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Inspection on 09/01/07 for The Normanhurst Nursing Home

Also see our care home review for The Normanhurst Nursing Home for more information

This inspection was carried out on 9th January 2007.

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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The Normanhurst Nursing Home is a well-managed service, which continues to provide residents with a high standard of care. Detailed assessments are undertaken prior to and at the time of admission in order to ensure that all residents receive the care and support required. All personal care needs are clearly documented and met by a well-trained, reasonably consistent and dedicated staff team. Good links have been developed with specialist healthcare professionals including tissue viability nurses, continence advisors and community mental health services.Residents live in a safe, comfortable and homely environment with additional equipment and support in place for those in need. Residents can choose from a variety of meaningful and stimulating activities, whilst the provision of food is good. Comments received by residents and their relatives include: "The staff are brilliant. They are kind and caring and always approachable and cheerful". "This is a first class care home, which has looked after my mother exceptionally well". "We couldn`t wish for better".

What has improved since the last inspection?

The home has worked hard to meet many of the requirements made at the last inspection. The Manager has been undertaking monthly audits of the home`s medication systems; this has helped to improve the procedures for the ordering and discarding of medicines and ensure that controlled drugs are checked and signed by two members of nursing staff. In addition a drug error policy and procedure has been devised and implemented. The home`s adult protection policy and procedure has been updated in line with multi-agency guidelines and additional training has been provided to all staff. Robust recruitment procedures are in place for all new staff including colour identification photographs. Residents` personal belongings and valuables are stored securely.

What the care home could do better:

Minor shortfalls need to be addressed in respect of the safe handling and administration of medicines; medication administration records must contain either a signature or reason for non-administration and all medicines that are prescribed on an as and when basis (PRN) need to be recorded on the medication administration record. Clear criteria and written guidance for the administration of these must also be in place. In order to evidence that all policies, procedures and documents (including the combined Statement of Purpose and Service Users` Guide), as a matter of good practice in order to evidence that they are current and up to date it is recommended that they are dated at the time of review.

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 9th January 2007 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.V321252.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 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.V321252.R01.S.doc Version 5.2 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 normanhurst@btinternet.com 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.V321252.R01.S.doc Version 5.2 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 14th February 2006 Date of last inspection Brief Description of the Service: The Normanhurst Nursing Home is situated on Bexhill seafront and is interconnected with the Normanhurst Annexe and the Normanhurst Residential Care Home. The three homes are independently registered with reference to the category of the residents catered for, although are under the same ownership. They run separately from each other apart from the laundry and catering, which are completed centrally within the residential Care Home. The home comprises of 29 single and 2 double bedrooms over three floors. There is lift shaft available to accommodate those with reduced mobility and/or wheelchair users. 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 is also available on the ground floor. The home is close to local shops with rail and bus services within easy walking distance. Nursing staff and carers are on duty 24 hours a day. 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 home’s fees as of 6th December 2006 range between £550.00 £620.00 per person per week dependent upon needs. Additional costs are charged for hairdressing (from £3.50), chiropody (£10), outings, toiletries and newspapers (£ variable). Prospective residents/representatives are provided with written information regarding the services and facilities provided at the home. Copies of these documents are kept on display in the reception area alongside a copy of the most recent inspection report. The Normanhurst Nursing Home DS0000014019.V321252.R01.S.doc Version 5.2 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 Tuesday 9th January 2007 and lasted seven hours. 