Inspection on 30/05/08 for Norton Court Nursing Home

This inspection was carried out on 30th May 2008.

CSCI found this care home to be providing an Adequate service.

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 08/05/07

Norton Court Nursing Home 30/05/06

Norton Court Nursing Home 07/11/05

Norton Court Nursing Home 24/05/05

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 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Norton Court Nursing Home 2 Norton Court 201 Norton Road Stockton-on-Tees TS20 2BL Lead Inspector Mr Steve Tuck Key Unannounced Inspection 30th May 2008 9:50 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 Norton Court Nursing Home DS0000000192.V365891.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Norton Court Nursing Home DS0000000192.V365891.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Norton Court Nursing Home Address 2 Norton Court 201 Norton Road Stockton-on-Tees TS20 2BL 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) 01642 558234 01642 363858 norton.court@fshc.co.uk www.fshc.co.uk Tamaris Healthcare (England) Ltd Mr Adrian Peter Webb Care Home 50 Category(ies) of Dementia - over 65 years of age (0), Mental registration, with number disorder, excluding learning disability or of places dementia (0) Norton Court Nursing Home DS0000000192.V365891.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. To accommodate up to 4 individuals who are aged 55 years or above with Dementia care needs. 8th May 2007 Date of last inspection Brief Description of the Service: Norton Court is a care home which provides accommodation, personal and nursing care for fifty people. The home supports people who are older and may have mental health needs including dementia. The building provides 42 single rooms and there are also communal toilets, showers and bathrooms, situated throughout the building, which are fitted with adaptations to help people who are frail or have difficulty getting around. Each floor has several lounge and dining areas which have been set out to make best use of the daylight and views of the gardens. The building is in a well-established residential area alongside two other care services. There are car parking spaces at the front of the building including disabled parking bays near the entrance. There is easy access into building through the main doors into the reception area. Norton Court is a short walking distance from local shops, is a short bus or car ride from Stockton town Centre. There is access to local transport directly outside the building. The home is run and managed by Tamaris Healthcare (England) Limited a company which is owned by Four Seasons Health Care Limited. The weekly fees for living at this home are between £389 to £496 The costs of newspapers, hairdressing, and toiletries are not included in the fees. Fees vary depending on people’s circumstances, further details can be found in the homes Service User Guide. Norton Court Nursing Home DS0000000192.V365891.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This inspection took place over three days and was a scheduled unannounced inspection. Before the visit: We looked at: • Information we have received since the last Key Inspection. • How the service dealt with any complaints & concerns since then. • Any changes to how the home is run. • The provider’s view of how well they care for people. We asked them to examine their own service and write to us with the results. The Visit: An unannounced visit was made on 30th May 2008. During the visit we: • Talked with the people who use the service, the staff and the deputy manager. • Observed life in the home. • Looked at information about the people who use the service & how well their needs are met. • Looked at other records, which must be kept. • Checked that staff had the knowledge, skills & training to meet the needs of the people they care for. • Looked around parts of the building to make sure it was clean, safe & comfortable. • Checked on what improvements had been made since the last visit. We told the deputy manager what we had found. What the service does well: The home has a friendly atmosphere and the staff who work there are open and welcoming so that the people who live their and their relatives or visitors feel comfortable, supported and are put at ease. One relative said, “They’re marvellous I don’t have to worry, I know these people are genuinely care for the people who live here.” Norton Court Nursing Home DS0000000192.V365891.R01.S.doc Version 5.2 Page 6 People who move to the home have their needs assessed by social or healthcare workers and the manager so that everyone is sure that this is the right place for them to live. This is very important, as people often have complicated needs that require well managed and agreed ways of supporting them. The home is successful at supporting people who have found it difficult to live in a care home and have ways of expressing themselves which challenges staff. Care is provided to people with a wide range of needs, with varied expectations and backgrounds. This diversity is reflected in the staff team, giving the manager the opportunity to recruit staff from the same background as the people living in the home. This ‘match’ helps staff to understand peoples’ needs and people who use the service are more reassured that they get support from staff who understand them. Both care practice and staff recruitment practices are governed by equal opportunity principles. Staff are selected in ways that makes sure they are suitable to work with vulnerable people and more than half of the care team have recognised care qualifications. What has improved since the last inspection? What they could do better: Plans which show how people are to be cared for must be written in enough detail to show the specific actions staff are to take to support peoples’ needs, preferences and lifestyle. And care plans must be written in enough detail so that they can be