Inspection on 07/06/07 for Norton Lodge Care Home

This inspection was carried out on 7th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

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

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Norton Lodge Care Home Norton Village Runcorn Cheshire WA7 6QA Lead Inspector David Jones Unannounced Inspection 7 and 13 June 2007 12:15 X10029.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 Lodge Care Home DS0000069070.V343068.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 and Care Homes for Adults 18 – 65*. 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 Lodge Care Home DS0000069070.V343068.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Norton Lodge Care Home Address Norton Village Runcorn Cheshire WA7 6QA 01928 714792 01928 795107 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) Janet Bailey Dawn Gittins Julie Williams Care Home 32 Category(ies) of Dementia - over 65 years of age (32) registration, with number of places Norton Lodge Care Home DS0000069070.V343068.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 32 service users to include: *up to 32 service users in the category DE(E) (Dementia over 65 years of age). *up to 5 named service users aged 55 years of age and above in the category DE (Dementia under 65 years of age). *up to 1 named service user in the category of MD(E) (Mental Disorder over 65 years of age). *up to 6 service users in the category of PD (Physical Disability). *up to 5 named service users in the category of OP (Old age not falling within any other category). *One named service user in the category DE (Dementia under 65 years of age) 11 May 2006 Date of last inspection Brief Description of the Service: Norton Lodge is a privately run care in the Norton Village area of Runcorn. The home provides personal care to up to a maximum of 32 people. The building is an eighteenth century Georgian House set in an acre of well-maintained gardens. A bus route and train station are nearby. Halton Lea shopping centre and Runcorn old town are within easy travelling distance. There are 30 bedrooms, two of which can be used as twin rooms, and 10 of which have en-suite facilities. There are two communal lounges and two separate dining rooms. There is a passenger lift for access between the first and ground floors. Information about Norton Lodge including copies of the most recent inspection report can be obtained by contacting the home. Fees for accommodation, board and care depend on assessed needs and dependency levels. There are no additional charges. People who live at the home buy their own items such as newspapers and toiletries. Norton Lodge Care Home DS0000069070.V343068.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection of Norton Lodge was unannounced. It included a visit to the home, carried out over two days for a total of just over 11 hours. The visit was just one part of the inspection. Before the visit, the manager of the home was asked to complete a questionnaire to provide CSCI with up to date information about the home. CSCI questionnaires were also made available for the people who live at the home, their families and health and social care professionals, such as nurses and doctors, and their views have been taken into account. Other information received since the last key inspection was also reviewed. During the visit, various records were looked at and a tour of the home was carried out. Observations were made of how staff interacted with and provided care for the people who live at the home. A number of people who live at the home, visiting relatives and care staff were spoken with. They gave their views and these have been included in this report. What the service does well: People who are considering moving to a Norton Lodge are able to visit the home and are given information to help them decide if they want to move in. They have an assessment before they move in so they know their needs can be met at the home. Care staff work with each person and their families to develop a plan of care so they receive care in the way they prefer and their needs are met. The principals of privacy and dignity are promoted so people feel respected and valued. All people living at Norton Lodge spoke highly of the standard of care, facilities and services provided. One said, “This is the “Best Home I have ever been in.” Visiting health care professionals including a doctor and district nurse, speak highly of the staff team. They say that they are well trained and work in partnership so the health care needs of the people who live at the home are met. People who live at the home say they are free to do as they choose so they can live their life in the way they want to. One of the people said “its free and easy here”. They liked to go for walks from time to time and they come and go as they please. Norton Lodge Care Home DS0000069070.V343068.R01.S.doc Version 5.2 Page 6 There is a coded key lock on the front door to make sure that people who would not be safe if they went out on their own, do not go out unsupervised. Others who can go out on their own safely know the key code so they can go out when they choose. The manager and staff understand the importance of helping the younger people who live at the home to achieve their goals. They are helped to take part in activities in a way that puts them in the driving seat so they can develop their lifestyle at a pace that suits them. People are helped to make choices about what they do each day so they are active, stimulated and can learn to develop their personal and life skills as they wish. Thorough checks are done on new staff so the people who live in the home are protected and know the staff are suitable to work with them. Staff are trained, supported and supervised so they have the motivation and skills they need to meet the needs