Inspection on 07/11/05 for Norton Court Nursing Home

This inspection was carried out on 7th November 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 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 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 Inspection 11:00 7 November 2005 th 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.V256385.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Norton Court Nursing Home DS0000000192.V256385.R01.S.doc Version 5.0 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 Tamaris Healthcare (England) Ltd (wholly owned subsidiary of Four Seasons Health Care) Sheryl Tonia Smith 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.V256385.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Manager (Mrs Sheryl Smith) should attain a relevant Management qualification by 2005. 24th May 2005 Date of last inspection 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 DS0000000192.V256385.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. During the unannounced inspection the inspector spoke to three 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. The home submitted a pre inspection questionnaire. A total of five hours were spent at the home. What the service does well: What has improved since the last inspection? Care plans have been developed and were found to include evidence of assessment for residents to ensure that individual plans of care are appropriate to need. Work continues to be carried out, including the provision of a number of new carpets, bedroom, lounge and dining furniture. This has greatly improved the environment, promoting the comfort of residents. The programme of redecoration continues to take place however the colour scheme adopted by the company does not promote individuality of resident’s bedrooms. Exposed hot water pipes have been covered to reduce the risk of injury to residents as required at the previous inspection. Norton Court Nursing Home DS0000000192.V256385.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Norton Court Nursing Home DS0000000192.V256385.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Norton Court Nursing Home DS0000000192.V256385.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Contracts must be agreed with all residents and/or representatives to ensure that they are aware of the terms and conditions of services provided. EVIDENCE: The core standards were not assessed at this inspection. Evidence was seen that indicated Four Seasons Health Care have developed a contract/ terms and conditions of service. The inspector was told that the home is in the process of distributing these to resident’s representatives for agreement. Norton Court Nursing Home DS0000000192.V256385.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7&9 Families who spoke to the inspector were satisfied with the care that their relatives receive. Care plans included documentation that should enable the staff to meet the needs of the resident. Medication is administered as required promoting the safety and wellbeing of the residents. EVIDENCE: Four residents plans of care were examined these were found to contain documentation in relation to assessment need, including moving and handling, social assessment, continence assessment and nutrition. These were seen to be completed with appropriate information as required at the previous inspection. All files examined contained plans of care, risk assessments, evaluation and records regarding behaviour and care received. Norton Court Nursing Home DS0000000192.V256385.R01.S.doc Version 5.0 Page 10 Family members who spoke to the inspector told her that care needs were discussed with them and they were informed of changes. One family member said her relative received ‘good care’ and staff were ‘ friendly and supportive’. Another spoke of the ‘good communication’. Documents in resident’s files indicated the home enables residents to access GP’s and other professionals as necessary. A good rapport was observed between staff and residents. The home has a policy with regard to administration of medication. An audit of medication found no concerns with the ordering, storage, administration and disposal of medication. Norton Court Nursing Home DS0000000192.V256385.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15 The home offers a satisfactory and varied diet. EVIDENCE: The home uses a set four-week menu plan. Staff indicated alternatives were available and the food was of satisfactory quality and quantity. All dietary needs can be catered for. The home offers the residents a snack type meal at lunchtime and a more substantial meal at teatime. Staff felt this was working well, service users were more settled and there was less waste. Staff also said that service users have the choice of a full cooked breakfast if they wish. The inspector was informed that staff had access to food supplies so that service users could have a snack at any time even if catering staff were not on duty. Families who spoke to the inspector all expressed their satisfaction with the meals and choice provided. Norton Court Nursing Home DS0000000192.V256385.R01.S.doc Version 5.0 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 the following standard(s): These standards were not assessed on this occasion. EVIDENCE: Norton Court Nursing Home DS0000000192.V256385.R01.S.doc Version 5.0 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 the following standard(s): 19 Improvements continue to be made, improving the environment for resident’s comfort. EVIDENCE: On the day of the inspection the home was found to be pleasant, clean and odour free. Refurbishment to bedrooms continue including new furniture and decoration. It was noted that the colour scheme continues the same with no different décor between resident’s bedrooms. A number of these bedrooms were seen to be personalised with ornaments and pictures, where this was not the case all bedrooms looked similar. Norton Court Nursing Home DS0000000192.V256385.R01.S.doc Version 5.0 Page 14 Exposed hot water piping in ensuite noted at the previous inspection has been lagged to protect the residents from risk of injury. The inspector was lead to believe that these were to be boxed in, in the near future. The seat handle top one of the assisted baths continues to be broken as noted at the previous inspection. Bathing facilities would be greatly improved if these were upgraded to meet the increasing needs of the residents as recommended at the previous inspection. During the inspection it was noted that one of the bedrooms is now being utilised as a hairdressing salon. The inspector was told that there are plans to extend the kitchen facilities By utilising a bedroom. The commission for Social Care Inspection must be notified of any structural changes and contingency plans for provision of service prior to work commencing. Norton Court Nursing Home DS0000000192.V256385.