used to co-ordinate the work of staff and show if changes in peoples’ condition have taken place. Where people have dementia, the home must follow current best practice to make sure that peoples’ plan of care and staff support is relevant to their history and needs. There needs to be adaptations made to the surroundings so that people with dementia remain as independent as possible and be reassured by surroundings that they find familiar. Norton Court Nursing Home DS0000000192.V365891.R01.S.doc Version 5.2 Page 7 The manager and staff must be vigilant to make sure that regardless of the pressures they are under, the privacy and dignity of people living at the home is always upheld. There must be an accurate record of the amount of medication held at the home. Where staff decide that people living at the people need to have medication or not, then the way that they make that decision must be written down. Maintenance must be improved, it needs to be planned, happen quicker and anticipate that heavily used areas such as the first floor will need more maintenance and refurbishment. And there must be no offensive odours at 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. The summary of this inspection report can be made available in other formats on request. Norton Court Nursing Home DS0000000192.V365891.R01.S.doc Version 5.2 Page 8 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 Norton Court Nursing Home DS0000000192.V365891.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Trained staff from the home find out and understand the needs of people who wish to live there before they move in. This information helps to make sure that peoples needs can be met at the home and agree the ways in which staff are to support them. EVIDENCE: People who live at the home have an agreement about the purpose of their stay, proposed length of stay, and fee levels. This should help them to understand their rights and the homes responsibilities. By looking at the record kept at the home we could see that each persons needs are assessed before they move to the home, either by health services staff, local authority social workers and the manager. This is so that the Norton Court Nursing Home DS0000000192.V365891.R01.S.doc Version 5.2 Page 10 manager has a good understanding of peoples’ health and social care needs and can be sure that the home is going to be suitable for people who are going to live there. The manager also finds out what cultural and lifestyle needs people have to make sure that these can be met. The manager and senior staff have also had training which has given them the skills to find out what peoples needs are. As a result of these measures, all of the people living at the home at present have been properly placed and the home is able to meet their needs. One relative said, “ I was pleased that the home could respond to my mothers needs, they asked her and us what we felt she would need which made the difficult choice of her moving into the home much easier.” Norton Court Nursing Home DS0000000192.V365891.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Each person has an individual plan of care, which should set out in detail their preferences and how their assessed needs will be met. But these do not fully describe the measures which staff are to use therefore making it difficult for them to consistently meet peoples’ needs. EVIDENCE: All people who live at the home have a plan of care which gives a description of how their needs are to be met. There is a set structure for these records with pre-printed documents for staff to fill in. Where people have clearly identified nursing care needs or treatments taking place these are written down and regularly updated by nursing staff. Peoples physical condition is also monitored for example their weight is monitored to make sure they are eating enough to stay healthy and steps are taken to help prevent people from getting pressure damage or recover from it. Norton Court Nursing Home DS0000000192.V365891.R01.S.doc Version 5.2 Page 12 However records which describe how their social care needs are to be met did not match the actual support and actions which staff currently carry out. Staff have a variety of knowledge and experience of caring for people living at the home but this information is not yet successfully combined in the care plans so that these can be used to consistently provide fully co-ordinated care. All of the staff interviewed could describe peoples’ needs, preferences and histories, however the potential areas of good practice were not generally shared with colleagues nor were these written down in care plans. For example: - Someone who is likely to fall over because they prefer to walk with their eyes shut did not have a plan in place which describes how staff are to support them to get enough rest. - One person with continence needs did not have an assessment or a plan in place to describe how staff are to support them. - One person who finds it difficult to accept help to bathe did not have a plan in place which describes the way that staff are to support them. - Three peoples records which were looked at which did not have life histories or personal descriptions which described them, their lives and backgrounds; although this was known by staff. - The way that staff support one person who gets frustrated, upset and physically challenges staff is not written in their care plan. - There is not a plan in place which describes how support would help someone who has enjoyed being outside in the homes gardens in the past, to do that once again. As well as this, for people who have lived at the home for a number of years, some of their needs and wishes have changed with time. Staffs’ knowledge and understanding of their needs had not been written into care plans. For example some people on the first floor have particular phrases they use, activities or actions and staff give consistent responses which they know will