Inspection on 25/08/05 for Norwood House Nursing Home

This inspection was carried out on 25th August 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Norwood House Nursing Home 11/03/09

Norwood House Nursing Home 23/07/08

Norwood House Nursing Home 24/01/08

Norwood House Nursing Home 23/03/07

Norwood House Nursing Home 18/01/06

Norwood House Nursing Home 15/03/05

Norwood House Nursing Home 29/06/04

Norwood House Nursing Home 15/03/04

Similar services:

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Ravensworth Lodge

Abbey The

Snydale Care Home

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

CARE HOMES FOR OLDER PEOPLE Norwood House Greenthwaite Close High Spring Gardens Keighley BD20 6DZ Lead Inspector Paul Newman Unannounced 25 August 2005 10.00am th 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 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. Norwood House 20050825 Norwood House Stage 4 S19884 V242169 J52.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Norwood House Address Greenthwaite Close High Spring Gardens Keighley BD20 6DZ 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) 01535 602137 01535 692017 Norwood House Nursing Home Ltd Mr Andrew Makin Care Home with Nursing 31 Category(ies) of Physical Disability (31) Dementia (31) registration, with number of places Norwood House 20050825 Norwood House Stage 4 S19884 V242169 J52.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Age 60 years and over Date of last inspection 25/08/05 Brief Description of the Service: Norwood House was once a private house, owned by a prosperous local mill owner and commands magnificent views of the Aire Valley from its position on the hillside above Utley and about a mile from Keighley town centre. The home has undergone two extensions and the grounds extensively remodelled with a new access road being completed in 1997. The current providers have owned the home since 1985. Mr Makin is a registered nurse and is also the registered manager of the home. Mrs Makin is also actively involved in some aspects of the management of the home. The providers live on the site and have a high profile within the home. The home is registered to provide personal care with nursing for 31 service users over the age of 60 years, including those with physical disability or mental impairment. Accommodation is provided mainly in single rooms, the majority of which have en-suite facilities, with some shared rooms available, without en-suites. Communal lounges and a dining room are provided on the ground floor, with a large conservatory at the front of the house, overlooking the well maintained gardens. Those bedrooms at the rear enjoy the views over the valley. There is access to the grounds by means of a ramp and there is a paved seating area for service users. Norwood House 20050825 Norwood House Stage 4 S19884 V242169 J52.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Over an inspection year from April until March, regulated care homes have a minimum of two inspections a year; these may be announced or unannounced. The last inspection was unannounced and took place on the 15 March 2005. There have been no further inspections until this unannounced visit. The people who live in the home prefer the term resident, and this is the term that will be used throughout this report. The lead inspector currently allocated this home for inspection was unavailable and it was the first visit to the home for the inspector carrying out the inspection. The purpose of this inspection was to gain an overview of the care, services and facilities provided and to check on the progress with any issues raised in the last inspection report. During the inspection some records were looked at, some parts of the home were seen, such as bedrooms, lounges and bathrooms; but the large majority of time was spent observing care staff carrying out their work; conversations were held with the manager, five members of staff, two student nurses on placement, four relatives and seven residents. Survey cards were left at the home for residents, relatives or visitors to complete and return to the Commission for Social Care Inspection (CSCI). These cards provide an opportunity for people to share their views of the service with the CSCI. Comments received in this way will be shared with the provider without revealing the identity of those who replied and are included in this report. The inspection started at 10.00 and lasted for six hours, in addition time was spent preparing for the inspection. What the service does well: The home is well managed and the interests of the residents are the main concern of the manager and staff. The staff are well organised. They are experienced, well trained, know what they are doing and have a good knowledge of the residents they care for. They have good relationships with residents and relatives who like the staff and are confident in them. Relatives feel welcome at the home and together with the residents, feel there is a warm and homely atmosphere. Some comments made were: ‘staff are friendly and easy to talk to’, ‘this is an excellent well run and organised home’, ‘always friendly, welcoming and helpful’. There is a varied and interesting activity programme that residents are involved in planning. Residents’ rooms are personalised with their own belongings they exercise choice about spending time in their bedroom or in communal areas. Varied menus provide choice and there is a commendable approach to make sure that special dietary needs are met. Norwood House 20050825 Norwood House Stage 4 S19884 V242169 J52.doc Version 1.40 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. Norwood House 20050825 Norwood House Stage 4 S19884 V242169 J52.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Norwood House 20050825 Norwood House Stage 4 S19884 V242169 J52.