28 residents were accommodated on the day of the inspection. Individual discussions took place with six residents over the course of the inspection. In order to gather evidence on how the home is performing, individual discussions took place with four members of staff on duty, whilst the majority of the inspection was undertaken with the Registered Manager. In addition, the Inspector had the opportunity to talk with four relatives and a visiting Tissue Viability Specialist Nurse on the day of the inspection. Three care records were examined in some detail for the purpose of monitoring care. Other records and documentation inspected included: the home’s Statement of Purpose, pre-admission assessment procedures, medication practices, the provision of activities, complaints procedure and the systems in place to safeguard residents from harm, staffing levels and the provision of relevant training. In addition the home’s systems for monitoring their own effectiveness and managing residents’ personal belongings were inspected. Most areas of the home were seen. A detailed pre-inspection questionnaire was received prior to the visit to the home. This provided the Inspector with information relating to the premises, maintenance and associated records and details of the home’s policies and procedures. What the service does well: The Normanhurst Nursing Home is a well-managed service, which continues to provide residents with a high standard of care. Detailed assessments are undertaken prior to and at the time of admission in order to ensure that all residents receive the care and support required. All personal care needs are clearly documented and met by a well-trained, reasonably consistent and dedicated staff team. Good links have been developed with specialist healthcare professionals including tissue viability nurses, continence advisors and community mental health services. The Normanhurst Nursing Home DS0000014019.V321252.R01.S.doc Version 5.2 Page 6 Residents live in a safe, comfortable and homely environment with additional equipment and support in place for those in need. Residents can choose from a variety of meaningful and stimulating activities, whilst the provision of food is good. Comments received by residents and their relatives include: “The staff are brilliant. They are kind and caring and always approachable and cheerful”. “This is a first class care home, which has looked after my mother exceptionally well”. “We couldn’t wish for better”. What has improved since the last inspection? What they could do better: Minor shortfalls need to be addressed in respect of the safe handling and administration of medicines; medication administration records must contain either a signature or reason for non-administration and all medicines that are prescribed on an as and when basis (PRN) need to be recorded on the medication administration record. Clear criteria and written guidance for the administration of these must also be in place. In order to evidence that all policies, procedures and documents (including the combined Statement of Purpose and Service Users’ Guide), as a matter of good practice in order to evidence that they are current and up to date it is recommended that they are dated at the time of review. The Normanhurst Nursing Home DS0000014019.V321252.R01.S.doc Version 5.2 Page 7 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 summary of this inspection report can be made available in other formats on request. The Normanhurst Nursing Home DS0000014019.V321252.R01.S.doc Version 5.2 Page 8 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.V321252.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 5 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents and their relatives are provided with sufficient information prior to admission in order to support their decision of where to live. Good systems are in place to ensure that only residents whose needs can be met are admitted to the home. EVIDENCE: The home has a combined Statement of Purpose and Service Users’ Guide in place, which has been updated since the last inspection. 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 philosophy of care, aims and objectives, admissions policy, the accommodation and services that are provided, staffing levels and organisational structure, complaints procedure, the arrangements for residents to engage in social activities, fire The Normanhurst Nursing Home DS0000014019.V321252.R01.S.doc Version 5.2 Page 10 precautions and the outcome of the home’s most recent quality assurance assessment. The majority of residents are admitted from the adjoining care home. Records confirmed that all residents have a thorough assessment of need undertaken by the Manager of the home prior to admission. All of the residents and relatives spoken with said that they had the opportunity to meet with the Manager and care staff of the home prior to moving in, in order to determine whether or not the home could meet their needs and expectations. Intermediate care is not provided. The Normanhurst Nursing Home DS0000014019.V321252.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The assessed needs of residents are well met by the homes care planning procedures. Medication practices are improved however minor shortfalls must be addressed. Residents and their relatives can be assured that leading up to and at the time of their death that The Normanhurst Nursing Home will treat them and their family, with care, sensitivity and respect. EVIDENCE: Three individual care plans were examined during the inspection. Each were noted to be sufficiently detailed and include in depth assessments for all areas identified during the home’s pre-admission assessment process including: mobility, pressure area care, nutrition and manual handling. There was evidence that the Registered Manager reviews and updates these at least on a monthly basis with input from residents’ keyworkers. Since the last inspection, the Manager has implemented daily progress reports, which nursing staff are required