put people at ease and make them feel more comfortable. One of the staff said, “I now realise its important to write down the things that I know about someone’s life; we know a lot about people here but we don’t write that down.” The home is registered to provide care to people who have mental ill health or dementia type illness. Care planning arrangements for these people do not yet reflect current best practice. For example, care plans do not specify how people who have an altered sense of time or reality are to be supported or Norton Court Nursing Home DS0000000192.V365891.R01.S.doc Version 5.2 Page 13 what their personal timescales actually are. Care plans, which place the person at the centre of a network of support for their needs and lifestyle requirements, are yet to be put in place. This can be particularly important for people who become increasingly reliant on staff as their level of dementia increases. The deputy manager can show that she has been careful to make sure that people living at the home are able to be successfully supported there and that their nursing care needs can be effectively met. She shows a full understanding of the needs of the people who live at the home and works in partnership with other healthcare professionals. Due to their levels of need, people who live at the home are not able to organise their own medicines, and appointed staff therefore help in this area. Nursing staff who are trained in this area administer medication at the home. Medication is securely stored and records are kept which should help staff to make sure that people living at the home have the medication that they have been prescribed. But three of the seven records examined had mistakes. After looking at this in more detail, the deputy manager confirmed that three people had too much medication in stock because their unused tablets had built up in previous months and had not been returned to the pharmacist as they should have been. Some people’s Doctors have prescribed them medication which they can take if they are upset or stressed. Staff gave good descriptions of the techniques they use to divert or resolve peoples’ anxieties so that they only have to use this medication when it is absolutely necessary; and the home is successful at supporting people who challenge in this way. Both care and nursing staff said that they recognise when people should be encouraged to take their medication although this is always a last resort. But the way that they make this decision is not yet clearly written down. Since the last inspection there has been one incident when the privacy and dignity of one person living at the home was not upheld as their personal care tasks were not carried out in private. The manager has since taken steps to make sure that all staff support peoples’ personal care in private and peoples’ dignity is respected. Norton Court Nursing Home DS0000000192.V365891.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live at the home are encouraged and supported by the staff to lead fulfilling lives with their rights as individuals being respected and to eat healthily which supports their physical and emotional wellbeing. Contact with family members and friends are supported where possible so that people keep up links with those outside the home. EVIDENCE: The home is a busy place with visitors coming and going and staff who encourage people to talk, be included and feel comfortable. People living at the home and staff talked about the things that they do at the home. There are two staff who are activity co-ordinators at the home who help to think of ideas, plan and support people to take part in meaningful pastimes. For example games sessions, cooking (baking cakes), film nights, bingo, seasonal social events and other celebrations, performers and entertainment. Events are organised so that family members can attend and some people go out from the home with their friends or relatives which helps them to stay in touch. The Norton Court Nursing Home DS0000000192.V365891.R01.S.doc Version 5.2 Page 15 manager is looking at ways to support the activities of people who have dementia type illness which may prevent them from taking part in group activities. A number of corridors which have a theme relating to their past histories is being designed. The homes gardens are well planned and maintained by the handyman so that they can be used by people at the home and there is easy access to a summer house. People living at the home are encouraged to make choices about their diet. Most said that they like the meals at the home and that they are asked what they would like to eat. Staff were seen asking people about their choice of meal and size of portion to make sure that people got what they wanted. Comments from some of the people living at the home were, “The food is good – better than my cooking.” “I have enjoyed my lunch today.” Staff are available during meals to offer support and assistance where needed The cook have extensive knowledge of the meals which people living at the home prefer. She understands the benefit of using fresh ingredients to help people to remain. Menus were available which confirmed that a range of meals are provided which give people a balanced diet and refreshments are available throughout the day and night. People living at the home and their families are involved in choosing the meals that are included in the menu. Where people need it food supplements are available to help people to maintain their health for example if they have diabetes or have difficulty maintaining their weight. Norton Court Nursing Home DS0000000192.V365891.