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 3, 4 and 5. Standard 6 does not apply to this home. Residents and their relatives are provided with clear and accurate information about the care and services provided at the home. The assessment and admission process includes introductory visits to the home and people are able to make an informed choice about the home based on the written information and what they see. Well-informed and knowledgeable staff meets residents’ needs. EVIDENCE: The home’s current residents handbook was provided and used as a benchmark by the inspector to check that the home does what it says will it do. The information meets requirements, is clear and well presented and gives a good picture of the care and services. All prospective residents and/or their relatives are given the handbook. Residents are assessed before they are admitted to the home and each of the three care plans seen had evidence that this had been done. Two conversations with relatives clearly indicated that they felt they had been fully involved in the assessment. It was clear also from conversations that residents and/or their relatives had taken Norwood House 20050825 Norwood House Stage 4 S19884 V242169 J52.doc Version 1.40 Page 9 opportunities to visit the home to satisfy themselves about the care and services and they said that the staff had been very helpful and welcoming. One of the care plans seen was for a resident who had recently been admitted and by coincidence a review meeting was being held after a six seek trial period. The meeting involved the resident, a social worker and other family members. The purpose of the review was to make sure that the home was able to meet the residents needs and everyone was happy with things that were being done. Following the review the relatives said that they were very happy indeed with how the home had communicated with them and had made a good job of settling their relative in. Conversations with the staff found them knowledgeable about individual residents needs and their daily lifestyle preferences. Systems of communication are well established to make sure that the right information is passed on a daily basis Norwood House 20050825 Norwood House Stage 4 S19884 V242169 J52.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 and 10. Staff know the care needs of the residents, treat them with respect and make sure that residents can live their lives privately. Residents care needs are met but this is not always fully evidenced in the care plan documentation. EVIDENCE: The previous inspection had identified that although good care was being provided the care plan documentation did not always fully evidence this. There has been much discussion in the home and coincidentally there had been a meeting the evening before the inspection visit involving qualified nurses and the manager to look at additional documentation and approaches that could be included. Some of this was seen but has yet to be started and the manager felt that over the next few months changes would be made. The next inspection will therefore take a more focused look at the effectiveness of these changes. There was good evidence at the shift changeover of detailed information being passed to staff coming on duty about individual residents. This included a referral to the GP for one resident that staff were concerned about. The Doctor visited during the handover. The care plans seen showed attention to routine optical, dental and foot care as well as liaison with GP’s and more specialist Norwood House 20050825 Norwood House Stage 4 S19884 V242169 J52.doc Version 1.40 Page 11 healthcare services. Assessments were in place for pressure area care, nutrition and continence and falls risk assessments were also up to date. Observations throughout the day showed staff to be professional but personable with residents and relatives and the relationships were warm and friendly. Residents looked well cared for. Staff were observed to manage the residents sensitively and survey questionnaire results indicated that staff are held in high regard. Residents said that staff gave them good support, gave assistance when they needed it and respected their privacy like knocking bedroom doors before entering. This was also supported by observations of staff practices. Norwood House 20050825 Norwood House Stage 4 S19884 V242169 J52.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15 Residents are encouraged to join in social and leisure activities, to maintain links with their friends and family and to exercise choice and control over their lives. They are offered a good varied and nutritious diet that takes account of individual dietary and care needs. EVIDENCE: The home’s resident handbook makes it clear that there are no set routines for getting up and going to bed and people can eat in their rooms if they wish. This was confirmed in conversations with residents during the day. Some newspapers and journals are provided by the home. The home has its own mini bus that is adapted to take two wheel chairs, so trips out can be arranged, Bolton Abbey being the most recent. There is a weekly activity programme that includes exercise, in-house games and quizzes, massage and aromatherapy, handicrafts, music, entertainers and the importance of one to one quality time is also realised. There are links with local schools and churches, and events like the summer fair and parties that raise money for the residents’ fund. Mrs Makin, joint owner of the home, is a member of NAPA (a national organisation for providers of activities for older people) and attends days where ideas and information can be shared. Norwood House 20050825 Norwood House Stage 4 S19884 V242169 J52.doc Version 1.40 Page 13 Whilst the lunchtime meal was not observed, residents and relatives said that the food was consistently good. The home is particularly good at linking with speech and language therapy specialists for care of people with swallowing difficulties. The menus seen provided choice but it was the range of meal preparation that was impressive, indicating good attention to individual care needs and good communication, preparation and kitchen organisation. For example the lunch time menu might provide for a choice of braised steak and onions or country chicken casserole both with potatoes and a selection of fresh vegetables but both meals are provided to specific residents in textured, puree, and soft forms, with diabetic, low fat and vegetarian alternatives. Norwood House 20050825 Norwood House Stage 4 S19884 V242169 J52.