Care Home: Northfields

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What the care home does well The service provides a well-managed support to the people living in the home, with a great deal o0f emphasis on the individual needs of the people living there. Individual plans are detailed, and clearly show the importance of the individual person. A well-trained staff team are available to meet the needs of the people living in the home. What has improved since the last inspection? Since the last inspection, the home has been redecorated throughout, and new carpets have been laid, and the people living in the home have helped choose the colours. Medication procedures have been improved to make sure that people are supported to take their prescribed medication CARE HOME ADULTS 18-65 Northfields 49a Northfields West Earlham Norwich Norfolk NR4 7ES Lead Inspector Alan Buttery Unannounced Inspection 7th May 2008 14:00 Northfields DS0000027527.V364041.R01.S.doc Version 5.2 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 Northfields DS0000027527.V364041.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 Adults 18-65. 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. Northfields DS0000027527.V364041.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Northfields Address 49a Northfields West Earlham Norwich Norfolk NR4 7ES 01603 458865 01603 458969 northfields@efitzroy.org.uk www.efitzroy.org.uk Elizabeth Fitzroy Support 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) Mrs Susan Ann Rzecki Care Home 7 Category(ies) of Learning disability over 65 years of age (7) registration, with number of places Northfields DS0000027527.V364041.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Up to seven (7) Service Users who have a learning disability and are over the age of 65 years may be accommodated. The total number of Service Users accommodated not to exceed 7. Date of last inspection 8th May 2006 Brief Description of the Service: Northfields is a detached, purpose built, chalet style house that is run as a residential care home providing accommodation and care for up to seven older people with learning and physical disabilities. The home is operated as two units within the home, has a shaft lift to the first floor and has seven single bedrooms all containing a washbasin of which one is upstairs and six downstairs. Each unit has a communal lounge, dining room, kitchen, adapted bathroom and toilet and there is a patio area and well-kept garden to the rear of the property and parking to the front. The home is sited in the middle of a residential area on the outskirts of the city of Norwich and is near local shops and healthcare facilities. Northfields DS0000027527.V364041.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 3 star. This means the people who use this service experience excellent quality outcomes. This was an unannounced visit and looked at the key minimum standards for older people. During the visit the manager of the service provided information and documentation required, and we were able to speak to and observe some of the people living in the home. What the service does well: What has improved since the last inspection? What they could do better: Northfields DS0000027527.V364041.R01.S.doc Version 5.2 Page 6 No concerns were raised as a result of the inspection. 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. Northfields DS0000027527.V364041.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Northfields DS0000027527.V364041.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Procedures are in place to ensure full information would be obtained before anyone moved to the home to ensure identified needs could be met. Individual plans detail how people wish their support to be provided together withy likes and dislikes. EVIDENCE: This is a home for people with Physical and learning disabilities, and since the last inspection, there have been no changes to the people living there. The people living in the home seem to get on well with each other, and no changes are envisaged. The providers have procedures are in place to manage any new admissions should a vacancy occur, which would include discussions with those still living in the home, ensuring that anyone moving to the home was compatible with the existing residents. The procedure would include a detailed assessment of need, discussions with the individual and their family, discussions with any professionals involved with that persons support Northfields DS0000027527.V364041.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 and 9 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Health needs are identified and met with the support of local professionals and in a way the individual prefers. EVIDENCE: Individual Plans are in place for all the people living in the home, and during the inspection, three of these were examined. The individuals are all fully involved in the care plans, and where appropriate this includes family members. The care plans include person centred plans as well which detail amongst other things the individuals likes and dislikes. The individual plans are kept under review on a frequent basis, and evidence of this was seen within the files we examined during the inspection. Northfields DS0000027527.V364041.R01.S.doc Version 5.2 Page 10 Each individual has a nominated key worker, who meets with the individual they support on a regular basis, and in addition residents meetings give the people living in the home the opportunity to discuss anything that affects the individuals collectively. For example over the last year, the redecoration of the home and the colour schemes have been discussed and agreed within these meetings. Staff have assisted the people living in the home to make their choices by collecting samples of the paint and upholstery and carpets to show to them and helping them decide on suitable colours. The individual plans also contained details of the individual risk assessments which look at the risks involved in day-to-day living and in specific activities, and the measures needed to reduce the risk to an acceptable level. The local community support team are involved in some of the risk assessment planning to ensure that activities that they are part of are included. Staff are aware of the risk assessments and where they are kept, and they are reviewed on a regular basis. Northfields DS0000027527.V364041.