Inspection on 26/04/05 for Norton House

This inspection was carried out on 26th April 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 House 25/04/08

Norton House 15/01/08

Norton House 26/04/07

Norton House 30/09/04

Norton House 07/06/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE NORTON HOUSE 10 Arneway Street LONDON SW1P 2BG Lead Inspector Ffion Simmons Announced 26 April 2005 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 HOUSE G09-G60 S10862 NORTON HOUSE AIV213931 260405 STAGE 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Norton House Address 10 Arneway Street, London SW1P 2BG 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) 020 7976 7681 Firstname.Surname@anchor.org.uk Anchor Trust Ms Irene Obonyo-Odoge Care Home 39 Category(ies) of Old age, not falling within any other category registration, with number (39) of places NORTON HOUSE G09-G60 S10862 NORTON HOUSE AIV213931 260405 STAGE 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Service User under 65 Years. To enable care to be provided to a service user under 65 years. This is from 12 April 2005 to 11 July 2005. Date of last inspection 2nd December 2004 Brief Description of the Service: Norton House is registered to provide care and accommodation for 39 older people. There are 29 long-stay beds, 1 respite bed and 9 rehabilitation beds. The home is situated in a quiet cul de sac, off Horseferry Road, in Victoria and is close to local shops. The service is operated by the Anchor Trust, with all placements being made by Westminster Council. NORTON HOUSE G09-G60 S10862 NORTON HOUSE AIV213931 260405 STAGE 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The announced inspection was carried out over two days in April 2005 and lasted fourteen hours. The inspector spent time talking to service users, the Manager and staff and checked documentation and records. The inspector made a total of 16 requirements, 3 of these requirements have not been met from previous inspection reports. What the service does well: What has improved since the last inspection? The individual care plans have been improved and are now being reviewed regularly. Some work has been undertaken to establish the wishes of service users regarding death and dying and preferred times for getting up and going to bed are now noted. A study in conjunction with the Primary Care Trust has been completed for identifying service users who are at risk of falling. A better system for recording complaints has been implemented since the last inspection. This enables the home to record more detail surrounding the complaint and the action taken. NORTON HOUSE G09-G60 S10862 NORTON HOUSE AIV213931 260405 STAGE 4.doc Version 1.30 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. NORTON HOUSE G09-G60 S10862 NORTON HOUSE AIV213931 260405 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 HOUSE G09-G60 S10862 NORTON HOUSE AIV213931 260405 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) 3, 5, 6 Service users’ needs are assessed prior to moving into the home to ensure that individual needs can be met. The rehabilitation unit is well equipped, and the care is provided by well-qualified and well-supported staff. The necessary specialist care for maximising service users independence is provided in order for them to return home is provided. EVIDENCE: The file of the most recently admitted service user contained sufficient information as evidence that their needs have been assessed prior to their admission. This service user had the opportunity to view the home and to stay at the home for respite care prior to making their decision to move in on a long-term basis. There is a designated unit in the home for providing rehabilitation. The unit is equipped with gymnasium and therapy room containing specialist equipment for working towards maximising service users’ independence. Physiotherapist and Occupational Therapist work within the unit from Monday to Friday. Staff confirmed that the average length of stay in the unit is six weeks although it may be extended in certain circumstances. Staff spoken with on the rehabilitation unit were very positive about their work, felt well supported by NORTON HOUSE G09-G60 S10862 NORTON HOUSE AIV213931 260405 STAGE 4.doc Version 1.30 Page 9 the Physiotherapist and Occupational Therapist and had good training opportunities. A service user on the rehabilitation unit also commented positively by saying that staff are “terribly kind and always willing to help.” NORTON HOUSE G09-G60 S10862 NORTON HOUSE AIV213931 260405 STAGE 4.doc Version 1.30 Page 10 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, 9, 10, 11 The care plans are better and provide staff with more information for caring for service user. Daily notes are still not detailed enough and do not fully reflect the care given. Risk assessments are not detailed and as a result are not useful tools for minimising risk and protecting service users from harm. Medication systems are good but staff need to ensure that when codes are used that they are defined so that it is clear why medication was not administered. EVIDENCE: Individual care plans of four service users were seen and the inspector noted that there has been some improvement in the quality of the care plans. The quality of the daily notes need to be further improved to contain more detail to reflect the actual care provided. There has been a history of falls among some of the service users. Service users who are at risk of falling have been identified through a study in conjunction with the Primary Care Trust. The risk assessments completed however do not draw out ways for managing the risk of service users falling and are not regularly updated. NORTON HOUSE G09-G60 S10862 NORTON HOUSE AIV213931 260405 STAGE 4.doc Version 1.30 Page 11 One of the service users tracked, was identified as being at risk of developing a pressure sore. The service user had developed a pressure sore, but there was no risk management strategy in place and at the time of the inspection there was no equipment available for pressure relief. District Nurses have been into the