Care Home: Norfolk Villa

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What the care home does well Many of the people living at the home said the care and support provided by the home was very good. The care staff observed during the inspection were friendly and one person living at the home said, "It`s lovely here". Observation throughout the inspection showed the staff to be being kind gentle and very caring towards people living in the home. The home provides good quantity and choice of food and meals are well presented and people said they enjoyed them. What has improved since the last inspection? On the second day of the inspection a painter was in the home upgrading one area of the home. During the last year the home has converted a bathroom in to a wet room so that it is accessible for more people. What the care home could do better: The administration and recording of Controlled Drugs must be monitored and audited to protect those people who are prescribed controlled medication. CARE HOMES FOR OLDER PEOPLE Norfolk Villa 45 Alma Road Pennycomequick Plymouth Devon PL3 4HE Lead Inspector Kim Fowler Unannounced Inspection 22nd September 2008 09:00 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 Norfolk Villa DS0000003485.V371632.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. Norfolk Villa DS0000003485.V371632.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Norfolk Villa Address 45 Alma Road Pennycomequick Plymouth Devon PL3 4HE 01752 661979 01752 668072 care@norvil.freeserve.co.uk 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) Mr Robert Timothy Teasdale Mr Robert Timothy Teasdale Care Home 19 Category(ies) of Old age, not falling within any other category registration, with number (0) of places Norfolk Villa DS0000003485.V371632.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: 2. Old age, not falling within any other category (Code OP) The maximum number of service users who can be accommodated is 19 Date of last inspection Brief Description of the Service: The home is a large detached building over 150 years old. It is located in the Pennycomequick area of central Plymouth. A full range of amenities and facilities are within walking distance of the home, including bus routes and Plymouth railway station. The home provides accommodation for up to nineteen residents. It has been extended over they years and currently has nineteen single bedrooms, eleven of which have en-suite toilet facilities and two have en-suite bathroom/shower facilities. There are two communal bathrooms in the home, one of which has a Parker Bath for those residents requiring assistance with bathing. The main lounge is in the extension on the ground floor at the rear of the building. There are two dining areas one in the older part of the building and the other at the rear of the sitting room. There are small gardens to the front of the building and to the side of the extension. The bedrooms are both on the ground and first floors of the building. Stair lifts provides access to the first floor although some mobility using stairs is required by residents due to small flights of stairs between corridors. The home has a No Smoking policy. Additional charges include hairdressing, chiropody, dentist, newspapers, toiletries, and outside activities. The home is registered to provide care and accommodation for older people. It does not provide intermediate care and it is not registered to provide nursing care. The current fees range from £285 to £347. Norfolk Villa DS0000003485.V371632.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The inspection was unannounced and took place over two days. The first day started on the 22nd September at 10am and finished at 4pm. The second visit, on 30th September at 9:45am, was to recheck and discuss the Controlled Drug and medication issues that arose on the first day of the inspection. Mr Teasdale the Registered Provider was available throughout both days and the Matron of care was also available to assist. The inspector made a tour of the building and spoke to most the people living at the home and the staff on duty at the time of the inspection. Documentation relating to the care planning process and the management of the home were examined. Any comments are in the relevant section of the report. What the service does well: What has improved since the last inspection? On the second day of the inspection a painter was in the home upgrading one area of the home. During the last year the home has converted a bathroom in to a wet room so that it is accessible for more people. Norfolk Villa DS0000003485.V371632.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Norfolk Villa DS0000003485.V371632.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Norfolk Villa DS0000003485.V371632.