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 15, 16 and 17 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Individuals living in the home have access to a range of work and leisure pursuits, which give them the opportunity to lead a fulfilling life in a way they choose. EVIDENCE: Within the individual plans are details of the day to day work and recreational activities that the people living in the home are part of, although as most of the people are now of retirement age, only one still attends a structured day service. The others either choose to spend time in their room, or go on various daytime trips, shopping or to social clubs. At the weekend some of those living in the home go out for breakfast or for lunch, go shopping or visit local markets. Northfields DS0000027527.V364041.R01.S.doc Version 5.2 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 and 20 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Choice is offered in all areas of the individuals lives, backed up by person centred plans. EVIDENCE: The individual plans and person centred work that has been undertaken with the people living in the home ensures that support provided is given in a way suited to the preferences of the individual. Details on the files we examined during our visit showed that the people living in the home receive appropriate support from health professionals in the local area, as well as opticians and dentists services. After some difficulties with medication last year procedures have been changed, and all staff involved with administering medication receive suitable training. There is no one living in the home able to administer his or her own medication. Northfields DS0000027527.V364041.R01.S.doc Version 5.2 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Procedures are in place to ensure any concerns complaints or allegations are quickly dealt with. EVIDENCE: As part of a larger organisation, the service follows the corporate complaints procedure, and ensures that any concerns are dealt with in accordance with this procedure, and within set timescales. Procedures are also in place to ensure that any adult protection concerns are dealt with and staff all receive training in safeguarding procedures. There have been no issues raised in the last year. Northfields DS0000027527.V364041.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 and 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The service provides a clean and comfortable home for the people living there, and gives them the chance to contribute in all day-to-day decisions affecting them. EVIDENCE: During our visit, we looked around the home, and were shown one of the bedrooms by the person living there. The home is purpose built, and split into two sides, with groups of 3 and 4 residents. The building is modern and light, and appropriately furnished and has been redecorated in the last year. Some of the residents were able to help choose colours, and visit local DIY stores to buy the required paint. In addition, communal areas have had new carpets in the last year, and again residents were able to help choose the carpets. Northfields DS0000027527.V364041.R01.S.doc Version 5.2 Page 15 The home was clean and tidy, and free from any odours, and during the visit we saw residents helping in the kitchen, and one made the inspector a cup of tea. Northfields DS0000027527.V364041.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 34 and 35 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The staff team in the home are well trained and offer appropriate support to the people living in the home. EVIDENCE: The staffing is divided between the two sides of the home, although at times one member of staff ‘floats’ between the two sides. Normally there are three members of staff working in the home. All staff receive a good level of training and an analysis of training is produced annually and used to plan future training. As well as the mandatory training, the service also provide training specific to the needs of the people living in the home, for example around communication, dementia and challenging behaviours. The service has been fully staffed over the past year, with better staff retention than previously. We looked at three staff files, and all showed that the recruitment procedures are followed, and the required information is in place, including application forms, references, CRB checks and training records. Northfields DS0000027527.V364041.R01.S.doc Version 5.2 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39 and 42 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. The home is well managed and the interests of the people living in the home at the forefront of any decisions made. EVIDENCE: The service is well run the manager is experienced, and about to complete her Registered manager’s award. There was clear evidence in the person centred plans and observations during our visit that the people living in the home are involved in all day to day decisions that affect them, and encouraged to be ‘part’ of the house, undertaking some domestic tasks. Northfields DS0000027527.V364041.R01.S.doc Version 5.2 Page 18 Health and safety procedures are in place ensuring the safety of staff and residents, and appropriate training given to the staff team. An annual health and safety audit is carried out by the provider. Northfields DS0000027527.V364041.R01.S.doc Version 5.2 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 X 4 X 3 3 X X X Northfields DS0000027527.V364041.R01.S.doc Version 5.2 Page 20 No Are there any outstanding requirements from the last inspection? 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. Refer to Standard Good Practice Recommendations Northfields DS0000027527.V364041.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Northfields DS0000027527.V364041.R01.S.doc Version 5.2 Page 22 - 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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