Inspection on 21/08/06 for Norwood Residential Home

This inspection was carried out on 21st August 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 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 Residential Home 15/08/05

Norwood Residential Home 14/04/05

Norwood Residential Home 10/11/04

Norwood Residential Home 11/05/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Norwood Residential Home 14 Park Road Ipswich Suffolk IP1 3ST Lead Inspector Anna Rogers Key Unannounced Inspection 21st August 2006 9:30 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 Norwood Residential Home DS0000024461.V308120.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. Norwood Residential Home DS0000024461.V308120.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Norwood Residential Home Address 14 Park Road Ipswich Suffolk IP1 3ST 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) 01473 257502 01473 216697 home.fxg@mha.org.uk Methodist Homes for the Aged Ms Nicola Louise Cantwell Care Home 39 Category(ies) of Dementia - over 65 years of age (4), Old age, registration, with number not falling within any other category (39) of places Norwood Residential Home DS0000024461.V308120.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th August 2005 Brief Description of the Service: Norwood is a care home providing personal care and accommodation to 39 older people. It is owned by Methodist Homes for the Aged, a charitable organisation that has a number of homes throughout the country. The organisation does not restrict its care provision to Methodists or those who follow any religious persuasion. The home is situated in a residential area of Ipswich town, overlooking Christchurch park and close to the town centre and associated facilities. The property consists of the original building (formerly a Bishops palace) and a modern purpose built extension. All bedrooms have en-suite facilities. There are 37 single bedrooms and one twin room to accommodate 39 residents. The home has three floors with a passenger shaft lift giving access to the first floor and a chair lift to the second. The extensive gardens are well maintained, accessible to all and are one of the outstanding features of the home. The current fees are £435 to £495 per week. These fees do not include personal newspapers, chiropody or hairdressing. Norwood Residential Home DS0000024461.V308120.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over eight hours. This was a key inspection, which focused on the core standards relating to older people. The report has been written using accumulated evidence gathered prior to and during the inspection. This included the pre inspection questionnaire, which provides data about the home, sixteen residents ‘Have your say’ and one relatives/visitors comment card. Additionally a number of records held at the home were looked at including care plans and associated records of three residents, staff recruitment, medication and health and safety records. Time was spent talking with the manager, deputy manager and an assistant manager who was responsible for medication. The chef and two members of staff were also spoken with. Three relatives and ten residents were spoken with during the day and the inspector also joined residents for lunch. What the service does well: Norwood House is very well managed and provides a good quality care to the people living at the home. Assessments of need are undertaken. Residents are involved in a review after 8 weeks to confirm that Norwood can meet their identified needs and a care plan is then developed. Residents are encouraged to maintain their independence and keep in touch with their local community, family and friends. The home employs an activities co-ordinator who involves residents in identifying a wide range of group and individual activities to meet the interests and abilities of residents. The staff team work well together and are provided with training and support to help them care for residents. Residents described staff as being respectful and helpful. Comments such as “they are wonderful”, “l could not live anywhere better” and “l feel very lucky to live in a place where people genuinely care for me” indicate the positive way residents and their relatives and friends feel about the care provided. One relative spoken with said they were so impressed with the progress of their relative since coming to Norwood that they were thinking of booking a place for themselves. The environment is well cared for and provides a welcome to visitors. All areas are clean and well maintained. The maintenance person/gardener is popular with residents for responding to their requests and for providing areas of interest within the gardens. Norwood Residential Home DS0000024461.V308120.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. Norwood Residential Home DS0000024461.V308120.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 Norwood Residential Home DS0000024461.V308120.