CARE HOMES FOR OLDER PEOPLE
Normanby House 6 Belgrave Crescent Scarborough North Yorkshire YO11 1UB Lead Inspector
Irene Ward Unannounced 12 May 2005 10.30 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. Normanby House J53-J04 S7961 Normanby House V223402 120505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Normanby House Address 6 Belgrave Crescent, Scarborough, North Yorkshire YO11 1UB 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) 01723 501638 01723 369318 Anchor Trust Mrs Penelope Jane Fletcher 25 Category(ies) of OP Old age (25) registration, with number of places Normanby House J53-J04 S7961 Normanby House V223402 120505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 16/12/04 Brief Description of the Service: Normanby House provides personal care and accomodation for up to 25 older people and is owned and managed by Anchor Trust. The home is a semidetached property which consists in part of a converted dwelling house and purpose built accomodation. The accomodation is spaced over three floors and all areas are accessed by a vertical passenger lift. The home is set in its own gounds with flower beds and a summerhouse. There is car park to the front of the home. Normanby House is in easy access of local amenities such as shops and public transport. Normanby House J53-J04 S7961 Normanby House V223402 120505 Stage 4.doc Version 1.30 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 12th May 2005, which started at 10.30hrs and finished at 15.00hrs. A tour of the home was carried out which included the service users private accommodation, a selection of records were looked at and time was spent observing activity in the home, talking and listening to service users, relatives and staff. The focus of the inspection was a number of key standards, inspecting the care records of five service users in detail to establish if they corresponded with service users experiences in the home. There were also discussions with a visiting doctor and Gill Stockhill, acting manager of the home. What the service does well: What has improved since the last inspection?
Written plans relating to service users needs via care assessments have improved. This gives clear guidance to all staff when providing care and ensures a consistent approach when meeting the needs of service users. More staff are having formal training which helps them meet service users’ needs. Normanby House J53-J04 S7961 Normanby House V223402 120505 Stage 4.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. Normanby House J53-J04 S7961 Normanby House V223402 120505 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 Normanby House J53-J04 S7961 Normanby House V223402 120505 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) 2, 3 and 6 Prospective service users can be confident before moving into the home that their needs can be met. EVIDENCE: A pre-admission assessment is carried out and an assessment form is completed prior to admission into the home. A care plan from a placing or funding authority where applicable is also obtained. The information on files was comprehensive and details give good indication of the care needs of prospective service users. All service users are given Terms and Conditions of Residence, which is signed and dated, by service users or their representative and a copy is held on file. The acting manager stated that the home does not provide intermediate care. Normanby House J53-J04 S7961 Normanby House V223402 120505 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) 8 and 9 The health care needs of service users are well met. EVIDENCE: Each of the five case files inspected, including the most recent admission into the home, contained comprehensive plans of care. Risk assessments covering areas of daily living were available and up to date. The health care needs of service users were recorded on their individual care plans. Service users who self medicate have lockable facilities in their own rooms to keep their medication safe. For those service users that are unable to self medicate the home operates a monitored dosage system, which was inspected and was appropriately stored and records were accurately maintained. Senior staff have all nearly completed the Safe Handling of Medication training and are to receive their certificates on completion. A visiting doctor commented that the home was always clean and that staff were helpful and that senior staff were always available. The only problem is the “layout of the building” with long winding corridors” Normanby House J53-J04 S7961 Normanby House V223402 120505 Stage 4.doc Version 1.30 Page 10 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) 12 and 15 Service users’ lifestyles within the home reflects some of their wishes but does not satisfy all of their recreational and social needs. EVIDENCE: Visiting arrangements are flexible throughout the day as this was confirmed by the comments made by relatives. However service users and a relative who commented that there is “little stimulation” and that there was a lack of activities available at the home. One service user was overheard saying to another service user said that she would have loved to have gone out as it was such a lovely day. This was discussed with the acting manager who said that activities are to be looked at by the staff team to see how improvements can be made. Service users are to asked about their preferences and wishes regarding activities so they may be facilitated. The home does provide some activities as a newsletter written by a service user gives “dates for your diary” in April, and refers to a coffee morning, a video show, a clothes sale and a cheese and wine party and gentle exercise class each Wednesday morning but as some service users said this is not enough. One service user does a lot of fund raising and is out in Scarborough most days.
Normanby House J53-J04 S7961 Normanby House V223402 120505 Stage 4.doc Version 1.30 Page 11 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. There were tureens on each table so that service users could help themselves to food. Staff helped service users who needed assistance in a respectful manner. Service users were all asked by staff what they would prefer to eat and drink. Normanby House J53-J04 S7961 Normanby House V223402 120505 Stage 4.doc Version 1.30 Page 12 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 Service users are confident that their complaints and concerns are dealt with and are acted upon. EVIDENCE: The home’s complaints procedure is available to service users and visitors as it is on display in the main entrance to the home. Service users commented that if they had a complaint or a concern that they would speak directly with staff on duty. It then would be acted upon. Service users were also confident that the registered manager would always put things right. Normanby House J53-J04 S7961 Normanby House V223402 120505 Stage 4.doc Version 1.30 Page 13 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) 19,21,23,24 and 26 The standard of the environment of the home is good and provides service users with a clean and homely place in which to live. EVIDENCE: The home is a large building with an entrance hall with corridors running off. Service users accommodation is over three floors, which are all serviced by a passenger lift. There is a dinning room on the ground floor and a large communal lounge on the first floor, which also has a small kitchen attached for service users’ and relatives’ use. There is a main bathroom and toilet on each floor. Service users’ bedrooms all have en-suite facilities with toilet and shower. The home was decorated to a good standard. The home was very clean and tidy throughout; there were no offensive odours present. Normanby House J53-J04 S7961 Normanby House V223402 120505 Stage 4.doc Version 1.30 Page 14 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) None None of these standards were assessed. EVIDENCE: Normanby House J53-J04 S7961 Normanby House V223402 120505 Stage 4.doc Version 1.30 Page 15 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 and 38 Service users’ health safety and welfare are promoted and protected. EVIDENCE: The home’s deputy manager is acting manager for three months until the registered manager returns from her Area Manager’s post. However from discussions held with service users, they still believed the registered manager to be the manager of the home although comments were made about her rarely being present in the home as she was doing other thing for the organisation. This was discussed with the deputy who is acting manager. As there had not been an opportunity to arrange a meeting, she agreed that a service users’ meeting should be arranged as soon as it is possible to inform service users of the temporary management arrangements. A number of health and safety records were inspected all of which were up to date and accurately maintained.
Normanby House J53-J04 S7961 Normanby House V223402 120505 Stage 4.doc Version 1.30 Page 16 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 x 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 3
COMPLAINTS AND PROTECTION 3 x 3 x 3 3 x 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 Standard No 16 17 18 Score 3 x 3 x x 2 x x x x 3 Normanby House J53-J04 S7961 Normanby House V223402 120505 Stage 4.doc Version 1.30 Page 17 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 Regulation None Requirement Timescale for action 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. 2. Refer to Standard OP 12 OP 33 Good Practice Recommendations Social activities for service users should be improved. Service users should be informed as soon as it is possible to any change made to the management arrangements for the home. Normanby House J53-J04 S7961 Normanby House V223402 120505 Stage 4.doc Version 1.30 Page 18 Commission for Social Care Inspection 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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