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home and their families can make a complaint if they are unhappy, have a grievance or dispute which helps them to have control over their lives and there are measures in place which protect people who live at the home from being harmed which helps to promote their safety and security EVIDENCE: There is a complaints procedure which tells people what to do if they are not happy. This informs people about who they should make a complaint to and how much time that a complaint will take to look at. There is a record kept at the home of all complaints, which includes details of any investigation and the outcome. No one has approached the Commission for Social Care Inspection (CSCI) because they have been unhappy with the way that the home has managed their complaint. A relative said, “If I had a problem I would speak to the manager straightaway- they don’t have a problem with you approaching them if you are unhappy.” Although it has been shown that no abuse has taken place at the home, there has been six instances since the last inspection where staff or the manager Norton Court Nursing Home DS0000000192.V365891.R01.S.doc Version 5.2 Page 17 have raised concerns. This has shown that staff and the manager are actively monitoring the service that is delivered and the day-to-day lifestyles of people at the home. While investigations by workers from the local council, the homes managers and the Police has shown that abuse has not taken place, the outcomes of this work has identified areas where practices at the home need to improve. For example to make sure that peoples privacy and dignity is respected. Norton Court Nursing Home DS0000000192.V365891.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People live in an environment which is homely and should promote their privacy, independence and comfort during their stay. But this could be improved if better, more regular maintenance and replacements take place. EVIDENCE: All communal areas and some of the bedrooms were viewed during the inspection. Norton Court is a purpose built home which has been designed to provide accommodation for older people with a range of care needs. Norton Court Nursing Home DS0000000192.V365891.R01.S.doc Version 5.2 Page 19 Although an older building built in the 1980’s it has been designed to provide a number of different lounge and dining areas and give people a variety of places in which they can spend their day. The outside of the building is well maintained with attractive garden areas and open spaces which people like to look at or enjoy. Inside the home there are some areas such as the downstairs lounge which have recently been refurbished by the staff in their own time, and the handyman (who is a tradesman). The furniture fittings and standard of finish is excellent but unfortunately this contrasts with other areas of the home such as the first floor lounge and corridors which have damaged paintwork and soft furnishings which are in urgent need of replacement. Bathroom facilities on the first floor were also noted to be in a poor state of repair. One bathroom in particular which is used by most people had a broken cistern, peeling discoloured paintwork and was not a pleasant facility for people to use. Also, the first floor medical room has a very strong unpleasant odour which the owners had been unable to rectify. These areas were brought to the attention of the deputy manager. The deputy manager also confirmed that whilst the handyman carried out maintenance, the inside of the home has not benefited from an organised scheme of refurbishment and renewal but that this has been promised by the owners and contractors had visited to view the scale of the work. People did say that they were happy with their rooms and some had brought personal possessions and keepsakes which made them feel at home. One relative said, “We’ve tried to make it a home from home for her with photographs and her ornaments.” One person living at the home said, “I like being in my room its quiet and they look in on me to see if I’m alright.” People who have dementia live on part of the first floor of the home. Although the manager has plans for themed corridors at the home, at the time of the inspection there were no adaptations in place which help to make sure that current best practice for people with dementia can be followed. For example, changes to signage around the home, the placing of appropriate photographs and creating distinct colour contrasts / schemes to people to find their way around. Research by experts has shown that adaptations like this help to support people with dementia who may become increasingly needy. Laundry is carried out at neighbouring home situated across the car park. This arrangement appears to work well for the people at the home and arrangements are in place to make sure that clean clothing is always returned to their owner and mistakes are avoided. Norton Court Nursing Home DS0000000192.V365891.R01.S.doc Version 5.2 Page 20 The home is inspected by the Fire Prevention Authority and the local council to make sure that the building and safety systems are suitable for the protection of those who live and work there. Norton Court Nursing Home DS0000000192.V365891.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are sufficient staff working at the home to meet the needs of the number of people who presently live there. The ways that staff are employed makes sure that people are protected and most staff have been trained to make sure that their care practice is good. EVIDENCE: At the time of the inspection there were 32 people living at the home and the manager has organised the home so that overall there are sufficient staff available to meet the needs of people who currently live there. However since the last inspection there has been one reported instance where there were insufficient staff available to properly support people. The deputy manager confirmed that if someone now needs additional support because they have needs which challenge the service then sufficient staff are made available to support them. Staff spend time with people who live at the home, listening to their opinions and experiences and taking part in discussions and laughing together which creates a happy atmosphere