Inspection on 27/02/07 for The Normanhurst Residential Care Home

This inspection was carried out on 27th February 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 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

The Normanhurst Residential Care... 10/02/06

The Normanhurst Residential Care... 18/05/05

The Normanhurst Residential Care... 14/12/04

The Normanhurst Residential Care... 23/08/04

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 Residential Care Home De La Warr Parade Bexhill-on-sea East Sussex TN40 1LB Lead Inspector Niki Palmer Key Unannounced Inspection 27th February 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 Residential Care Home DS0000021254.V325980.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 Residential Care Home DS0000021254.V325980.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Normanhurst Residential Care 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 www.normanhurst.com Mr David Lewis Mr Robert Hebbes Ms Claire MacMillan Care Home 82 Category(ies) of Old age, not falling within any other category registration, with number (82) of places The Normanhurst Residential Care Home DS0000021254.V325980.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. That only older people will be accommodated. The maximum number of residents to be accommodated is eighty two (82). Residents should be aged sixty five (65) years or over on admission. That one (1) named service user aged between 63 and 65 on admission may be accommodated 10th February 2006 Date of last inspection Brief Description of the Service: The Normanhurst Care Home is situated on Bexhill seafront and is interconnected with the Normanhurst Annexe and the Normanhurst Nursing 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 provides accommodation and personal care for up 82 older people and comprises of 64 single and nine double bedrooms. 43 of the single rooms have en-suite facilities, whilst all of the double rooms have en-suite facilities. There are three day rooms for residents to use in addition to a large dining area. The home is close to local shops with rail and bus services within easy walking distance. Carers are on duty 24 hours a day. The Normanhurst Care Home provides care to residents who are privately funded and also those who are funded by social services. The home’s fees as of 19th December 2006 range between £332.00 - £500.00 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 Residential Care Home DS0000021254.V325980.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 Care Home will be referred to as ‘residents’. This unannounced inspection took place on Tuesday 27th February 2007 and was undertaken by two Inspectors. The inspection lasted approximately five hours. 63 residents were accommodated on the day of the inspection. Individual discussions took place with a number of residents over the course of the inspection. In order to gather evidence on how the home is performing, individual discussions took place with three members of staff on duty including the Deputy Manager, whilst the majority of the inspection was undertaken with the Registered Manager. Four care records were examined in some detail for the purpose of monitoring care. Other records and documentation inspected included: the home’s preadmission assessment and care planning 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. All communal areas of the home were seen and a small sample of residents’ bedrooms. 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 Care Home is a well managed service that is committed to providing a high standard of care to residents in a ‘hotel like’ atmosphere. It employs a good number of highly skilled and experienced staff, some of which have worked at the home for many years. Details of the services and facilities offered by the home are clearly documented within the home’s Statement of Purpose and Service Users’ Guide. This helps to support prospective residents in determining whether or not the home is suited to their needs. Prospective residents also have the opportunity The Normanhurst Residential Care Home DS0000021254.V325980.R01.S.doc Version 5.2 Page 6 to visit the home on an informal basis and stay for a short period of time in advance of signing a terms and conditions of contract. All residents’ personal and social care needs are clearly recorded within individual plans of care, which are drawn up shortly after their admission. These are regularly reviewed and updated by the Registered or Deputy Manager as their needs change. A variety of social activities and leisure pursuits are offered by the home. Residents confirmed that they can choose whether or not to take part in these. Some comments received by residents over the course of this inspection include: ‘It’s absolutely marvellous. We can’t fault it in any way’ ‘The staff are so kind and can’t do enough for you’ ‘I’m looked after extremely well’ What has improved since the last inspection? The home has worked hard to meet all the requirements made at the last inspection. The home’s Statement of Purpose and Service Users’ Guide has been updated. This provides residents with detailed information about the mobile telephone mast, which is situated on the top of the building. It is not connected at this time. A copy of the home’s most recent inspection report is available in the main reception area for residents to read at their leisure. A new full-time chef has been employed. Although there were no concerns raised at the last inspection regarding the provision of food, all residents spoke very positively of this. Many areas of the home have been redecorated to a high standard throughout. Feedback from residents through regular residents’ meetings and survey questionnaires is obtained. The results of these are clearly documented in an easy to read and understand format. Clear records are maintained in respect of residents’ personal valuables, which have been handed over to senior members of staff for safekeeping. The Normanhurst Residential Care Home DS0000021254.V325980.R01.S.doc Version 5.2 Page 7 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 summary of this inspection report can be made available in other formats on request. The Normanhurst Residential Care Home DS0000021254.V325980.