Inspection on 03/10/05 for The Normanhurst Nursing Home

This inspection was carried out on 3rd October 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Normanhurst Nursing Home 09/01/07

The Normanhurst Nursing Home 14/02/06

The Normanhurst Nursing Home 15/03/05

The Normanhurst Nursing Home 26/07/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE The Normanhurst Nursing Home De La Warr Parade Bexhill On Sea East Sussex TN40 1LB Lead Inspector Niki Palmer Unannounced Inspection 3rd October 2005 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Normanhurst Nursing Home DS0000014019.V254214.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 Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Normanhurst Nursing Home DS0000014019.V254214.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Normanhurst Nursing Home Address De La Warr Parade Bexhill On Sea East Sussex TN40 1LB 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) 01424-217577 01424-734650 Mr D C Lewis Mr R Hebbes Imelda Mary Rea Care Home 31 Category(ies) of Old age, not falling within any other category registration, with number (31) of places The Normanhurst Nursing Home DS0000014019.V254214.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. That only older people requiring nursing care are to be accommodated Service users should be aged sixty five (65) years or over on admission That no more that thirty one (31) service users are to be accommodated 15th March 2005 Date of last inspection Brief Description of the Service: The Normanhurst Nursing Home is situated close to the seafront and town centre in Bexhill on Sea. The building is interconnected with The Normanhurst Care Home and The Annexe (a registered home for older people with a dementia type illness). Each of the homes are independently registered, although under the same ownership. They run separately from each other apart from the laundry and catering, which is completed centrally within the residential care home. The home comprises of 29 single and 2 double bedrooms. There is a lounge for the residents to use on the ground floor, which opens onto the garden at the rear of the home where seating is provided. A dining room can also be found on the ground floor. The Normanhurst Nursing Home is registered to provide general nursing care to residents who are privately funded and also those who are funded by social services. The Normanhurst Nursing Home DS0000014019.V254214.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001, uses the term ‘service user’ to describe those living in care home settings. For the purpose of this report, those living at The Normanhurst Nursing Home will be referred to as ‘residents’. This unannounced inspection took place on a Monday between 10:00am and 17:10pm. The inspection began with discussions with the Registered Manager of the home in respect of progress made since the last inspection, followed by the examination of five care records. In order to gather evidence on how the home is performing, individual discussions took place with five residents, whilst others commented on their care during lunchtime, the Inspector having been invited to join them for a meal. In addition, three care staff were spoken with during the visit. A detailed inspection of the premises and its facilities took place. 28 residents were accommodated at the time of the inspection. Other records and documentation inspected included: the home’s recruitment procedures, activities, staffing rotas, adult protection policies and procedures, staff training files and quality assurance systems. What the service does well: What has improved since the last inspection? The home now has a Registered Manager who has worked hard to meet many of the requirements made in the previous inspection report. Improvements have been made to the overall environment, staff are provided with a thorough induction and all residents have the opportunity to engage in a variety of stimulating activities both within and outside of the home. The Normanhurst Nursing Home DS0000014019.V254214.R01.S.doc Version 5.0 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. The Normanhurst Nursing Home DS0000014019.V254214.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Normanhurst Nursing Home DS0000014019.V254214.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 3. Residents are provided with sufficient information to help them judge if the home is appropriate for them. The pre-admission assessment process needs to be developed to ensure that the home can meet assessed needs. EVIDENCE: The home has a combined Statement of Purpose and Service Users’ Guide in place, which was updated in July 2005. A copy of this is kept on display in the main entrance area of the nursing home, alongside the home’s most recent inspection report. The information provided was found to be very detailed and to contain information such as: the home’s aims and objectives, statement of values, admission policy, the accommodation that is provided, staffing levels and details, complaints procedure and the outcome of residents’ questionnaires. In addition, all residents are provided with a general information sheet outlining their room number, telephone extension line, details of meal times, any additional charges (newspapers, hairdressing and chiropody) and a separate terms and conditions of contract. Most of the residents spoken with said that they found this information useful both prior to and following admission to the home. The Normanhurst Nursing Home DS0000014019.V254214.R01.S.doc Version 5.0 Page 9 The vast majority of residents are admitted from the adjoining care home. Three pre-admission assessments were seen on the day of inspection all of which were found to be brief in nature and contain minimal information. For example it was recorded in two of the assessments seen that the individual’s ‘require all care’, yet there were no further details recorded in relation to their nursing needs. In addition, it was not clear where or when the assessment took place and who was present at the time. This was discussed in detail with the Registered Manager of the home and a requirement made. Intermediate care is not provided. The Normanhurst Nursing Home DS0000014019.V254214.