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 5, 6 does not apply to this service. Quality in this outcome area is good. Residents can expect to have a needs assessment undertaken prior to admission, which forms the basis of their care plan. This judgement has been made using available evidence including a visit to this service. EVIDENCE: From a sample of three assessments it was evident that the assessment format is very detailed and covers a wide range of needs. From the sample seen the evidence collated provided a clear picture of the residents’ needs. There was also evidence that the manager includes in their assessment the level of mental frailty the resident may have to ensure the home can meet their needs in the area of dementia. It was positive to note that the residents and their relatives were involved in the assessment wherever possible and that the assessment focuses on the resident to remain as independent as possible within their abilities. The manager confirmed that other professionals, for example a specialist in elder care, Occupational Therapists (OT) and nutritionists, dieticians are Norwood Residential Home DS0000024461.V308120.R01.S.doc Version 5.2 Page 9 consulted where specialist needs are identified. There was evidence that the information gathered from the home’s assessment is used to produce individual care plans. There is a clear procedure in place for prospective residents to visit prior to their admission. From discussion with residents it is clear that for some residents they did visit, had visited the home to visit a friend already resident or a relative had identified the placement for them. Residents are admitted for a trial period of approximately eight weeks during which they and their relatives can decide if they want to stay and the home can confirm that they feel they can meet the resident’s needs. There was evidence of a letter sent to the resident and their relatives at the end of the trial period inviting them to the in house review. Following the review a letter is sent from the manager to the resident (and their family) where appropriate to confirm the decision and reaffirm that the home feels they can meet the residents on going needs. Residents spoken with said they could remember going to a meeting to discuss “their progress” and all those spoken with confirmed that they were happy to stay and felt the meeting was relaxed but recognised the importance of it. One resident who had spoken with the inspector at the last inspection said they could remember their meeting and they were still very happy with their decision to stay at the home. Norwood Residential Home DS0000024461.V308120.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. Residents can expect to be treated with dignity and respect and to have their health and personal needs identified. Access to healthcare services will be supported to ensure their needs are reviewed on a regular basis. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three care plans were seen. At the front of each care plan there is a personal profile sheet with the details of the resident’s next of kin and general practitioner (GP), past medical history and known medical conditions. The care plan format is detailed and each plan seen is broken down into individual components of care for example, personal and oral hygiene, pressure care, continence and nutrition. There were also records of medical diagnosis and ongoing health and medical treatment. Details relating to health professionals involved in the care of the residents were clearly recorded and included GP’S and Community Nurses. Residents spoken with confirmed the access they have to health professionals and said staff were active in calling in a GP when necessary. Norwood Residential Home DS0000024461.V308120.R01.S.doc Version 5.2 Page 11 Some of the residents spoken with were aware of the existence of their care plan while some others recognised that their needs were identified but did not seem familiar with the name and one resident said, “Oh that’s what it is called”. Each resident is allocated a designated key worker who is responsible for updating the information with the resident and where applicable family members. There was evidence that each component of the care plan is reviewed each month although on one residents plan some components had been missed. None of the current group of residents are being treated for pressure sores although it is evident that the home is proactive in identifying potential residents who could develop pressure areas because of their mobility difficulties. As noted in the previous section of this report, residents are assessed to maintain their independence. Residents spoken with said that they are supported when getting up, going to bed, dressing and completing personal care where they need it. One resident said they were competent to bath themselves but welcomed the support given when getting in and out of the bath. It was evident from inspection of care plans and discussion with residents and the Chef that nutrition of residents is monitored. The Chef confirmed that they would meet with all new residents to discuss their individual choices and preferences. The Chef would also be informed about any special diets to ensure they are catered for and weight is monitored. Residents spoken with confirmed that they are supported to attend health related appointments such as opticians and dentists. Residents also said that their mobility aids such as wheelchairs are appropriately maintained and batteries kept charged. Residents who use walking frames said they were able to access their rooms and gardens although one resident said, “l would like to do it all much more quickly” “but staff tell me to take it slowly” Staff spoken with said they complete a record titled ‘daily record’ when there is something significant to record. However from inspection of these records it was noted that there were gaps when no entry had been made from between two to eight and nine days. On one resident’s file an entry on a daily record stated “needs help with dressing” but the monthly review section of the care plan for the same period titled personal care had recorded still able to do unaided. The administration of medication by one of the assistant managers was observed during the lunch time period. The trolley is brought into the dining room and each resident is given their medication in a medicine pot directly from the blister pack and observed to take it before the administration chart is signed. Norwood Residential Home DS0000024461.V308120.R01.S.doc Version 5.2 Page 12 The home has a medication room which is temperature checked. It has been noted that the temperature has