Inspection on 13/02/07 for Norton Place

This inspection was carried out on 13th February 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 14 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Norton Place 24/01/08

Norton Place 11/01/06

Norton Place 03/09/05

Norton Place 08/02/05

Norton Place 21/09/04

Norton Place 09/03/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Norton Place 162 Ness Road Shoeburyness Essex SS3 9DL Lead Inspector Mrs Bernadette Little Unannounced Inspection 13th February 2007 10:30 Norton Place DS0000015552.V319465.R01.S.doc Version 5.2 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 Place DS0000015552.V319465.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 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 Place DS0000015552.V319465.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Norton Place Address 162 Ness Road Shoeburyness Essex SS3 9DL 01702 291221 01702 291221 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) Estuary Housing Association Limited Ms Judith Anne Hounsell Care Home 11 Category(ies) of Dementia (2), Learning disability (11) registration, with number of places Norton Place DS0000015552.V319465.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. To provide care to two named residents with learning disabilities and who have dementia, aged under 65 years, and whose names are known to the Commission. No more than eleven Younger Adults with a learning disability to be accommodated and provided with care with nursing. Excluding any person who is liable to be detained under the provision of the Mental Health Act 1983. 11th January 2006 Date of last inspection Brief Description of the Service: Norton Place is a care home with nursing for 11 residents with learning disabilities. It is situated in the grounds of the NHS Health Care Services in Shoeburyness. It is close to local shops, facilities and the seafront. The home has in 11 single bedrooms, a lounge/dining room, sensory room and a conservatory at the entrance to the premises. All the rooms are situated on the ground floor. There is a very large garden at the rear of the home. There is parking at the front of the premises and the home has a minibus with access for wheelchair users. The pre-inspection questionnaire identifies the weekly fees as being £1,548.78. Additional charges/costs identified as incurred by residents relate to chiropody (£10), hairdressing, personal toiletries, magazines, activities, massage/reflexology or sensory therapy. Norton Place DS0000015552.V319465.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site visit was undertaken as part of the key inspection of Norton Place and approximately seven hours and a half hours were spent at the home. There were ten residents living at Norton Place at the time of the inspection and time was spent with those who were home. Residents were generally unable to express views verbally due to their complex learning and communication disabilities, but observations of practice and responses to non-verbal communications were considered as part of the inspection process. The registered manager was not on duty at the time of this sit visit. Five staff were spoken with. A tour of the premises was undertaken and records, policies and procedures were sampled. Records for two residents were case tracked and were sampled for another resident. Discussion of the inspection findings took place with the staff during the inspection. Requests for information were sent to five relatives/formal advocates and a social worker and all responded. Information was also received from an interactive therapist working with residents. Two surveys were returned by staff who had endeavoured to ascertain views of residents who had some verbal communication, but because of their other needs were unable to provide answers that related to the questions. A well completed pre-inspection questionnaire had been requested and received by the commission in May 2006, supported by clear documentation such as rosters. The assistance of all those at Norton Place is appreciated. What the service does well: Residents at Norton Place had a comfortable, homely place to live. They were supported by staff who knew them well and knew how to meet their needs in a kind and friendly way. The home was generally well-managed, and people knew what was to be done, when and how to do it, so that residents got good quality care. Comments from relatives/advocates included “ the staff are very caring to all their clients… if(resident) were at home (they) could not be better looked after” and “ in my opinion Norton Place is well run, with loving care and attention.. I cannot fault it”. Norton Place DS0000015552.V319465.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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 Place DS0000015552.V319465.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Norton Place DS0000015552.V319465.