chair exercises to music, two visiting entertainers, movie matinees, bingo and hand massage or manicure pamper sessions in the residents own room. On the day the Red Arrows flew over Bournemouth a grand picnic was held on the Southbourne overcliff. Photographs were available of the event and residents spoken with agreed that it had been a very enjoyable outing. Norlington Care Home DS0000055350.V350556.R01.S.doc Version 5.2 Page 12 Money provided by fund raising activities undertaken by residents, their families and staff is available to provide social activities for the residents. A recent tabletop sale had proved very successful. A record is maintained of all visitors to the home. Visiting arrangements are included in the Service Users Guide. Open visiting is encouraged after 10:00 am except by arrangement. Visitors spoken with confirmed that they were always made welcome by the staff. Those residents who were able to articulate a view confirmed that they were able to make choices about such matters as what they ate and at what time they had breakfast. One resident was spending the day in bed as they were feeling very tired. Residents are able to “personalise” their bedroom with additional items of their choice. This was confirmed when visiting residents’ bedrooms. Residents are asked at what time they would like their breakfast and this is entered in the ‘night time care plan’. Residents confirmed that they are provided with a choice of lunch and evening meal. During the inspection a care assistant was observed asking residents what they would like for supper that evening. One resident visited before lunch confirmed that they knew what they would be having for the midday meal and had been provided with a choice. The menus viewed appeared well balanced and nutritious including the provision of five pieces of fruit and vegetables each day. There were adequate fresh fruit, vegetables and dry store items available. Residents are provided with breakfast, lunch, evening meal and a snack in the evening with soft diets pureed in separate piles to aid presentation. Residents agreed that the food supplied is good. Residents commented ‘the food is very good considering how many they have to cook for’, ‘have no complaints about the food’ and ‘I enjoy whatever they give me’. The chef visits all residents to talk to them about their likes and dislikes. Norlington Care Home DS0000055350.V350556.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The systems in place provide residents with the confidence that their complaints will be listened to and acted upon and they are protected from abuse. EVIDENCE: The home has a comprehensive complaints procedure including the address of the CSCI and timescales. One complaint has been received by the home since the last inspection. The complaint had been well documented, investigated and action taken to address identified issues. The complainant had been satisfied of the outcome following the investigation. The registered manager undertakes an audit of complaints every three months. The home has an adult protection policy that clearly provides the actions that would be taken if an adult protection issue were reported in line with the local multi agency ‘No Secrets’ guidelines. As seen in the staff training files and confirmed when talking to staff they have received training and been provided with a copy of the home’s prevention of abuse policy. Norlington Care Home DS0000055350.V350556.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The standard of the environment is good providing the residents with a comfortable, clean and well maintained place to live. EVIDENCE: The home is well decorated and comfortably furnished. A full time and a part time person are employed to ensure that the home is well maintained and to assist with implementing the ongoing refurbishment plan including the upgrading of two bathrooms. A fire risk assessment is in place together with an action plan. The home is working towards meeting the recommendations. Low-level lighting is now provided in all rooms and this forms part of the monthly monitoring undertaken by the home. A number of bedrooms still have fluorescent strip lighting. The resident’s preference for this type of lighting has been included in the individual care records. Norlington Care Home DS0000055350.V350556.R01.S.doc Version 5.2 Page 15 One relative commented ‘the home is as good as it always has been’. On the day of inspection the home was clean and no malodours were noted. All residents and visitors spoken with commented positively about the laundry service and the cleanliness of the home. Designated staff are employed to attend to the laundry and the cleaning of the home. All staff have received infection control training and been provided with a copy of the revised infection control policy. This was confirmed when talking to staff. One resident asked for their wardrobe to be opened so that they could show how well their personal laundry was dealt with. Norlington Care Home DS0000055350.V350556.