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 Residential Care Home DS0000021254.V325980.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, 2, 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 and opportunities to ‘test drive’ the home are available. 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 home, alongside a copy of 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 and the arrangements for residents to engage in social activities. The Normanhurst Residential Care Home DS0000021254.V325980.R01.S.doc Version 5.2 Page 10 Two of the residents spoken with who had recently moved in to the home said that the home had initially been recommended to them by a friend. They said that they found the written information that they were given about the home to be very informative, although they did comment that they were unaware that they were expected to sign into and out of the home each time they left or returned. Although the Registered Manager has explained the reasons for this (for fire safety purposes), it is recommended that the home’s procedures in relation to this are included within the Statement of Purpose and Service Users’ Guide. Most residents spoken with said that they had visited the home in advance of their admission in order to support them with their decision to move. Many had visited on an informal basis, usually alongside one of their relatives to ‘get a feel of the place’, whilst others had used the home on a regular short-term holiday/respite break. All of those spoken with said that The Normanhurst creates a ‘hotel-like’ atmosphere, which supported their decision to move to the home on a permanent basis. One person commented: ‘I came for a short respite stay prior to moving. I was given the choice of room’. The Registered Manager confirmed that either she or the Deputy Manager hold responsibility for assessing all prospective residents prior to admission in order to ensure that the home can meet their needs and aspirations. Records confirmed that information is gathered at this time from a number of sources including: telephone contact with the person and/or their relatives, at the time of the person’s initial visit to the home, or at individuals’ previous place of residence. Albeit that all four of the assessments were reasonably detailed, the home is required to ensure that they are signed and dated by the person completing the form. Terms and conditions of contract were seen in each of the residents’ plans of care. Intermediate care is not provided. The Normanhurst Residential Care Home DS0000021254.V325980.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 and 10. 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. Residents will be better protected once the home has reviewed and improved medication policies and procedures. Residents can be assured that they will be treated with respect, dignity and kindness. EVIDENCE: The home has worked hard over the past two years to improve the home’s care planning procedures and documentation, in order to make them clear, accessible and user-friendly for staff. Four were looked at in some depth. Shortly after admission, keyworkers set some time aside to speak with the resident in order to ascertain a pen portrait of their life history. Those seen were found to be personalised and include many things that are important to that person e.g. where they lived and worked, family members and their pastimes and interests. The Normanhurst Residential Care Home DS0000021254.V325980.R01.S.doc Version 5.2 Page 12 The support that individual’s require for all activities of daily living are recorded within their plans of care, based on comprehensive risk assessments. Whilst on the whole there was sufficient guidance in place for most areas, there were some instances where this was unclear. One example of this was where it had been documented that the person requires support with bathing, but there was no further information available to assist staff to do this e.g. if the support requires one or two carers or their preference of a bath or shower. It was also noted that a number of updated care plans, risk assessments and other documentation had not been signed or dated by the member of staff responsible. 