CARE HOME ADULTS 18-65
Norwyn House Norwyn Charmouth Road Raymonds Hill Axminster Devon EX13 5ST Lead Inspector
Teresa Anderson Unannounced Inspection 13:00 19 October 2005
th Norwyn House DS0000021991.V249042.R01.S.doc Version 5.0 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 Norwyn House DS0000021991.V249042.R01.S.doc Version 5.0 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. Norwyn House DS0000021991.V249042.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Norwyn House Address 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) Norwyn Charmouth Road Raymonds Hill Axminster Devon EX13 5ST 01297 35111 Miss Barbara Jill Anning Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Norwyn House DS0000021991.V249042.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection None 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 so aids and adaptations are not required. The communal space is made up of 2 lounges (the owners and their family tend to use one of these), 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 owners provides transport in the family cars. Limited parking is available. Norwyn House DS0000021991.V249042.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place as part of the normal programme of inspection, between 1pm and 3.30pm. As this is the second inspection, this report should be read in conjunction with the report dated 18th May 2005. Norwyn currently has four residents, three of whom were out when the inspection started. Two were attending a local club and another was out for lunch but returned during the inspection. The inspector met and spoke with two residents and with the owner and her partner. These residents were not able to answer direct questions but appeared happy and relaxed throughout the inspection. All communal areas were seen, together with one residents bedroom. Two members of staff were on duty. What the service does well: What has improved since the last inspection? What they could do better:
On this occasion no improvements were recommended or required. The requirement to cover all radiators or to provide cool touch radiators is ongoing. Norwyn House DS0000021991.V249042.R01.S.doc Version 5.0 Page 6 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 DS0000021991.V249042.R01.S.doc Version 5.0 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 Norwyn House DS0000021991.V249042.R01.S.doc Version 5.0 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): These standards were inspected during the inspection in May. EVIDENCE: Norwyn House DS0000021991.V249042.R01.S.doc Version 5.0 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): These standards were inspected during the inspection in May. EVIDENCE: Norwyn House DS0000021991.V249042.R01.S.doc Version 5.0 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 the following standard(s): 12 Resident’s lives are enriched by the activities in which they choose to take part. EVIDENCE: Residents at Norwyn choose their own activities and this is restricted only by lack of appropriate opportunities and by residents income. One resident works at a local pub. He and another resident attend a local club and other residents attend an Arts, Crafts and Drama group. One resident goes out every second fortnight to watch a band. One resident chooses to spend every weekend with his father and is about to commence a cooking course. One resident goes into the local town once a week to visit the library and use the internet. Apart from these structured activities, residents at Norwyn are very active and tend to come and go and lead the life of a family. For example, during the inspection the owner was going out to collect another resident and to pick up a piece of garden equipment. Two residents decided to join him. One resident was discreetly supervised whilst holding and interacting with the owners’ youngest child.
Norwyn House DS0000021991.V249042.R01.S.doc Version 5.0 Page 11 It is general knowledge amongst the owners family and friends that any invitations to Norwyn or to other homes or events will include ‘the whole family’. The residents had fairly recently returned from a holiday in Butlins which they had thoroughly enjoyed. Norwyn House DS0000021991.V249042.R01.S.doc Version 5.0 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 the following standard(s): These standards were inspected during the inspection in May. EVIDENCE: Norwyn House DS0000021991.V249042.R01.S.doc Version 5.0 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 the following standard(s): 23. Appropriate training supports residents right to protection from abuse. EVIDENCE: Since the last inspection staff have received training in the protection of vulnerable adults. There is obviously a clear understanding of the issues involved and of the importance of this training. Residents were clearly comfortable and relaxed in the company of staff. Norwyn House DS0000021991.V249042.R01.S.doc Version 5.0 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 the following standard(s): 24 and 30. Residents live in a safe and hygienic environment. EVIDENCE: During the last inspection it was noted that windows did not have restricted openings and that staff had not received training in infection control. Since then window restrictors have been applied and all staff have now received training in infection control. The programme of covering or providing cool to touch radiators in on-going based on risk assessment. Norwyn House DS0000021991.V249042.R01.S.doc Version 5.0 Page 15 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): 33 Residents are well supported by the staff group both during the day and at night. EVIDENCE: Since the last inspection the owner has set up contingency plans for the very few occasions when only one member of staff is on duty at night. Norwyn House DS0000021991.V249042.R01.S.doc Version 5.0 Page 16 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): 39 and 42. Residents are at the heart of this home, which is run in their best interests and which promotes their well being and safety. EVIDENCE: The day of weekly residents meetings has been changed to accommodate one resident who is not available to attend on Sundays. At these meetings residents are encouraged to discuss whatever they wish. Topics include holidays, decorating and food. Resident questionnaires are undertaken to determine if residents are satisfied with the services provided and to seek suggestions for improvement. The owners ensure that those residents who need help to complete these receive this from people other than the owners in order to promote openness and honesty. Relatives questionnaires are not undertaken, however there is obviously a free flow of information and easy relationships between the owners and relatives which encourages openness and honesty. Since the last inspection window restrictors have been applied to prevent accidental falls.
Norwyn House DS0000021991.V249042.R01.S.doc Version 5.0 Page 17 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 x x x x Standard No 22 23 Score x 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score x x x x x Standard No 24 25 26 27 28 29 30
STAFFING Score 2 x x x x x 3 LIFESTYLES Standard No Score 11 x 12 3 13 x 14 x 15 x 16 x 17 Standard No 31 32 33 34 35 36 Score x x 3 x x x CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Norwyn House Score x x x x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 3 x DS0000021991.V249042.R01.S.doc Version 5.0 Page 18 Yes 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 OP24 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). Timescale for action 31/12/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Norwyn House DS0000021991.V249042.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Exeter 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
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