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The Norlington Care Home has systems in place for the recruitment and training of staff to ensure they are able to safely meet the needs of the people living at the home. EVIDENCE: Staff rosters are maintained showing which staff are on duty at any time during the day and night. In addition to care staff the Norlington employs staff to cover housekeeping, cooking, maintenance and administration. The call bell system is monitored three monthly to ensure calls are being answered within an acceptable time. The number and skill mix of the staff on duty has been reviewed since the last inspection and further recruitment has taken place. Reading care plans, visiting residents and talking with staff confirmed that the number of registered nurses and health care assistants rostered to work were sufficient to meet the dependency needs of the residents. This will need to be kept under review. Resident’s spoken with agreed that if they needed assistance a member of staff would respond very quickly. Of the twenty-seven care staff employed at the Norlington Care Home ten have achieved at least a level 2 NVQ in care and seven are at present undertaking the training. Norlington Care Home DS0000055350.V350556.R01.S.doc Version 5.2 Page 17 Three staff records viewed evidenced all the relevant checks and information had been obtained prior to the member of staff commencing at the home. Training records of two recently appointed members of staff contained documentation to evidence that an induction had been undertaken using the Skills for Care induction standards. The care staff have all received manual handling, infection control and health and safety training. The home has a number of residents diagnosed with dementia and all care staff have received relevant training. This was confirmed by reading training files and talking with staff. A training programme for staff on the care of people with diabetes has been commenced. A member of staff is given the opportunity to shadow the community diabetic nurse when she holds the series of clinics for the newly diagnosed diabetic. Staff have recently received a training session on the care required for a resident when they need a urinary catheter to meet their assessed need. All care staff now have a training plan developed following appraisal. Norlington Care Home DS0000055350.V350556.R01.S.doc Version 5.2 Page 18 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 and 38 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The management arrangements at the home and the quality assurance system ensures that the residents live in a home that is well managed and the service provided meets their needs. EVIDENCE: Carolyn Jolliffe, the registered manager is a first level nurse and has completed the Foundation Degree in Care Home Management. The registered manager has attended a number of courses for clinical updating. June and Gary Tempany, directors of the Norlington Care Home are closely involved in the management of the home. A deputy matron commenced in post in June. The deputy matron provides support to the registered manager and is assisting Norlington Care Home DS0000055350.V350556.R01.S.doc Version 5.2 Page 19 with the further development of care documentation and the monitoring of the care provided. There was evidence that apart from having an open door policy the manager has also arranged meetings for staff, residents and their families to have a say in the way the home is run. The home has introduced a self-monitoring programme including care records, medication, accidents, complaints and infection control. Surveys have been used to gather the views of the residents and their relatives or representatives. The responses were generally very positive and the issues identified had been dealt with as appropriate. The surveys have recently been extended to include GPs but the response has been poor. Regular residents meeting are held and a monthly newsletter produced. The registered manager completed and has returned the Commission for Social Care Inspection, Annual Quality Assurance Assessment and will now use the document as part of the home’s quality monitoring programme. Family, friends or professional advisors assist all residents to manage their financial affairs. Pocket money is held for a number of residents and all transactions are recoreded clearly and accurately. Two residents records were randomly checked and found to be correct. All gas installations, central heating, electrical wiring and appliances and equipment used to meet service user needs have 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. Fire training, drills and fire safety checks have been completed as required. An accident book is maintained and analysed monthly. An accident to a resident identified in their care records had been recorded in the accident book. Staff have received training in health and safety including manual handling and first aid. Norlington Care Home DS0000055350.V350556.R01.S.doc Version 5.2 Page 20 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 N/A 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 Norlington Care Home DS0000055350.V350556.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? Yes 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. 4. Standard OP9 Regulation 13(2)Sch 3 Requirement The Registered Person shall make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received in the care home including: The care records must provide clear guidance to indicate when prescriptions marked ‘as needed’ or ‘prn’ should be given when the resident is unable to request the medication. Timescale for action 30/11/07 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 Norlington Care Home DS0000055350.V350556.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 Norlington Care Home DS0000055350.V350556.R01.S.doc Version 5.2 Page 23 - 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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