Inspection on 27/04/05 for Norwood Trust Limited

This inspection was carried out on 27th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Norwood Trust Limited 09/07/07

Norwood Trust Limited 05/10/06

Norwood Trust Limited 10/11/05

Norwood Trust Limited 10/11/04

Norwood Trust Limited 20/07/04

Norwood Trust Limited 04/03/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Norwood 21 Arkwright Road Marple Stockport SK6 7DB Lead Inspector Sylvia Brown Announced 27 April 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Norwood F54 F04 norwood A s8570 v215429 270405 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Norwood Address 21 Arkwright Road, Marple, Stockport, SK6 7DB 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) 0161-449-0391 0161-449-3091 Norwood Trust Limited Mr L Horton CRH Care Home 14 Category(ies) of LD Learning disability registration, with number of places Norwood F54 F04 norwood A s8570 v215429 270405 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Service users to include up to 14 LD. Date of last inspection 10 November 2004 Brief Description of the Service: The Norwood Turst was established in 1985 and is a registered charity. Norwood is a care home providing personal care and accommodation for 14 adults between the ages of 32 and 62 years with a learning disability, ten of whom are accommodated in the main house and four who lead semiindependent lives in a purpose built bungalow in the grounds. Norwood is a large Victorian semi-detached house with a purpose-built bungalow at the rear of the property. Both buildings are furnished and maintained in a homely manner and are suitable to meet the needs of the current service users. The main accommodation consists of six single bedrooms, two shared bedrooms, two lounges, dining room, kitchen, laundry and bathrooms. All the bedrooms are located on the two upper floors. There is no lift and the stairs to the second floor are particularly steep. The bungalow consists of four single bedrooms, lounge and separate dining kitchen, two toilets and a bathroom. The home is located in the Marple area of Stockport. The village centre, which is approximately a ten to 15 minute walk away, has a wide variety of shops, banks and a post office, as well as a cinema, restaurants and swimming pool. A regular bus service (with a stop outside the home) is in operation. The train station is a short distance from the property. Norwood F54 F04 norwood A s8570 v215429 270405 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection of Norwood was announced and took place over one day, starting at 8am, with a total of 7.5 hours spent on the premises. The registered manager ensured that relatives of the residents were aware of the inspection and made arrangements for the inspector to meet with five parents and a resident’s sister. The inspector met with the residents in the morning as they prepared to leave for their place of work or day centre. As at previous inspections, the residents appeared happy and contented with their life and were, as far as possible, living as part of the community. There have been no admissions to the home for a number of years, with the residents being a stable group of younger adults, some of whom have lived at Norwood for more than 15 years. Prior to the inspection the registered manager provided the CSCI with a thoroughly completed pre-inspection questionnaire Comment cards were received from five residents and 11 relatives. One comment card was received from a medical professional involved in the home and direct comments were received from the appointed Social Services social worker for the home. Comments received have, as far as possible and as is appropriate, been included in the report. What the service does well: The home continues to enable a group of adults who have a learning disability to live lives as ordinary people. They are supported to find work placements and continue with their learning. Norwood provides the residents with a homely environment. The home is well maintained and sufficiently spacious to enable residents to pursue hobbies and interest and undertake small tasks as expected in any home. The staff team is in the main a stable workforce with minimal vacancies arising, this enables residents to form friendships and positive relationships with staff. From information received it is evident that the home continues to communicate well with families of the residents. The registered manager communicates effectively with the CSCI, providing a monthly report of the independent visitors evaluations. Norwood F54 F04 norwood A s8570 v215429 270405 stage 4.doc Version 1.30 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 F54 F04 norwood A s8570 v215429 270405 stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Norwood F54 F04 norwood A s8570 v215429 270405 stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 4 & 5 Residents’ needs are continually assessed and support services provided to enable them to reach their maximum potential. EVIDENCE: The home has a written Service User Guide that details the services offered, staffing structure and living arrangement. This document is available in a format suitable to meet the needs of those with a learning disability The last resident admitted to the home was able to visit prior to making any decisions about their future. Inspection of residents’ files confirmed that assessments were in place and up to date. Contracts and terms and conditions of residency were also in place, as was a written care plan. Care plans demonstrated that specialists are consulted and that the home is able to meet the needs of people with a learning disability and those approaching older age. Records also demonstrated that residents’ personal aspirations were recognised and support provided to enable them to, as far as possible and safe, to fulfil their desires. Family members stated that they were kept informed of any changes and that they are “delighted to have a home like Norwood” for their son or daughter. Norwood F54 F04 norwood A s8570 v215429 270405 stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8 & 9 The needs of residents are recognised, recorded and assessed. Residents are enabled to make decisions, with those who are able being supported to take some risks as part of a semi-independent lifestyle. EVIDENCE: Inspection of care plans showed that they identified need and recorded attainable goals for the resident to reach. Care plans were evaluated and amended as the needs of residents changed. Family members stated that they are informed of