Inspection on 03/09/05 for Norton Place

This inspection was carried out on 3rd September 2005.

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 but made no statutory requirements on the home.

Other inspections for this house

Norton Place 24/01/08

Norton Place 13/02/07

Norton Place 11/01/06

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

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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 Bernadette Little Unannounced Saturday 3 September 2005 rd The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 I56 I06 S15552 Norton Place V247862 030905 Stage 4.doc Version 1.40 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 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 CRH 11 Category(ies) of LD Learning Disability (11) registration, with number of places Norton Place I56 I06 S15552 Norton Place V247862 030905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Total number of service users not to exceed 11. 2. Nursing and personal care to be provided to service users who have a learning disability. 3. Excluding any person who is liable to be detained under the provision of the Mental Health Act 1983. Date of last inspection 8th February 2005 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. Norton Place I56 I06 S15552 Norton Place V247862 030905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection that took place on a Saturday when 10 residents were living at the home. Time was spent talking with the staff and the residents and looking at the everyday things that happen at Norton Place, for example lunchtime, the way that staff and residents chatted together and the activities that residents were doing. Records and documents were looked at, as were all rooms in the house. The help given by the staff and residents was appreciated. What the service does well: 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. Norton Place I56 I06 S15552 Norton Place V247862 030905 Stage 4.doc Version 1.40 Page 6 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 Standards Statutory Requirements Identified During the Inspection Norton Place I56 I06 S15552 Norton Place V247862 030905 Stage 4.doc Version 1.40 Page 7 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 4, 5 The assessment process was thorough to ensure that residents’ needs’ could be met by the home. Information about the home was readily available to residents and their representatives. EVIDENCE: The pre-admission records were sampled for the two most recently admitted residents. These showed a detailed process and confirmation on one file from Estuary that they could meet the resident’s needs. Not all assessments were signed and dated. The registered manager visited both prospective residents prior to admission. Staff confirmed that the usual process of residents visiting the home for trial visits prior to admission could not be followed in these cases as both residents were in hospital. A copy of the service user guide and the persons individual contract was kept in their own bedroom. The pictorial format contract for one resident contained their photograph and the number of the room they occupied. The document for the second resident had been signed and dated by the registered manager but did not contain a photograph or the room number. There was no specific information in either document regarding the additional charges to be paid by residents. This could be maintained as a separate record. Norton Place I56 I06 S15552 Norton Place V247862 030905 Stage 4.doc Version 1.40 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8, 9, 10 Care management documents provided staff with clear and detailed instructions on providing safe and consistent care for residents. Any limitations placed on residents could be more clearly considered and documented. EVIDENCE: The two care plans sampled had numerous care aims covering all aspects of the residents’ needs and strengths. Each aim identified the support needs of the resident for that issue. They were supported by risk assessment and evidenced review. There was limited evidence in one case relating to meaningful activities. Care notes were written regularly and generally were detailed and informative. Residents were seen to be offered opportunity to make decisions on everyday things in the home according to their abilities. Staff spoken with described appropriate management of information regarding residents. Norton Place I56 I06 S15552 Norton Place V247862 030905 Stage 4.doc Version 1.40 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15, 16, 17 Residents had opportunity to take part in meaningful activities, including keeping contact with family and friends, and to use community facilities. Norton Place provided residents with a varied and nutritious diet. EVIDENCE: Discussion with residents and staff and observation of the records confirmed that residents access facilities in the community including the library, church services and shopping. Activities at home were varied and were supported by an identified member of staff. The activity diary kept for each resident also clearly identified that there were regular visitors to the home. Staff confirmed that most residents had regular family contact. Records also indicated that the home had sought to access independent advocacy services for residents. Staff spoken with said they were not aware of any infringement of residents’ rights at Norton Place and no record of infringement of rights was available. However, some practices needed to be considered and recorded, for example, Norton Place I56 I06 S15552 Norton Place V247862 030905 Stage 4.doc Version 1.40 Page 10 the front door at the home was locked or access to the conservatory being restricted at times. There were ample food stocks available, including plenty of fresh fruit and vegetables. Staff confirmed that these were used