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 4, 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information about the service, opportunities for trial visits and detailed assessments ensured that residents and their advocates were able to make informed decisions about living at Norton Place. EVIDENCE: Staff were unaware of the statement of purpose and service user guide or where they might be found in the home. Staff were advised that a service user guide used to be kept in each of the residents bedrooms. One of these was found, but was dated July 2004. Two relatives’ surveys received said that they felt they had received ample information about the resident moving into the home. The file for a recently admitted resident showed that the home had undertaken their own preadmission assessment. There was also an assessment by a social worker and an assessment of the persons’ nursing needs. The home had consulted with the commission to seek agreement to vary their registration prior to admitting the resident. Records showed that the resident had had opportunity for trial visits to the home prior to admission. Norton Place DS0000015552.V319465.R01.S.doc Version 5.2 Page 9 The two files sampled had a copy of the licence to occupy as well as a service user contract that contained pictures to support residents to understand what was being said. One of the service user contracts looked at did not say what room was to be the resident’s own room. The other contains a record that shows that the resident was not able to sign a contract. This contained a separate list regarding additional charges made to the resident, including £20 per week massage, £10 per sensory session, £10 from chiropody and £6 for haircut. Norton Place DS0000015552.V319465.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents assessed needs were followed through in care plans that gave staff the necessary information to provide good care outcomes, while encouraging considered risk and independence. EVIDENCE: Care plans were in place for both of the residents whose care files were tracked. Both of these covered lots of different aspects of the resident’s daily life and needs and included things such as communication, hobbies and interests, mobility, personal care, relationships, daily activities, food and weight management, finance. Additionally, there were other care plans specifically relating to dementia and extra things that need to be considered because of this, for example communication, therapeutic interventions, consent to medication or treatment and safety issues. Norton Place DS0000015552.V319465.R01.S.doc Version 5.2 Page 11 Care plans were supported by a detailed identification of hazard and risks that had information on how to manage the risk and the individual persons care. The records that told staff how to support residents’ care also reminded staff to encourage residents to keep their independence and do things for themselves. Individual risk assessments were seen, for example relating to supporting a resident in using a taxi or being in a public place. Care notes were written each night and at least once each day. Norton Place DS0000015552.V319465.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents had some opportunities for meaningful activities both at home and in the community. Residents’ dignity, privacy and independence was respected and supported by the home’s routines and staff practice. Mealtimes were a positive experience for residents that could be enhanced by greater choice and consideration of the nutritional input. EVIDENCE: Care plans sampled included a section on hobbies and interests. Records showed that some residents like to be involved in drawing, writing, knitting and listening to music and this was observed. Financial records confirmed some opportunities in the community. Other residents attended day resource centres. Care notes sampled for one resident referred to their having sensory sessions. There was limited information on any other social opportunities/ interactions for this person. A daily diary was available to record activities for each resident that was not always completed. Norton Place DS0000015552.V319465.R01.S.doc Version 5.2 Page 13 A survey form said the manager and staff have always been supportive introducing new ideas/different approaches to the overall emotional and physical well-being of the residents.” Staff members and residents interacted positively and staff were clearly aware of residents personalities, abilities and preferences. Staff advised that some residents are able to choose to spend time in their own room and go there unaccompanied. A staff member stated that staff make sure to keep doors closed while undertaking personal care to protect privacy and dignity and also to allow each person some personal time alone in their own room. One survey received included the comment “ the residents are very well cared for and the staff afford the residents dignity and choice”. Five surveys, from different sources, all confirmed that they can visit people living at Norton Place in private, and one advised they are welcomed whether they arrive announced or unannounced. The cooks post at Norton Place is vacant. Two care staff were managing the menu, writing it up week by week. The menu displayed showed no choice of meals and some repetition, for example, sausages were planned for the main meal on both Tuesday and Friday that week. While sausages were clearly a favourite of one resident, this would not fully reassure that the nutritional content had been given appropriate consideration. The record of food served showed a choice of cereals for breakfast and that one resident had a cooked breakfast. Bowls of fruit were readily available. Staff advised that residents are offered these mainly for a snack in the afternoon or perhaps for dessert. Observation of the lunchtime meal showed that staff sat with residents, interacted with them, explained what was to happen at each stage and positively encouraged them to eat and drink. For one resident who has a sight impairment, the staff member put food on the spoon, touched the resident’s arm, so that the resident could then take the spoon and bring it to their own mouth. Tables were set with cloths and the choice of jugs of drinks. Norton Place DS0000015552.V319465.