the written care plan and that, as far as is reasonable, residents are aware of their plans of care. All families spoken to stated their satisfaction with the manner in which their son or daughter was cared for. The registered manager stated that it is his intention to develop improved routine systems for consulting with residents individually and as a group. Norwood F54 F04 norwood A s8570 v215429 270405 stage 4.doc Version 1.30 Page 10 One resident was observed to be independently entering and leaving the grounds and undertaking small tasks for the home which included going to the local shopping area. Some families spoke of their son or daughter independently travelling to see them and of the work undertaken by staff to enable them to gain the confidence to travel alone. The registered manager is aware that, at times, some residents wish to stay up later than staff are on duty. The manager explained that staffing rotas will be evaluated and consultation with the resident regarding their preferred bedtime routine will be undertaken. The social worker appointed to the home confirms that she has addressed this issue with the home and is satisfied with the home’s progress toward implementing change. Norwood F54 F04 norwood A s8570 v215429 270405 stage 4.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15, 16 & 17 Residents at Norwood are supported to live fulfilled lives and are enabled to have everyday experiences. EVIDENCE: The inspector had the opportunity of talking to residents who confirmed that they were able to go out into the community and enjoy individual hobbies and interests. In addition to going to work and day centres, residents have joined the library, go swimming and take part in community life as they wish. Records identified that residents’ personal preferences were respected and care plans demonstrated and family members confirmed that residents continue with their preferred hobbies, both within the home and when visiting family members or within the community. Most of the residents have family contact. Family members stated they were made to feel welcome and were appropriately involved in the decision making process. Norwood F54 F04 norwood A s8570 v215429 270405 stage 4.doc Version 1.30 Page 12 Inspection of stocks identified that fresh food was provided, including vegetables and fruit. There was a sufficient quantity of healthy food stocks to indicate that residents receive a healthy diet. Residents assist staff in shopping for groceries and various food items. Residents’ weights are monitored and menus devised to include residents’ preferred food. Some residents are able to make snacks for themselves, however the registered manager was made aware that residents should be encouraged more to learn cooking skills and be provided with opportunities and encouraged to make main meals for themselves and others. From information received, routines in the bungalow should be prioritised to enable the most independent residents to prepare main meals under supervision. Norwood F54 F04 norwood A s8570 v215429 270405 stage 4.doc Version 1.30 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 & 20 Residents receive sufficient support to maintain their health. EVIDENCE: A comment card received from the home’s medical centre stated that Norwood communicates well with them and works in partnership to achieve good health for the residents. They stated the home demonstrates a clear understanding of the care requirements of residents and that they are satisfied that the health care needs of residents are met. Families stated they felt their respective relatives’ health care was looked after. Ten of the 11 returned comment cards from families stated that they were kept informed about important matters affecting the residents. Medication records were appropriately maintained, however, in the main, the home takes responsibility for administration and management of medication on behalf of residents. It was evident through talking to residents and evaluation of care plans that some residents may, with support and supervision, be able to manage their own medication, including administration. Norwood F54 F04 norwood A s8570 v215429 270405 stage 4.doc Version 1.30 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 Family and visitors were not fully aware of the home’s complaint procedure. Residents felt safe and well cared for. EVIDENCE: Families spoken to at the inspection gave mixed views on how complaints are dealt with at the home, some saying that issues are resolved appropriately whilst others stated that issues of complaint often reoccur. Three of the 11 returned comment cards from families stated they were not aware of the home’s complaint procedure. Four stated that they had cause for complaint. Inspection of the complaints record identified one recorded complaint since the last inspection. However, five comment cards stated they has made a complaint and the pre-inspection questionnaire identified that no complaints had been received within the previous 12 months. The home has not had a consistent routine for the recording complaints received. All returned comment cards from residents stated they felt safe and well cared for. In the period between the past and present inspections the inspector consulted with the social worker with responsibility to review residents’ care. Concerns have been raised regarding the home’s approach which, at times, is old-fashioned and institutionalised and could be construed by some as institutionalised abuse. The social worker has informed the registered manager of these issues and she reports she is satisfied with the progress being made to improve staff practice. The pre-inspection questionnaire identified that staff required up to date training in adult protection procedures. Norwood F54 F04 norwood A s8570 v215429 270405 stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 & 30 Norwood provided residents with a homely environment which is clean and well maintained and suitable to meet their current physical needs. EVIDENCE: Since the last inspection, the home has continued to upgrade a number of areas. Redecoration of the kitchen, utility and bedrooms in the bungalow has been completed. The main office has been moved from the first floor to enable space for a single bedroom. New table tops have been fitted to dining tables, a new washing machine, which meets current standards, has been purchased, as has a new refrigerator in the bungalow. The registered manager presented the inspector with a planned programme for upgrading the home in the coming