Inspection on 26/04/07 for Norton House

This inspection was carried out on 26th April 2007.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Norton House 25/04/08

Norton House 15/01/08

Norton House 26/04/05

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 Jacqueline Derbyshire Unannounced Inspection 26th April 2007 11:00 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 House DS0000010862.V333808.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 House DS0000010862.V333808.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Norton House Address 10 Arneway Street London SW1P 2BG 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) 020 7976 7681 www.anchor.org.uk Anchor Trust Manager post vacant Care Home 39 Category(ies) of Old age, not falling within any other category registration, with number (39) of places Norton House DS0000010862.V333808.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service User Under 65 Years To enable care to be provided to one service user under the age of 65 years on the rehabilitation unit. This arrangement is for one service user at any one time and is to be reviewed in 12 months time (31 July 2006) 29th June 2006 Date of last inspection Brief Description of the Service: Norton House is registered to provide care and accommodation for 39 older people. 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 DS0000010862.V333808.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on Thursday 26th April 2007. Tony Lawrence and Jackie Derbyshire, CSCI Regulation Inspectors carried out the Inspection. The Inspectors spent a total of 13 hours talking with residents, the homes new Manager and staff, inspecting care records, staff records and touring the premises. One Inspector spent time on all of the floors looking at the medication records. There is an activities coordinator who was seen to be providing activities to different residents throughout this inspection; they were seen to be enjoying participating and comments were made to the Inspectors. The Inspectors were pleased with the progress that has been made in ensuring care records and other information kept by the home have been up dated and are relevant for each resident living there. The 7 requirements set in 9th October 2006 have been met, 11 new requirements have been set from this Inspection. The weekly cost for a resident is at present £510.00. What the service does well: What has improved since the last inspection? The care plans have greatly improved with a lot of relevant up to date information written in each. The risk assessment records looked at linked in with the assessed need of the resident and did show how the home was looking at minimising any risk area. Frozen food storage has improved with all packaging that has been opened having a date of opening and use by date recorded. The Manager is keeping the CSCI up dated on any protection issues. Norton House DS0000010862.V333808.R01.S.doc Version 5.2 Page 6 All staff now have an (CRB) Enhanced criminal disclosure. The medication procedure has improved with all up to date records in place. 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. The summary of this inspection report can be made available in other formats on request. Norton House DS0000010862.V333808.R01.S.doc Version 5.2 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 House DS0000010862.V333808.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1, 3 and 6. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The homes Statement of Purpose needs to be updated to reflect the changes that have taken place in the home. EVIDENCE: The Inspectors looked at the homes Statement of Purpose that was seen to be out of date in its content. The Statement of Purpose must have all relevant information in place that sets out the aims, objectives and philosophy of care that the home will provided to all residents living there. The Inspectors looked at the records of five people living at the home and each resident had a needs assessment from the placing local authority. The residents care plans were then written in conjunction with the needs assessment. Norton House DS0000010862.V333808.R01.S.doc Version 5.2 Page 9 There is a rehabilitation unit in the home that provides a full intensive package of care. Physiotherapists and occupational therapists are employed to assist in setting up a programme of care that assists an individual in re-establishing themselves back into the community. One of the Inspectors spent time on the rehabilitation floor and was very aware of how busy the staff team were in working with the residents to meet their assessed needs. Norton House DS0000010862.V333808.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10 and 11. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The care plans are very comprehensive with information in place that show how staff are supporting the people living at the home with their social, health, emotional, communication and independent living skills. EVIDENCE: The Inspectors looked at five care plans of people living at the home; the Inspectors looked at the records of residents with high dependency needs. All five care plans had comprehensive records in place that informed staff of how to support the individuals in their areas of care. Risk assessment records were also in place that worked in conjunction with each area of risk that was identified. The care plans in Norton House have improved and in talking with staff they stated that they are now familiar with the recording procedures. The health care records looked at for the five people did have the relevant information recorded, there is an issue for the Manager to make sure that any resident with pressure sores has the assessed record written by a tissue viability nurse in place. Norton House DS0000010862.V333808.R01.S.doc Version 5.2 Page 11 All staff that are involved in the treatment must record any treatment of care and a full mapping of the pressure sores must be monitored including the dimensions of the sores with photographic evidence. The medication records of residents were looked at on all floors, the medication recording and storage procedures have greatly improved. In discussion