to complete at the end of each shift. Those seen were found to provide clear and detailed accounts of individual’s progress and care needs. The Normanhurst Nursing Home DS0000014019.V321252.R01.S.doc Version 5.2 Page 12 All residents are registered with a local General Practitioner (GP) and there was evidence that specialist advice is sought on an individual basis e.g. continence advisor, Parkinson’s Disease Nurse and Community Mental Health Team. In addition to this, the Manager has developed good links with the Tissue Viability Team in order to help prevent, assess those at risk and treat persons who are at risk or have developed pressure area care damage. The Normanhurst have bought in this service at no extra cost to individuals. Specialist equipment is in place throughout the home for all residents who have been assessed as in need. The home’s medication systems and records were viewed. Concerns were raised during the home’s previous inspection regarding the ordering, recording and storage of medicines. Since this time the Manager has been undertaking monthly audits of the home’s medication systems, which have addressed many issues raised at the last inspection, however further shortfalls were noted during this inspection: - There continues to be gaps apparent on the medication administration records where either a signature or reason for non-administration should appear. - Medications that are prescribed on an as and when basis (PRN) do not appear on the medication administration records and in addition there is no criteria or guidelines for nursing staff to follow when administering these. Albeit that a medication error policy and procedure has been implemented to support and encourage nursing staff to report any errors no matter how minor, it needs to be amended to state that all errors must be notified in writing to the CSCI. The home has some controlled drugs on the premises. A small number of these were randomly checked against records and found to be correct. It was pleasing to note that two signatures are always recorded at the time of administration. All of the residents and their relatives spoken with during the inspection confirmed that nursing and care staff are respectful at all times and promote individuals’ rights 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. All residents, their relatives and their GP’s are asked their wishes, preferences and arrangements that they would like to be followed in the event of dying and death. These are clearly recorded within individual plans of care. On the day of the inspection nursing staff were observed to offer comfort and care to a dying person and support relatives during this difficult time. The Normanhurst Nursing Home DS0000014019.V321252.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A variety of appropriate, stimulating and meaningful daily activities are planned. Relatives and visitors are made to feel welcome at the home. The provision of food is wholesome, nutritious and plentiful. EVIDENCE: All of the residents spoken with commented on how eventful the lead up to Christmas was. Additional activities were planned for residents to take part in including: helping or observing the decorating of the tree, hymns, a carol service, festive bingo, a raffle and pantomime in addition to regular events such as reminiscence, organ recitals, film showings and board games. Since the last inspection through consultation with residents an additional 12 hours for an activities organiser has been agreed. All residents (those who wish to do so and are able) are asked one week in advance of their choice of activities for the following week. A timetable is then drawn up and given to each of the residents. All events and activities are advertised in the home’s monthly newsletter, which is provided to all residents across the three homes. This also gives details of residents’ forthcoming birthdays, a crossword and poetry written by residents. No activities were planned on the day of this inspection. The Normanhurst Nursing Home DS0000014019.V321252.R01.S.doc Version 5.2 Page 14 The Manager explained that all weekly activities will resume to normal week commencing 15th January following the festive period. A concern was raised at the previous inspection regarding the inappropriate and exceptionally loud music that was playing in the lounge area of the home. The Manager confirmed that a new stereo has been purchased since this time, which care staff have been advised how to use. On the day of this inspection the volume was noted to be of an acceptable level and residents were offered a choice of what to listen to. Two of the residents spoken with commented that although there are plenty of activities to participate in, what they would really like to see is ‘more entertainment’. This was raised with the Manager of the home who explained that organising entertainment within the home can be quite costly, however due to the Christmas raffle additional money has been raised, which may be put towards this. All relatives and visitors met during the inspection said that they are always made to feel welcome by care staff when visiting their friends/relatives at the home and that there are no restrictions placed on visiting times. Comments received include: ‘Staff are always pleasant and polite and I am always offered a drink on my arrival’. ‘Whenever we arrive (often unannounced) staff are always welcoming and seem pleased to see us’. Residents confirmed that the home encourages them as much as possible to make their own decisions and choices (to the best of their ability) in relation to many aspects of their lives e.g. when to go to bed and get up in the morning, whether they would like to remain in the comfort of their own rooms or in the communal area at different times of the day and what activities they would like to participate in (or not). All meals are prepared in the centrally located kitchen in the adjoining Care Home. A choice of hot lunchtime meal and lighter evening snacks are advertised daily in the dining area of the home with specialist diets appropriately catered for, including low sugar and vegetarian alternatives. All of the residents spoken with commented positively about the provision of meals. On the day of the inspection a small number of residents had chosen to dine together in the pleasantly decorated dining room, whilst others remained in their own rooms. The lunchtime meal served on the day of the inspection was appetising and plentiful. A small number of residents were offered discreet support where necessary. It was noted that all residents who are reliant on care staff to support them with their mobility were left for a considerable length of time after the meal in the dining area; one person had The Normanhurst Nursing Home DS0000014019.V321252.R01.S.doc Version 5.2 Page 15 to wait up to 45 minutes for a member of staff to support them. A recommendation has been made in respect of this. The Normanhurst Nursing Home DS0000014019.V321252.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has good systems in place to ensure that all complaints will be dealt with appropriately. Residents are better protected from potential harm, neglect and abuse through the home’s clear and updated policies and procedures and through staff receiving appropriate training. EVIDENCE: The home has a detailed complaints procedure in place, which is included within the home’s combined Statement of Purpose and Service Users’ Guide. It gives clear guidance with regards to how a complaint can be made and how the complainant can expect it to be dealt with. Residents and relatives spoken with said that they would feel confident in raising concerns directly with the Manager of the home. No complaints have been received by either the home or the CSCI since the last inspection. Following requirements made during the home’s previous two inspection reports, the home has updated and amended it’s polices and procedures in line with local multi-agency guidelines to safeguard residents from potential harm and abuse. In addition all staff have received in-house training around Adult Protection and the Protection of Vulnerable Adults (PoVA). All staff spoken with over the course of the inspection demonstrated a sound knowledge of what constitutes abuse, how to recognise it and who suspected abuse should be reported to. The home has appropriately referred two adult protection alerts to Social Services in the past 12 months. The Normanhurst Nursing Home DS0000014019.V321252.R01.S.doc Version 5.2 Page 17 The Normanhurst Nursing Home DS0000014019.V321252.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22, 24 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Normanhurst Nursing Home presents as a safe, comfortable and wellmaintained place to live. EVIDENCE: Accommodation comprises of 29 single and 2 double bedrooms over three floors. Although a thorough inspection of the premises did not take place on this occasion, those areas seen were found to be clean, well-maintained and safe. 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, fire retardant chairs, video and DVD players and other personal possessions – pictures, bedding, photographs etc. All of the residents and relatives spoke highly of the accommodation. One person commented: The Normanhurst Nursing Home DS0000014019.V321252.R01.S.doc Version 5.2 Page 19 ‘I have seen the home transformed over recent years’. Mobile hoists for moving and handling purposes are provided on each of the floors throughout the home in addition to other equipment such as handling belts, commodes, grab rails and wheelchairs. A small number of bedrooms have been fitted with non-slip linoleum flooring in agreement with residents and their relatives. This helps to maintain a high standard of cleanliness and hygiene. The Manager confirmed that all newly admitted residents are offered the choice of carpet as an alternative. Good working practices and procedures for managing Methicillin Resistant Staphylococcus Aureus (MRSA) and other infectious conditions are in place throughout the home. Suitable equipment such as gloves, aprons and hand wash is adequately provided throughout. The Normanhurst Nursing Home DS0000014019.V321252.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing arrangements are good and ensure that residents’ needs are met by sufficient numbers of skilled and suitably trained staff. Residents are safeguarded by the home’s robust recruitment procedures. EVIDENCE: In addition to the Registered Manager, the home currently employs nine Registered General Nurses (RGN’s) and 18 care assistants - five of whom are trained to at least NVQ level 2 in care whilst a further five are currently working towards this qualification. Staff members spoken with said that they have found the training to be helpful, informative and the skills transferable to their work. Residents and their relatives spoken with said that the home is mostly well staffed however over the Christmas period a number of agency staff were used. The Manager explained that this was largely due to staff sickness. The home