been excessive and to manage this problem an air conditioner has been ordered. There is a locked cupboard within the medication room for medication and a separate locked cabinet for controlled drugs. Currently no controlled drugs have been prescribed. Medication is provided by a local pharmacy who delivers the medicines monthly. The stock of medication was seen and this small amount was recorded and stored in a locked cupboard. No homely remedies are kept at the home. All medication returned to the chemist is recorded and signed for by the pharmacist. The medication charts for three residents were seen and found to have no gaps. When medication has not been given the reason (using the code printed on the bottom of each chart) is used. It was noted that one resident was routinely refusing a medicine but the assistant manager confirmed that the medication was for pain relief and the resident was able to express a view as to whether they required the second dose. One resident has been prescribed PRN medication and the prescription stated take one or two tablets but the record did not routinely record whether one or two tablets had been administered. It was clear from discussion with the assistant manager that they were aware of this problem and said it made it difficult to check tablets if the number administered had not been recorded. As part of encouraging residents to maintain their independence they are encouraged through a risk assessment process to self-administer their medication. There are good systems in place for staff to monitor this and for the resident to ask staff to take over the responsibility. It was clear from discussion with residents that they feel staff do support them and encourage them to continue this task for as long as the resident feels happy to do this. If staff feel the resident is not managing they will undertake another risk assessment in discussion with the resident. It was clear from discussion with the assistant manager, residents and inspection of records and the storage of medicines that the practice reflected the home’s medication policy and procedures. Residents spoken with confirmed that staff are very respectful and refer to them by their preferred name, and knock on bedroom and bathroom doors before entering. It was clear from discussion that residents feel that staff do not take them for granted and will always check with the resident what assistance or help they may need rather than assuming because the resident required help on one day they will need help the following day. Norwood Residential Home DS0000024461.V308120.R01.S.doc Version 5.2 Page 13 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 the following standard(s): 12,13,14,15 Quality in this outcome area is good. People who use this service can expect there to be an activities co-ordinator employed to help support their abilities, choices and interests. Residents can expect to be provided with a varied and balanced diet that residents are consulted about. This judgement has been made using available evidence including a visit to this service EVIDENCE: An activities co-ordinator is employed to arrange daily and regular activities for residents. As noted at previous inspections the co-ordinator is very enthusiastic. On the day of this inspection they were on a training course related to the co-ordinator role. The notice board had a list titled “Dates to Remember” which had a number of dates between now and December of activities already arranged. The activity for the afternoon was an actor/singer from a well-known television programme. It was clear from observation during the performance and discussion with residents afterwards that the entertainer was a popular choice. Other activities that have either taken place or are planned included a summer BBQ with entertainment, a classical and flamenco guitarist and other entertainer groups, shopping trips and pre Christmas events. Norwood Residential Home DS0000024461.V308120.R01.S.doc Version 5.2 Page 14 The co-ordinator is aware that not all residents can or want to join in group events and tries to ensure that one to one activity time is organised. For example on the day of this inspection one resident was watching a musical video. Another resident proudly showed the inspector their manicured nails that they had had done during the morning. The more able residents are encouraged to maintain their independence and keep the community links they may have. Residents who have reasonable mobility and are confident to go out on their own or with friends go into the main town centre, go out for meals and enjoy walks in the park that backs onto the home or enjoy the homes own gardens. Some residents spoken with said they preferred their own company and although they chose to join the other residents for meals they were contented to remain in their rooms to either read the daily newspaper or books brought by the community library, do crosswords, watch television or as one resident said, “l like to just sit and watch the wild life from the window”. There were a number of visitors to see residents throughout the day of inspection. It was observed that staff greeted the visitors and asked how they were. Three sets of relatives/friends who were visiting on the day of the inspection spoke with the inspector about how well their relatives were cared for. One relative said how impressed they were about how much their relative had improved in their outlook on life since being a resident. Another relative said, “ l am going to put my name down to come here” as l am so impressed with the care provided. Until recently the home had used a catering company to provide meals. However it has now cancelled the contract and the catering is provided in house. The staff who worked for the company have transferred to Methodist Homes employment. The deputy