Care Home: Normanton

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What the care home does well People moving into Normanton can be confident that staff will be able to meet their needs. This is because they are involved in a detailed assessment, before they are offered a place. The home has an experienced manager and staff are trained in meeting the needs of older people. A resident told us that Normanton `provides excellent management and caring services`. Another person told us their relative is `looked after very well and receives a high standard of care`. People can be confident that they will be involved in planning their care so staff know how they wish to be supported and they are offered choices. A relative told us that staff were `always pleasant and caring`. Residents, relatives and staff feel Normanton provides a homely environment for people to live in. People can be confident they will be offered a choice of meals that they will enjoy and meets their dietary needs. People can be confident that robust recruitment procedures are in place to ensure suitable staff are employed. The manager demonstrates a positive approach to seeking the views of residents and their relatives. She makes sure people are kept informed of developments and changes within the home and seeks their views as to whether they are suitable or not. The information in the manager`s self assessment (AQAA) provided us with reliable information about the service and matched our assessment that the home is well managed and seeks to continually review and develop the service it provides. Surveys we received back, offer the following comments: `There is always a happy, caring atmosphere, with the right balance of care and efficiency`. `Their attention to all aspects of health is first class and there are very good relationships with our Doctor and nurses`. `My Mother is always in her own clothes which are clean and clothing well co-ordinated. I know that being a resident at Normanton, her quality of life has been enhanced, that her dignity is maintained in all aspects of the care she receives`. What has improved since the last inspection? The manager makes small improvements to the service that they offer to residents continually. These changes may not be huge but they feel that the small things make a big difference. They have, however, implemented changes with regard to the supply and administration of medication and infection control, which will effect a positive improvement at Normanton. What the care home could do better: The management of this service has a good awareness and understanding of what they want to achieve and how to do this including involving people who use the service. Recording of the rationale for use of bed rails could be more detailed. This should include documenting the person centred aspect of the safety management including discussion had with other parties in the multi-disciplinary team. Recording regular checking of the rails and any maintenance required. Training should be implemented for all staff who use them during their work. Key inspection report Care homes for older people Name: Address: Normanton 168 Ellesmere Road Shrewsbury Shropshire SY1 2RJ     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Pat Scott     Date: 1 1 0 3 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 24 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought 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 The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Normanton 168 Ellesmere Road Shrewsbury Shropshire SY1 2RJ 01743271414 01743271441 samedwards@macace.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Kenneth Franklin Edwards,Mrs Mary Ursula Edwards care home 29 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 29 The registered person may provide the following category 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 category (OP) 29 Mental disorder, excluding learning disability or dementia (MD) 10 Date of last inspection Brief description of the care home Normanton is situated on the Ellesmere Road, approximately two miles from the centre of Shrewsbury and within easy access of all major services and amenities. The home is largely purpose built with the main living areas and majority of bedrooms being on the ground floor. It features 21 single rooms and 4 shared rooms, 22 of which Care Homes for Older People Page 4 of 24 Over 65 0 29 10 0 Brief description of the care home have en suite facilities. Residents are able to enjoy attractive gardens to the front of the building with further lawns extending to the rear. Normanton makes their services known to prospective service users in: The Statement of Purpose and Service Users Guide. The inspection report is available within the home. The care home rates are reviewed annually on 1st April each year and service users are notified one month in advance. The only additional charges to service users are for extra hairdressing, chiropody, newspapers, dentist and opticians. This is clearly laid out in the terms and conditions. Care Homes for Older People Page 5 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This is a key inspection for Normanton. This inspection site visit provided an opportunity to find out how peoples developing care needs are being met, together with the services plans for improvement. This report draws on information received from the home in their Annual Quality Assurance Assessment, which is a self-assessment process that requires care services to record how well care outcomes for the people living in their service are being met as well as providing a range of statistical information about the service. We also looked at information we have about how the service has managed any complaints and responded to safeguarding referrals. We reviewed what the service has told us about things that have happened in the service, these are called notifications and are a legal requirement. Care Homes for Older People Page 6 of 24 We reviewed the previous key inspection outcomes of 7/6/2007 and subsequent annual service reviews. We gathered relevant information from other organizations such as the Environmental Health Office (EHO), Health and Safety Executive (HSE) and the Fire Safety Officer (FSO). We spoke with 6 people about their experience of care and reviewed their care plans. 