home to provide information and guidance on the identification and prevention of pressure sores. Service users’ nutritional needs are well assessed and monitored on a monthly basis. Medication policies and procedures are in place and on the whole medication records were well completed. When codes are used when medication is not administered, these must be defined/explained. Service users wishes and feelings in relation to death and dying have been noted but further information is required. NORTON HOUSE G09-G60 S10862 NORTON HOUSE AIV213931 260405 STAGE 4.doc Version 1.30 Page 12 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) 12,13,14,15 The range activities offered within the home is good, but the home does not provide enough opportunities for service user to go out into the community. There is a good choice of food available and service users’ nutritional needs are well met. Some service users were disappointed with the quality of the food on offer. EVIDENCE: The activities on offer within the home include quiz, games, coffee mornings, sing-along, karaoke, videos and pamper sessions. On one day of the inspection, a mobile clothes shop visited the home, which gave service users the opportunity to choose and purchase their own clothes. A birthday party was also taking place during one of the inspection days, which was very well received. The home needs to provide more opportunities and activities outside the home. One service user described life in the home as “years of wasted life being here. I used to go out to theatres, trips but I’m not able to go out in this chair”. Another service user said that they had to use someone else’s wheel chair to go out, which caused confusion. Steps must be taken to ensure that service users are assessed for the necessary disability equipment so that they are enabled to maintain links with the local community. The quality of the NORTON HOUSE G09-G60 S10862 NORTON HOUSE AIV213931 260405 STAGE 4.doc Version 1.30 Page 13 daily notes varied and some lacked sufficient detail to evidence that service users are supported to maintain their interests. The home provides the option of a cooked breakfast in the morning and a choice of lunch and evening meal and evening snack. A service user commented that the food is “still not good, we need a good cook”. NORTON HOUSE G09-G60 S10862 NORTON HOUSE AIV213931 260405 STAGE 4.doc Version 1.30 Page 14 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 The complaint system in the home has improved and there was evidence that complaints made by service users/relatives/staff are taken seriously, are recorded and investigated. EVIDENCE: Complaints records were checked. The complaints documentation has been reviewed and updated to provide more detail regarding the nature of the complaint and the action taken to investigate the complaint. The records indicated that all complaints received by the home had been investigated. The home’s complaints procedure is well publicised in the service user’s guide and is on display in the home. Pre-inspection information indicated that staff have received training in the protection of vulnerable adults since the last inspection. During the course of the inspection, a service user disclosed to the inspector that the staff team sometimes handle them roughly. The Manager has been asked to fully investigate the allegations and report their findings to the Commission. NORTON HOUSE G09-G60 S10862 NORTON HOUSE AIV213931 260405 STAGE 4.doc Version 1.30 Page 15 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 The standard of the environment in the home is good and service users benefit from spacious single rooms. The home provides service users with a homely and clean environment. EVIDENCE: A tour of the building was undertaken. Each service user has a single room. All rooms are spacious with an en-suite lavatory and shower and have sufficient space for wheelchair users to move around easily. Service users were generally satisfied with their home. There is a separate laundry room situated on the ground floor away from the kitchen area. The room is equipped with two washing machines and dryers. The home was found to be clean and hygienic during the inspection. NORTON HOUSE G09-G60 S10862 NORTON HOUSE AIV213931 260405 STAGE 4.doc Version 1.30 Page 16 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, 30 There are sufficient numbers of staff on duty for meeting the needs of service users. Recruitment procedures are thorough and all necessary checks are completed on all staff. Allegations have been made about the conduct of staff. This needs to be investigated. Staff are not receiving the necessary training and induction for their role of caring for service users. EVIDENCE: Duty rotas were seen and reflected that the home has sufficient number of staff on duty for meeting the needs of the service users. Staff also confirmed that they felt the staffing levels are adequate. There is a senior carer on shift to oversee the care provided on each shift. The files of three new staff members were checked and demonstrated that the home’s recruitment procedures are thorough and based on equal opportunities. All pre-employment checks are completed on staff including references and CRB checks. Staff are interviewed and are required to complete an application form prior to them being appointed. Some of the service users spoken with expressed satisfaction with the care provided by staff. However another service user said “some staff are rough and throw you onto the bed.” Service users also expressed that the language used by some staff is terrible, “they swear and they shout at each other”. The Manager has been asked to investigate these allegations and report the findings to the commission. NORTON HOUSE G09-G60 S10862 NORTON HOUSE AIV213931 260405 STAGE 4.doc Version 1.30 Page 17 The training records are currently being reviewed and reflected that staff are not up to date with their training is safe working practices. Although the home’s induction programme is based on the TOPSS induction programme, there was limited evidence to support that staff had completed