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. from a continence advisor, Parkinson’s Disease Nurse and Community Mental Health Team. Specialist equipment is in place throughout the home for all residents who have been assessed as in need. Staff spoken with had a good understanding of the individual needs of residents. The home’s medication systems were inspected. The home uses a weekly dosette box for each individual, which is delivered by the local community pharmacist. A number of practices were observed on the day of inspection, which raised a number of concerns: - The Manager was observed to peel back the protective cellophane covering of one person’s dosette box to remove a person’s medication for the rest of the week. Although this was at the GP’s request, care staff are not permitted to do this. - Should a resident be prescribed any additional medicines e.g. antibiotics, which have not been delivered to the home within the dosette box, staff are taking it upon themselves to add these to the dosette box, again by peeling back the protective cellophane covering. Therefore there is no label on the box to state what the added tablets are. This is considered to be secondary dispensing, which care homes are not permitted to do. - A number of residents are prescribed medicines, which are for use on an as and when required basis (PRN), yet there were no guidelines in place to support staff when such medicines are to be used. - Whilst risk assessments are in place for all residents who wish to selfadminister their medication, it was noted that in a number of rooms, medication was left out on bedside tables etc. This included cough linctus and a number of other homely remedies. - There is no medication error policy and procedure in place. The Normanhurst Residential Care Home DS0000021254.V325980.R01.S.doc Version 5.2 Page 13 Through detailed discussions with the Registered Manager, it would appear that some of the home’s policies and procedures are outdated and unclear. In light of the Registered Manager’s willingness to improve and rectify the home’s policies and procedures in respect of this, which will be followed up by a Pharmacy Inspector, the overall outcome for this area is considered to be good. All residents have their own bedroom; double rooms are available for couples to share. All of the residents spoken with were very complimentary of the staff and the support that is provided at the care home. Their comments included: ‘The staff are so kind and can’t do enough for you’ ‘I’m looked after extremely well’ Historically, all residents have been referred to as ‘Mr or Mrs’. The Registered Manager explained that since the last inspection, through feedback from residents both on a one to one basis and through residents’ meetings, all residents are now asked what they would prefer to be known as. Individuals’ preferences are recorded within individual plans of care. The Normanhurst Residential Care Home DS0000021254.V325980.R01.S.doc Version 5.2 Page 14 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 offered to residents. Relatives and visitors are made to feel welcome at the home. The provision of food is wholesome, nutritious and plentiful. EVIDENCE: All events and activities are advertised on the home’s information board in the reception area and in the home’s monthly newsletter, which is provided to all residents across the three homes. The newsletter also gives details of residents’ forthcoming birthdays, a crossword and poetry written by residents. A number of residents spoke positively about the variety of activities that are offered, whilst others said that they prefer not to take part. Activities include: bingo, reminiscence, art clubs, keep fit, escorted community activities and seasonal activities. A sewing/knitting group was taking place on the day of the inspection in one of the small lounges, which a number of residents took part in. The facilitator was observed to have a good rapport with residents; whilst knitting, she took the opportunity to engage residents in a variety of different topics and conversations. The Normanhurst Residential Care Home DS0000021254.V325980.R01.S.doc Version 5.2 Page 15 Residents spoken with confirmed that their friends and relatives are always made to feel welcome to the home. One person told the Inspector that their friends enjoyed spending Christmas Day at the home, including taking part in the planned activities and eating the festive lunch. Residents are encouraged by the home to exercise choice and control over their lives as much as possible. The majority of residents spoken with said that they view the home as a hotel and can ‘come and go’ as they wish, get up and go to bed whenever they choose and participate in a variety of activities or not. Due to the size and layout of the home, mealtimes take place over two sittings, although those who wish to do so can remain in their own rooms. Residents confirmed that they are given the preference and choice at which time they would prefer to eat. It was pleasing to note that the majority of residents spoke highly of the provision of food, which has been a cause for concern in the past. The home has recently employed a new full-time chef who has consulted with the residents regarding their preferences. Comments received from residents include: ‘The food is very good and much better’ ‘The standard of food is much better although the portions are smaller’ ‘Alternatives are always offered’ ‘I had the opportunity to talk with the chef about what improvements I would like to see. It’s greatly improved now’ One of the Inspectors enjoyed a meal with the residents. The meal itself was nicely presented and tasty; a choice of main-course and sweet was offered. The dining area is ‘waitress served’ by care staff on a rotational basis. The members of staff on duty over the lunchtime period were observed to be attentive towards residents. A number of the residents commented that although they are offered fruit at lunchtimes, it is generally tinned fruit. This was discussed with the Registered Manager and a recommendation made. The Normanhurst Residential Care Home DS0000021254.V325980.