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3/5/6. Quality in this outcome is good. This judgement has been made using available evidence including a visit to this service. The completion of pre-admission assessments ensures that any prospective new person’s needs are known, and they can be assured that the home can meet their individual needs. EVIDENCE: The files examined for people living at home show that they had a completed pre-admission assessment carried out. Another file examined showed the placing authorities care plan supported the assessments. This ensured that the care staff were aware of peoples needs. Several staff were spoken with during the inspection and were fully aware of the needs of each person currently living at the home. Including one person who currently requires additional support. Norfolk Villa DS0000003485.V371632.R01.S.doc Version 5.2 Page 9 One person living at the home was spoken to and confirmed that they had visited the home before they were admitted. Another person was able to state that there relative had been to the home with them before being admitted. Norfolk Villa Residential Home does not provide Intermediate care. Norfolk Villa DS0000003485.V371632.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7/8/9/10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at this home receive consistent health and personal care as appropriate The home’s poor practice relating to controlled medication administration could place people living at the home at risk. EVIDENCE: Each file examined of people living at the home contained an individual care plan based on care needs and how the home would meet these needs. The daily care plans are easy assessable for staff on duty and risk assessments are held on individual files for the protection of all people living at the home. These care plans give detailed instructions to all staff as well as information to new staff to ensure intimate personal care is being provided in a manner that meets with the approval of people receiving the care. This is particularly important where people are unable to express themselves verbally. Norfolk Villa DS0000003485.V371632.R01.S.doc Version 5.2 Page 11 Evidence was recorded into individual files that people living at the home are referred to the District Nurse team when needed. Recorded onto an individual care plan was that a District Nurse was due to visit one person living in the home to support staff as the person had changing health care needs. All people living at the home have access to all health care services and this information was recorded into individual files examined. These files recorded that there was input from other professionals including GP’s, SALT (Speech and Language Therapist), chiropodist and consultants based at the local hospital. The medication is kept in a fixed lockable cupboard, and there is a separate fixed lockable box for any controlled medication held within this cupboard. The home continues to opt for a traditional system of medication dispensing and storing. The home has in the past received support and guidance from the CSCI Pharmacist Regulation Inspector on the best way to manage this system. From discussion with the staff who dispenses the medication they have received recent and regular medication training and are confident that this system works for them. However the controlled drugs were not completely secure, nor were they administered and recorded correctly. This places people receiving this medication at risk. Discussions were held with the owner, Mr. Teasdale and the care Matron. A second follow up visit was under taken to ensure the home had changed the system on how controlled drugs were administered and how they were recorded and reported. Mr. Teasdale had also written to the Commission before the second visit stating how this system would be improved and the information he had given to the staff to maintain the safety of people who receive controlled medication. A second examination of the controlled drug system showed that the home had taken on board the suggestions and had implemented these suggestions. They also had further plans to improve this system and these were shared with the inspector; when implemented this would further protect people who receive controlled medications. The inspector spoke to most people living at the home and some were able to comment directly about their experiences of living at the home. All clearly stated that they were well cared for. The inspector observed those residents with confusion being treated respectfully by the care staff, staff knocking on bedroom doors and staff assisting people with meals. Several people said they were assisted promptly. It was observed that people who chose to wander freely through the home were able to. One person said, “The staff are wonderful”. The owners confirmed that any people living at the home who are near the end of life or develop a terminal illness are able to remain at the home if the staff Norfolk Villa DS0000003485.V371632.R01.S.doc Version 5.2 Page 12 team and the District Nurse Services are able to continue to meet individual’s needs. One person currently receiving extra support from the home with input from the District Nurse team, though unable to communicate themselves, looked well cared for, comfortable and had a designated District Nurse file held in their bedroom. Norfolk Villa DS0000003485.V371632.