2 staff working at the home were interviewed and records were reviewed. One Regulatory Inspector carried out this inspection over 3 hours. Care Homes for Older People Page 7 of 24 What the care home does well: What has improved since the last inspection? What they could do better: The management of this service has a good awareness and understanding of what they want to achieve and how to do this including involving people who use the service. Recording of the rationale for use of bed rails could be more detailed. This should Care Homes for Older People Page 8 of 24 include documenting the person centred aspect of the safety management including discussion had with other parties in the multi-disciplinary team. Recording regular checking of the rails and any maintenance required. Training should be implemented for all staff who use them during their work. 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 24 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be confident that they will have their needs fully assessed and have the opportunity to visit the home before living there. This ensures that all parties can be sure the home can meet all individual needs in the required way. Evidence: People we spoke with said that communication between them and the staff is very good and that they understood about all aspects of their care, treatment and support and choices available to them. They had been given full information about the home both verbally and written and had had the opportunity to visit beforehand. One person talked about being able to express their views and to be involved in making decisions about their care. A relative spoken with confirmed that they were always kept up-to-date with developments and fully understood the care given to their relative. Some people in the home have mental health problems and their relatives spoke of Care Homes for Older People Page 11 of 24 Evidence: being able to represent the views of that person on their behalf and being involved in some way in making decisions about their care, which they welcomed. Care Homes for Older People Page 12 of 24 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that the care they receive will be based on their individual needs and support their dignity. People will be supported to have their medicines and there are safe systems in place for people who need help with this area of their lives. Evidence: Discussion with the manager showed that she recognises the diversity and rights of people who live in the home. Observation of care showed that the staff maintain privacy, dignity and independence of the people in their care. Examination of care plans showed that people experience effective, safe and appropriate care, treatment and support that meets their assessed needs and protects their rights. The manager has taken account of relevant research and guidance into health and social care. She has implemented nutritional and pressure area score assessments. This is a proactive approach to care which identifies problems at an early stage. When changes to peoples health does occur the manager makes relevant referrals to other professionals, such as; district nurse, GP, social services. Care Homes for Older People Page 13 of 24 Evidence: People we spoke with were very complementary about the staff that care for them. Comments were made such as: The staff are very kind to me and they look after me well Everything is excellent here, and managers are all ways on site and you can always speak to them The care my mother receives has kept her stable, she always look clean and well dressed. I dont have to worry about her when Im not here We observed a very high level of personal care and attention to clothing, nail and hair care that enabled people to maintain their dignity and individual identity. People spending time in bed because of their frailty, all looked comfortable and well supported with drinks and call bells to hand. Aids to independence and prevention of pressure sores are available and in use. Basic agreements for the safe and appropriate use of items such as bed rails are in place. We discussed with the manager the need to make the initial assessment/rationale undertaken with the district nurse to use them, more specific to the individual and those involved in their care. Records of frequent review, recording, training and checking/maintenance of the rails could be improved. People were observed to be cared for in bed with rails in situ. All looked very comfortable and safe. People told us that Normanton felt like home. A resident said We are very spoilt and the staff are all lovely. Our interviews with staff showed that they fully understood their role in the home and were very knowledgeable about residents needs. There are good systems in place for ensuring people receive their prescribed medication safely and regular audits are carried out to confirm staff are working to the homes polices and procedures. Staff have a positive approach to promoting the health of the people living at Normanton. Regular assessments of their nutritional status and weight are carried out. Where needed people are given dietary supplements to boost their intake and immune system. Care Homes for Older People Page 14 of 24 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are given opportunities to lead dignified, comfortable and fulfilling lives based on their individual preferences, abilities and choices. People are provided with a choice of meals that they enjoy and maintain their health. Evidence: Details of the activities and events taking place on a daily basis are displayed for people to see. In addition to the one to one and group activities, arranged by the coordinator, trips out and visiting entertainers also provide for leisure opportunities. A relative told us that staff make an effort to stimulate and entertain residents. People told us the home was very welcoming. We saw that visitors are served with tea and coffee. There are regular opportunities for residents and relatives to give their views on how the home is run. Each person living in the home has a plan of care that takes account of their individual interests, preferences and life history so activities can be matched to their individual needs. A relative said Normanton is their home. Friends and relatives are encouraged to visit Care Homes for Older People Page 15 of 24 Evidence: any time of the day and are made to feel very welcome. Another person said