with the Manager the inspectors were told that the medication records are monitored on a regular basis. The Inspectors discussed the photographs on the medication sheets on the rehabilitation unit that are excellent, it was discussed with the Manger that this format should be used on all floors as some photographs of residents on other floors were not a good likeness. The Inspectors spent time on all of the floors and observed staff working closely with all residents. Personal care was provided to all residents in the privacy of their own rooms or in bathrooms. The Inspectors spent time talking to resident’s and comments made included: “ I have lived here for two years and I have no complaints with the help and care provided by the staff”. “ I am happy with the care I receive, staff are busy but helpful when I need them”. The Inspectors saw information in the five peoples records that informed the staff of how they would like to be looked after if their health deteriorated. There was also information on each file that showed the residents wishes in relation to their death. Norton House DS0000010862.V333808.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People living in the home are supported to take part in a range of appropriate activities EVIDENCE: Residents who spoke with the Inspectors said that they are able to make choices about their daily lives. Examples included choices at meal times, daily routines and choice of clothes. Care plans include details of each person’s hobbies and interests. The home employs an activities co-ordinator that works with staff to provide individual and small group activities. A weekly programme of activities is provided that includes exercise and reminiscence sessions, ball and board games, bingo and dominoes. During this inspection the activities co-ordinator ran a group discussing items from the day’s newspaper and later was seen providing one to one activities to individuals. Relatives and visitors were seen coming into the home throughout this inspection. Norton House DS0000010862.V333808.R01.S.doc Version 5.2 Page 13 The Manager confirmed that staff from the home are involved in managing 23 of the residents finances. Records looked at could not give a correct figure of some individual’s financial balance. There is a central bank account that is used for all residents’ savings; it was discussed with the Manager that all residents have to have their own bank account. The Inspectors were unable to track financial transactions as receipts were not in place. A secure lockable cupboard or draw should be supplied for all residents in their rooms to keep any items they wish keep secure and safe. People moving into the home are encouraged to bring personal possessions and small items of furniture with them, the Inspectors felt that all bedrooms are well personalised. One Inspector spent time on three floors at lunchtime, the food provided looked very appetising. There was a choice of meals for residents and any special diets are provided when health staff or a dietician advises this. Staff were seen to ask residents what they wanted to eat and were very patient. Food and drink monitoring charts were seen in two residents files that had information recorded over 24 hour periods. Residents comments on the food provided at the home included: “ The meals have improved significantly in the last 6-8 weeks”. “ The food is sometimes not good, not bad but sometimes lovely”. The Manager and Catering Manager should check that out of date food is disposed of accordingly as there was weetabix in the dry storage that was out of date from September-December 2006. The Catering Manager did dispose of the weetabix when it was bought to her attention. Norton House DS0000010862.V333808.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has clear complaints and protection policies and procedures that are known to service users, staff and visitors. EVIDENCE: The home has a clear complaints policy and this is displayed on notice boards on each floor. An Inspector checked the records of complaints there have been 13 in the last 12 months. Two of the complaints did not have the investigation information attached; the Manager must make sure that all of the information is in place with the outcomes and any actions taken. Residents spoken with told the Inspectors they would speak to a member of staff if they had a complaint. The home follows the local authority’s protection of vulnerable adults procedures and these are available in the home for reference. The Manager confirmed that there have been 5 protection issues in the home in the last 12 months, all have been responded to following the correct protection of vulnerable adults procedures and the CSCI has been up dated on all issues. Norton House DS0000010862.V333808.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19, 21, 24, 25 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is comfortable and a programme to improve the decoration is ongoing. EVIDENCE: During this visit the Inspectors saw all communal parts of the home and some resident’s bedrooms, with their permission. Each resident has a single room with ensuite facilities. Staff have supported people to individualise their rooms with photos and other personal items. As written in this report a lockable storage space has to be made available to all of the people living at the home to keep any items they wish. All residents who spoke with the Inspectors said that they are happy with the accommodation at Norton House. As well as the ensuite facilities, there is a sufficient number of toilets and assisted bath and shower rooms that are located close to the residents rooms and communal areas. Norton House DS0000010862.V333808.R01.S.doc Version 5.2 Page 16 There is a need to make sure that hot water temperatures in resident’s bedrooms and assisted bath and shower rooms enable the residents to have a comfortable bath or shower. The home’s maintenance person and staff record water temperatures throughout the home each week. While these are well recorded, the records show that temperatures well below 43°C are regularly recorded. The home’s hot water supply system must be checked to make sure that hot