Care Home: Norfolk Lodge

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What the care home does well All residents had an up to date care plan to help staff to support them to meet their personal, health and social care needs. Staff monitored residents` ongoing healthcare needs and referred people to healthcare professionals in a timely way. The staffing levels in the home had improved. This had helped to ensure that routines revolved around the needs and preferences of the residents and not the staff. Residents and staff told us that they thought there were sufficient staff to meet people`s needs. The home had established a system for monitoring the quality of the service it provided. This included seeking and acting upon the views of people using the service, or their relatives. The QA system should be further developed to ensure that this is a continuous process and there is a clear plan as to how the service is to develop. Records of residents` money handed over for safekeeping were clear and accurate. The manager had introduced a weekly check to ensure that the records continued to be kept properly and residents` interests were safeguarded. What the care home could do better: Improvements in medicines management meant that people using the service werereceiving their medication as it was prescribed. However, medicines must be given from the container the pharmacist provides, to ensure that it is administered safely. Although improved, the recruitment process should be more robust to ensure that references are validated. This helps to protect people using the service. Random inspection report Care homes for older people Name: Address: Norfolk Lodge 32 Kings Lynn Road Hunstanton Norfolk PE36 5HT one star adequate service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Jane Craig Date: 0 4 0 5 2 0 1 0 Information about the care home Name of care home: Address: Norfolk Lodge 32 Kings Lynn Road Hunstanton Norfolk PE36 5HT 01485532383 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Sylvia Ince Type of registration: Number of places registered: Conditions of registration: Category(ies) : ARMS Associates Ltd care home 23 Number of places (if applicable): Under 65 Over 65 0 23 dementia old age, not falling within any other category Conditions of registration: 23 0 The maximum number of service users who can be accommodated is 23 The registered person may provide the following categories of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other categories - Code OP Dementia - Code DE Date of last inspection Brief description of the care home Norfolk Lodge is registered to provide personal care for to up to 23 people older people who may have needs associated with dementia. The home is owned by ARMS Care Homes for Older People Page 2 of 9 Brief description of the care home Associates Limited, who also own two other care homes nearby. Norfolk Lodge is set in secure and well-maintained gardens in a residential area of Hunstanton. It is close to local amenities, including shops and the sea front. The home is a two-storey building. It has a mix of single and shared rooms, most of which have en-suite facilities. Bedrooms on the first floor are accessed by a stair lift. Communal rooms comprise two lounges and a dining room. There are assisted bathing facilities on both floors. Information about the home, including the latest inspection report, is available to anyone thinking of moving in. The range of fees is available from the manager. Extra charges are made for toiletries, hairdressing, newspapers, activities provided by external entertainers, transport and escorts to hospital and other appointments. Care Homes for Older People Page 3 of 9 What we found: After our last key inspection on 3rd August 2009 we judged Norfolk Lodge to be providing adequate outcomes for people using the service. We made six requirements for the service to be improved. These were in the areas of health and personal care, staffing and management. We carried out this random inspection to check on the progress made towards meeting those requirements. We looked at the care records for three residents. Since our last inspection a new, electronic care record system had been introduced. There were standard care plans and risk assessments which were altered slightly after staff entered information about the residents individual needs and preferences. In most cases the plans to support people to meet their personal care needs were sufficiently detailed. This helped to ensure that staff provided care in a way that promoted the residents independence and took account of their individual preferences and choices. The manager and staff told us that they were still learning how to use the system and as a consequence some of the risk assessments and strategies for health care were not specific enough. For example, a plan to assist someone who had moving and handling needs did not tell staff what type of hoist or sling they should use. However, staff had generally found other ways of recording the information to ensure that residents received the care they needed. Despite these minor problems the manager and staff said they preferred the new system and found it more informative. Records such as weight checks and food and fluid charts were in place, which helped staff to monitor residents ongoing health needs. We made a requirement after the last inspection that there must be no unnecessary delay in referring people for medical attention. The care records for one person showed that staff had identified that she was unwell. They had monitored her condition closely and made a timely referral to the GP. Residents we spoke to said that staff looked after them well and gave examples of when they had been treated by a doctor or nurse. A member of staff also told us, People are never left without treatment. We looked at how medicines were stored and recorded. With one exception, there were complete records of medicines received and there were no gaps on medication administration records. This helped to form an audit trail and evidence that people were receiving their medication as it was prescribed. Medicines were generally stored safely but staff had been storing and administering one tablet outside its original container, which was unsafe. The assistant manager told us that she carried out monthly audits on all medication and her next audit would have identified this practice, which would have been stopped. During our last key inspection we found that, because of staff shortages, the staff team had implemented some routines that helped them but were not in the best interests of the people using the service. At this visit we were told that staffing levels had improved and there were 4 staff on duty in the afternoon and evening. This helped to ensure that residents could have more of a choice about when they had a bath or changed into their night clothes. A member of staff confirmed, We have not put people into night clothes in the afternoon for a while. The manager and staff confirmed that there were sufficient staff to meet the needs of the current residents. Two residents we spoke to both said Care Homes for Older People Page 4 of 9 they were not kept waiting for staff if they needed help. We looked at the staff files of two recently recruited staff. One had been recruited in accordance with good practice. She had two appropriate references and a CRB disclosure before she started work. The second had brought pre-prepared references that had not been checked to guarantee their authenticity. They had an ISA first to ensure that they were not barred from working with vulnerable people. The provider advised that a satisfactory CRB disclosure had been returned but it could not be found on the day of our visit. Since our last inspection the assistant manager had carried out an audit of the service, looking at policies, procedures and practices. Where possible, any shortfalls had been rectified at the time. For example, policies had been revised and updated. Quality surveys had been sent out to relatives, some had been returned and individual comments or suggestions had been acted upon. The computerised system in use for care planning also contained a quality monitoring tool which assisted in the audit of records and systems. We looked at the records of money held on behalf of residents. They provided an accurate record of money deposited or withdrawn. Receipts were in place when money had been spent on behalf of a resident. All transactions had been carried out by two staff and there was a weekly check of all money and records. We received notification that, following a fire inspection, a requirement had been made to replace the fire doors as they did not comply with current legislation. The manager confirmed that these had been ordered. The fire risk assessment had been updated and all staff had received instruction about the new fire exit that was in place. What the care home does well: What they could do better: Improvements in medicines management meant that people using the service were Care Homes for Older People Page 5 of 9 receiving their medication as it was prescribed. However, medicines must be given from the container the pharmacist provides, to ensure that it is administered safely. Although improved, the recruitment process should be more robust to ensure that references are validated. This helps to protect people using the service. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 6 of 9 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 9 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 Medicines must be given 21/05/2010 from the container that the pharmacist provides. The container must have the persons name on the label and the full instructions for the care worker to refer to. This is to ensure that medication is administered safely and in accordance with the prescribers instructions. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 29 33 Pre prepared (to whom it may concern) references should not be accepted without first checking their authenticity. The system for monitoring and improving the quality of the service should be further developed to ensure that it is a continuous process and leads to a clear plan as to how the service is to be improved. Care Homes for Older People Page 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 9 of 9 - 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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