There is a lovely family atmosphere. They keep us very well informed of all aspects. People are offered nourishing meals each day. We could see from our discussions with people that individual arrangements are made for people who need special diets or have particular preferences. One person told us their relatives meal was Always beautifully presented on their plate. Care Homes for Older People Page 16 of 24 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that they will be protected and their individual rights supported because there is an open and inclusive atmosphere in the home and staff work in their best interests. Evidence: In several sections of this report we have identified that the manager has a very open approach to listening to residents, relatives and staff and involving them in the running of the home. This means that the home has not received many complaints and we have not been notified of any concerns between our inspections. People are encouraged to make complaints formally through written procedures and informally through day-to-day contact with staff. People can use a suggestion box or talk directly to staff. People we talked with said that they would have no hesitation in mentioning anything they are unhappy with and felt that all would be sorted out immediately. Conversation with staff showed their knowledge of how to keep people safe. They confirmed that they attend regular training on protecting people from abuse. The manager has taken on board the implications of the Mental Capacity Act in making sure people act in the best interests of residents and involve them in decisions about their lives. Care Homes for Older People Page 17 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a safe, clean home, which is kept under review by the manager, so that the improvements benefit the people who live there. People can be confident that there are suitable systems in place to provide them with fresh clean laundry and prevent infections spreading. Evidence: A tour of the premises showed the home is very comfortable, clean and bedrooms immaculately presented. There are some new furnishings including curtains, bedding and lamps. All the bedrooms seen were personalised and were warm and all had call alarms. Some residents said they had chosen to bring their own furniture into the home. We spoke with a member of staff who confirmed they had received appropriate training, especially around health and safety and infection control and they wear protective clothing. The service has undergone an infection control audit by the PCT with good results. Care Homes for Older People Page 18 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by a long serving staff team that have been selected for their suitability to work with vulnerable people and receive the training and supervision they need to respond to peoples diverse and changing needs. Evidence: People commented positively on the approach of staff. One person said the staff are Always pleasant and caring. Two other people said The staff are wonderful. I cannot praise them enough. They work very hard to a very high standard and We feel the staff are very hard working and welcoming. The recruitment records we reviewed showed us that the manager is receiving the required checks and references before staff are employed. There are good records of the recruitment and interview process to show that the correct procedures have been followed. There is a training plan in place to make sure staff receive the regular training they need to stay up to date. Staff are trained in specific areas, according to their role in the home, to enable them to support the needs of older people. Staff confirmed they are well supported and are able to approach senior staff and the manager. Care Homes for Older People Page 19 of 24 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident in the services provided at Normanton because the home is well managed and takes account of their views. There is a genuine commitment to reviewing the quality of the service provided and making sure that the health & safety systems in place to protect people living, working and visiting the home are up to date. Evidence: The manager provides effective leadership and management of the home based on providing good outcomes for the people who live there and involving their relatives. A relative told us there is a genuine commitment from the manager to listen to what people say about the home, ideas are acted upon and people provided with feedback. A member of staff told us The manager of our home is very interested in what their staff have to say. Residents and their relatives receive feed back from the surveys carried out via Care Homes for Older People Page 20 of 24 Evidence: meetings or newsletters. The home has a good history of meeting the required standards and providing excellent outcomes for people. The manager who is very experienced keeps up to date with current best practice to ensure appropriate procedures are followed and any care intervention is based on evidence based practice. The self assessment (AQAA) the manager submitted was sent to us on time. The information provides a true reflection of the service and confirms what we found during our visit. It also shows us that the manager works to achieve excellent outcomes for the people living in the home and is open to new opportunities. Health and safety risk assessments covering the work of the home are in place and kept under review. Records of all accidents are maintained and reviewed by the manager to identify any emerging patterns or risks for individual people. The manager keeps us informed of events in the home, such as accidents and incidents. The range and frequency of notifications have not raised any concerns with us. The manager has provided dates of regular servicing of equipment and systems within the home. Care Homes for Older People Page 21 of 24 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, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 24 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, Care Homes 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 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 Care Homes for Older People Page 23 of 24 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. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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