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): 12/13/14/15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people living at Norfolk Villa can be confident that the home offers good home cooked meals. The home welcomes and encourages families and friends to visit and regular trips out are arranged. EVIDENCE: The owner confirmed that regular activities are brought into the home and trips out are arranged. The Registered Providers also stated that activities are offered as much as possible by one of the care staff: those people who were able to confirmed that activities are carried out in the home. Some activities aren’t always planned as people can request and chose from listening to music or watching a film. The home has recently organised “Tuk Tuk” tours (A three wheeler vehicle) for people living in the home. These proved a great success and the home is now building a ramp so all people can access these unusual vehicles. Norfolk Villa DS0000003485.V371632.R01.S.doc Version 5.2 Page 14 Two people spoken with confirmed that they often went out on their own. One will catch a bus to another town and the other likes to walk locally. Neither of the files held for these two people held risk assessments on these activities and the home were advised to complete one for each activity. The owner agreed to carry this out. Visitors are welcome at any reasonable time and can visit their friend/family in the privacy of their own room. Several family visits had been recorded into either individual care plans or the home daily diary. On person said, “My niece comes to visit and I go out with them”. One visitor spoken with stated that they are welcome at any reasonable time and are always made to feel welcome. They said. “The home is lovely”. The owner confirmed that most people manage their own money or family member do this on their behalf. The home only holds a small amount of petty cash to purchase everyday items. Receipts are kept and recorded on what and were the money was spent. During discussion with people about food they said it was “lovely” or “excellent”. One person was able to comment that they were able to make a choice on the food. Most people living at the home that were able to made positive comments about the food provided. The menus were displayed for all and one of the staff, the owner or an employed cook cooks the lunchtime meal. The meal served that day was Cottage pie, Cauliflower, carrots and Brussels sprouts. Followed by apple pie with a choice of ice cream or fresh cream. Norfolk Villa DS0000003485.V371632.R01.S.doc Version 5.2 Page 15 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): 16/18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live at Norfolk Villa and their relatives can be confident that any issues of concern or complaints will be taken seriously and dealt with promptly. EVIDENCE: Some of the people living at Norfolk Villa were able to confirm that the Registered Provider, Mr. Teasdale, was approachable and could discuss any concerns. One person said, “ He always comes in to see us to see if everything is alright”. The Commission has received one anonymous complaint prior to this inspection. This complaint was passed to the provider to deal with. The correspondence received provided evidence that the complaint was fully investigated. A copy of all correspondence sent to the Commission was held at the home and showed that the home dealt with this complaint using their own complaints procedure and within the recorded timescales. Discussion with the provider on how the investigation was carried out showed that the complaint was not upheld. The homes complaints procedure and was made available in the main entrance for all to access. Norfolk Villa DS0000003485.V371632.R01.S.doc Version 5.2 Page 16 The staff spoken with confirmed that many of them had completed the local authorities Safeguarding course. From discussion with these staff showed that they understood the process of adult protection. Mr. Teasdale the Registered Provider stated that he was in the home most days and would deal with any issue raised straight away. Observation showed that Mr. Teasdale had a good open relationship with the people living in the home. Norfolk Villa DS0000003485.V371632.R01.S.doc Version 5.2 Page 17 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): 19/24/25/26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Norfolk Villa continues to maintain a clean and suitable environment for it’s stated purpose and people living at the home can be assured that they will live in a comfortable home that is regularly maintained. EVIDENCE: A tour of the building confirmed that the home was very clean and tidy, with no offensive odours. All bedrooms and communal areas were pleasantly decorated. There is access to the front patio area via the lounge and dinning room and this leads to a pleasant seating area that is sheltered. The main lounge carpet and the downstairs hallway carpet both required attention, either they required cleaning or replacing. Mr. Teasdale stated that he was waiting for the usual caret fitter to come to measure for the new Norfolk Villa DS0000003485.V371632.R01.S.doc Version 5.2 Page 18 carpets. On the second visit to the home Mr. Teasdale confirmed that the carpets fitted had been and both carpets would be replaced very soon. The home has converted one bathroom into a modern wet room and new garage door s have been fitted to gain easier access to the laundry room situated in this area. Most bedrooms reflect individual’s choice and many held personal item’s brought in by individuals. On the second unannounced visit to the home a painter was upgrading one area of the house and a carpenter was building a ramp so all the people living in the home could access the three wheel “Tuk Tuk” tour vehicle. A local company carries out most of the laundry at the home and the home will only provide a basic laundry service for a minimal of