of people who live at the home. Health and safety is promoted and well managed so the people who live at the home and staff are safe. What has improved since the last inspection? Norton Lodge has changed hands since the last inspection. The new owners have over thirty years experience providing care for older people. They have brought a new philosophy of care, which is person centred and focused on meeting the needs of each person who live at the home in a supportive and homely environment. The new manager has a clear understanding of the key principles of the organisation and is suitably qualified and experienced so the home is run in the best interests of the people who live there. The service users guide has been revised since the new owners took over and includes up to date information about the home so all people who live at the home and their representatives have the information they need. The care plan format has been improved to identify each person’s individual needs and personal preferences so they know they will receive the care they need in the way they prefer. People who live at the home are asked about what they like to do so staff know what activities to offer to keep people stimulated, active and involved. People who live at the home and their relatives say the home has improved since the new owners took over and one said that there is more to do. People are now able to choose their meal on the day it is to be served so they can make a better choice depending on the weather and how they feel on the day. Norton Lodge Care Home DS0000069070.V343068.R01.S.doc Version 5.2 Page 7 The new owners are in the process of redecorating and refurbishing the home and many improvements have been made. The people who live at the home and their relatives are consulted about the changes. They are very pleased with the results and are looking forward to the work being completed. There is a large, attractive garden, which has been enclosed with a fence so all people living at the home can go into and enjoy the garden in safety. Staff have received relevant training and over 60 have achieved an NVQ at level 2 in care or above so the people who live at the home are in safe hands. Their training has included issues relating to equality and diversity including age discrimination so they are able to understand the diverse needs of people who live at the home. All staff receive regular supervision so they are supported in their work and can develop their skills to meet the needs of the people who live at the home. A new quality assurance system is being established so people who live at the home are consulted on quality issues and their views are taken into consideration. The home’s electrical wiring system has been checked and all required work has been completed so people who live at the home and staff are safe. What they could do better: Arrangements to administer medication in the home must be improved so people who live at the home are safe and receive their medicines as their doctor prescribed them. The statement of purpose and service users guide should be made available in user-friendly formats including illustrations, Braille or on an audiotape where required so all the people who live at the home can have the information in a form that is easier for them. Assessment and care planning for people with dementia needs to be developed further to make sure that people who live at the home who have dementia receive care in a person centred way. Steps need to be taken to make sure that people with dementia who live in the home can take their meals in the dining room in the normal way. Improvements need to be made to the ground floor shower room so people can use it in privacy. All new staff should receive induction training that reflects the “Skills for Care” common induction standards so they get the training they need to meet the needs of people who live at the home when they start work. Norton Lodge Care Home DS0000069070.V343068.R01.S.doc Version 5.2 Page 8 Staff training for the care of people with dementia and equality and diversity needs to be improved so staff can be helped understand people’s differing needs and gain the skills they need to provide care in a person centred way for everyone living 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 Lodge Care Home DS0000069070.V343068.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Outcomes Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) Norton Lodge Care Home DS0000069070.V343068.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. New people who are interested in moving to Norton Lodge have their needs assessed and are provided with the information about the care, facilities and services at the home so they know their needs can be met there. EVIDENCE: The information about the home (service users guide) has been revised since the new owners took over the management of the home. It includes up to date information on the philosophy of care, facilities and services provided so all people who live at the home and their representatives have the information they need when making decisions about the home. Norton Lodge Care Home DS0000069070.V343068.R01.S.doc Version 5.2 Page 11 The statement of purpose and service users guide should be made available in user-friendly formats so all the people who live at the home have the information in a form, such as Braille, large print or photographs, that it easiest for them to understand. Each person living at the home has a contract or statement of terms and conditions so they have written information about their rights and responsibilities relating to the provision of care and accommodation at the home. Thorough assessment and admissions procedures have been established so all new people wishing to move to the home have their needs assessed. They are able to visit and try out the home