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 and 10. Residents’ healthcare needs are met well by the home. All residents are treated with kindness, dignity and respect. EVIDENCE: Five individual plans of care were examined. Since the last inspection the home has implemented a new care planning format, which although is detailed and comprehensive, it was found to be rather confusing to follow and read. Thorough details of personal and nursing care interventions had been recorded, particularly for moving and handling, maintaining pressure area care and nutritional monitoring. In addition, there was evidence that good multidisciplinary working with specialist services such as physiotherapists and Community Psychiatric Nurses is taking place on a regular basis. All of the care plans seen had been recently reviewed and updated as necessary. Although a number of risk assessments had been completed to a satisfactory standard, they are currently being used more as a prompt for staff as opposed to detailing the clear action that is to be taken in order to minimise potential risks. A recommendation has been made in respect of this. The Normanhurst Nursing Home DS0000014019.V254214.R01.S.doc Version 5.0 Page 11 All of the residents spoken with during the inspection confirmed that nursing and care staff respect their right to privacy and dignity. It was noted on the day of inspection that all residents are addressed by their preferred term, staff knock on bedroom doors before entering and personal care is carried out in the privacy of either residents’ own bedrooms or bathrooms. The Normanhurst Nursing Home DS0000014019.V254214.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 and 15. Social and leisure activities are managed well by the home. All residents receive a varied, wholesome and nutritious diet. EVIDENCE: Since the last inspection the home has worked hard to provide residents with a variety of stimulating social and leisure activities. A garden party was held in August 2005 in aid of a local charity, which residents and staff confirmed was ‘fun and enjoyable’. Throughout the home (in both communal areas and residents’ own bedrooms), forthcoming activities are advertised such as a new memorabilia group, reminiscence, a film showing each Sunday afternoon, sewing and a game of skittles. Social activities attended are recorded in individual plans of care. Three of the residents spoken with also said that since the staffing levels have been increased in the afternoons there is now more of an opportunity to go out in to the local community with staff, weather permitting. Residents and staff confirmed that visitors are always made welcome throughout the day. Residents’ feedback regarding the provision of food within the home is sought on a regular basis through questionnaires and residents’ meetings, minutes of which, were seen on the day of inspection. In addition a ‘food remarks book’ is The Normanhurst Nursing Home DS0000014019.V254214.R01.S.doc Version 5.0 Page 13 kept within the nursing home. All meals are prepared in the large central kitchen for each of the homes. Daily menus are on display in the living room area. Each day, a vegetarian alternative is offered in addition to jacket potatoes, salads and omelettes. On the day of the inspection, a vegetarian option was provided. It was found to be hot, tasty and nutritious. One of the residents expressed dissatisfaction with the main meat dish provided and was offered an alternative. It was noted however salt, pepper and other condiments were not available. The Normanhurst Nursing Home DS0000014019.V254214.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18. The home needs to ensure that up to date written policies and procedures are in place to safeguard residents from harm. EVIDENCE: Although the home has a written policy and procedure in place for the Protection of Vulnerable Adults, it is not in accordance with local multi-agency guidelines. A requirement has been made in respect of this. Two adult protection alerts have been raised in respect of The Normanhurst Nursing Home since the last inspection. The first was made to East Sussex Social Services in relation to: information handed over to agency staff, the management of continence, infection control and moving and handling. This complaint was fully investigated by the CSCI under local procedures and was partially upheld. A number of requirements and good practice recommendations were made. The home was found to be complying with these on the day of inspection and have been referred to under the relevant standards in this report. The second was raised and investigated by the Registered Manager with regard to specific nursing procedures being carried out. The complaint was upheld. All staff have recently undertaken training in the Protection of Vulnerable Adults and nursing practices have been updated. The Normanhurst Nursing Home DS0000014019.V254214.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24 and 26. The Normanhurst Nursing Home presents as a warm, comfortable and homely place to live. EVIDENCE: It was pleasing to note that a number of improvements have been made to the overall environment since the last inspection. New dining room furniture has been purchased and many areas of the home redecorated. A new wheelchair accessible toilet has been fitted on the ground floor and a bathroom made accessible on the first floor to enable room for a hoist. Non-slip flooring has replaced carpet in two of the bedrooms in consultation with residents and their families, and many areas re-carpeted throughout. Indeed on the day of inspection new carpets were being fitted on the ground floor. All of the bedrooms seen were found to be decorated and personalised to a high standard. Residents are encouraged to bring their own furniture with them on admission such as televisions, video and DVD players and in one The Normanhurst Nursing Home DS0000014019.V254214.R01.S.doc Version 5.0 Page 16 bedroom a refrigerator. All of the residents spoke highly of their own bedrooms and communal areas. In response to one of the requirements made following an adult protection investigation, the home has improved its procedures for managing methicillin resistant staphylococcus aureus (MRSA) and other infectious conditions. Suitable equipment such as gloves, aprons and hand wash is adequately provided throughout the home and replaced each night by the night staff. The Normanhurst Nursing Home DS0000014019.V254214.