Inspection on 16/12/05 for Northfields

This inspection was carried out on 16th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Northfields 08/05/06

Northfields 29/06/05

Northfields 29/09/04

Similar services:

Pemdale

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

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

CARE HOME ADULTS 18-65 Northfields 49a Northfields West Earlham Norwich Norfolk NR4 7ES Lead Inspector Linda Wells Unannounced Inspection 16th December 2005 13:30 Northfields DS0000027527.V264317.R01.S.doc Version 5.0 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 Northfields DS0000027527.V264317.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 Adults 18-65. 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. Northfields DS0000027527.V264317.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Northfields Address 49a Northfields West Earlham Norwich Norfolk NR4 7ES 01603 458865 01603 458969 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) Elizabeth Fitzroy Support Mrs Jane Grant Care Home 7 Category(ies) of Learning disability over 65 years of age (7) registration, with number of places Northfields DS0000027527.V264317.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Up to seven (7) Service Users who have a learning disability and are over the age of 65 years may be accommodated. The total number of Service Users accommodated not to exceed 7. Date of last inspection 29th June 2005 Brief Description of the Service: Northfields is a detached, purpose built, chalet style house that is run as a residential care home providing accommodation and care for up to seven older people with learning and physical disabilities. The home is operated as two units within the home, has a shaft lift to the first floor and has seven single bedrooms all containing a washbasin of which one is upstairs and six downstairs. Each unit has a communal lounge, dining room, kitchen, adapted bathroom and toilet and there is a patio area and well-kept garden to the rear of the property and parking to the front. The home is sited in the middle of a residential area on the outskirts of the city of Norwich and is near local shops and healthcare facilities. Northfields DS0000027527.V264317.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection undertaken on the 16th December 2005 over four hours and was carried out as part of a routine inspection plan and following a complaint investigation visit carried out by CSCI on the 02nd December 2005. One of the four elements of the complaint was partially upheld and two requirements were made. Details of this investigation can be provided by CSCI on request. Prior to inspection comment cards were received from five residents, five relative/visitors and a G.P. All of the residents indicated that they liked living at the home and felt safe and everyone demonstrated that they were satisfied with the overall standard of care provided for residents. On the day of inspection seven residents were living at the home, one remained in her bedroom, three were seen to return from community day care facilities, one from a visit to the Zoo with a staff member and one from a Christmas shopping trip with a staff member. All residents were seen to be sitting in the two lounges, walking around the home or in their bedrooms, watching television and listening to music. Conversation was limited for some of the residents and staff members were seen to talk openly with all residents in a warm, inclusive, respectful manner that promoted choice. The inspection took the form of a tour of the building, individual discussion with three residents, three staff members and the manager, observation of all residents, group discussion with two residents, examination of care plans, records and certificates and compliance with requirements and recommendations from the last inspection. What the service does well: What has improved since the last inspection? Residents have benefited from the improved, updated information seen held on each resident, the regular resident meetings held by key workers and the increased training of staff members to ensure the needs of residents are fully met and they are consulted. Northfields DS0000027527.V264317.R01.S.doc Version 5.0 Page 6 What they could do better: The requirements and recommendations from the last inspection have mostly been complied with but there is still more to do to completely ensure that residents are fully protected, consulted and the environment well maintained in all areas. The following six requirements and three recommendations were made to further improve the experience of living and working at the home for residents and staff. • A record of the program of day care facilities residents attend, the support they require to get ready and details of the transport arrangements must be held in their plan of care to ensure their needs are fully met. Staff members must undertake additional training in the administration of medication on a regular basis and when an incident has occurred to ensure residents are protected. Residents must have their arrangements at death recorded in their plan of care to ensure that they are consulted and that the wishes of all residents are known. Deep cleaning or replacement of the carpets that are stained must be carried out to make all areas of the home attractive for residents. The target of 50 of staff having completed NVQ2 training must be met to ensure that staff members are fully trained to meet the needs of residents. The Quality Assurance system to be carried out in the home must include feedback and the views of residents, visitors/relatives, other professionals and staff to ensure that the opinions of everyone are sought on the standard of care and service provided at the home. It is recommended that residents be encouraged to wear a dressing gown when sitting in the lounge to ensure their dignity is maintain. It is recommended that the training records held for each staff member are stored in their individual file. It is recommended that a copy of the inspection reports completed by CSCI be made available to relatives and visitors to the home. • • • • • • • • 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. Northfields DS0000027527.V264317.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Northfields DS0000027527.V264317.