currently has one full-time vacancy for a care assistant and for a weekend RGN. Both posts have been advertised and the home is in the process of recruiting for these. Staff training in the past 12 months includes: Skills for Care induction, fire safety, food hygiene, PoVA, moving and handling and first aid. Infection control and palliative care are planned for the near future. The Normanhurst Nursing Home DS0000014019.V321252.R01.S.doc Version 5.2 Page 21 Three staff recruitment files were randomly checked. It was pleasing to note that each of the files were found to contain all the required checks, including colour photograph identification, two written references, evidence of a PoVA First check and Criminal Record Bureau (CRB) check prior to employment. The Manager and staff confirmed that the home does appoint new staff to work at the home with the minimum of a PoVA First check, however they are supervised until to the CRB check is returned. The Registered Manager confirmed that all new members of staff receive a thorough induction to the home and shadow others for a period of time (one to two weeks) prior to working unsupervised. Since the last inspection the home has implemented a new induction programme for staff called Common Induction Standards issued by Skills for Care. A newly appointed person commented that they found this to be useful and helpful. The Normanhurst Nursing Home DS0000014019.V321252.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 37 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ interests are safeguarded and promoted in respect of the home’s management and administration systems. EVIDENCE: The current Manager was registered with the CSCI in September 2005. She is a Level 1 RGN who has worked in a variety of settings with older people over many years and has completed her Registered Manager Award (RMA). 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.V321252.R01.S.doc Version 5.2 Page 23 Residents’ meetings are held weekly, minutes of which are kept. Each of the residents spoken with said that these meetings are very informal, although can be very useful and informative. One person commented that the laundry arrangements have improved as a result of one of the meetings. The Registered Manager has recently introduced a new quality assurance system to the home based on meeting the National Minimum Standards. The results of these have been published and made available to others. In addition, feedback from residents’, relatives and visiting health and social care professionals questionnaires was sought in August 2006. As a result of these the Manager has secured additional hours for an activities organiser and improved the laundry arrangements. Most residents and/or their relatives manage their own finances. The home has safe storage facilities for residents’ money, cash cards, or other valuables, to which only three senior members of staff have access. It was pleasing to note that since the last inspection the home’s procedures for the storage of residents’ valuables have been improved; all valuables are safely locked away and residents are given a receipt to confirm the date, item(s) and person responsible for depositing the belongings. The home has a number of policies and procedures in place, some of which were seen on the day of inspection. In order to evidence that documents are current and up to date, the home has been asked to ensure that they are dated at the time of review as a matter of good practice. Evidence provided within the homes returned pre-inspection questionnaire identified that all equipment is well maintained and regularly serviced including: fire equipment, hot water temperatures, emergency lighting, hoists and adaptations and emergency call system. The Normanhurst Nursing Home DS0000014019.V321252.R01.S.doc Version 5.2 Page 24 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 X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 3 X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X 3 3 The Normanhurst Nursing Home DS0000014019.V321252.R01.S.doc Version 5.2 Page 25 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 OP9 Regulation 13(2) 17(1)(a) Sch3(k) 13(2) 17(1)(a) Sch3(k) Requirement Timescale for action 09/01/07 2. OP9 3. OP9 13(2) 17(1)(a) Sch3(k) That medication administration records contain either a signature or reason for nonadministration [Outstanding from 14/02/06]. That all medicines that are 20/02/07 prescribed on an as and when basis (PRN) are recorded on the medication administration record. Clear criteria and written guidance for the administration of these must be in place. That the medication error policy 20/02/07 and procedure be amended to state that all errors must be notified in writing to the CSCI. The Normanhurst Nursing Home DS0000014019.V321252.R01.S.doc Version 5.2 Page 26 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. Refer to Standard OP37 Good Practice Recommendations That all policies, procedures and documents (including the combined Statement of Purpose and Service Users’ Guide) are dated at the time of review in order to evidence that they are current and up to date. That residents who require support during and after mealtimes are given individual support and attention. 2. OP15 The Normanhurst Nursing Home DS0000014019.V321252.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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.V321252.R01.S.doc Version 5.2 Page 28 - 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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