before they make any decisions about moving in. Two people who had recently moved in said they had been made very welcome and had settled in well. Case records for three people who live at the home including one who had recently moved in were checked. They all contained appropriate assessments, including a social worker’s assessment where appropriate, and care plans. Information provided by people who live at the home, their relatives and health and social care professionals confirms that the manager and staff work in partnership to ensure that each person’s needs are identified and met. For example a visiting district nurse stated: “each person is very individual and this is evident in the home as each person is treated as individual with psychological, social and spiritual needs. I have witnessed the care home consider the different needs of individuals including ethnicity, age, disability, faith, gender and sexual orientation”. Norton Lodge Care Home DS0000069070.V343068.R01.S.doc Version 5.2 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) 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, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are the key standards. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care that a person living at the home receives is based on their individual needs, so they receive the care they need in the way they prefer. The principals of dignity and privacy are promoted so people who live at the home feel respected and valued. Norton Lodge Care Home DS0000069070.V343068.R01.S.doc Version 5.2 Page 13 EVIDENCE: All of the people who live at the home have a care plan. These are developed with each individual and confirm how his or her health and personal care needs are to be met. The care plan format has been developed to reflect the person’s individual needs relating to lifestyle and include arrangements to support personal development, education, occupation, community links, social inclusion, leisure and relationships amongst other important aspects of care. Each care plan includes details of the individual’s wishes and personal preferences so they know they will receive the care they need in the way they prefer. One of the care plans seen was for a person with dementia. Staff were observed to provide care for this person in a sensitive, understanding way but there was no clear guidance on how to use information about the person’s past life to help them in their daily lives. The new manager is in the process of exploring good practice on assessment and care planning for people with dementia so the needs of people with dementia will be met in the best possible way. Some but not all of the care plans were signed by the person or their relatives. Managers and staff should make sure that all of the people who live at the home or their representatives are invited to read and sign their care plan to make sure that it reflects all their needs and the way they wish them to be met. Case records and discussion with the people who live at the home and their relatives confirms that the manager and staff work closely with health care professionals including doctors and specialist nurses to make sure that the people who live at the home get the treatment they need. Visiting health care professionals responding to CSCI’s survey forms, including a GP and a district nurse seemed satisfied with the standard of care provided at the home. The district nurse said, “they look after the residents very well and contact the district nurse or doctor for guidance on health care including pressure area care and specialist equipment and they always act on recommendations.” The manager and care staff work in partnership with health care professionals so the health care needs of the people who live at the home are met. Appropriate arrangements are in place for the administration, recording and safe storage of medicines including stock records. However, the records showed that medication for one of the people who lived at the home had been signed for but not given. This had happened on a number of previous occasions. It was identified that some staff would benefit from further training on the administration of medication so the people who live at the home are protected and receive the medication their doctor has prescribed. Norton Lodge Care Home DS0000069070.V343068.R01.S.doc Version 5.2 Page 14 Assessments did not look at whether or not a person would be able to look after their own medicines. None of the people living at the home currently manages their own medicines. However, the manager has produced a new assessment form to identify those people who would be able to look after their own medicines rather than having them given to them by staff. This will help to promote independence and well-being. Norton Lodge Care Home DS0000069070.V343068.R01.S.doc Version 5.2 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. 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 have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with assistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the 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. Care and support is provided in a person centred way so the lifestyle in the home reflects the choices, expectations and personal preferences of people who live there. EVIDENCE: The manager and staff understand the importance of helping the younger people who live in the home to achieve their goals. They are encouraged to Norton Lodge Care Home DS0000069070.V343068.R01.S.doc Version 5.2 Page 16 follow their interests and take part in community life. The way this is done puts them in control so they can develop their lifestyle at a pace that suits them. Younger people who live at the home said that staff help them to find out what opportunities there are locally for going out. They were involved in a number of interesting