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. 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. There should be at least one member of nursing staff on duty who has qualification in mental health. Training should take place for all staff with regard to the resident’s specific needs. EVIDENCE: The manager of the home had recently taken up post and as yet has not recruited any staff, however one of the two files of the recently recruited staff examined contained no evidence of CRB or POVA first check being carried out. This file also contained only one reference. Staff records seen included a photograph as required at the previous inspection. There was evidence in the second file of both CRB and POVA first check; however there was no record of the date of the CRB and at what level this was carried out. Norton Court Nursing Home DS0000000192.V256385.R01.S.doc Version 5.0 Page 16 Staff who spoke to the inspector indicated staffing levels currently met the needs of the residents, however, staff commented on the increasing dependencies causing some difficulties at busy times. It was also found that levels of qualified staff provided were appropriate, however on occasions this did not include a nurse with mental health qualifications. Four staff training files were examined these were found to contain evidence of mandatory training, such as fire safety and moving and handling. Other training completed included CoSHH, infection control, POVA, food hygiene and challenging behaviour. Staff who spoke to the inspector confirmed this. Information obtained in the pre inspection questionnaire indicated 30 of the care staff have achieved NVQ at level 2 or above. The manger told the inspector that further training including dementia awareness and managing conflict was planned. Norton Court Nursing Home DS0000000192.V256385.R01.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 & 35 The managerial style promotes an open and positive atmosphere. EVIDENCE: The manager has recently taken up the position. He is a Registered General Nurse, however he needs to complete an appropriate management qualification. The Commission for Social Care Inspection has received an application for registration in relation to the manager. Staff who spoke to the inspector commented on the smooth change of managers and the positive approach of the new manager. All said that he was approachable and issues raised were addressed. Norton Court Nursing Home DS0000000192.V256385.R01.S.doc Version 5.0 Page 18 The manager told the inspector that he has commenced quality audits of care planning, medication and accidents. Regulation 26 visit reports are supplied to the Commission for Social Care Inspection on a monthly basis. Documentation seen indicated regular service checks have been completed with regard to the hoists used for moving and handling residents as required at the previous inspection. The inspector was told that work is to be carried out in relation to the recommendations made by the Fire Officer. The home continues to use a joint bank account for the retention of resident’s personal allowances and maintain computerised records of individual accounts. Norton Court Nursing Home DS0000000192.V256385.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 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 2 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 2 X X X X X X X STAFFING Standard No Score 27 2 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X 2 X X x Norton Court Nursing Home DS0000000192.V256385.R01.S.doc Version 5.0 Page 20 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 2 Regulation 5 Requirement Contracts / terms and conditions of service must be agreed with residents or their representatives. (Previous timescale of 01/01/04not met) Repairs must be carried out with regard to the broken seat handle. (Previous timescale of 01/07/05 not met) There must be at least one nurse with a mental health qualification on duty at all times. All staff employed after 26th July 2004 must have undergone a CRB / PoVA first check prior to employment. (previous timescale of 01/10/04 not met) Two written references must be obtained prior to employment. (previous timescale not met) The manager must obtain his NVQ level 4 or equivalent in management. Timescale for action 01/01/06 2 19 23 01/01/06 3 4 27 29 18 19 01/12/05 07/11/05 5 6 29 31 19 9 07/11/05 01/06/06 Norton Court Nursing Home DS0000000192.V256385.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 2 3 4 Refer to Standard 19 27 29 30 Good Practice Recommendations Consideration should be given to a more varied decor scheme in resident’s bedrooms to promote individuality and orientation. Staff levels should be monitored to ensure that individual residents needs are met if dependancy levels increase. Documentation recording evidence of CRB should include details of date obtained and level of check carried out. The registered person should make arrangements for a minimum of 50 of care staff to be qualified to NVQ Level 2 or equivalent by 2005. Individual bank accounts to be obtained for residents. 5 35 Norton Court Nursing Home DS0000000192.V256385.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Tees Valley Area Office 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 DS0000000192.V256385.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. 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