regularly and were aware of identified specific dietary needs. The roster showed that there is a cook on duty seven hours a day from Monday to Friday. Staff advised that the cook planned the menu. A certificate to confirm that the cook had had food hygiene training was available in the kitchen. The care staff undertook all the cooking at the weekend, without an increase in care staffing levels. A nutrition record was maintained. Appropriate utensils were provided to meet resident need. Six residents needed feeding but one was in bed at the time of this inspection. The four staff that fed the five residents in the dining room at lunchtime sat with them and spoke to them appropriately. Norton Place I56 I06 S15552 Norton Place V247862 030905 Stage 4.doc Version 1.40 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19, 20, 21 Staff were effective in supporting residents to access all relevant health care professionals. Medication systems within the home were assessed as safe. EVIDENCE: Staff advised that five residents were permanent wheelchair users, four residents could mobilise and one resident was cared for in bed. Records showed that residents had been supported to access appropriate equipment, for example a new wheelchair, hoists/sling, and appropriate seating. Moving and handling assessments were not considered at this inspection. Care files demonstrated the involvement of specific healthcare professionals for example neurologist, consultant psychiatrist or occupational therapist, as well as a record of general healthcare appointments, for example optician. Care plans included a management plan relevant to the individual residents’ health care needs, for example, tissue viability where a resident came to the home from hospital with a pressure sore. Charts were used to support effective monitoring, for example seizures, bowels, behaviours, weight and turning. Medication was administered by a qualified nurse, who confirmed that they followed the guidelines issued by the Nursing and Midwifery Council. The medication administration records sampled were well maintained. Protocols Norton Place I56 I06 S15552 Norton Place V247862 030905 Stage 4.doc Version 1.40 Page 12 were in place for as required medication. A sample of staff signatures and initials was not available. Estuary had a corporate policy on care of the terminally ill person. One resident file sampled showed the families wish for a residents’ funeral and where they were to be interred with other members of their family. Norton Place I56 I06 S15552 Norton Place V247862 030905 Stage 4.doc Version 1.40 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22, 23 The information for residents on how to make a complaint was readily available and in a suitable format. Appropriate processes were in place to protect residents. EVIDENCE: A pictorial format complaints procedure was seen to be displayed in the home. A copy was also included in the service user guide in every residents bedroom. Stan spoken with were aware of the complaints procedure and the need for confidentiality in storing these records. Permanent staff were also aware of the chain of command in reporting such incidents. None of the staff on duty were aware of where or how to record a complaint if it was received by them. The qualified nurse in charge of the home advised that they had not had specific training on the protection of vulnerable adults from either Estuary or their employing agency, but they had covered such issues as part of their nursing training. Permanent staff at home spoken with confirmed that they had had recent training on this issue. All staff spoken with were aware of different types of abuse that could occur. All were aware of the whistleblowing policy and stated the confidence to report any concerns appropriately. Norton Place worked appropriately with other professionals in a recent issue regarding the protection of vulnerable adults. The multidisciplinary team closed the investigation, as there was no evidence to support it. Norton Place I56 I06 S15552 Norton Place V247862 030905 Stage 4.doc Version 1.40 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27, 28, 29, 30 Norton Place gave the residents a comfortable, clean and safe living environment with facilities and equipment that met their needs. EVIDENCE: Each resident had their own bedroom that was this individually personalised. The majority of residents had a plaque outside their room, made in their craft activities that identified the space as theirs. Bedroom doors were lockable and a key was seen in one door. Two residents said that they liked their rooms and one explained how they had chosen their new carpet. A more recently admitted resident still had the vinyl type flooring that had been assessed as appropriate for the previous resident of that room. The lounge/dining room presented as homely. Residents’ artwork was attractively displayed in the home. The sensory room was well maintained and equipped. The last inspection report identified that the home was awaiting the fitting of a ramp to allow residents easier access to the garden. Grab rails were fitted throughout the home. Call bells were not accessible to residents from their bed. Norton Place I56 I06 S15552 Norton Place V247862 030905 Stage 4.doc Version 1.40 Page 15 The last inspection report identified that the fitting of a new sluice was to be included in the homes budget for 2005, where the homes macerator had been removed. This remained outstanding. The laundry was clean and well maintained and the washing machine had a sluicing facility. Norton Place I56 I06 S15552 Norton Place V247862 030905 Stage 4.doc Version 1.40 Page 16 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 35 The staff worked as a team to meet the needs of residents. The staffing levels did not always best support in this. Residents would be better safeguarded if evidence of