Inspection on 18/05/05 for Norwyn House

This inspection was carried out on 18th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Norwyn House 23/04/08

Norwyn House 19/06/07

Norwyn House 08/01/07

Norwyn House 19/10/05

Norwyn House 20/10/04

Norwyn House 13/04/04

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

CARE HOME ADULTS 18-65 Norwyn House Charmouth Road Raymonds Hill Axminster EX13 5ST Lead Inspector Teresa Anderson Announced 18 May 2005 10:00 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. Norwyn House D54 D06_s21991_norwyn_v217887_180505 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Norwyn House Address Charmouth Road Raymonds Hill Axminster Devon EX13 5ST 01297 35111 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) Miss Barbara Jill Anning Care Home 5 Category(ies) of LD Learning disability (5) registration, with number of places Norwyn House D54 D06_s21991_norwyn_v217887_180505 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 20 October 2004 Brief Description of the Service: Norwyn is a detached 3 storied residential property situated on the A35 near Axminster, Devon. The home offers personal care and accommodation for up to 5 service users with learning difficulties. It operates as a small, family home where residents and the owners and their family live together. All service users are able bodied meaning aids and adaptations are not required. The communal space is made up of 2 lounges, a large kitchen/dining room and a separate dining room. Care is delivered by a small team of carers. The house is surrounded by approximately one and a half acres of garden. There is a local bus service and the owner provides transport in the family cars. Limited parking is available. Norwyn House D54 D06_s21991_norwyn_v217887_180505 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place between 10.00am and 3.00pm as part of the normal programme of inspection. The inspector saw the entire home; spoke with 3 of the 5 residents, the owners and with one member of staff. The owner completed a pre-inspection questionnaire and a visiting care manager/nurse gave comments regarding the home. No comments cards were received by CSCI. Records in relation to care planning were inspected. Due to communication difficulties none of the service users present were able to tell the inspector about their life in the home. What the service does well: What has improved since the last inspection? Since the last inspection the owners have bought an adjacent piece of land which will provide alternative and safer access to the home. The number of staff employed at the home and on duty has been increased. Many areas of the home have been redecorated and refloored as chosen by service users. One bathroom has been refurbished to a high standard. A fish tank has been installed in the lounge which some service users take great pleasure in. Norwyn House D54 D06_s21991_norwyn_v217887_180505 stage 4.doc Version 1.30 Page 6 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. Norwyn House D54 D06_s21991_norwyn_v217887_180505 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 Norwyn House D54 D06_s21991_norwyn_v217887_180505 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) 2 The staff at Norwyn work hard to help residents to identify their own goals and sometimes very creatively to help residents have their needs met. EVIDENCE: The most recently admitted residents have settled in well. Although they were unable to discuss their involvement in the admission process, evidence from documents and professionals demonstrates that each resident underwent a staged introduction to the home and made a positive choice to live at Norwyn. Care plans demonstrate that each resident is treated as an individual. Their needs and aspirations are continually assessed and reviewed and form the core of the planned care and the care provided. The manager and staff have an excellent understanding of service users needs and preferences. Norwyn House D54 D06_s21991_norwyn_v217887_180505 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 and 9. Residents benefit from the way they and appropriate support services are involved in decision-making and risk taking. Care planning and risk assessments provide staff with the information they need to meet the needs of residents. EVIDENCE: The owners and staff work hard to ensure that service users make their own choices. For example service users chose new flooring for the lounge and dining room, they choose how their bedrooms are decorated and choose their activities. Service users have chosen where to go on holiday this year and who should accompany them. Care plans provide accessible information and guidance about residents needs. They clearly state individual goals which encourage independent living skills. Risks are carefully identified and minimised. Restrictions on choice or freedom are recorded and risk assessed in individual plans. This sometimes involves making difficult decisions, which are always made involving the multidisciplinary team, the service user, and where appropriate the family. Further advice and support is arranged, for example from the psychologist or psychiatrist as needed. This is particularly important for those residents who are less able to contribute to care plans and decision making. Norwyn House D54 D06_s21991_norwyn_v217887_180505 stage 4.doc Version 1.30 Page 10 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) 13, 15, 16, and 17. Residents benefit from living in a community of which they are a part. Their preferences and needs in relation to personal, family and sexual relationships are met and their rights as citizens and household members are respected. Meals are well balanced, varied and are enjoyed by residents. EVIDENCE: Service users are supported, dependent on preferences, to take advantage of local facilities such as the pub, shops and car boot sales. They visit with and telephone or are visited and telephoned by friends and relatives and are free to bring friends home when they wish. The owners are considering altering the use of communal rooms to allow more comfortable privacy when residents receive visitors and do not wish to use their bedrooms. Norwyn has routines, just like any busy household, but the owners and staff try to keep these to a minimum to promote family living and independence. This can make the home appear somewhat chaotic at times, but everyone is happy and gets what they want and need. Norwyn House D54 D06_s21991_norwyn_v217887_180505 stage 4.doc Version 1.30 Page 11 Permission has to be given by residents before entry into their bedrooms is allowed and all rooms have locks. Some residents choose to have a key to their bedrooms and one chooses to have a key to the front door. Residents enjoy the meals provided. They choose what and where they eat although some restrictions have to be placed on some service users who would prefer to have chips everyday. One resident who was recently unwell was helped and supported to maintain a nutritious diet when her appetite was much reduced. Appropriate advice and interventions were taken. Norwyn House D54 D06_s21991_norwyn_v217887_180505 stage 4.doc Version 1.30 Page 12 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 and 21. Service users receive personal care in a way that promotes their independence and needs and their health needs are well met. Medicines are well managed ensuring safe administration to service users. Service users who are ill are exceptionally well supported and cared for at home, where they wish to live and to