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. This home employs adequate numbers of staff to meet the assessed needs of residents, however the procedures for the recruitment of staff need to be improved. EVIDENCE: The Normanhurst Nursing Home employs eight Registered General Nurses (RGN’s), 11 care assistants (three of which are trained to at least NVQ level 2 in care) and one personal carer to meet the personal and nursing needs of residents. They are currently trying to recruit for three full-time care assistants and one RGN post. At this time they are covering additional hours with agency staff. In response to a requirement made following a recent adult protection investigation the home has produced written information for agency staff on arrival to the home which includes a layout of the home, residents’ names and room numbers, fire procedures and a copy of the night staff shift plan. The Registered Manager has also altered the staffing numbers on shift throughout the day and shift plans/routines. Many of the staff spoken with said that this had helped to share some of the workload and enable them to spend more time with residents, which was echoed by the vast majority of residents. The Normanhurst Nursing Home DS0000014019.V254214.R01.S.doc Version 5.0 Page 18 Since the last inspection, the Inspector has met with one of the Registered Providers of the home in relation to recruitment procedures. It was pleasing to note on the day of inspection that all newly appointed members of staff were in receipt of a PoVA First check and there was evidence that Criminal Record Bureau checks had been applied for. Some concerns were raised however, in relation to photo identification, previous employment history and a statement of health. In addition it was not clear in what capacity the applicant knew the referees. This was discussed in detail. Requirements and a recommendation were made. Since the last inspection the home has updated its induction training programme in order that it meets TOPPS specifications. One of the newly appointed staff members spoken with during the inspection confirmed that this had been helpful in his induction. Staff training files are now maintained separately for each of the homes. The Normanhurst Nursing Home DS0000014019.V254214.R01.S.doc Version 5.0 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 and 33. The Normanhurst Nursing Home has good management and administration systems in place. There is evidence that residents’ views are sought and acted upon. EVIDENCE: The current Manager was registered with the CSCI in September 2005. She is a Level 1 Registered General Nurse who has worked in a variety of settings with older people over many years and completed her Registered Manager Award in May 2004. It was evident throughout the course of this inspection that she has worked hard to improve standards of care, management and administration within the home since the last inspection. All of the residents and staff spoke positively of her leadership skills and said that they found her ‘approachable’. The Normanhurst Nursing Home DS0000014019.V254214.R01.S.doc Version 5.0 Page 20 Good quality assurance systems have recently been introduced to the home by the Registered Manager. Residents’ meetings are taking place on a regular basis, minutes of which are kept. The last meeting took place in September 2005, 15 residents attended. In addition, residents’ questionnaires are handed out on a six monthly basis, and feedback from visiting professionals is also sought. These questionnaires are on display in the main entrance area. Positive feedback was noted from a community physiotherapist, chiropodist and NVQ assessor. All feedback is given to one of the Registered Providers, and positive outcomes for residents are visibly noticeable (the redecoration of some areas, hairdressing facilities and flexible bath times). The Normanhurst Nursing Home DS0000014019.V254214.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 1 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 2 3 X X X X 3 X 3 STAFFING Standard No Score 27 3 28 2 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X X The Normanhurst Nursing Home DS0000014019.V254214.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? YES 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 OP3 Regulation 14(1)(a) Requirement Timescale for action 03/10/05 2. OP3 14(1)(c) 3. OP18 12(1)(a) 4. OP29 19 & Schedule2 It is required that residents are only admitted to the home following a detailed preadmission assessment of their health and social care needs. It is required that appropriate 03/10/05 consultation takes place with prospective residents and/or their representatives during the pre-admission assessment process. The date, place and those present at the time of the assessment must be recorded. It is required that the home 03/12/05 updates its policy and procedure for the Protection of Vulnerable Adults in accordance with local multi-agency guidelines. This should include a definition of abuse, what constitutes abuse and what actions need to be taken in the event of suspecting abuse. It is required that no person is 03/10/05 employed to work within the home without complete details of their employment history, including any gaps in employment. DS0000014019.V254214.R01.S.doc Version 5.0 The Normanhurst Nursing Home Page 23 5. OP29 19 & Schedule2 19 & Schedule2 6. OP29 7. OP29 19 & Schedule2 It is required that all recruitment files contain photographic identification [OUTSTANDING FROM PREVIOUS INSPECTION] It is required that two written references are obtained and it is clearly documented in what capacity the applicant is known to the referee. It is required that a statement is provided by the applicant as to their mental and physical health prior to employment. 03/10/05 03/10/05 03/10/05 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. 3. 4. 5. Refer to Standard OP7 OP7 OP15 OP28 OP29 Good Practice Recommendations It is recommended that the current format of care plans be reviewed in order to make them easier to read and follow. It is recommended that current risk assessments be amended to provide staff with clear details of the action that is to be taken to minimise any potential risks. It is recommended that salt, pepper and additional condiments are made available to residents at each mealtime. It is recommended that at least 50 of care staff are trained to NVQ level 2 by December 2005. It is recommended that the current application form is reviewed and amended to allow for a thorough history of employment, statement of health and the names of two referees which states the capacity in which the applicant is known. The Normanhurst Nursing Home DS0000014019.V254214.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 The Normanhurst Nursing Home DS0000014019.V254214.R01.S.doc Version 5.0 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. 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