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 4, 5, The written information available about the home is complete and enables residents and staff to make a decision on whether the home will meet the needs of anyone wishing to live there. EVIDENCE: The homes Statement of Purpose, Service User Guide and Terms and Conditions contract were seen and found to contain relevant information. The manager said that prior to admission as much information as possible was collected from a prospective resident, their family and other professionals. She said residents, their family or friends sometimes visited the home, that she often visited residents in their own environment and that residents were admitted on a one-month trial basis. No resident had been admitted to the home and the records held showed that an assessment was completed prior to admission to the home to ensure that the needs of residents were identified as being able to be met by the home, that the views of residents, their family members and other professionals were sought and that residents and their relatives, friends or advocates visited the home prior to admission. Northfields DS0000027527.V264317.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 8, 9, The health and personal care needs of residents were met, they were well looked after and the records held had improved but were not fully completed. EVIDENCE: Residents were seen to be well looked after and examination of four plans of care revealed that they were improved and contained personal health and social care information, daily report, exceptional report, food chart, nutrition, support plan, routine, professional guidelines, ok health check, involvement with other professionals, medical appointments, weight records, key worker meetings, risk assessments, reviews, personal, social and leisure activities and a photograph of the resident. However, they did not contain a program of the day care facilities residents attend, the support they require to prepare and details of the transport arrangements and a requirement was made that this information be held in their plan of care to ensure their needs are fully met. Staff members gave examples and records demonstrated that residents were consulted on their daily activities, given choice, supported to take risks, were protected and that their confidentiality was maintained by the individual and safe storage of their information. Northfields DS0000027527.V264317.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 13, 16, 17 Meals and social activities are both planned and provide daily variation and interest for the people living in the home. EVIDENCE: Residents have access to community leisure activities and records were seen to demonstrate that residents attend a local day centre, take part in-house activities such as music and cookery and enjoy outings such as shopping, going for walks, attend community events such as the theatre and are taken on holiday by staff members. The staff gave examples of how they work with residents to support them in their personal development, behavioural management and in maintaining friendships and relationships by working with other professionals, encouraging each resident to be independent and to make choices whilst ensuring that the rights of each resident were promoted and protected. Staff said that the menus were agreed with residents, twice a week, before the shopping was carried out and records showed that the meals were varied and balanced and food hygiene certificates held by staff members. Northfields DS0000027527.V264317.R01.S.doc Version 5.0 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20, 21 Personal support is given to residents in the way they prefer, their needs are met but they are not fully protected by the homes medication procedures. EVIDENCE: Residents were assisted with decision-making and the staff spoken to said that they assisted the residents with limited communication skills by understanding their response to questions and preferred manner of communication, using simple sign language, pictures, observation and as recorded. The plans of care did not contain the arrangements at death for each resident and a requirement was made that this information be held for each resident to demonstrate that they were consulted and their wishes known. Residents said that they received personal and emotional support from staff members who were always willing to listen to them and demonstrated that they knew who to tell if “they were unhappy”. Two residents were observed to have had a bath following their return from an outing and a day care facility and both said that they chose to wear their nightclothes and not get dressed again. However, one resident chose to sit in the lounge in his pyjamas and a recommendation was made that he be encouraged to wear a dressing gown when sitting in the lounge to ensure his dignity is maintain. Northfields DS0000027527.V264317.R01.S.doc Version 5.0 Page 12 Records demonstrated that staff had undertaken training in medication administration, medication was stored correctly, policies and procedures were held but had not been fully complied with on one occasion when medication, was administered by a staff member to the wrong resident. Records demonstrated that the appropriate action was taken to protect the health of the resident and a requirement was made that the member of staff be retrained. The manager said that since the incident the member of staff had not administered medication and was to be retrained. Northfields DS0000027527.V264317.R01.S.doc Version 5.0 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 The home has an active procedure on the protection of vulnerable adults that protects residents and supports the investigation of any cause for concern. EVIDENCE: No complaints have been received by the home since the last inspection however, a complaint was received by the APU from a health professional and passed to CSCI on the 02nd December 2005 that a resident did not give consent for a procedure carried out on him and that restrictive practice was being carried out on the resident. There were four elements to the complaint and following an investigation by APU and CSCI no evidence of restrictive practice was found but one element of the complaint was partially upheld and two requirements were made. Residents spoken to all said that if they were unhappy they would tell their key worker or the manager and all agreed that they would be listened to and appropriate action taken to resolve the problem to the satisfaction of all concerned. Residents are protected from abuse, neglect and self-harm by the objectives, policies and procedures of the home and staff have undertaken training in Adult Abuse to help them recognise, prevent and deal with any potential abuse. Northfields DS0000027527.V264317.