Inspection on 24/05/05 for Norton Court Nursing Home

This inspection was carried out on 24th May 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 but made no statutory requirements on the home.

Other inspections for this house

Norton Court Nursing Home 25/11/08

Norton Court Nursing Home 30/05/08

Norton Court Nursing Home 08/05/07

Norton Court Nursing Home 30/05/06

Norton Court Nursing Home 07/11/05

Norton Court Nursing Home 13/10/04

Norton Court Nursing Home 20/05/04

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

CARE HOMES FOR OLDER PEOPLE Norton Court Nursing Home 2 Norton Court 201 Norton Road Stockton-on-Tees TS20 2BL Lead Inspector Jane Bassett Unannounced 24 May 2005 10:00am 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. Norton Court Nursing Home B51-B01 S192 Norton Court V228710 240505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Norton Court Nursing Home Address 2 Norton Court, 201 Norton Road, Stockton-onTees, TS20 2BL 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) 01642 558234 01642 363858 Tamaris Health Care (England) Ltd, (Whollly owned subsidiary of Four Seasons Healthcare) Sheryl Tonia Smith CRH 50 Category(ies) of DE(E) Dementia - over 65 registration, with number MD Mental Disorder of places Norton Court Nursing Home B51-B01 S192 Norton Court V228710 240505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: No conditions of registration. Date of last inspection 13th October 2004 Brief Description of the Service: Norton Court is a 50 bed care home providing both personal and nursing care for older people with mental health needs including dementia. It is a teo- storey purpose built home providing single accomodation, 42 with en-suite toilet facilities. A passenger lift gives residents access to the first floor. There are 3 lounges and dining facilities that are available for residents as well as a patio area situated at the rear of the building. The home is situated approximately two miles from Stockton town centre and is close to local amenities, shops and public transport. The home provides a car park for use of visitors. Norton Court Nursing Home B51-B01 S192 Norton Court V228710 240505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. During the inspection the inspector spoke to two family members, three staff and the manager of the service. Due to the residents capacity and frailty it was not possible to obtain their opinion of the home, however all residents seen appeared settled and comfortable in their surroundings. Documentation including plans of care, and staff records were examined. A total of five hours were spent at the home. What the service does well: What has improved since the last inspection? What they could do better: The employment process must be made more robust to protect the residents from possible abuse. Care plans need to include evidence of assessment for all residents to ensure that individual plans of care are appropriate to need. Residents or their representatives must be provided with agreed terms and conditions of service provided. Norton Court Nursing Home B51-B01 S192 Norton Court V228710 240505 Stage 4.doc Version 1.30 Page 6 Refurbishment should be continued to maintain the improvement of the environment for residents, this must include compliance with the Lifting Operations and Lifting Equipment Regulations 1998 and the Fire Officers recommendations, to promote the comfort and safety of residents. 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. Norton Court Nursing Home B51-B01 S192 Norton Court V228710 240505 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 Norton Court Nursing Home B51-B01 S192 Norton Court V228710 240505 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 & 4 The admission procedure carried out by the home was found to include assessment of care needs for individual residents, based on activities of daily living. Families spoken to confirmed this. This should ensure that the home can meet the needs of the residents. EVIDENCE: The manager informed the inspector that the home still awaited terms and conditions of accommodation to be agreed with residents or their representatives as identified at previous inspections. Three residents care files were examined, these contained evidenced of pre admission assessments carried out by the home. Two of the files also contained assessment information supplied by social worker and hospital staff. The family members who spoke to the inspector told her that they had the opportunity to visit the home and discuss care needs prior to admission. Norton Court Nursing Home B51-B01 S192 Norton Court V228710 240505 Stage 4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 & 10 Families who spoke to the inspector were satisfied with the care that their relatives receive. Care plans included documentation that should ensure that residents assessment of need are recorded, however work needs to continue to ensure that this is applicable to all residents care plans. Without this there is no assurance that all care needs will be met. EVIDENCE: Three residents care files examined were found to contain documentation in relation to assessment of need. In all files the social assessment was found to contain little or no information. Moving and handling and continence assessments were found not to be completed in one of the files. All files were found to contain comprehensive plans of care, risk assessments, evaluations and records re behaviour and care received. Norton Court Nursing Home B51-B01 S192 Norton Court V228710 240505 Stage 4.doc Version 1.30 Page 10 There was no documented evidence of discussion of care needs with representatives, however both family members told the inspector that care needs had been discussed and they were satisfied with the care that their relative receives. One family member said they were ‘happy with the care’ and that ‘staff were obliging’. Another said staff were ‘friendly but respectful’ and created a ‘homely’ atmosphere that promoted residents comfort. Documentation in residents files indicated the home enables service users to access GP`s and other health professionals. Staff demonstrated through actions and responses that they ensure the service users privacy, dignity and choice in all aspects of daily living. Norton Court Nursing Home B51-B01 S192 Norton Court V228710 240505 Stage 4.