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 protected from potential harm, neglect and abuse. 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. One resident said: ‘I’ve never had to make a complaint, but if I had any concerns I would call through to reception’ No complaints have been received by either the home or the CSCI since the last inspection. The home has a detailed Adult Protection and whistle-blowing policy and procedure in place in accordance with local multi-agency guidelines, however it must be noted that these are not easily accessible to staff as they are contained within a number of different folders, which are poorly organised. In light of the fact that all staff spoken with had received training in this area and confirmed that they would feel confident in reporting any concerns of suspected abuse and poor practices within the home, a recommendation has The Normanhurst Residential Care Home DS0000021254.V325980.R01.S.doc Version 5.2 Page 17 been made for the Manager to review the organisation and accessibility of this information. No alerts have been raised since the last inspection. The Normanhurst Residential Care Home DS0000021254.V325980.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, 21, 23, 24, 25 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 Care Home presents as a homely, comfortable and wellmaintained place to live. EVIDENCE: Since the last inspection a number of areas of the home have been redecorated and improved. Building work has been completed to improve access to the main entrance area with a graded non-slip ramp. The dining room has been repainted and new dining furniture bought. Whilst on the whole the comments received from residents were positive, some of them did comment during this and the previous inspection that they do not like the new lighting or artwork that have been purchased as they are relatively modern and not particularly in keeping with the overall style of the building. Residents said that they have raised these concerns with one of the Providers, but they feel their views and opinions have been ignored. The Normanhurst Residential Care Home DS0000021254.V325980.R01.S.doc Version 5.2 Page 19 A number of bathrooms have undergone improvements including having new hand basins, baths and toilets installed. A number of hot water outlets were randomly tested. The temperatures of these were found to vary between 45°C and 52°C. Some residents said that they prefer the hot water to be around 52°C, however the home must ensure that those outlets are subject to a risk assessment and clearly labelled. 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. It was noted during the inspection that a number of bedrooms had freestanding air purifiers and heaters in them. In order to ensure that these do not pose any potential risks to residents, the home is required to undertake individual risk assessments for these. No radiators throughout the home are currently guarded. Albeit that the Manager feels that residents are unlikely to burn or scald themselves on these as they are regulated, the home must ensure that all radiators that could potentially harm residents in the event of falling (those on the stairs for example) are individually risk assessed. Although a thorough inspection of all areas of the premises did not take place on this occasion, those seen were found to be clean and well-maintained. The Normanhurst Residential Care Home DS0000021254.V325980.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: The Normanhurst Care Home has a relatively stable team of care staff, some of which have worked at the home for many years. In addition to the Registered Manager, the home currently employs 36 care staff, 14 of which are trained to at least NVQ level 2 in care, whilst a further four are currently working towards this qualification. Staff members spoken with said that they have found this training to be helpful, informative and the skills transferable to their work. Staffing rotas confirmed that there are always at least eight members of staff on duty between 8am and 8pm. Waking night staff are employed to work each night to attend to residents’ needs. Residents spoke quite freely and were particularly praiseworthy of the staff at the home. They also commented that the home is adequately staffed with enough carers to meet their needs. Some of their comments include: ‘The staff are very good’ ‘The staff are wonderful and very kind’ The Normanhurst Residential Care Home DS0000021254.V325980.R01.S.doc Version 5.2 Page 21 ‘[Member of staff] is just marvellous’ Staff training in the past 12 months includes: fire safety, food hygiene, adult protection, moving and handling and first aid. Infection control and a number of refresher updates are planned in the near future. 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 the CRB check is returned. This was confirmed by care staff. Staff also said that they have a clear job description and contract in place. The Registered Manager and staff spoken with said that all newly appointed members of staff are expected to undertake an induction programme based on meeting the outcomes of ‘Skills for Care’. One member of staff commented that they were initially employed to work at the adjoining nursing home. It was pleasing to note that they were still required to undertake a thorough induction programme when starting work at the Care Home. Staff confirmed that regular supervision sessions take place with senior members of staff. They said that they found this to be particularly helpful in identifying any training needs. Team meetings are also held, although this is predominantly only for senior members of staff. Care staff spoken with did say that regular feedback is given by either the Manager or Deputy during the handover of shifts. The Normanhurst Residential Care Home DS0000021254.V325980.