items. However there is a large industrial washing machine available if needed. The home clinical waste contract was discussed and was satisfactory. Norfolk Villa DS0000003485.V371632.R01.S.doc Version 5.2 Page 19 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): 27/28/29/30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home are supported by well-motivated and caring staff in sufficient numbers to meet the needs of those currently living at the home. EVIDENCE: The staff interviewed felt that the home had sufficient staff on duty and observation of staff throughout the inspection showed them to be relaxed, patient and helpful when assisting the people. There is usually 4 or 5 staff on duty and the home has 2 waking night staff with Mr. Teasdale confirmed that he is available on call when needed. Many of the care staff employed at the home are long serving staff members having worked at the home for a number of years therefore have a great deal of experience working with older people. Some of the people living at the home were able to state that the care received is very good. Examination of staff files showed that all staff had the required preemployment checks, including CRB (Criminal Record Bureau Disclosure) in place ensuring as far as possible unsuitable staff are not employed. Currently 6 staff hold an NVQ qualification at level 2 or above this is a nationally recognised care qualification for which staff have had their work performance and knowledge evaluated by an external training organisation. Norfolk Villa DS0000003485.V371632.R01.S.doc Version 5.2 Page 20 Through this training staff received further training in first aid and health and safety ensuring they have the knowledge to deal with emergencies. The Induction training is provided by Skills for Care organisation and is comprehensive in detail. The Registered Providers wife who is a lecturer at the local college carries out most of the training for the staff including signing off all Induction training. Staff spoken with confirmed that the home holds staff meetings and supervision sessions. The staff interviewed felt that they were able to express their view at these meetings. Regular consultation with staff ensures staff can contribute to the running of the home and are aware of the home’s aims and objectives, philosophies of care and promotes consistency and improvement. Norfolk Villa DS0000003485.V371632.R01.S.doc Version 5.2 Page 21 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): 31/33/35/38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management of this home is very good and ensures that records are effectively maintained; they the respect of people living and working in the home. EVIDENCE: The Registered Provider, Mr. Teasdale, have owned and managed the home for many years and has plenty of experience in running the care home, and is well thought of by those who live and work at Norfolk Villa. Both the staff and some of the people living at the home were able to confirm that Mr. Teasdale is in the home most days and always finds time to speak to them. Mr Teasdale confirmed that the home hold regular residents meetings. The minutes of these meetings were available and the Registered Provider Norfolk Villa DS0000003485.V371632.R01.S.doc Version 5.2 Page 22 explained that any issues of concern are raised at these meetings. Mr. Teasdale also offers people one to one meetings when needed. Formal questionnaires were available near the front door for visitors to complete, however very few are completed and visitors will always seek him out if they wish to discuss any issues. The home does not manage the money of anyone living in the home. It does hold a small amount of petty cash for everyday item for a few people. However receipts and records are available for inspection, showing a clear audit trail of expenditure. Sampling of servicing records indicated that equipment is serviced regularly and maintained in good working order, including the fire alarm system. Certificates were available on all Health and Safety equipment. Gas and electrical appliances were being routinely serviced and checked. Electrical systems were being serviced during the inspection by a outside contractor. The fire protection system was well maintained. Maintenance checks are being carried out. The staff member is receiving appropriate fire protection training to ensure that they have the skills to deal with emergencies. Good health and safety practices reduce any unreasonable risk, affecting people living at the home, to an acceptable level. Norfolk Villa DS0000003485.V371632.R01.S.doc Version 5.2 Page 23 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 X X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 3 3 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 3 Norfolk Villa DS0000003485.V371632.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action 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 OP9 Good Practice Recommendations All medication, in particular controlled drugs, should be audited and any errors or change be reported to the GP and recorded onto individuals file. Norfolk Villa DS0000003485.V371632.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Norfolk Villa DS0000003485.V371632.R01.S.doc Version 5.2 Page 26 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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