projects. For example one person had joined a local history society and was also exploring how he could get a season ticket for the football team he supports. He had recently visited the football ground, helped by staff from the home, and had enjoyed the experience. He said, “the new management is very good, there is a lot going on, things are happening”. The manager knows the importance of making sure that people have support to take part in activities, including social activities. Staff were seen interacting with people with dementia who live in the home; they listened to them and responded in a positive manner. However, this did not always happen. For example the care plan for one person with dementia identified that staff should try to find out what music the person liked. Staff spoken with confirmed that this had not been done. One staff member was seen to ask the person a trick question to show their level of confusion. This shows that some staff have a lack of understanding of the needs of people with dementia. The manager and staff are aware that further development in meeting the needs of people with a dementia is needed and arrangements have been made for staff to attend a training course. People who live at the home say there are no restrictive rules and they are able to get up and go to bed at times that suit them. They are free to do as they choose and live their life in the way they want to. One said “it’s free and easy here”. They liked to go for walks from time to time and they come and go as they please. There is a coded key lock on the front door to make sure that people who would not be safe if they went out on their own, do not go out unsupervised. Others who can go out on their own safely know the key code so they can go out when they choose. Visitors to the home are made welcome and the people who live at the home can choose to entertain their guests in their own rooms, the lounges or garden areas. Developing and maintaining relationships is recognised as an important factor in people’s lives and this is reflected in their care plans. Visiting relatives who responded to the survey stated, “My relative is extremely happy at Norton Lodge. They keep me well informed I am confident I would be contacted in an emergency.” When people need help with decision-making, support is obtained from their independent advocates, relatives or health and social care professional to help them make an informed decision in their best interests. Norton Lodge Care Home DS0000069070.V343068.R01.S.doc Version 5.2 Page 17 All people who live at Norton Lodge praise the standard of catering. Mealtimes are treated as an occasion and are something to look forward to. The home has an experienced cook who provides nutritious food, including specialist diets. Choice is offered with every meal on the day the meal is to be served so people are helped to make a choice depending on the weather and what they fancy at the time. This is a significant improvement on the previous system where people had to make the choice of main meal the day before. Some of the people with a dementia were being helped to eat their meals whilst sitting in easy chairs in the lounge. This was being done because the chairs in the dining room do not provide sufficient support, as they do not have arms. This should be reviewed and steps taken so that people with dementia can eat their meals at the dining table as normal. Norton Lodge Care Home DS0000069070.V343068.R01.S.doc Version 5.2 Page 18 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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 feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected. 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. There is an effective complaints procedure so people can raise their concerns and be listened to. The home uses the local authority’s procedures to make sure that people who live in the home are safeguarded from possible abuse or harm. EVIDENCE: The culture at the home is open enough for people who live there to feel confident they can raise any concerns they have and they will be listened to. They say that they are happy with the standard of care and services provided. They have good relationships with the manager and staff and are able to express their views about the home in an open and confident manner. There have been no complaints since the last inspection. The complaints procedure for the home sets out how to make a complaint and how it will be dealt with. The procedure is available in the home although some people who live there were not aware of it. The manager has produced a large print version for people with eyesight problems but it needs to be produced in other formats such as Braille so all the people who live at the home, including those with dementia, have a version that is easier for them to understand. Norton Lodge Care Home DS0000069070.V343068.R01.S.doc Version 5.2 Page 19 The local authority’s adult protection procedures are used at the home. These give clear guidance on what to do if there is a suspicion or evidence of abuse or neglect. They also include arrangements for whistle blowing. All staff working at the home have received some form of training on the procedures for safeguarding adults so they know when incidents must be referred to the local authority and can ensure that vulnerable people are safeguarded from abuse. The manager is reviewing staff training on protecting adults from abuse to make sure that all staff know what to do if they know or suspect that abuse is happening. Norton Lodge Care Home DS0000069070.V343068.