manager has taken responsibility for this group of staff and has produced an induction programme for them to ensure they are familiar with the relevant policies and procedures. Staff training and supervision has also been included. Residents have been involved in planning the menu with the catering staff. A new four-week menu has been produced to cover the summer months and the Chef indicated that residents would be consulted again to look at an autumn/winter menu. The inspector joined a resident for lunch. The meal chosen by the majority was cottage pie with fresh vegetables followed by gooseberry pie and custard/cream/ice cream. Alternatives were available for those not wishing to have the main choice, which included jacket potatoes with a choice of fillings, salads, fish or sausages. Residents spoken with said cottage pie is one of the favourites. Norwood Residential Home DS0000024461.V308120.R01.S.doc Version 5.2 Page 15 The mealtime was unhurried with staff available to help but not being intrusive. Residents were able to choose the size of the meal and could help themselves to vegetables on each table. The majority of residents choose to have their meal in the main dining room but if they prefer residents can have their meal served in their room. One resident was observed to being helped with their meal in the dining room. This was unhurried and time given between mouthfuls. The member of staff, who knelt beside the resident, was also observed to engage in conversation with the resident. Norwood Residential Home DS0000024461.V308120.R01.S.doc Version 5.2 Page 16 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 the following standard(s): 16,18 Quality in this outcome area is good. People who use this service can expect to be listened to and their concerns responded to. Residents can expect staff to have a clear understanding of what they should do to protect residents from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a complaints procedure, which provides clear information about the stages and timescales of the complaint process. No complaints have been received since the last inspection. Residents spoken to throughout the day said that they were confident that staff would respond to any concern they had. One resident said in their feedback card in response to who they would talk to if they had a problem or concern “ we are lucky to have someone like Nicky” (the registered manager) if l had a concern l would talk with her”. The home has a protection of vulnerable adults policy, detailing the procedures to follow to safeguard residents from abuse, a whistle blowing policy and “No Secrets Here” leaflet. It was noted at the last inspection that the home did not have a copy of the Suffolk protection of vulnerable adults inter agency policy, procedures and guidelines for staff. The manager confirmed that a copy of this is now available. Staff have received Protection of Vulnerable Adults (POVA) training. From discussion with staff it was also clear that they had a good understanding of Norwood Residential Home DS0000024461.V308120.R01.S.doc Version 5.2 Page 17 indicators of abuse, which if observed they would inform a member of the senior team and ensure that their observations were further explored. Staff spoken with also confirmed that if they witnessed a colleague treating a resident in an unacceptable way they would report it to a senior member of staff. Discussion with the deputy manager said that they are arranging POVA training for the catering staff Norwood Residential Home DS0000024461.V308120.R01.S.doc Version 5.2 Page 18 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 the following standard(s): 19,21,22,26 Quality in this outcome area is good. Residents can expect to live in a safe and well-maintained environment, which has been adapted to meet the needs of residents. An effective system is in place to keep the home clean and fresh. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home provides a welcoming and friendly atmosphere. It was noted that there are a lot of photos of communal events residents have been involved in. When the inspector mentioned these to residents identified in the photos some were able to recount the event for example the summer BBQ. All areas of the home are clean and tidy with no unpleasant odours. The gardens provide a quiet area to walk and sit in the nicer weather. On the day of this inspection a number of residents were observed, some walking purposefully which they later described as “my daily exercise” and others just ambling and enjoying the views. Norwood Residential Home DS0000024461.V308120.R01.S.doc Version 5.2 Page 19 The handyman/gardener has introduced some additional and humorous interest in the garden with garden ornaments for example, a mole appearing out of the ground, which is moved around the garden. Residents also said the handyman is very willing to help them and one resident gave an example of a problem they had with their window which was sticking. Evidence from previous inspections and confirmed during this inspection shows residents with mobility difficulties are assessed on admission to see if their care needs indicate that they should be admitted as a priority to ground floor rooms or a first floor room. It was evident from discussion with the manager that residents needs are reviewed and there was evidence of a resident who had a bedroom on the first floor moving to a ground floor room as their care needs have increased. There was evidence from the training records that care staff have attended manual handling training within the last 12 months. All bedrooms have en suite toilets and sinks. Five residents invited the inspector to view these and all were clean and fresh and fitted with grab rails positioned to provide additional support for residents’ independence. Communal assisted baths