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents generally received the support necessary to ensure their physical and emotional health needs were met, but the accuracy of some records relating to medication did not best protect residents. EVIDENCE: Residents were unable to express views on their preferences for personal care. Relatives and advocates who provided information said they were satisfied with the care provided to the residents. Staff spoken with were very aware of monitoring residents and looking for signs that would show that they were not well. They also spoke of ensuring that residents have plenty of fluids and appropriate equipment to make sure that there are no pressure sores, something that a staff member said “ we are very careful about here”. Care notes for one of the files sampled did not record turns as indicated in the care plan and no turning chart was maintained. Risk assessments were in place in relation to moving and handling, and had been reviewed. Leading from this, information on getting up and going to bed provided clear instruction for staff to follow for that particular person and also Norton Place DS0000015552.V319465.R01.S.doc Version 5.2 Page 15 included reminders to staff to keep residents covered up during transfers to protect their dignity. The reference in this case to bed rails also told staff about the risk assessment that was available, and how to manage these to make sure that residents were kept safe. Care plans on mobility identified the individual sling type to be used for the individual resident. Records showed that residents had been registered with the GP and also had had contact with other healthcare professionals such as the optician, the epilepsy nurse and the occupational therapist. Staff knew about residents’ health-care needs, and were able for example, to advise that, as recorded, a resident had had new glasses yesterday. The manager also regularly tells the commission about any illness or hospital admissions that the residents have. Satisfactory practice was observed during administration of medication. Protocols for ‘as required’ medications were attached to the residents’ medication care plan, giving staff clear information. Omissions were noted on some of the Medication Administration Recording (MAR) sheets for one of the three residents sampled, so it was not possible to tell if the resident had actually had their medication. Changes had been made to a resident’s medication on the verbal advice of the GP, and a staff stated a difference of views on how and when this was to be recorded/implemented. Advice was provided on considering that hand-written changes or additions to instructions for prescribed medicines are signed and dated by the person making the entry at the time of the event. The list of homely remedies was signed by the GP as acceptable for all residents in June 2005. Other residents have been admitted since that date. Norton Place DS0000015552.V319465.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The information for residents/advocates on how to make complaints was in plain language supported by pictures. Residents were not always best protected by staff knowledge and training. EVIDENCE: Pictorial information on making a complaint to Estuary was displayed in the entrance hall. The residents’ licence to occupy said that they should contact the registration officer directly if they had any complaints, and also gave the wrong contact information. The commission does not investigate individual concerns, but the person can go to their funding authority if they dont want to use Estuary’s own policy and procedure on complaints. The pre-inspection questionnaire of May 2006 stated that no complaints had been received by the home. The qualified nurse in charge of the home on the day of the inspection did not have any up-to-date information regarding complaints. One staff member was aware of where the complaints and compliments book was kept and the last entry was dated 2004. The agency qualified nurse in charge of the home was aware of the complaints procedure and advised that they would involve the permanent staff before taking any action as they may have more information about the resident and the situation. Norton Place DS0000015552.V319465.R01.S.doc Version 5.2 Page 17 The commission have not received any complaints about this home. The families and professionals surveyed had not made or received any complaints about the home. The staff member in charge of the home advised that they had not had training on the protection of vulnerable adults. They were was unaware of appropriate reporting procedures, local protocols/guidance or the homes policy and procedure on adult abuse or whistle blowing. The permanent care staff member on duty on the early shift had had training on protection of vulnerable adults and was able to advise of different ways that abuse could occur, including restricting residents’ choice. The staff member was aware of the whistleblowing procedure and appropriate reporting procedures. A permanent staff member on duty on the late shift advised that they had not yet attended training on protection of vulnerable adults. The staff training matrix indicates however that they received this training in June 2005. Norton Place DS0000015552.V319465.