Inspection on 05/10/06 for Norwood Trust Limited

This inspection was carried out on 5th October 2006.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 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 10/11/05

Norwood Trust Limited 27/04/05

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 Trust Limited 21 Arkwright Road Marple Stockport Cheshire SK6 7DB Lead Inspector Sylvia Brown Unannounced Inspection 5th October 2006 08:30 Norwood Trust Limited DS0000008570.V314800.R01.S.doc Version 5.2 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 Trust Limited DS0000008570.V314800.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 Adults 18-65. 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 Trust Limited DS0000008570.V314800.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Norwood Trust Limited Address 21 Arkwright Road Marple Stockport Cheshire SK6 7DB 0161-449 0391 NO FAX 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) Norwood Trust Limited Leslie Horton Care Home 14 Category(ies) of Learning disability (14) registration, with number of places Norwood Trust Limited DS0000008570.V314800.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 14 LD. Date of last inspection 10th November 2005 Brief Description of the Service: The Norwood Trust 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. The fee structure at the home commences at £340 with the current highest fee being £350. Norwood Trust Limited DS0000008570.V314800.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection site visit to Norwood House was conducted as part of the overall inspection process of the home. It commenced at 11:00am and looked at all the key standards. Time was spent talking with service users, who kindly shared their lunch time with the inspector, where they explained their care needs and day to day routines. Their records were looked at to see if their needs were recorded and that they received the support they required. Health and safety records were also looked at, as was the building. The current registered manager has given six months’ notice, as he is to retire. The manager to be proposed is currently on NVQ level 4 training and has been at the home for a considerable time in a management position. The inspector spent time with the registered manager discussing the home’s developments and future plans. Comment cards were left at the home for service users, relatives and staff. At the time of writing, no comments cards had been returned from service users, six from relatives and two from staff. Comments have, where relevant, been included within the report. The next inspection report will incorporate all comments received between this and the next inspection. What the service does well: The home continues to provide service users with a homely environment and a family atmosphere. Most service users have lived at the home for a long time and have formed strong bonds, similar to that of brothers and sisters. Without exception, all service users are supported to live their lives as they desire and have opportunities to have new and fulfilling experiences. Service users are consulted with and are able to affect, in part, how the home is run. Comments received from relatives confirmed their satisfaction with the services provided at the home. They stated they are made to feel welcome, are kept informed and included in decision making processes. Norwood Trust Limited DS0000008570.V314800.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 Trust Limited DS0000008570.V314800.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Norwood Trust Limited DS0000008570.V314800.R01.S.doc Version 5.2 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 the following standard(s): 2 Quality in this outcome area is good. All service users had assessments in place which were kept under review and were up to date. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: There have been no new admissions since the previous inspection. Current service users’ care files contained assessments of their care needs and personal aspiration. Assessments were kept under review and up to date. It was evident from talking with service users that they were able to fulfil some of their aspirations with support from staff. It was also evident that some service users were considering their long term future. The home appeared to be supportive and was providing service users with all the information they required. However, the home recognises that many service users have families who are actively involved in their lives and that major decisions will not be made without their appropriate involvement. In order to protect the service users, the home has systems in place to consult with various professionals and advocacy services if service users’ wishes come onto conflict with relatives and/or the home. Norwood Trust Limited DS0000008570.V314800.R01.S.doc Version 5.2 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 the following standard(s): 6, 7 & 9 Quality in this outcome area is good. Each service user has an individual plan. Staff respect service users’ rights to make decisions and support them to take responsible risks. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: Each service user had a written care plan which contained detailed information about who they were, their hopes and their needs. Records indicated service users are consulted about all aspects of their lives and ensured, as far as possible, that they were able to live as they desired. Records demonstrated various consultation processes with service users on both an individual and group basis. When talking with them they confirmed that staff were aware of what they wanted for the future and their preferred day to day routines. Service users stated that that they spoke with their support workers about all aspects of their life and felt they were receiving the support they wanted and needed. Norwood Trust Limited DS0000008570.V314800.R01.S.doc Version 5.2 Page 10 Relatives’ comment cards confirmed that they were satisfied with the overall care and support provided by the home. When talking with both staff and service users it was clear that service users were treated as individuals and supported to make decisions and choices for themselves. Most service users have family who support them to manage their finances, however small balances are held at the home to ensure service users have access to their money when they wish. Some service users manage their own finances and have independent bank accounts which the home does not have access to. Risks and risk taking is seen by the home as everyday life occurrences. Care files detail service users’ preferred life routines and social desires which includes some risk taking. Service users are supported to gain confidence and manage risk safely. Guidance is detailed in the records and monitoring systems are in place to, as far as possible, safeguard the service user. Norwood Trust Limited DS0000008570.V314800.R01.S.doc Version 5.2 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 the following standard(s): 11, 12, 13, 14, 15, 16 & 17 Quality in this outcome area is good. Service users have individual lifestyles and are appropriately supported to live as they desire within the community. They receive a healthy tasty diet. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: The home supports service users to live full and active lives. Records detail service users’ involvement within the immediate and wider community. They confirmed how the were supported to attend work and/or day centres and the many activities they undertake in the evening and at weekends. Hobbies and interests are promoted, with many of the service users having interests they enjoy. Through talking with service users it was evident that some had developed more independence skills and were enjoying more flexible routines which they have developed for themselves. Norwood Trust Limited DS0000008570.V314800.R01.S.doc Version 5.2 Page 12 All service users have been on holiday with the home. They said they had been able to choose where they went and who with. One service user did not have the confidence to leave the home overnight. As a consequence, the home has provided a number of day trips to the service user’s preferred places. Service users spoke of their holidays and how they had been able to do what they wanted, including some time alone. Families are actively involved with the home and are made to feel welcome. Comments received from relatives have contributed to the development and running of the home. Service users are expected to assist in the upkeep of the home and have small tasks to complete according to their ability and willingness. Some assist in the shopping, others in the garden and one service user takes care of the aviary. Meals and mealtimes are like a number of families, chaotic at times, as service users return from their day time activity and prepare for the evening. As a consequence, the home has employed a cook who now prepares the evening main meals for both staff and service users. At weekends, meal times are less structured with meals taken both within and out of the home. The home’s menu has recently been changed and offers winter type dishes. The quality of food is of a good standard. One service user stated that they take a lot of time choosing what they want when they go shopping and “always get nice things”. Advice has been given to ensure that the home can demonstrate that service users continue to have choice at all mealtimes and they are not restricted to snack alternatives if the main meal is not desired. Norwood Trust Limited DS0000008570.V314800.R01.S.doc Version 5.2 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 the following standard(s): 18, 19 & 20 Quality in this outcome area is good. Service users’ health and welfare are promoted and safeguarded. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: Records confirmed that service users’ health and emotional needs are assessed and monitored. They are able to visit their own doctors, dentist, opticians and chiropodists within the community as they individually desire and need. Heath care issues are tightly managed with consideration being given and plans developed for those who are reaching middle age with associated health care issues. Records demonstrated that the home is prepared to make difficult decisions when a service user’s health care and/or capacity exceeds that which can be managed. The home is not registered for older people and will not be able to support service users who are not mobile or have mental health frailty which impacts on others. Norwood Trust Limited DS0000008570.V314800.R01.S.doc Version 5.2 Page 14 In the main, most medication is administered to service users. Records were in place and were correctly detailed. For those service users who self administer their own medication, risk assessments were recorded. Systems were in place for monitoring their medication weekly in order to detect any errors. The overall care provision appears to be of a good standard. Relatives comments include “My son has been there more than 15 years and I am more than happy at the way he is looked after.” And “Our daughter is very happy at Norwood and we have no complaint about her care.” Norwood Trust Limited DS0000008570.V314800.R01.S.doc Version 5.2 Page 15 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 the following standard(s): 22 & 23 Quality in this outcome area is good. Service users are aware of and have confidence in the home’s complaints systems. They are safeguarded from abuse and have confidence to report any concerns they have. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: The home has effective complaints and protection procedures in place. All complaints are recorded, as is the action taken to find a positive outcome. There have been no issues of complaint made to the CSCI. Adult protection procedures continue to be in place. There have been no allegations of abuse. Most staff have undertaken adult protection training or are awaiting training with the local authority. On the day of the inspection service users spoken to stated they felt safe and would report anything they felt scared of or were unsure about. There are evident positive relationships amongst staff and service users and whistle blowing procedures have, in the past, been activated by staff about incorrect staff practice and concerns. Norwood Trust Limited DS0000008570.V314800.R01.S.doc Version 5.2 Page 16 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 the following standard(s): 24, 25, 26, 27, 28 & 30 Quality in this outcome area is good. Service users live in a well maintained, clean and safe, homely environment. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: Norwood House is a large detached home which is bright and homely, offering service users comfort and space to live as they desire. Alterations have been made to increase the single bedroom ratio and plans are underway to divide the remaining double room into two singles. Bedrooms were individual in their decoration and layout, with service users being able to choose their own wallpaper, colour and bedding designs. Bathing and toileting areas remain the same. Consideration is being given to making significant changes to these areas to make them appropriate for people with a disability. Norwood Trust Limited DS0000008570.V314800.R01.S.doc Version 5.2 Page 17 There is ample space for service users to continue with their hobbies, join together in the evenings for TV viewing or have solitude and privacy in their own rooms. The home is maintained to a high standard and is kept clean and fresh with no odours evident. The gardens to the rear are large and offer service users ample space for activities, growing their own produce and relaxing. Norwood Trust Limited DS0000008570.V314800.R01.S.doc Version 5.2 Page 18 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 & 36 Quality in this outcome area is poor. Norwood is generally well run, however robust recruitment procedures for the protection of vulnerable adults had not been followed. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: Inspection of two files identified that robust recruitment and selection procedures which protect service users were not followed. Though references and CRB checks had been obtained prior to appointment, one set of references were not from the last employer. There was no evidence that one staff had seen the application form completed in their name. The writing was that of someone else and there was no signature to verify that the staff member had agreed the information. The details on both applications forms were poor. There was no information about previous employment, the person’s skills to meet the position applied for, education or evidence of training. There was no formal information regarding the interview process, other than the letter of employment indicated interviews had taken place. Norwood Trust Limited DS0000008570.V314800.R01.S.doc Version 5.2 Page 19 Staff commented that “staff are not recruited though advertising, rather management employ people by word of mouth.” The registered manager stated he was aware that shortcuts had been made and that plans were already underway to fully redevelop recruitment procedures and practices. There was no written information to confirm that staff had completed a home’s induction/orientation programme or completed formal induction procedures. There was no indication of any training being completed since employment that was approximately four months prior to the inspection visit, nor was there any information regarding formal supervision being undertaken. The registered manager holds regular formal staff meetings which are recorded and provided to the CSCI. Staff are kept informed of changes to working practices and where practice needs to be improved. The needs of service users are discussed as a group and everyone has the opportunity to contribute to the development of support packages. The registered manager stated that two staff were about to commence the Learning Disability Award Framework training and that informal supervision was constantly given as he worked alongside new workers. Notwithstanding the above failings in recruitment procedures, most staff have been at the home for some time. They respect service users and have attitudes and characteristics that are appropriate for the work and support required from them. Job descriptions were in place and staff have access to all policies and procedures. When spoken with, it was evident that most staff have the skills and experience necessary for the tasks they are expected to do. From speaking with them and service users about the support they receive, it was also evident that staff had knowledge of the disabilities and specific conditions of service users. Norwood Trust Limited DS0000008570.V314800.R01.S.doc Version 5.2 Page 20 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. Norwood is a well managed and run home. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: There are no changes to the management. As stated in the summary of the report, the current registered manager has given six months’ notice, as he is to retire. The manager to be proposed is currently on NVQ level 4 training and has been at the home for a considerable time in a management position. Other than recruitment, the home is very well run. Norwood Trust Limited DS0000008570.V314800.R01.S.doc Version 5.2 Page 21 The registered manager provides service users with the opportunity of meeting as a group as well as individuals to discuss the running of the home. The meetings are recorded and copies supplied to the CSCI. The service users stated they liked the meetings and felt “our home runs better”. It is clear that information received is acted upon and service users receive updated information on the action taken as a consequence of the comments. Quality assurance procedures have been completed for 2006 and the report is in the process of being finalised and produced for distribution. Health and safety records looked at confirmed that the home takes its responsibility seriously. Norwood Trust Limited DS0000008570.V314800.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 4 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 3 X Norwood Trust Limited DS0000008570.V314800.R01.S.doc Version 5.2 Page 23 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 YA34 Regulation 19 Requirement The registered person must ensure that robust recruitment and selection procedures are in place and followed at all times. Timescale for action 06/10/06 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 Refer to Standard YA35 YA35 Good Practice Recommendations The registered person should ensure that all staff complete induction training and initial mandatory training to meet their employment roles and responsibilities. The registered person should ensure that training and development plans record long term and ongoing training to verify employees have the skills to support service users with a learning disability. The registered person should ensure that all staff receive formal individual supervision as they need and not less than six times per year. 3 YA36 Norwood Trust Limited DS0000008570.V314800.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Ashton-under-Lyne Area Office 2nd Floor, Heritage Wharf Portland Place Ashton-u-Lyne Lancs OL7 0QD 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 Trust Limited DS0000008570.V314800.R01.S.doc Version 5.2 Page 25 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!