are available on both floors and additional toilets are also available. Hoists are available to assist residents and there was evidence that these routinely serviced and maintained. An effective call bell system is in place and it was noted when talking with residents in their rooms that the call bell had been placed near to them in case they wanted assistance. One resident who is blind was able to tell the inspector where they expected their call bell to be. The conservatory does not have a call bell facility fitted. The inspector spent 20 minutes with a resident in this area and it became apparent that if the resident had been alone and fallen they would have to wait for someone to find them as the route to the conservatory is away from the main corridors of the home. All areas seen were clean and fresh. There was evidence from the record that the temperature of hot water is tested from the source and again before a resident gets into their bath. The recorded temperatures showed that the temperature is maintained within the safe levels. Two residents spoken with said that staff were very supportive and considerate when assisting them in and out of the bath using a hoist. The home has good procedures in place to prevent and control the spread of infection. There is a main laundry room on the ground floor that is well equipped. Residents confirmed that the laundry service is very good and that they had their washing collected and returned to their rooms. One resident said that occasionally clothing went missing and was observed to discuss this with the laundry person when their clean laundry was returned. Norwood Residential Home DS0000024461.V308120.R01.S.doc Version 5.2 Page 20 Domestics are employed and cover specific areas around the home. Since the last inspection an additional domestic has been employed to ensure domestic cover is available seven days a week. Each domestic has a ‘trolley’ equipped with cleaning materials for use during their shift and these are kept secure when not in use. Staff have access to hand washing facilities with liquid soap and paper hand towel dispensers located in bathrooms and toilets. The training records indicated that staff have attended cross infection training within the last 12 months. Since the last inspection the kitchen has been completely refurbished with new non-slip flooring, and kitchen equipment. Discussion with the Chef confirmed there is a cleaning schedule in place to ensure the cleanliness is maintained. Norwood Residential Home DS0000024461.V308120.R01.S.doc Version 5.2 Page 21 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is adequate. Residents can expect their needs to be met be appropriately trained and competent staff. Residents cannot be assured that the recruitment and selection practice will fully protect them until a full previous employment record is requested. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Norwood Residential Home DS0000024461.V308120.R01.S.doc Version 5.2 Page 22 Staffing levels are determined by the number of residents in each of the categories of need using the home’s own assessment formula. From the data provided by the manager prior to this inspection the breakdown of the categories of need show that currently of the 38 residents 31 have low care needs and 6 have high care needs. The staff rotas show that there are a minimum of four care staff and at least one duty manager on the morning and afternoon shifts. The staffing levels take account of resident’s activities and the geographical layout of the building. At night there are two waking night staff on duty and a manager on call. Residents spoken with on the day of inspection were very positive about the staff team and their availability but some did mention that they had been told that the home is to be extended and an application made to register some additional beds for people with dementia. The majority of views from the residents “Have your Say” questionnaires indicate that they feel there are sufficient staff but comments were received from two residents that “it would be greatly helpful if the key worker could spend time with their ‘special residents’ to get to know them better and help with any problems,” and “in my opinion there are not enough carers so that people like me who shows independence are left to get on with it”. However another comment from a resident said” care, support, advice and help are always available not only from one’s key worker but from all staff”. It is evident from the data provided prior to this inspection and discussion with staff during the inspection that training continues to receive a high priority. Of the 21 care staff 14 hold an NVQ level or above which equates to 66 of staff. Core training identified includes health and safety, fire safety, first aid and manual handling with evidence from discussion with staff and records that this is routinely updated. Other training undertaken in the past 12 months includes nutrition, care in medicines, confidentiality, activities (attended by the Activities Co-ordinator), standards and values. The manager also confirmed that in preparation for caring for more people with dementia all staff will undertake a course produced by the Alzheimers Society titled “Introduction to quality dementia care”. The manager has already begun their training and they said they are exploring further appropriate training provided by the Alzheimers Society. As noted in section 3 of this report catering has been taken back by the home from a catering agency. The deputy manager said that training provided to other staff members would be extended to catering staff where appropriate and this includes protection of Vulnerable People (POVA) training. Catering staff have also completed food hygiene training and re visited the Food Safety Act. Norwood Residential Home