at the home. Staff turnover at the home is low Norton Court Nursing Home DS0000000192.V365891.R01.S.doc Version 5.2 Page 22 which gives people who live there and staff the opportunity to get to know each other. The manager confirmed that the majority of the staff team have now attained NVQ awards in care at level 2, and some are working towards either Level 2 or 3. There is a plan in place which describes the training which staff are to undertake and is based on their personal training requirements and interests. The cook has recently achieved an NVQ level 3 in Food standards and hygiene. The manager makes deliberate attempts to recruit staff from similar cultural backgrounds as the people living at the home. In some cases they share the same community and social links which helps to make sure that people are confident with the way in which they are supported. The manager and staff confirmed that that people are not appointed before checks are carried out. This includes receiving appropriate references and completing a criminal record check. Norton Court Nursing Home DS0000000192.V365891.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The managers at the home makes sure that people who live there are supported properly and give leadership and direction to staff so that the quality of the service they give is improved. EVIDENCE: The manger has worked at this home for about ten years is a qualified nurse and has recently completed his Registered Managers training (RMA). The deputy manager who has been appointed to the home in the past six months is also a qualified nurse who has experience and training to support the needs of people who have mental health needs and dementia. Both managers have Norton Court Nursing Home DS0000000192.V365891.R01.S.doc Version 5.2 Page 24 many years experience on which to base her practice and continue to demonstrate considerable knowledge and skill in this care setting. The manager and deputy have shown there capacity to organise the service on a day to day basis and following the management and direction of the organisation. This reassures people living at the home and their relatives that the service can continue to be provided in their best interests The manager collects the views of service users, families and friends so that he can check to see if the service is meeting the needs of all parties. There are a number of meetings held at the home and other informal occasions where the manager is able to check that people are satisfied with the service. This helps the manager to monitor progress and develop the service. There were no noticeable hazards at the home throughout the inspection and arrangements are in place to minimise risks for service users and staff. The home is also subject to inspections by the Fire Authority and local authority environmental health officers to make sure that the home is safe. Norton Court Nursing Home DS0000000192.V365891.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 3 2 X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Norton Court Nursing Home DS0000000192.V365891.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15 Requirement The manager must make sure that all care plans must have enough detail to show the specific actions staff are to take to support their needs preferences and lifestyle. Reviews must reflect the progress towards those goals. This is to make sure that staff plan and review how they work with people and that they write this down so that everyone in the home works in the same way. 2 OP7 12 This is a new Requirement. The manager must make sure that all support for people with dementia follows current best practice and this is recorded in each persons care plan. This is to make sure that people who have dementia at the home are supported in ways that are most suitable for them. This is a new Requirement. Norton Court Nursing Home DS0000000192.V365891.R01.S.doc Version 5.2 Page 27 Timescale for action 01/09/08 01/09/08 3. OP9 13 The manager must make sure that there is an accurate record of all medication held at the home. This is to make sure that people get the treatment they have been prescribed. 15/07/08 4. OP9 13 This is a new Requirement. Where people are prescribed medication to take only when they need it, the manager must make sure that staff have clear guidance which show how staff have made these judgements. This is to help staff to make consistent judgements about when people need to take the medication they have been prescribed. 15/07/08 5. OP10 12 This is a new Requirement. The manager must make sure that there are no practices taking place at the home which do not promote the privacy and dignity of people living there. This is to make sure that people living at the home are properly treated. 30/07/08 6. OP19 23 This is a new Requirement. 30/07/08 The manager must make sure that there is a plan of urgent and routine maintenance, redecoration and refurbishment must be developed and start to be implemented. This is so the home can be brought up to acceptable standards of repair, hygiene and comfort. Norton Court Nursing Home DS0000000192.V365891.R01.S.doc Version 5.2 Page 28 7 OP22 23 This is a new Requirement. The manager must make sure that adaptations to the home are in place that support people with dementia and follow current best practice. This is to make sure that people with dementia are supported in an environment which best suits their needs. 15/09/08 8 OP26 16 This is a new Requirement. The manager must make sure that there are no offensive odours at the home. This is to make sure that people live and work in hygienic and pleasant surroundings. This is a new Requirement. 30/07/08 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 Norton Court Nursing Home DS0000000192.V365891.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Norton Court Nursing Home DS0000000192.V365891.R01.S.doc Version 5.2 Page 30 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!