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents at Norton Place lived in a home that was comfortable and equipped to meet their needs. Attention was needed to fire doors to safeguard residents. EVIDENCE: The lounge/dining room was bright and cheerful but areas of damage to the walls and décor did not make it the best living environment for residents. The dining tables also were showing signs of wear and tear. A ramp had been fitted in the lounge to allow residents easier access to the garden. Each resident had their own bedroom and all were individual in their decoration and furnishings. Residents’ had a name plaque on the wall outside their door that marked it as their own space. Doors were fitted with locks. Many of the bedrooms had vinyl flooring, which did not best present as homely and were not clearly justified in their care file. Light switches were placed so that those residents who used a wheelchair could easily reach them. One of the wheelchairs was noted to need a thorough cleaning. Norton Place DS0000015552.V319465.R01.S.doc Version 5.2 Page 19 Residents had the use of an assisted bathing and shower facility. Staff confirmed adequate and appropriate equipment for each resident, for example hoists, pressure relieving mattresses etc. Several of the doors did not fully self-close. The person in charge was informed because of the potential fire hazard. The maintenance book showed that the registered manager had already reported this to Estuary. Rooms where oxygen was used were clearly identified. The linen cupboard showed that each resident had colour-coded towels and bed linen which respected their dignity. One type of incontinence pads was kept on a shelf in the communal toilet. This did not best respect residents’ dignity. The surveys completed by relatives confirmed that the home is always clean and fresh. The laundry room was clean and tidy. Appropriate systems were available for disposing of clinical waste. The home continues to await the fitting of a sluice. Norton Place DS0000015552.V319465.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are offered positive relationships by well supported and caring staff. Residents were not shown to be best protected by the staff recruitment, induction or training records. EVIDENCE: The main hallway had a display board at an appropriate height level for residents titled “ your staff today are”. It was disappointing that the photographs displayed were not accurate to the staff on duty. Staff confirmed that there were three care staff and one qualified staff on duty each day shift. There was an additional member of care staff undertaking the cooking. A housekeeper was also on duty. Night staffing levels of one qualified and one care staff were also increased to provide one-to-one care for a specific resident. The pre-inspection questionnaire provided by the registered manager advised that there were five care staff who had achieved NVQ level 2 or above. One of the permanent members of staff confirmed that they had completed NVQ 3 training while one of the regular agency staff on duty advised that they were currently undertaking NVQ level 3. Norton Place DS0000015552.V319465.R01.S.doc Version 5.2 Page 21 Three permanent staff spoken with advised of a nice team and a nice place to work. One comment was “ being a small unit allows good care, we dont miss things and we work well together”. Staff, including agency staff, were aware of the need to have one staff monitoring the lounge at all times, and this was observed to be put into practice. The staff spoken with were very clearly aware of residents needs, and any relevant up-to-date issues affecting their wellbeing. There was a handover for each shift that included permanent and agency staff. There was regular usage of agency staff, and efforts were made to use the same agency staff to assist with continuity of care for residents. This was not always successful, the qualified staff in charge of the home advised that she had been there once a week for the past month, although stated she had been there a lot sometime back. One permanent staff member said that the situation is better now as there were more permanent staff and that the agency staff used are mostly regulars. Two of the three agency staff on duty had evidence of their identity. One agency staff member on duty did not have any identification and was not known to the qualified staff in charge of the home. The roster confirmed their information that they had worked at the home once, last week. No records were available in relation to this member of staff, either confirmation from the agency of their identity and of appropriate checks having been undertaken, or in relation to their training. The qualified member of staff in charge of the home was informed Estuary’s procedure of where and how to access the recruitment files for inspection. Recruitment files were sampled for one carer and one ancillary staff member. Both contained applications, evidence of identity, criminal record bureau checks but no declaration of health. The application for one staff did not contain a full history and there was no evidence of this being explored. An induction programme was also on file for both staff that identifies training. There was no evidence of any of this training in either of the staff members files, or on the file of another staff member who advised they have worked at the home for approximately one year. Another permanent staff member advised that training had been provided more recently but the file available showed out of date training for example fire training and food hygiene in 2001. The training matrix provided identified a variety of training had occurred for each of the staff. Staff spoken with confirmed regular supervision that included relevant issues and was undertaken either by the registered manager or the deputy manager. Staff also advised that team meetings are regularly held and minutes were seen. Norton Place DS0000015552.V319465.