DS0000024461.V308120.R01.S.doc Version 5.2 Page 23 Recruitment records for three staff recruited since the last inspection were examined. Each file contained an application form and evidence of a Criminal Record Bureau (CRB) check. Two of the checks were satisfactory but the third identified an offence that the applicant had not disclosed. Each file had two satisfactory references and personal identification. The application form had been completed but not all three applicants had provided a full employment record and although there was evidence of interview notes there was no evidence that the gaps in employment had been explored. Norwood Residential Home DS0000024461.V308120.R01.S.doc Version 5.2 Page 24 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is good. Residents can expect to live in a home that is well managed and the manager provides effective leadership to ensure their safety and welfare are protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager who has been in post for approximately three years has a diploma in management and holds the registered managers award. The manager has high and clear expectations of how they expect staff to care for residents. It was evident from discussion with staff that the manager does monitor the practice within the home and will take action if a member of staff is not caring for residents in an acceptable way. Staff spoken with also confirmed the availability of the manager and said “Nicky operates an open door policy”. Discussion with residents on the day and from comments made in “You’re your Say” questionnaires confirms that they can approach the manager about any Norwood Residential Home DS0000024461.V308120.R01.S.doc Version 5.2 Page 25 concerns. One resident in response to who they would speak to if they were not happy said “I am fortunate in having Nikki, the manager and several senior staff members who are experienced and confidential to turn to in times of need”. Other residents, through questionnaires and in discussion with the inspector identified the manager as someone to talk with about any concerns. Residents said that they have a residents meeting although some felt it could be better attended. During this meeting they are informed of any thing that is happening in the home, for example they have been told about the impending changes regarding admitting more people with dementia once the extension (still in the planning stage) is completed. Residents also spoke about their involvement in planning menus and said favourites are included. As noted they also make suggestions for activities, entertainment and outings. As noted from previous inspections residents, relatives or friends take responsibility for their own finances. Residents can look after their own money and are provided with a lockable container in their bedrooms for this purpose. The home will look after money for residents including money they may have withdrawn from their own accounts or money provided by relatives. This is kept in a safe and the duty manager holds the key. Individual records were not checked during this inspection but from discussion with residents who use the facility it is clear they are satisfied with how the home manages this arrangement. Other residents said that their relatives deal with the finances and they ask them to provide money for hairdressers, chiropody and daily newspapers. Evidence was seen during the inspection that the health, safety and welfare of residents are protected. Detailed risk assessments and regular staff training is in place ensuring the safe working practices for moving and handling, fire safety, and infection control. The fire service visited the home on the 1st March 2006 and no recommendations were made. There was evidence of equipment for example hoists, fire equipment and the passenger lift being serviced regularly. The central heating system was checked and a boiler upgrade has been recommended, quotes for this work are currently being obtained. The gas equipment has been checked within the last 15 months and found to be satisfactory. The electrical wiring last been checked and some work has been identified, quotes for this work are being undertaken. COSHH assessments have been completed for all cleaning products. The home continues to maintain good records relating to accidents and near misses. Time was spent with the Chef who demonstrated through their record keeping how the home manages the storage, preparation and cooking of food. There was also evidence of fridge/freezer temperatures being maintained. Norwood Residential Home DS0000024461.V308120.R01.S.doc Version 5.2 Page 26 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 X X 3 X 4 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 3 3 X X X 3 STAFFING Standard No Score 27 3 28 4 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Norwood Residential Home DS0000024461.V308120.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP29 Regulation 19 (1) (a) Requirement The recruitment procedure must be reviewed to ensure a full CV is provided and gaps explored. Timescale for action 31/10/06 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. 2. 3. Refer to Standard OP7 OP22 OP29 Good Practice Recommendations There should be a review of the purpose of the daily records to ensure they cross-reference with the details in the care plan. A review should be undertaken about the availability of the call bell system in communal areas There should be a clear protocol for managing the return of a Criminal record Bureau (CRB) check that shows an undisclosed offence. Norwood Residential Home DS0000024461.V308120.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 Residential Home DS0000024461.V308120.R01.S.doc Version 5.2 Page 29 - 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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