die. EVIDENCE: Care plans show that health care is promoted and needs are anticipated and managed well. One resident has shown a marked improvement due to the appropriate involvement of specialist services. Specialist services are also being involved at an early stage in anticipation of a residents predicted future needs. Residents are well prepared for and accompanied to healthcare appointments including healthcare promotion appointments. Systems and records for the receipt, administration and disposal of medications are of a good standard. All medications are kept securely and the manager demonstrates a good understanding of medication used and is keen to support residents to be involved in self medication according to their assessed ability. Norwyn House D54 D06_s21991_norwyn_v217887_180505 stage 4.doc Version 1.30 Page 13 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 and 23. The complaints and concerns of residents are taken seriously and acted upon. Residents are not fully protected from abuse as staff have not received training in the protection of vulnerable adults. EVIDENCE: Since the last inspection there have been no complaints. Some residents have a good understanding of the complaints procedure whilst others rely on staff who are tuned into the individual residents form of communication. Each week there is a meeting where concerns, complaints or issues can be raised. Staff spoken with demonstrated a good awareness and understanding of the complaints procedure and whistle blowing policy. Good financial records are kept which are clear, accurate and up to date. All the residents were relaxed and comfortable in the presence of staff. However, staff have not received training in the protection of vulnerable adults. Norwyn House D54 D06_s21991_norwyn_v217887_180505 stage 4.doc Version 1.30 Page 14 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 and 30 Norwyn is a very busy, homely and comfortable house that is clean and suits the residents and owners who live together. Residents safety could be better promoted with the addition of some safety mechanisms. EVIDENCE: Norwyn is a three storey house with a large kitchen/diner, dining room and two lounges. One lounge tends to be used by the owner-occupiers, but this is available to service users and their visitors if they wish. The house is very busy with people coming and going and has been described as ‘quite chaotic at times which adds to the homeliness and charm’. The lounge has recently been redecorated and carpeted. The dining room has been refloored and replastered and is awaiting decoration. The flooring in a bathroom has been changed and another bathroom has been refurbished. Ongoing decorative improvements are planned. An adjacent piece of land has recently been purchased and the owners intend to reroute the drive for easier and safer access to and from the A35. Norwyn House D54 D06_s21991_norwyn_v217887_180505 stage 4.doc Version 1.30 Page 15 The owners have covered a number of radiators or supplied cool surface radiators. The remaining have been risk assessed and will be covered as part of the ongoing refurbishment programme. Not all of the upstairs windows have window restrictors which potentially poses a risk to residents. The owner has agreed to fit these in the short term. The laundry is situated in the kitchen, which is unusual in a care home. This has been approved by the Environmental Health Officer. Good management systems are in place and a separate laundry is planned for the future. Norwyn House D54 D06_s21991_norwyn_v217887_180505 stage 4.doc Version 1.30 Page 16 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) 33, 34 and 35. The skills and experience of staff together with recruitment procedures meet the needs of and protect residents. However, at times the level of staffing at night might not always be sufficient to meet residents’ needs. EVIDENCE: Norwyn is a family home with the owners living in the home with residents. Staffing levels during the day are sufficient to meet the needs of residents. However, there are some nights when there is only one member of staff on duty. The owner has agreed to devise an on call rota to ensure that any emergencies can be dealt with. Recruitment procedures are good and the necessary checks are made for the protection of service users. The training received by staff is relevant and current and, in line with good practice, is provided using the Learning Disability Award Framework (LDAF). Norwyn House D54 D06_s21991_norwyn_v217887_180505 stage 4.doc Version 1.30 Page 17 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) 42. The home is managed effectively and efficiently. Safety could be improved through the provision of window restrictors and infection control training. EVIDENCE: The manager is currently undertaking the Registered Managers Award and is using this training to improve management systems in the home. For example, she has recently written a business and development plan, she is considering the use of Monitored Dosage Administration and is developing her skills in relation to quality assurance. The manager implements policies and procedures and staff training to ensure that the health and welfare of service users are protected. This does not yet include infection control training. Risk assessments relating to health and safety issue are comprehensive and staff demonstrated a good knowledge and understanding of them. The fire logbook is up to date. Upstairs windows do not have window restrictors. Norwyn House D54 D06_s21991_norwyn_v217887_180505 stage 4.doc Version 1.30 Page 18 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 x 4 x x x Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 Standard No 11 12 13 14 15 16 17 x x 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x x 3 3 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Norwyn House Score 3 4 3 4 Standard No 37 38 39 40 41 42 43 Score x x x x x 2 x D54 D06_s21991_norwyn_v217887_180505 stage 4.doc Version 1.30 Page 19 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 24 Regulation 13(4) Requirement The registered person must ensure that all parts of the home to which service users have access so far as reasonably practicable are free from hazards to their safety. (This relates to the ongoing programme of radiator covering). The registered person must ensure that all parts of the care home to which service users have access so far as reasonably practicable are free from hazards to their safety. (This refers to the need to fit window restrictors on all upstairs windows to which service users have access). Timescale for action 31/12/07 2. 42 13(4) 31/05/05 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. 2. Refer to Standard 30 23 Good Practice Recommendations The registered person should ensure that staff are trained in the control of infection. The registered person should ensure that staff receive training in the protection of vulnerable adults. D54 D06_s21991_norwyn_v217887_180505 stage 4.doc Version 1.30 Page 20 Norwyn House 3. 4. 5. 33 The registered manager should ensure that the numbers of staff on duty at night ensure that the management of emergencies can be carried out effectively and efficiently. Norwyn House D54 D06_s21991_norwyn_v217887_180505 stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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 Norwyn House D54 D06_s21991_norwyn_v217887_180505 stage 4.doc Version 1.30 Page 22 - 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. 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