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 29, 30 The standard of the environment within this home is mainly good providing residents with an attractive, safe and homely place to live, however some areas require attention. EVIDENCE: The home is purpose built and a tour of the building revealed that improvements have been made and that residents benefit from a home that has a bright, homely environment that was clean, odour free, well decorated in most areas and furnished and maintained to a good standard. The carpets in the hallways and some bedrooms were in need of deep cleaning or replacing and a requirement was repeated. The manager said that she was in the process of arranging for the carpets in the hallways to be cleaned. The home has specialist equipment, sufficient and suitable adapted toilet, bathing and washing facilities and residents had personalised their bedrooms. All infection control measures were in place and the laundry room contained a service washing machine and tumble dryer and sluicing facilities to aid in the protection of the health and safety of all residents and staff. Northfields DS0000027527.V264317.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 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, 34, 35, 36 Staff member are competent, the procedure for the recruitment and training of staff were robust and provide adequate safeguards to protect people living at the home. EVIDENCE: Residents were well cared for and staff members were aware of the needs of each resident and their role and responsibilities. Staff members spoken to said that they felt supported by the manager, assistant manger, the daily handover, received supervision and attended staff meetings to ensure the protection of those living at the home. Records showed that residents were fully protected because all staff recruitment checks had been carried out and CRB checks, references, personal details and proof of identity of each staff member were held in each staff file. Staff had undertaken basic training such as induction and foundation, food hygiene, emergency aid, medication, moving and handling and some staff had completed training in challenging behaviour. The numbers of staff that had completed or commenced NVQ 2 or NVQ3 had increased however, staffing changes had resulted in three new staff members working at the home and a requirement was made that the increase in the numbers of staff undertaking NVQ2 be continued to enable the target of 50 to be met and to ensure that Northfields DS0000027527.V264317.R01.S.doc Version 5.0 Page 16 staff were fully trained to meet the needs of residents. A recommendation was also made that the list of the training undertaken by staff members that is stored in one file be held in their individual staff file to demonstrate the training and updated training that staff had completed and to ensure confidentiality is maintained. Northfields DS0000027527.V264317.R01.S.doc Version 5.0 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 40, 41, 42, 43 The manager is supported by the assistant manager, in providing leadership, guidance and direction to staff to ensure that residents receive a good standard of care and support. EVIDENCE: Residents and the staff spoken to said that the home was run in a way that promoted the best interests of those that live there, that the manager was supportive and had a friendly, open approach that promoted team work. Residents are protected by the management and administration procedures carried out in the home. Policies and procedures have been produced on all aspects of the home and service provided and the records held promote and protect the rights and best interests of each service user. Those who returned their comment cards commented that they did not have access to inspection reports produced by CSCI and the manager said that plans were being discussed to make them available to relatives, visitors, other Northfields DS0000027527.V264317.R01.S.doc Version 5.0 Page 18 professionals and staff in the future therefore a recommendation was made that copies be available to anyone who wished to read them. A Quality Assurance system is in the process of being produced that the manager said would be carried out monthly with residents. A requirement was made that the Quality Assurance system include the feedback and views of residents, relatives, visitors, other professionals and staff members on the standard of care, service, facilities and lifestyle provided for residents and that an action plan of improvements be produced from the information gathered. To ensure that the health and safety of residents is protected the servicing and testing of all equipment had been carried out, relevant and timely certificates were held and records were stored securely. The manager successfully monitored identified financial budgets for the home and there was no reason to doubt that the financial security of Elizabeth Fitzroy Support was not sound. Northfields DS0000027527.V264317.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 X 3 3 Standard No 22 23 Score 2 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X 3 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 X 3 3 LIFESTYLES Standard No Score 11 3 12 X 13 3 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score 3 X X 3 2 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Northfields Score 2 3 2 2 Standard No 37 38 39 40 41 42 43 Score 3 3 2 3 2 3 3 DS0000027527.V264317.R01.S.doc Version 5.0 Page 20 YES 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 YA6 Regulation 17.1 Requirement The registered person must ensure that a program of day care facilities residents attend is held in their plan of care. The registered person must ensure that staff members are retrained in the administration of medication. The registered person must ensure that the arrangements at death are recorded in the plan of care of each service user. The registered person must ensure that the carpets in the home are deep cleaned or replaced. (Previous target of 31st October 2005 not met) The registered person must ensure that the target of 50 of staff undertaking NVQ2 training is met. The registered person must ensure that an effective Quality Assurance system is in place and carried out in the home. Timescale for action 31/03/06 2. YA20 13.2 01/02/06 3. YA21 12.2 30/04/06 4. YA24 23.2.b 31/03/06 5. YA35 18.1.c 31/03/06 6. YA39 24.1.2.3 30/06/06 Northfields DS0000027527.V264317.R01.S.doc Version 5.0 Page 21 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 YA18 Good Practice Recommendations It is recommended that residents be encouraged to wear a dressing gown when sitting in the lounge to ensure their dignity is maintain. It is recommended that a copy of the inspection reports completed by CSCI be made available to relatives and visitors to the home. It is recommended that the training records held for each staff member are stored in their individual staff file. 2. YA39 3. YA41 Northfields DS0000027527.V264317.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Northfields DS0000027527.V264317.R01.S.doc Version 5.0 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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