Inspection on 27/10/06 for Norway Lodge Nursing Home

This inspection was carried out on 27th October 2006.

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

Norway Lodge Nursing Home 15/06/07

Norway Lodge Nursing Home 21/06/06

Norway Lodge Nursing Home 13/02/06

Norway Lodge Nursing Home 03/08/05

Norway Lodge Nursing Home 17/12/04

Norway Lodge Nursing Home 14/06/04

Similar services:

Thornton Lodge

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

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

CARE HOMES FOR OLDER PEOPLE Norway Lodge Nursing Home 10 Reservoir Road Prenton Birkenhead Wirral CH42 8LJ Lead Inspector Julie King & Paula Smithson Key Unannounced Inspection 27th October 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Norway Lodge Nursing Home DS0000020924.V318691.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Norway Lodge Nursing Home DS0000020924.V318691.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Norway Lodge Nursing Home Address 10 Reservoir Road Prenton Birkenhead Wirral CH42 8LJ 0151 608 8164 0151 608 8164 chrisaread@btconnect.com 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) Mrs Elizabeth Mary Coquelin Christine Alison Clarke Care Home 29 Category(ies) of Old age, not falling within any other category registration, with number (29) of places Norway Lodge Nursing Home DS0000020924.V318691.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 28 beds nursing / 10 beds personal care in an overall total of 28 1 named adult under 65 years of age within the overall total of 28 1 named service user over 50 years old, within the overall number of 29 places 21st June 2006 Date of last inspection Brief Description of the Service: Norway Lodge is a large detached property in the Prenton area of the Wirral. It has large car parking area to the front of the property with garden benches where the service user’s can sit. The home provides both nursing and personal support to older people. The accommodation is provided on three floors which are easily accessible by passenger lifts. On the ground floor there is a large lounge and dining room and some bedrooms. Accommodation is provided in both single and shared bedrooms and many of the bedrooms have a toilets ensuite. To the rear of the property there is a secluded garden, which is used frequently by the service user’s. Norway Lodge Nursing Home DS0000020924.V318691.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. As part of a key inspection, this site visit took place over two days, during which a full tour of the premises took place, staff and care records were examined. A specialist pharmacy inspector conducted a separate unannounced inspection on day two of this site visit. All staff on duty plus most residents were spoken to during this visit. What the service does well: What has improved since the last inspection? What they could do better: The environment needs further improvement regarding floor and wall coverings, general maintenance (and window cleaning); also staff training in all mandatory areas. Quality assurance does not fully meet the required standard, and there is still no evidence of a current PAT (Small appliance test) Electrical Safety Test – this will be taken up with provider. Norway Lodge Nursing Home DS0000020924.V318691.R01.S.doc Version 5.2 Page 6 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. Norway Lodge Nursing Home DS0000020924.V318691.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Norway Lodge Nursing Home DS0000020924.V318691.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,3,4,5,6. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home’s Statement of Purpose and Resident Guide provides enough information for prospective residents so they can be clear about the services the home provides to meet their care needs. EVIDENCE: The provider has a Statement of Purpose and Resident Guide to give prospective residents a reflection of the services and facilities provided at Norway Lodge. Most of the resident’s files examined did not have a contract of terms and conditions available for inspection, nor was there any supporting documentation to set out responsibilities of all parties and what is included in fees, etc. A requirement will be issued to the registered provider to ensure that all residents have a valid contract at all times. Norway Lodge Nursing Home DS0000020924.V318691.R01.S.doc Version 5.2 Page 9 Pre admission assessments provide a basic assessment of actual and potential needs of each prospective resident; thus allowing a care plan to be developed. However it was recommended that the pre admission assessment tool is utilised in more detail to ensure that all prospective resident’s needs are fully identified, therefore providing adequate information upon which to formulate a care plan. Multidisciplinary healthcare team (MDT) input is evident in resident’s care files, and include reference to NHS out-patient’s appointments, opticians, dentistry, and tissue viability nurse specialist (TVNS) input at the home when needed. Trial visits are offered to all prospective residents prior to admission – this is re-iterated in the Statement of Purpose and Service User Guide. It is suggested to the manager that all trial visits are clearly documented in appropriate care files if and when they take place. Norway Lodge does not offer intermediate care, therefore standard 6 is not applicable. Norway Lodge Nursing Home DS0000020924.V318691.