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 & 14 Social activities are available for those who wish to participate and visitors are encouraged and made welcome. Staff demonstrated that they promote resident’s rights and choices. EVIDENCE: Families who spent time with the inspector said that they were always welcomed by the staff and could visit at any time. All who spoke to the inspector made positive comments with regard to the social activities that take place within the home, including games, craft and entertainment. Whilst activities may be limited due to resident’s capabilities staff encourage residents to participate. Staff were able to demonstrate through responses and observation of their actions that they ensured that residents were given the opportunity to make choices and that the routine of the home was flexible to accommodate these choices. It was difficult to ascertain the views of the majority of the service user group due to their capabilities, however all residents seen by the inspector appeared settled and comfortable in their surroundings. Staff also told the inspector that residents had access to churches for spiritual support if they wished. Norton Court Nursing Home B51-B01 S192 Norton Court V228710 240505 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 & 18 Staff demonstrated a understanding of and a commitment to the protection of the residents that they care for. Complaints are documented in such a way as to promote objectivity and confidence in the process. EVIDENCE: The manager told the inspector that the home has received one complaint since the previous inspection. Records seen showed that this had been recorded appropriately including outcomes and response to the complainant. One family member spoken to express his satisfaction with the response he had received to a concern raised, another confirmed that they were aware of how to raise a concern. A policy and procedure in relation to the protection of vulnerable adults from abuse is available to staff. All staff spoken to were aware of the actions that would be taken should a concern be identified and were able to demonstrate a commitment to protecting residents safety and wellbeing. Norton Court Nursing Home B51-B01 S192 Norton Court V228710 240505 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 & 26 Improvements have been made to the home, which have improved the environment for the resident’s comfort, however these need to continue to complete the refurbishment of the home. EVIDENCE: During the inspection it was noted that a number of environmental improvements have been achieved. These include the provision of new lounge and dining furniture, carpets to a number of bedrooms, lounge and corridor. A number of bedrooms have been re furnished and now provide lockable facilities. Vinyl flooring in shower, toilets and en-suites identified as stained at the previous inspection has been replaced. Decoration has been carried out to lounges, dining room, corridors and a number of bedrooms, however it was noted that the colour scheme was limited and bland. A number of service users bedrooms had been personalised with ornaments and pictures, where this was not the case all bedrooms looked similar. Norton Court Nursing Home B51-B01 S192 Norton Court V228710 240505 Stage 4.doc Version 1.30 Page 14 Work has been carried out to repair a number of the vanity units. Thermostatic valves have been fitted to hand basins, however this has created some exposed hot water piping in a number of en-suites that should be boxed in. The seat handle to one of the assisted baths was found to be broken and requires repair. Storage has been reviewed and improved by converting one unused bathroom to storage. The manager told the inspector that this leaves 6 bathing facilities, which meets the national minimum standard. Bathing facilities would be greatly improved if these were upgraded to meet the needs of the residents as recommended at previous inspections. The home was found to be clean, tidy and generally odour free. The manager told the inspector that it is planned to extend the kitchen facilities. The Commission for Social Care Inspection must be notified of any structural changes prior to work commencing. Norton Court Nursing Home B51-B01 S192 Norton Court V228710 240505 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 & 29 The procedure for recruitment of staff must be made robust and include POVA first checks for all staff prior to employment to promote protection to people living in the home. Staffing provide by the home was sufficient to meet the needs of the residents, however these must be monitored to ensure that they continue to meet any increasing dependencies. EVIDENCE: Staff and families who spoke to the inspector told