the induction training and have been thoroughly inducted to their post. NORTON HOUSE G09-G60 S10862 NORTON HOUSE AIV213931 260405 STAGE 4.doc Version 1.30 Page 18 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) 32, 33, 35, 36, 38 Some staff are dissatisfied with some aspects of the way the home is being managed and feel undervalued and unsupported. This potentially has an impact on the quality of the care delivered to service users. Shortfalls were noted in the health and safety systems in the home, which impacts on the home’s ability to maintain health and safety of service users. EVIDENCE: Although staff spoken with on the rehabilitation unit felt well supported and happy in their work, other staff within other units in the home felt that they were not supported or valued by the management team. They felt that they were not listened to when raising issues at team meetings and that there was poor communication within the home. Staff on the rehabilitation unit said they received regular supervision whereas staff on other units within the home said that they do not receive regular supervision. NORTON HOUSE G09-G60 S10862 NORTON HOUSE AIV213931 260405 STAGE 4.doc Version 1.30 Page 19 Quality assurance systems are in place for monitoring the standards of care in the home and to seek the views of service users. Visits on behalf of the registered provider are not carried out unannounced as per the regulations. Health and safety documentation was checked. Fire drills are not completed as per the requirements and portable electrical equipment are due for testing and is a requirement. There have been a number of falls documented since the last inspection. Falls risk assessments must provide details outlining how the risk is to be managed and should be regularly reviewed and updated as necessary. Training in the completion of risk assessments would be beneficial for all staff. NORTON HOUSE G09-G60 S10862 NORTON HOUSE AIV213931 260405 STAGE 4.doc Version 1.30 Page 20 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 x 3 x 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 x 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 x 15 2 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 2 28 x 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x 2 2 x x 2 x 2 NORTON HOUSE G09-G60 S10862 NORTON HOUSE AIV213931 260405 STAGE 4.doc Version 1.30 Page 21 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 7 &12 & 13 Regulation 16 [2] (m)(n) Requirement The quality of the care notes must be improved to fully demonstrate the care provided and to demonstrate that service users are supported to maintain their interests. (Previous timescale of 1st December 2004 not met) The Manager must ensure that risk assessments cover risk management strategies for managing the risk. (Previous timescale of 1st February 2005 not met) The manager must esure that the necessary intervention and pressure relieving equipment are available for service users who have been identified as being at risk of developing pressure sores. The Manager must ensure that codes used to explain why medications are not administered, are defined/explained. The service users wishes and feelings regarding death and dying must be fully recorded. (previous timescale of 31st of August 2004 not fully met) Timescale for action 01 August 2005 2. 8 13 [4] 01 August 2005 3. 8 13 [4] (c) 01 June 2005 4. 9 13 [2] 01 July 2005 5. 11 12 [1] [2] [3] 01 August 2005 NORTON HOUSE G09-G60 S10862 NORTON HOUSE AIV213931 260405 STAGE 4.doc Version 1.30 Page 22 6. 12 16 [2] (m) 7. 15 16 [2] (i) 8. 18 & 28 13 [6] 9. 10. 30 30 & 38 18 [1] 13 &18 [1] 18 [1] 11. 32 12. 13. 33 36 26 [3] 18 [2] 14. 38 23 [4] (c) The Manager must ensure that staff consult with service users about their social interests and make arrangements for enabling them to engage in local, social and community activities. This must include the provision and assessment of the necessary and appropriate disability equipment. The Manager must ensure that service users satisfaction with the quality of the food on offer in the home is improved. The Manager must ensure that allegations of rough handling and inappropriate behaviour by some staff members in the home are investigated and forward the findings to the Commission. The Manager must ensure that all staff complete induction training. The Manager must ensure that all staff have receiveid up-todate training in safe working practices. The Manager must look into the staffing issues identified, which include staff shouting and swearing; staff feeling that they are not supported and listened to and poor communication in the home. The Commission must be informed of their action plan for addressing these issues. The person in control visits must be unannounced as per the regulations. The Manager must ensure that supervision is offered to staff at least six times per year or more frequently should this be necessary. The Manager must ensure that fire drills are regularly performed as per the advice of the fire authority. 01 August 2005 01 August 2005 15 June 2005 01 August 2005 01 August 2005 01 August 2005 01 July 2005 01 August 2005 01 July 2005 NORTON HOUSE G09-G60 S10862 NORTON HOUSE AIV213931 260405 STAGE 4.doc Version 1.30 Page 23 15. 38 13 [4] (c) 16. 38 13 [4] The Manager must make arrangements to ensure that the protable electical equipment in the home is tested. The Manager must ensure that service users’ risk assessments and care plans are updated following an accident. 15 June 2005 01 July 2005 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 8 & 38 Good Practice Recommendations Training in the completion of risk assessments would be beneficial for all staff. NORTON HOUSE G09-G60 S10862 NORTON HOUSE AIV213931 260405 STAGE 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Hammersmith Local Office 11th Floor, West Wing 26/28 Hammersmith Grove 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 HOUSE G09-G60 S10862 NORTON HOUSE AIV213931 260405 STAGE 4.doc Version 1.30 Page 25 - 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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