training was available for all staff and evidence of identity was available for agency staff. EVIDENCE: Apart from one error, the roster indicated that there was always a qualified nurse on duty supported by three care assistants. While agency staff made up the greater part of most shifts, the roster, and staff spoken with, confirmed that there was always at least one permanent member of staff on duty. It was also confirmed that the majority of agency staff are regular and have worked with the residents for sometime at Norton Place. The agency qualified nurse and the permanent member of support staff on duty showed good communication skills and an effective teamwork approach. Staff demonstrated a positive approach to providing quality care for residents and for spending time interacting with them. Staff advised that opportunity for this could be more limited at weekends, due to increasing dependency levels of the current residents, along with the lack of ancillary staff. Concern was expressed that this could increase further once the empty bed was occupied. Norton Place I56 I06 S15552 Norton Place V247862 030905 Stage 4.doc Version 1.40 Page 17 A training plan was displayed, but evidence on individual training files was not always available for the training that staff advised had occurred. Agency staff did not have evidence of identity or training with them as required. Norton Place I56 I06 S15552 Norton Place V247862 030905 Stage 4.doc Version 1.40 Page 18 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 40, 43 The registered manager was not on duty but the report however identified that the home was managed and organised effectively to safeguard residents. EVIDENCE: The registration certificate was displayed. An application to vary the homes current registration to include the category of dementia care for one identified resident, admitted outside the homes registration category, is being processed. Staff spoken with said the manager is approachable and supportive and her door is always open. They stated that they have opportunity to participate in regular staff meetings and formal supervision sessions. Estuary provided corporate policies and procedures that were clearly available in the home. Some of those sampled or identified by staff included missing person, client access to files, resident finance, whistleblowing, protection of vulnerable adults, bullying and grievances. A certificate relating to employers liability was displayed. There was nothing to suggest that the home is not financially viable. Norton Place I56 I06 S15552 Norton Place V247862 030905 Stage 4.doc Version 1.40 Page 19 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 2 3 3 2 Standard No 22 23 ENVIRONMENT Score 2 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 2 3 3 2 2 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 2 Standard No 31 32 33 34 35 36 Score 3 3 2 x 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Norton Place Score 3 3 2 3 Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x x 3 I56 I06 S15552 Norton Place V247862 030905 Stage 4.doc Version 1.40 Page 20 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 5 Regulation 18(1)a Requirement A record must be maintained of care homes charges to residents including any extra amount payable for additional services not covered by those charges, and the amount paid by or in respective of each resident. The person registered must ensure that there are appropriate numbers of staff available in the home to meet residents need. This also includes ancillary staff. Staff records must contain records as required in Schedule 2. This referred to two references being available, and was outstanding from a previous inspection. The standard was not inspected on this occasion and will be carried forward to the next inspection. The person registered must ensure that the records required by Regulation of all persons working in the care home, including agency staff, are maintained in the detail identified in the Schedule. Evidence must be available that staff have had appropriate Timescale for action 1 October 2005 2. 33 18(1)a 1 October 2005 3. 34 19 (b)(1) 3 September 2005 4. 35 17(2) Schedule 4 1 October 2005 5. 35 18(1) (c) 1 October 2005 Page 21 Norton Place I56 I06 S15552 Norton Place V247862 030905 Stage 4.doc Version 1.40 training and updates to meet the needs of residents this includes all agency staff working at the home RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. Refer to Standard 2 5 16 20 26 Good Practice Recommendations All documents/asessments should be signed and dated. Each resident contract should contain the details indicated including a photograph of the resident and the number of the room they occupy. The home should reconsider whether there are areas where residents rights may be infringed and these should be documented. A sample list of staff names/signatures/initials should be maintained with the medication administration sheets. Unless risk assessment indicates otherwise, the flooring in the residents bedroom should be more homely, and individual to their needs, rather than to the needs of the previous resident of the room. 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. The home should have a maintenance and refurbishment plan that identifies when the ramp is to be fitted to allow easier access to the garden. The home should have a maintenance and refurbishment plan that identifies when the sluice is to be fitted. 6. 7. 8. 29 29 30 Norton Place I56 I06 S15552 Norton Place V247862 030905 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Kingswood House Baxter Avenue Southend-on-Sea Essex, SS2 6BG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Norton Place I56 I06 S15552 Norton Place V247862 030905 Stage 4.doc Version 1.40 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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