CARE HOMES FOR OLDER PEOPLE
Normanby House 6 Belgrave Crescent Scarborough North Yorkshire YO11 1UB Lead Inspector
Mavis Pickard Unannounced Inspection 12th December 2005 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 Normanby House DS0000007961.V268501.R01.S.doc Version 5.0 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. Normanby House DS0000007961.V268501.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Normanby House Address 6 Belgrave Crescent Scarborough North Yorkshire YO11 1UB 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) 01723 501638 01723 369318 gillianstockill@anchor.org.uk Anchor Trust ****Post Vacant**** Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Normanby House DS0000007961.V268501.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 12th May 2005 Brief Description of the Service: Normanby House provides personal care and accommodation for up to 25 older people and is owned and managed by Anchor Trust. The home is a semi-detached property, which consists in part of a converted dwelling house and purpose built accommodation. Resident accommodation is over three floors and there is access to all levels by a vertical passenger lift. The home has a small patio area with flowerbeds and a summerhouse. There is car park to the rear of the home. The front access to the premises in Belgrave Crescent is close to local amenities such as shops and public transport. Normanby House DS0000007961.V268501.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This report relates to an unannounced inspection carried out on the 12 December 2005 over a period of 3 hours. The inspection focused on the outcomes for residents living in the home and included the examination of care and health and safety documentation, staff records and a short tour of the home that looked at communal areas and some private accommodation. The person in charge at the start of the inspection, a senior care worker, was able to assist with the inspection. Later the acting manager Miss Gillian Stockill arrived. It is with Miss Stockill that the inspection was completed. Observations made during this visit show that the home is running well. The premises had been decorated for Christmas and presented as being festive and homely. The acting manager and residents said that they had dressed the ‘real’ Christmas tree that is in the sitting room. People spoken to on an informal basis said that they enjoyed living at Normanby House. What the service does well: What has improved since the last inspection?
The previous registered manager of the home has moved to another post within the organisation. The acting manager Miss Gillian Stockill is to apply for registration with the Commission. Residents and /or their representatives have been informed of the situation regarding the management of the home. A previous inspection report highlighted that activities in the home are limited.
Normanby House DS0000007961.V268501.R01.S.doc Version 5.0 Page 6 The acting manager is actively seeking to raise awareness among residents and staff that activities available in the home may be those of daily living and are not only defined as formal or planned activities and outings. The home however does evidence that activities are provided. The home has regular residents meetings where people can put forward their views about how the home is run. The manager said that some resident’s private accommodation has been refurbished and that there are plans to convert an upper area of the home previously the resident managers accommodation into a training room and/or private meeting room. There are also plans to re-design a large cupboard into a separate and secure storage for the medication trolley, shortly to be delivered. 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. Normanby House DS0000007961.V268501.R01.S.doc Version 5.0 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 Normanby House DS0000007961.V268501.R01.S.doc Version 5.0 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 the following standard(s): 1,2,3,4,and 5 The organisation provides detailed information about the services provided. All people are assessed, have the opportunity to visit the home prior to admission and are advised if the home can meet their needs. All people accommodated have a contract. The home does not provide intermediate care. EVIDENCE: From the examination of the home’s policies and procedures, assessment and care documentation and from speaking with the acting manager and staff the home evidences that people are appropriately assessed prior to admission, encouraged to visit the home and are provided with a written statement in respect of the home being able to meet their assessed needs. Evidence is available that all people accommodated have a written contract of residence. The home does not provide intermediate care.
Normanby House DS0000007961.V268501.R01.S.doc Version 5.0 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 the following standard(s): 7,9,10 and 11 Residents have individual care plans. The home has a safe medication policy that staff follow. People are treated with respect The home ensures that staff are trained to deal sensitively and professionally should a person pass away whilst resident in the home. EVIDENCE: A number of care plans were examined which showed that the home maintains detailed comprehensive guidance for staff detailing how individual care is to be delivered. Risk assessments covering areas of daily living are kept and reviewed appropriately. Residents who are responsible for their own medication have lockable facilities to keep their medication safe.