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16. Residents and relatives understand that they can raise concerns and feel confident in doing this. They feel staff listen and respond quickly to put things right. EVIDENCE: The complaints procedure is appended to the residents’ handbook. It was clear from the observations during the day and from what was said, that residents and relatives feel comfortable in raising any source of discomfort or concern, however small and feel that staff listen and act on this. Norwood House 20050825 Norwood House Stage 4 S19884 V242169 J52.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 26 The home is safe and well maintained and offers comfortable communal lounge areas. Bedrooms suit personal needs, can be personalised with your own possessions and made private. The home has a range of aids and equipment that make things like bathing and toileting easier and safe. EVIDENCE: All the communal areas, bathing facilities and some bedrooms were seen. No health and safety hazards were noted and staff were seen doing their work properly dressed and equipped, and their practices make sure the home is clean, free from unpleasant smells and hygienic. The home is comfortable and homely and is maintained to good standards. There is an ongoing programme of refurbishment and redecoration. Bedrooms are well furnished and were personalised with residents’ own possessions. There is a wide range of standard and specialist aids and equipment to make things safe for staff and residents. Further investment in profiling beds and air mattresses is being made. The owners are considering further improvements and an extension. Norwood House 20050825 Norwood House Stage 4 S19884 V242169 J52.doc Version 1.40 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28 and 30. There is a good core of experienced and well trained staff who know what they are doing. Newly appointed staff are properly trained and mentored. Relationships are good and the residents are well cared for. EVIDENCE: Five members of staff were spoken with. These were both experienced staff and some fairly new staff who were completing their inductions. They are well organised and there are well established systems of shift handovers, staff meetings that mean information about the residents is up to date. The staff spoken with knew the residents well and the relationships were good with a lot of warmth and humour. The care staff are supported by a team of ancillary staff. There is a training programme for all grades of staff and at the start of the visit, some domestic staff were involved in NVQ training with Mrs Makin. New care staff talked about their induction training and established staff confirmed that safe working practice training was up to date. Although further progress has been made since the last inspection, and the home is working towards the 50 target of NVQ qualified care staff for the end of 2005. Two student nurses on placement at the home drew on their other placement experiences and said that the staff at Norwood House were professional and caring and they had learnt much during their time at the home. ‘This has been a good experience’. They felt the residents were well cared for. Norwood House 20050825 Norwood House Stage 4 S19884 V242169 J52.doc Version 1.40 Page 17 The owners both felt that by taking students and adaptation nurses, this provided stimulation and motivation for qualified staff and they were delighted with the commitment and enthusiasm shown to make sure that the placement and learning experiences were to a high standard. Staff were observed to be professional but personable in their interaction and the residents and relatives spoken with, without exception, praised the staff for their caring and supportive approach. Norwood House 20050825 Norwood House Stage 4 S19884 V242169 J52.doc Version 1.40 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33 and 38. The home is well managed and the interests of the residents are the main concern of the manager and staff. Record keeping, safety checks and systems of communication make sure that the home is a safe place to live. EVIDENCE: The manger/owner is well qualified and experienced, keen to extend his knowledge and is actively involved in National and local organisations and groups concerned with the care of the elderly. The owners live ‘on site’ and are ‘hands on’ managers, know what is going on and check things personally. All of the residents, relatives and staff spoken with said that they are very approachable and listened to their views. There are other more formal ways of checking the standards that are being introduced like satisfaction surveys. The record keeping in the home is good. Risk assessments about residents are clear and up to date, and regular safety checks are made on equipment and are recorded to make sure the building is safe. The atmosphere in the home is Norwood House 20050825 Norwood House Stage 4 S19884 V242169 J52.doc Version 1.40 Page 19 warm and friendly and the residents and relatives said that they like this. Residents said that staff responded to the emergency call system very quickly and this made them feel safe. Norwood House 20050825 Norwood House Stage 4 S19884 V242169 J52.doc Version 1.40 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 3 3 x x x x 3 Norwood House 20050825 Norwood House Stage 4 S19884 V242169 J52.doc Version 1.40 Page 21 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 OP7 Regulation 15 Requirement All service user plans must set out in detail the action which needs to be taken by nursing and care staff to ensure that all aspects of the health, personal and social care needs of the service user are met. (previous timescale of 1/09/04 not met) NVQs must continue for care staff so that the target of 50 trained members of staff is reached by the end of 2005. Timescale for action 31/03/06 2. OP28 18 31/12/05 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 OP7 Good Practice Recommendations Daily recording should reflect how all aspects of the care plan are delivered on a daily basis. Norwood House 20050825 Norwood House Stage 4 S19884 V242169 J52.doc Version 1.40 Page 22 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 Norwood House 20050825 Norwood House Stage 4 S19884 V242169 J52.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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