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is a care planning system in place for all residents. This provides staff with most of the information they need to meet the resident’s needs. EVIDENCE: Recently admitted residents, and those requiring a high amount of care were case-tracked (followed from pre-admission into the home in all aspects to date), and spoken to in order to establish a holistic view of what that resident’s lifestyle is like in Norway Lodge. The residents said that they had had the opportunity to meet someone from the care home “for a chat” prior to admission; and that their families were involved. Norway Lodge Nursing Home DS0000020924.V318691.R01.S.doc Version 5.2 Page 11 The care plans are based on the Roper, Logan and Tierney model of nursing care; and evidence occasional input from the resident, their representative and the multidisciplinary healthcare team as needed. Monthly reviews and evaluations were evident on most care plans seen, and the plans were based on needs identified on the pre-admission assessments. However the registered manager must ensure that all care plans are reviewed as often as necessary, and the reviews are clearly recorded. Entries by qualified nurses which state “no change, continue”, are not acceptable. Detailed examination of care files evidenced that the standard of record keeping varied greatly depending upon which nurse had completed the records. Also some of the care plans required updating with what was actually being recorded on the daily report records – this was discussed with the manager who assured the inspector that all necessary documentation would be updated as a priority. Medications were examined as part of this unannounced site visit by the specialist pharmacy inspector, and a separate report containing the findings will be produced in due course. Residents spoken to said they were “happy living here”, and “the girls are nice”. Staff appear to have a good rapport with residents and most of their relatives, and were observed sitting talking to some of the residents during the afternoon. Norway Lodge Nursing Home DS0000020924.V318691.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Links with the local community are good, and support and enrich the resident’s lives. Meals in Norway Lodge are adequate, offering limited choice and variety, and cater for resident’s special dietary needs. EVIDENCE: Residents in the home are asked on admission about their lifestyle, choice of foods, and choices and preferences of the social activities they would like to participate in, dependant upon availability. On admission to the home the staff complete an initial care plan, which includes a social history as well as referring to hobbies, food likes and dislikes information, etc. This information is used to plan daily choices for each resident. Visitors are allowed in the home at any reasonable time of day, residents may entertain their visitors in the communal lounges, or in their own bedroom. Norway Lodge Nursing Home DS0000020924.V318691.R01.S.doc Version 5.2 Page 13 The gardens are accessible, and are an ideal setting for residents to sit with their relatives, especially in the summer months. Meals evidence a choice, and special dietary needs (such as diabetes) are catered for. Records are kept for the recording of fridge, freezer and cooked food, but were not fully completed as required. The fly screen on the rear kitchen (external) door was still torn – as at previous site visit, and there were numerous items of out of date stock on the shelves. A requirement will be issued to maintain and manage the kitchen in accordance with current requirements and good practice recommendations, and will be followed up during the next (unannounced) site visit, and possible referral to Wirral Environmental Health. Norway Lodge Nursing Home DS0000020924.V318691.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17,18. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A complaint and adult protection policy and procedure was in place that helps ensure the safety and welfare of residents. EVIDENCE: The residents, relatives and staff can now access complaint policies and procedures as and if necessary. The procedures includes information on ‘whistle-blowing’, in accordance with current Department of Health guidelines. The CSCI has received numerous complaints about this service since the previous inspection. Most of the staff are in the process of training in adult protection, with the remaining having training planned for the near future. A requirement will be made to ensure that all staff complete suitable and sufficient training in the prevention of adult abuse, and records of this training are kept. Norway Lodge Nursing Home DS0000020924.V318691.R01.S.doc Version 5.2 Page 15 Residents are enabled to exercise their right to vote, either via post or in person; and there is no religious or political persuasion in the home. Norway Lodge Nursing Home DS0000020924.V318691.