year. The home was as at other visits and inspections: clean, tidy and well maintained. Norwood F54 F04 norwood A s8570 v215429 270405 stage 4.doc Version 1.30 Page 16 Families spoken to were, in the main, positive about the environment and the manner in which it was maintained. Residents stated they were happy at the home and with their rooms. Those who were to receive single bedroom accommodation were excited and looking forward to “moving”. Norwood F54 F04 norwood A s8570 v215429 270405 stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34, 35 & 36 The home provides residents with a stable, experienced and competent work force. EVIDENCE: The inspection of records confirmed that staff were recruited and selected appropriately. It is recognised that staffing files in place prior to the new registered manager may not have all the required documents, however, as far as possible, arrangements are in place to have the information on file. The registered manager has introduced new systems to ensure that required documentation is obtained in future prior to new staff commencing employment. The current staff team are, in the main, long serving. Of the 15 staff, 11 have completed NVQ training at level 2 and two have completed NVQ level 3. Some relatives spoken with, and three of the 11 returned comment cards, stated that they felt there were not sufficient numbers of staff on duty. The staffing rota is somewhat complex as staffing is reduced during the day midweek due to the majority of residents being out of the home. Norwood F54 F04 norwood A s8570 v215429 270405 stage 4.doc Version 1.30 Page 18 As mentioned previously, staffing levels and availability late evening are under review. In addition, the inspector is not confident that sufficient staff are provided at the bungalow to support the residents and to meet its aims and objectives. The registered manager confirmed that he has yet to evaluate if the support to residents in the bungalow is sufficient to fully promotes their independence. Notwithstanding the above issues, without exception, residents stated they were happy with the staff and with the support they received. Formal supervision has commenced, with staff meetings in place to provide group supervision and guidance. The registered manager completes duties on rota and is available to observe practices directly and offer advice and guidance where required. From observation and feedback from residents and relatives, it is evident that residents benefit from a stable staff team who are experienced in providing care and support to people with a learning disability. Norwood F54 F04 norwood A s8570 v215429 270405 stage 4.doc Version 1.30 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 39, 40, 41, 42 & 43 Norwood is a well managed home with written polices and procedures in place for the protection , safety and well being of the residents. EVIDENCE: Since the last inspection the home has recruited a new manager. Although experienced and qualified, he has to ensure that he undertakes up-to-date management training and continue with his own learning. The registered manager has introduced a new administration system which will ensure that appropriate records are in place for the safe running of the home. The manager’s leadership style is one of leading by example and evaluating systems before introducing change. As a consequence, some changes are taking a while to be completed. Families talked positively about the new manager and of his “paced” management style. Norwood F54 F04 norwood A s8570 v215429 270405 stage 4.doc Version 1.30 Page 20 The home’s quality assurance procedure has been completed with a public report available and on display within the home. The registered manager demonstrated that he is currently reviewing the home’s policies and procedures, with a view to amending them to meet best practice. Statutory reviews have commenced for residents. Feedback from the social worker involved was positive. After initially raising concerns, she confirmed that the registered manager has acted upon information given and is improving practices. Inspection of health and safety records evidenced the home takes seriously the responsibility to maintain the health, safety and well being of residents. Records of servicing were up-to-date, as were health and safety monitoring systems. Residents’ comment cards all stated they were happy with living at the home, with one stating “I think the bungalow is a nice home and I am well looked after”. Without exception, all families stated they felt Norwood was an ideal place for their relative to live. Norwood F54 F04 norwood A s8570 v215429 270405 stage 4.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 2 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 2 3 3 3 2 Standard No 31 32 33 34 35 36 Score 3 2 3 3 3 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Norwood Score 3 3 2 2 Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 3 F54 F04 norwood A s8570 v215429 270405 stage 4.doc Version 1.30 Page 22 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 OP20 Regulation 14 Requirement The registered person must ensure that, after assessment, residents who have the ability are supported to manage and administer their own medication. The registered person must ensure that all complaints are recorded. The registered person must ensure that all levels of staff receive up-to-date training in adult protection procedures. The registered person must review staffing levels and ensure that staff are in sufficient numbers to provide the support serivices to meet the homes aims and objectives, both in the main house and the bungalow. Timescale for action 01/06/05 2. 3. OP22 OP32 22 13(6) 18(1)(a) 18(1)(a) 01/06/05 01/08/05 4. OP36 15/06/05 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. Norwood Refer to Standard OP9 Good Practice Recommendations The registered person should, after assessment, make provision for residents to remain up as long as they wish. F54 F04 norwood A s8570 v215429 270405 stage 4.doc Version 1.30 Page 23 2. 3. OP17 OP21 4. OP36 The registered person should ensure that residents under supervision have the opportunity of preparing main meals. The registered person should, as far as possible and as is suitable, discuss with residents ageing, death and illness and, where possible, ascertain their last wishes and feelings. The registered person should ensure that the registered manager has up-to-date management training and continue with his learning and development. 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