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 40, 41, 42, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents generally benefited from the internal management of the home. EVIDENCE: The registered manager is qualified and experienced, and her skills in managing the home effectively to benefit residents were clearly demonstrated throughout this inspection process. However, there was scope for developing the system for sharing information with staff left in charge of the home, to ensure continuity and consistency. Staff spoken with said that the manager and the deputy manager are approachable and staff can go to them at any time. The survey received from one professional stated that the manager is “ an excellent manager and this is reflected in the home”. Norton Place DS0000015552.V319465.R01.S.doc Version 5.2 Page 23 The staff on duty at the time of the site visit were unable to provide any information regarding the home system for monitoring the quality of its services to residents. The last monthly regulation 26 report available at the home was dated May 2006. Estuarys corporate policies and procedures were available in the home, but not all agency staff were aware of them to ensure residents’ protection. It was not possible to inspect and fully audit all records relating to resident’s money. Records were available of resident’s weekly expenditure and a group rolling float. Receipts are sent Estuary each week and therefore could not be confirmed. The limited records/receipts available showed that residents purchase individual items. Those sampled indicated that residents money was being used appropriately, for example in relation to toiletries or sensory activities. A recent fire risk assessment was displayed in the hall along with pictorial fire instructions. Current certificates for fire equipment were also displayed. Other than the issue of the failure of the fire doors to fully self close, no hazards or risks to residents were identified on the premises. Norton Place DS0000015552.V319465.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 4 3 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 2 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 2 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 2 13 3 14 2 15 3 16 3 17 2 PERSONAL AND HEALTHCARE Standard No 18 19 20 21 Score 3 3 2 X 3 3 2 2 3 3 x Norton Place DS0000015552.V319465.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA1 Regulation 5 Requirement The service user guide must be amended to reflect the changes in regulation of September 2006 and include the required information. Care records and activity records need to record the social/leisure/ meaningful occupational opportunities provided to residents so that they can be evidenced. The menu plan must be reconsidered to ensure adequate choice and nutrition for residents. Timescale for action 01/05/07 2. YA6 YA12 YA14 16m&n 01/04/07 3. YA17 16(2)i 01/04/07 4. YA20 13(2) 17(1) Records of the administration (or 13/02/07 reason for non-administration) of medicines must be accurate and complete. All staff must be aware of how to protect residents from abuse and be given the necessary information and training. The self-closing fire doors must be maintained to ensure the DS0000015552.V319465.R01.S.doc 5. YA23 13(6) 13/02/07 6. YA24 23(4) 13/02/07 Norton Place Version 5.2 Page 26 safety of residents and staff. 7. YA24 YA25 23(1)& 2(d) Residents must be provided with 01/04/07 a well decorated and a homely environment, and the vinyl floors in residents’ bedrooms reviewed unless there is a clearly evidenced reason for them. The records required by Regulation of all persons working in the care home, including agency staff, must be maintained in the detail identified in the Schedule. This is outstanding from two previous inspections. (This relates for example to the persons identity and evidence that appropriate references and checks have been undertaken to ensure the protection of residents). 9. YA35 18(1)a&c 19 & Sch2 All staff (including agency staff) 13/02/07 must be provided with training appropriate to the work that they are to do in the care home and records to evidence this training must be available. The home must show that they review regularly the quality of the care provided at the home and how service uses are involved in this. The registered person must ensure that the monthly monitoring visits are undertaken and that the reports hour in the home available for inspection. 01/04/07 13/02/07 8. YA34 17(2) Sch4 10. YA39 24 11. YA39 26 13/02/07 Norton Place DS0000015552.V319465.R01.S.doc Version 5.2 Page 27 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 YA5 Good Practice Recommendations Each resident’s service user contract should show the room that is regarded as their individual space while they live at the home. The home should reconsider whether there are areas where residents rights may be infringed and these should be documented, this relates to the use of the conservatory. Carried over form the last inspection. An assessment should be undertaken as to whether residents would be able to use the call bell in their room. If this is not indicated it should be noted in the care plan. Carried over from the last inspection. 2. YA16 3. YA29 Norton Place DS0000015552.V319465.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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. 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