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Most resident’s rooms are personalized, providing residents with a homely place to live. EVIDENCE: All areas of the home and most bedrooms were inspected. The majority of bedrooms were individualized according to the wishes of the resident, but most are in need of redecoration / refurbishment and renewal of floor coverings – especially rooms 16, 17, 18. Some areas have improved environmentally since the previous site visit, but communal and private rooms do require attention, as do the gardens to the front and rear. Norway Lodge Nursing Home DS0000020924.V318691.R01.S.doc Version 5.2 Page 17 Most bathrooms and toilets did not have lids on clinical or general waste bins, many extractor fans were not working, and some toilets had no working lights. A few of the main lounge chairs are broken and require replacement. One of the residents told the inspector they could not see out of their window properly because “it had never been cleaned”. All the windows of the home require cleaning as soon as possible, and from then on, cleaned on a regular basis. Bath panels in communal bathrooms are damaged and require repair / replacement, and consideration should be given to make these areas less clinical in appearance. Norway Lodge Nursing Home DS0000020924.V318691.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is consistency within the home provided by permanent staff, which helps to offer safety and stability for the residents. EVIDENCE: Improvements have been made to the recruitment procedures and all staff files seen should that all the appropriate checks and documents were in place. Staff that are new in post confirmed that they had undergone an induction programme and were supported to do their NVQ and ongoing training. Staff were observed carrying out their duties and assisting residents in a calm, sensitive and discrete manner. Residents spoken to told the inspectors that “staff are good” and “I need help to do things and without the girls I wouldn’t manage”. Other residents spoken to confirmed that staff were always available to help, and that the staff worked hard. Norway Lodge Nursing Home DS0000020924.V318691.R01.S.doc Version 5.2 Page 19 Accessing and participating in training has improved for most staff, but not all mandatory areas have been covered. The manager assured the inspectors that more training is planned in the near future to achieve full compliance with this requirement. Norway Lodge Nursing Home DS0000020924.V318691.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36,37,38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Norway Lodge’s management and leadership has improved, thus benefiting residents and enable them to air their views. EVIDENCE: The manager is now registered with the CSCI, and has commenced her NVQ 4/RMA, hopefully to complete early next year. All staff spoken to informed the inspector that they felt “happier than last time”, and the home “was more settled now”. The residents told the inspector that they were happy and felt “able to talk to the staff”. Norway Lodge Nursing Home DS0000020924.V318691.R01.S.doc Version 5.2 Page 21 Some quality assurance is now in place, and minutes of staff meetings were shown to the inspectors. Staff supervision and appraisals have commenced, but still require further expansion and greater individual staff involvement. Record keeping has improved in most aspects, especially staff records, but maintenance records are lacking in detail, and there was no PAT (Small Appliance Test) Electrical safety certificate – this is a non-compliance and requires urgent attention. Norway Lodge Nursing Home DS0000020924.V318691.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 2 3 3 3 N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 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 3 18 2 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 3 3 3 3 2 Norway Lodge Nursing Home DS0000020924.V318691.R01.S.doc Version 5.2 Page 23 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 OP2 Regulation 17 (2) Requirement The registered person must keep at the care home a record of the care home’s charges to service users, including any extra amounts payable for additional services not covered by these charges, and the amounts paid by or in respect of each service user. Previous timescale of 10/08/06 not met. The registered person must ensure that all staff receive adequate and appropriate training in the prevention of adult abuse. The registered person must ensure that the premises to be used as the care home are kept in a good state of repair internally and externally at all times - refer to findings in main body of report. The registered person must ensure that the heating systems of the care home are DS0000020924.V318691.R01.S.doc Timescale for action 01/02/07 2. OP18 13 (6) 01/02/07 3. OP19 23 01/02/07 4. OP19 23 01/02/07 Norway Lodge Nursing Home Version 5.2 Page 24 maintained/ and safety checked by a suitably competent person, and records of this are kept. 5. OP30 18 The registered person must ensure that all staff receive suitable and adequate training, specific to the role they perform, and specific to the needs of the service users - and that records of all training are kept. The registered person must ensure that the management of the home’s kitchens and food is in accordance with current Environmental Health requirements and good practice recommendations. 01/03/07 6. OP15 16 01/11/06 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 OP15 Good Practice Recommendations It is strongly recommended that all fridge, freezer and cooked meat temperature records are recorded on a daily basis. It is recommended that an additional care assistant is on duty during the night shift. It is recommended that qualified staff review care plans in accordance with current, not previous, good practice requirements. 2. 3. OP27 OP7 Norway Lodge Nursing Home DS0000020924.V318691.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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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