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 23 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 well maintained so that the people who live there live in comfortable, clean surroundings that meet their needs and expectations. EVIDENCE: Norton Lodge is in a pleasant residential area of Runcorn with good access to public transport so people who live at the home can go to local shops and other community facilities. It provides a homely environment that is well Norton Lodge Care Home DS0000069070.V343068.R01.S.doc Version 5.2 Page 21 maintained and comfortably furnished. The new owners are in the process of redecorating and refurbishing the home and many improvements have been made. The lounges and conservatory areas have been redecorated and re furnished, as have some of the bedrooms. En-suite toilets and showers have been fitted in some bedrooms, where space permits. The people who live at the home and their relatives are consulted about the changes. They are very pleased with the results and are looking forward to the work being completed. The bathroom on the first floor has been improved and redecorated so people will enjoy using it. Plans are in place to refurbish the bathing facilities on the ground floor including the bathroom with the specialist bath for people with mobility problems and shower room. Currently there is not enough room in the shower room to make sure that people’s privacy and dignity are maintained when staff need to open the door to help them. The people who live at Norton Lodge have diverse needs. The new owners are exploring solutions to problems with the environment of the home to make sure that the wide ranging needs of all the people who live at the home can be met appropriately. Plans are being drawn up to provide additional facilities to meet the needs of younger people who live at the home so they have opportunities to develop independent living skills. There is a large, attractive garden which has been enclosed with a fence so all people living at the home can go into and enjoy the garden in safety. Norton Lodge Care Home DS0000069070.V343068.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 28, 29 and 30 (Older People) and Standards 32, 34 and 35 (Adults 18-65) the 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 good. This judgement has been made using available evidence including a visit to this service. Staff are trained and there are enough of them on duty at any time to make sure that the needs of the people living in the home are met. EVIDENCE: People who live at Norton Lodge say the management and staff are very good. They say care staff are always on hand, they listen and provide the care and support people need. One person said Norton Lodge is the “best home I have ever been in.” Relatives and health care professionals such as doctors and nurses who visit the home also speak highly of the staff team. They say staff are well trained, knowledgeable, and work in partnership to ensure that the needs of the people who live at the home are met. A visiting district nurse said, “The staff are Norton Lodge Care Home DS0000069070.V343068.R01.S.doc Version 5.2 Page 23 lovely and very well trained. They look after the residents very well and notify the District Nurse or GPs if there are any problems regarding health care immediately”. Observation and staff rotas show that the service has enough staff available at all times to help the people who live at the home with care and activities in a person centred way. Staffing levels have been increased to reflect the diverse range of needs and rotas are flexible to fit around the lifestyles of individuals. Domestic staff including cooks and cleaning staff are employed in sufficient numbers so the catering needs of all the people who live at the home are met and the home is kept clean and hygienic, free from unpleasant odours. Two staff files were seen and showed that the recruitment procedures used at the home are thorough so the people who live in the home are protected from possible harm. New staff receive induction training and are not part of the duty rota until they are assessed as competent to carry out their role. The manager is in the process of developing the staff induction training procedures to include “Skills for Care” common induction standards so all new staff receive all training they need to meet the needs of the people who live at the home. There is a full training programme for staff at the home. In the last twelve months, training available has included: infection control; control of hazardous substances; fire safety training; moving and handling refresher training; continence and catheter care; age discrimination; falls awareness; podiatry; and dementia Loss and bereavement. Nine of 15 care staff members have an NVQ in care at level 2 or above, so the people who live at the home are in safe hands. However observation and further discussion with the manager indicates that some staff need further training on the care of people with dementia, administration of medication and equality and diversity. The manager is in the process of reviewing staff training needs. Arrangements have been made to make sure that staff receive the training they need so they have the skills to do their jobs effectively and ensure the well being of all people who live at Norton Lodge. Norton Lodge Care Home DS0000069070.V343068.R01.S.doc Version 5.2 Page 24 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. 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 a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s policies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 31, 33, 35 and 38 (Older People) and Standards 37, 39 and 42 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, and 38. 