her that the residents needs were currently being met, however staff are finding this increasingly difficult due to residents higher dependency levels. Three recently recruited staff files were examined, none of these contained a photograph. All file contained a Criminal Record Bureau check including POVA, however these were dated after employment. The manager said that POVA first checks had been obtained prior to employment, however there was no evidence to support this. One file contained only one reference and this had not been obtained from the previous employer. A robust process must be followed and risk assessments carried out for any concerns identified during this process prior to the commencement of employment in order to offer protection to vulnerable residents living at the home. Norton Court Nursing Home B51-B01 S192 Norton Court V228710 240505 Stage 4.doc Version 1.30 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 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) 31, 33, 35 & 38 The managerial style promotes an open and positive atmosphere. The home is maintained well, however action must be taken to promote residents safety and well being in relation to hoists and the fire officers recommendations. EVIDENCE: The manager told the inspector that she hoped to complete her NVQ level 4 in management in the near future. Whilst it is difficult to engage the service user group in meetings relatives are given the opportunity to meet with the manager. The Commission for Social Care Inspection are supplied with monthly reports following Regulation 26 visits. Residents, visitors and staff made positive comments about the staff team, good communication and support given by the manager. Staff said they felt supported and concerns raised were acted upon. Norton Court Nursing Home B51-B01 S192 Norton Court V228710 240505 Stage 4.doc Version 1.30 Page 17 The home continues to use a joint bank account for resident’s personal monies, however there are individual computerised records for each resident. Records seen indicated that regular checks are carried out with regard to hot water temperatures and fire alarm tests. Documentation indicated that fire drills have taken place. Staff spoken to confirmed this. Documentation seen indicated that maintenance and servicing had been carried out as required for the passenger lift, fire alarm, and potable electrical appliances. However certificates seen indicated that the hoists used for moving and handling residents have not been serviced since July 2004. Action must be taken in relation to recommendations made by the Fire Officer at his visit earlier this year. Norton Court Nursing Home B51-B01 S192 Norton Court V228710 240505 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 2 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION 2 x x x x x x 3 STAFFING Standard No Score 27 2 28 x 29 2 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 2 x 3 x 2 x x 2 Norton Court Nursing Home B51-B01 S192 Norton Court V228710 240505 Stage 4.doc Version 1.30 Page 19 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 2 Regulation 5 Requirement Contracts / terms and conditions of service must be developed and agreed with residents or representatives. ( previous timescale of 1st Januaruy 2004 not met) Appropriate assessments of residents needs must be carried out Exposed hot water piping in ensuites must be boxed in Repairs must be made to broken handle on bath seat Evidence must be recorded that all staff employed after 26th July 2004 must have undergone a POVA first check prior to employment. ( previous timescale of October 2004 not met) Two written references must be obtained prior to employment, one of which should be from previous employment Risk assessment to promote safety of vulnerable residents, must be carried out prior to employment if any concerns identified during staff recruitment Staff records must contain proof B51-B01 S192 Norton Court V228710 240505 Stage 4.doc Timescale for action 1st August 2005 2. 3. 4. 5. 7 19 19 29 15 13 23 19 1st August 2005 1st July 2005 1st July 2005 Immediate 6. 29 19 Immediate 7. 29 19 Immediate 8. 29 19 By 1st Page 20 Norton Court Nursing Home Version 1.30 9. 31 9 10. 11. 38 38 13 13 of identification including recent photograph The manager must obtain her NVQ level 4 or equivalant in management by the of end 2005. Action must be taken in relation to the Fire Officers report. Hoists used for the moving and handling of residents must be maintained and serviced as required in the Lifting Operations and Lifting Equipment Regulations 1998 August 2005 By 31st December 2005 By 1st August 2005 By 1st July 2005 12. 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. 3. 4. Refer to Standard 19 27 19 35 Good Practice Recommendations Consideration should be given to a more varied decor scheme in residents bedrooms to promote individuality and orientation. Staff levels should be monitored to ensure that residents needs are met if dependancy levels increase. Bathing facilities should be upgraded to meet service users needs. Individual bank accounts to be obtained for residents. Norton Court Nursing Home B51-B01 S192 Norton Court V228710 240505 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Unit B, Advance St Marks Court Teesdale, Stockton-on-Tees TS17 6QX 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 Norton Court Nursing Home B51-B01 S192 Norton Court V228710 240505 Stage 4.doc Version 1.30 Page 22 - 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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