Normanby House DS0000007961.V268501.R01.S.doc Version 5.0 Page 10 The home operates a monitored dosage system and will where necessary take responsibility for resident’s medication. From direct and indirect observation and from the examination of care documents it is clear that people are treated with respect and their privacy is upheld. The home maintains an appropriate policy detailing the way in which ‘end of life’ issues are dealt with by staff. The manager said that it is part of the pre-admission assessment that people are sensitively asked about their wishes regarding this issue and that she ensures as far as possible that people’s wishes are respected. Normanby House DS0000007961.V268501.R01.S.doc Version 5.0 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 the following standard(s): 13 and 14 Residents have contact with their family and friends were possible. Residents have choice. EVIDENCE: Visiting arrangements are flexible throughout the day during this inspection visitors were seen to come and go informally. There was evidence in the home that residents are living their lives as independently as possible. The acting manager said that during previous inspections it had been discussed that residents had little stimulation and that there is a lack of activities in the home. It is clear that the acting manager is keen to encourage residents, staff, and families to look on the ‘acts of daily living’ as activities. Staff should, she feels be aware that these small acts of daily living can be stimulating and very rewarding for residents. Being supported to make a drink, tidy and dust your bedroom, go for a short walk in the garden or to the local shop is as effective as an activity as a trip
Normanby House DS0000007961.V268501.R01.S.doc Version 5.0 Page 12 out or playing games in the home and sometimes more acceptable to residents. The home provides more formal activities. A newsletter written by a resident gives “dates for your diary” throughout the year and refers to coffee mornings a clothes sale, a cheese and wine party and gentle exercise classes. This may not be enough for everyone but can subsidise the activities and outings that family’s provide for their loved ones. Mealtimes at Normanby House are flexible. Choices are available each mealtime and all service users spoken with commented that the food at the home was very good. Normanby House DS0000007961.V268501.R01.S.doc Version 5.0 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 the following standard(s): Not inspected at this visit. EVIDENCE: Normanby House DS0000007961.V268501.R01.S.doc Version 5.0 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 the following standard(s): 19,20,21,22,23,24,25 and 26 Residents live in a clean, safe, comfortable environment that is well maintained and have access to appropriate facilities and equipment to meet their assessed needs. People personalise their own space. EVIDENCE: All the above standards were met. A tour of the home showed that the premises are well maintained, clean and comfortable. Hot water is regulated to ensure that its delivery is at a safe temperature [About 43°C] All radiators are guarded. Appropriate risk assessments are in place to evidence where there is a risk and how it will be minimised. Fire records are maintained appropriately. The home’s Fire Risk Assessment as required by the Fire Precautions [Workplace] Regulations 1997, was not examined at this visit. A number of residents private rooms were visited, they are personalised and comfortable.
Normanby House DS0000007961.V268501.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 There are sufficient appropriately recruited, experienced, qualified staff employed in the home to meet the needs of people accommodated. EVIDENCE: The staff rota was examined where it was found that there are at all times sufficient people working in the home to meet the needs of residents. There is always a senior person in charge during the waking day. At night a senior person is available to night staff by telephone. A rota is kept showing who is ‘on call’ at any time. The home employs a housekeeper to undertake the cleaning of the premises and a chef and catering assistant to ensure that meals are properly prepared, cooked and served. The recruitment processes employed by the home ensures that as far as is possible people are protected and are in safe hands. The organisation ensures that staff take periodic training on all aspects of care and health and safety. Normanby House DS0000007961.V268501.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,35 and 38 The home presently does not have a registered manager. The acting manager is competent and experienced. The ethos of the home is open and positive. The health and safety of residents is promoted. EVIDENCE: The person managing the home is yet to apply for registration with the current regulatory body [The Commission for Social Care Inspection] However the acting manager who has taken that responsibility for some time is experienced and competent and ensures that the atmosphere in the home is positive and friendly.
Normanby House DS0000007961.V268501.R01.S.doc Version 5.0 Page 17 Although results of any resident/relative questionnaires were not examined, from direct observation it is clear that the home is run in the best interests of the people accommodated. A range of health and safety documents for this home were examined along with policies and procedures that the organisation has formulated for all their establishments. All were found to be clear,detailed and designed to ensure the safety, including the financial safety, of residents and staff. Normanby House DS0000007961.V268501.R01.S.doc Version 5.0 Page 18 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 15 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 1 3 X X 3 X X 3 Normanby House DS0000007961.V268501.R01.S.doc Version 5.0 Page 19 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 OP31 Regulation Part 2(12)(1) Requirement The person seeking to be registered as manager must make application to the registration authority. Timescale for action 01/01/06 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 Normanby House DS0000007961.V268501.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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