water is provided at the right temperature. All areas of the home were seen to be clean and tidy on this Inspection. Norton House DS0000010862.V333808.R01.S.doc Version 5.2 Page 17 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): Standards 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. The home is well staffed to meet the care needs of the people living there. EVIDENCE: To assess these Standards, the Inspectors checked the home’s staffing rota and spoke with the Manager and staff. The home has a separate rota for each floor and these show that most areas are well staffed at all times of the day and night. In discussion with the Manager it was stated that the times of each shift have to be included on the rota. There is a care staff team of 48. The Manager confirmed that 50 of care staff have completed their NVQ Level 2 training. An Inspector checked the staff recruitment files for 3 care staff working in the home. The files are well organised, with all checks in place. All staff complete core training as part of their induction. Staff who spoke with the Inspectors were very positive about the training offered at Norton House. Norton House DS0000010862.V333808.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35, 36 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is well managed and people living there are looked after safely. EVIDENCE: The home’s Manager is a qualified and experienced manager. She is at present applying to be registered by the Commission as a ‘fit person’ to manage the home. Staff commented very positively about the leadership provided by the Manager. The Inspectors looked at the records of five people living at Norton House, each file had a quality review questionnaire in place that had been completed at the end of 2006. Norton House DS0000010862.V333808.R01.S.doc Version 5.2 Page 19 In discussion with the Manager it was apparent that all questionnaires had been completed with the assistance of care staff, and that residents should complete the questionnaires themselves or with the assistance of an advocate if required. The quality assurance record was given to the Inspectors; the folder had a lot of information and documents. The Inspectors requested a summary of the quality assurance information that would be sent to the CSCI and made available to any stakeholders. As written in this report the financial procedures currently in place at the home have to be revisited. All residents’ finances have to be kept separately with their own bank accounts; the home at present has a communal bank account and records make it very difficult to see the break down of individual’s finances. The Inspectors looked at 3 staff files and each file contained supervision records. The records show that supervision is now happening for all staff on a regular basis. In discussion with the Manger and looking at supervision schedules this shows that this area has greatly improved. There were three areas of health and safety discussed with the Manager. The fire alarm procedure records show that a member of staff is re setting the fire alarms after the alarm sounds. The Inspectors told the Manager to check the correct procedure that should be undertaken with the London Fire and Emergency Planning Authority (LFEPA). The fire risk assessment review also needs to be completed. There is a need to make sure that hot water temperatures in resident’s bedrooms and assisted bath and shower rooms enable the residents to have a comfortable bath or shower. The home’s maintenance person and staff record water temperatures throughout the home each week. While these are well recorded, the records show that temperatures well below 43°C are regularly recorded. The home’s hot water supply system must be checked to make sure that hot water is provided at the right temperature. Norton House DS0000010862.V333808.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 x 3 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 1 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 3 3 x 3 x x 2 3 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 2 x 1 3 x 2 Norton House DS0000010862.V333808.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? NO 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 2 Standard OP1 OP8 Regulation 6 13 Timescale for action The homes Statement of Purpose 26/07/07 must be up dated and contain all relevant information. The Manager must make sure 31/05/07 that the treatment plan and outcomes of pressure care are fully recorded for all residents. The Manager must make sure 11/05/07 that the weighing chair is repaired or replaced to make sure that residents weight can be monitored accordingly. The organisational procedures 26/10/07 for saving residents finances must be changed so that all residents having their own separate bank accounts. The home provides all residents 26/07/07 with a secure place in their rooms to keep their money or any other valuables if they choose to. The Manager must make sure 31/05/07 that any financial transactions undertaken for a resident has all of the receipts in place. The Manager and Catering 31/05/07 Manager must check that out of date food is disposed of DS0000010862.V333808.R01.S.doc Version 5.2 Page 22 Requirement 3 OP8 12 4 OP14 16 5 OP14 16 6 OP14 16 7 OP15 16 Norton House 8 OP33 24 9 OP38 23 10 11 OP38 23 23 OP38 appropriately. The organisation to provide a summary of the homes annual Quality Assurance document for the CSCI and any other stakeholders. The Manager and maintenance person to get all of the hot water outlets checked to provide water at the correct temperature. The Manager to make sure that the correct fire alarm procedure is followed by all staff. The Manager to review the homes fire risk assessment. 26/07/07 26/05/07 26/05/07 26/05/07 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 House DS0000010862.V333808.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection West London Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE 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 House DS0000010862.V333808.R01.S.doc Version 5.2 Page 24 - 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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