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 managed, in an open and respectful way, so it is run in the best interests of the people who live there. Norton Lodge Care Home DS0000069070.V343068.R01.S.doc Version 5.2 Page 25 EVIDENCE: Norton Lodge has changed hands since the last inspection. The new owners have over thirty years experience in providing care for older people. They have established a new philosophy of care for the home, which is person centred and focused on meeting the needs of the individual in a supportive and homely environment. Opportunities for personal development are provided. The new manager has a clear understanding of the key principles of the organisation and is suitably qualified and experienced so the home is run in the best interests of the people who live there. The manager leads a strong and established staff team. She is a qualified nurse with extensive experience in the care of older people. She is working toward an NVQ in management and care at level 4 so as to improve her knowledge and skills of meeting the diverse needs of the people who live at Norton Lodge. People who live at the home and their relatives speak highly of the new management. One said, “the home has greatly improved since the new owners took over” and another said, “the staff and management are much better since the change in management”. Senior staff spoke of improvements in management style with staff learning more, receiving more feedback and feeling better supported. One senior member of staff said the home has got a lovely atmosphere and staff know that they are doing a good job. Visiting health care professionals, including a GP and a district nurse, also spoke highly of the staff team, saying that they are suitably skilled and work in partnership to ensure the well being of the people who live at the home. Care staff said they are happy with the management of the home and describe the manager as an open, approachable and supportive leader. They say that the improvement in staffing levels means that they have more time to meet the needs of the people who live at the home and they are able to get to know them better. Quality assurance processes are in the early stages of development. The manager is in the process of running a survey to find out what people who live there, relatives and health and social care professionals’ think of the home. Arrangements have been made for the new owners to produce a report of their regular monthly visits and an area manager has been recruited who will be responsible for quality audit, based on a continuous system of consultation and development. This means that effective quality assurance processes will be established so the people who live at the home and their advocates and representatives will be involved in its continuous improvement. The manager ensures that people who live in the home are able to control their own money, except where they say that they do not wish to or they lack Norton Lodge Care Home DS0000069070.V343068.R01.S.doc Version 5.2 Page 26 capacity. Then other arrangements are made. People can deposit small amounts of money with the home for safekeeping. Appropriate records are kept with receipts so each person’s money can be checked easily and accounted for. Staff records confirm that all staff have regular formal supervision meetings so the people who live at the home benefit from a well informed and appropriately supported staff team. Arrangements are in place to ensure the health and safety of all employees and people who live in or visit the home. The manager ensures that risk assessments are carried out for all safe working practices. Information provided indicates that fire precautions are in place and routine maintenance checks of gas and electrical systems, electrical appliances, lift, stair lift, mobile hoist, fire alarms, extinguishers and emergency lighting systems are undertaken and are up to date. Norton Lodge Care Home DS0000069070.V343068.R01.S.doc Version 5.2 Page 27 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 2 3 3 3 4 X 5 3 6 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 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 ENVIRONMENT Standard No Score 19 3 20 3 21 2 22 X 23 3 24 X 25 X 26 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No Score 31 3 32 3 33 3 34 X 35 3 36 3 37 X 38 3 Norton Lodge Care Home DS0000069070.V343068.R01.S.doc Version 5.2 Page 28 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 Standard OP9 Regulation 13 (2) Timescale for action Action must be taken to make 31/07/07 sure that records of medicines given to people who live in the home are accurate and up to date to show that they have received their medicines as prescribed. Requirement 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 OP1 Good Practice Recommendations The statement of purpose and service users guide should be made available in user-friendly formats including illustrations, Braille or on an audiotape where required so all the people who live at the home can have the information in a format they find easier to understand. Work should continue to find out more about assessment and care planning for people with dementia so those people with dementia who live at the home receive person centred care. Steps should be taken to make sure that the people with dementia who live in the home can take their meals in the dining room in the normal way. DS0000069070.V343068.R01.S.doc Version 5.2 Page 29 2 OP7 3 OP15 Norton Lodge Care Home 4 5 OP21 OP30 6 OP30 The shower room on the ground floor should be adapted to make sure that the privacy and dignity of people using is are maintained. All new staff should receive induction training that meets the “Skills for Care” common induction standards so staff receive the training they need to meet the needs of people who live at the home. Staff should receive training on the care of people with dementia and on equality and diversity so they can develop the skills they need to meet people’s needs in a person centred way. Norton Lodge Care Home DS0000069070.V343068.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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. 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