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 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Normanhurst Care Home is a well managed home that is run in the best interests of residents. EVIDENCE: The Registered Manager has been in post for the last three years and has been working at the care home since 2001. She has completed her Registered Managers Award (RMA) and holds NVQ levels 2 and 3 in Care. She is currently working towards NVQ Level 4 in Management and is an NVQ assessor. Throughout the inspection she demonstrated a clear understanding of the needs of the residents living at The Normanhurst Care Home. Observations and discussions with staff and residents confirmed that she is respected, approachable and provides clear leadership throughout the home. The Normanhurst Residential Care Home DS0000021254.V325980.R01.S.doc Version 5.2 Page 23 Residents confirmed that regular residents’ meetings are held every two months. The dates of forthcoming meetings are advertised on the home’s information board in the main reception area. Minutes of these meetings are kept. This is improved since the last inspection. Residents and other interested parties were asked to complete a satisfaction questionnaire in Autumn 2006. The aim of the questionnaire was to focus on the following outcome areas: the politeness of staff and their willingness to help, the range of social activities, assistance with health and personal care, respect for dignity and to make personal choices, the provision of food and the maintenance of the home. It was pleasing to note that the results of this survey have been written up in an easy to read and understand format. Again, this is improved since the last inspection. The results were very positive for the home. The Registered Manager demonstrated a clear commitment to improving the home’s quality assurance systems. Most residents and/or their relatives manage their own finances. The home does however, have safe storage facilities for residents’ money, cash cards, or other valuables, to which only three senior members of staff have access. Clear records are kept of all personal valuables. This is improved since the last inspection. The home has a mobile telephone mast installed on the top of the care home. A requirement was made during the two the previous inspection reports for the home to collate up to date clinical research and evidence from the Department of Health regarding the possible health risks that telephone masts may pose and make this information available to all existing and new residents, with reference to be included within the home’s Statement of Purpose. Since the last inspection, clear information has been documented in relation to this. At this time the mast is not connected. The Manager has assured the Inspector that should this change all residents will be notified accordingly. 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 Residential Care Home DS0000021254.V325980.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 3 2 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X 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 3 X 3 3 2 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 X 2 The Normanhurst Residential Care Home DS0000021254.V325980.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP3 OP7 2. OP7 Regulation 14(1)(2) 15(1)(2) 17 15(1)(2) Requirement Timescale for action 31/07/07 3. OP9 4. OP24 OP38 13(2) 17(1)(a) Schedule 3(i)(k) 13(4)(a) (b)(c) That all written documents are signed and dated by the person completing them including: preadmission assessments, care plans and risk assessments. That specific guidance is included 31/07/07 within individual plans of care in relation to what support residents require with all activities of daily living. That the home reviews and 31/05/07 improves the policies and procedures for the safe handing of medicines. That individual risk assessments 31/07/07 are undertaken for: - all free-standing heaters and air purifiers in use throughout the home - all hot water outlets that exceed the recommended 43°C - all unguarded radiators that could potentially harm residents in the event of falling. The appropriate action must be The Normanhurst Residential Care Home DS0000021254.V325980.R01.S.doc Version 5.2 Page 26 taken. 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. Refer to Standard OP1 OP15 OP18 Good Practice Recommendations That details of the home’s procedures for signing into and out of the home are included within the home’s Statement of Purpose and Service Users’ Guide. That a variety of fresh fruit is offered to residents as an alternative to tinned fruit. That the home’s policies and procedures for the protection of vulnerable adults are clearly organised and therefore more accessible to staff. The Normanhurst Residential Care Home DS0000021254.V325980.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone Kent..ME16 9NT 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 Residential Care Home DS0000021254.V325980.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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