Care Home: Norton Grange

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What the care home does well This is a random inspection and therefore not all the core standards were assessed. People are being supported to plan for the forthcoming closure of the home. People are supported to live their lives pursuing what is important to them. People are supported to keep in touch with their families and friends so that they can maintain relationships that are important to them. People have the information that they need to enable them to decide if they want to live at the home. Prior to coming to stay there people can be confident that the home will be suitable to meet their needs. People told us that they were happy with how the home support them to meet their personal hygiene needs. People are involved in writing their care plan so that care and support can be provided in the way they prefer. People can be confident that they receive their medication at the times they require. People have access to a range of health and social care professionals and this ensures that the appropriate advice is sought to meet their health needs. People are offered a variety of nutritious meals that meet any special dietary requirements. People can be confident that their concerns are taken seriously and their views are acted upon. People can be confident that there are systems in place to protect them from harm. People benefit from being cared for by a staff team that are supported in their job roles. People can be confident that they are supported by people who have received training in order to meet their individual and collective needs. What the care home could do better: This is a random inspection and therefore not all the core standards were assessed. Arrangements should be in place so that people living at the home are involved in quality monitoring visits undertaken at the home by senior managers. This is to ensure that they are involved in the running of the home. Fire drills should be arranged regularly so that staff are aware of the actions to be taken in the event of a fire. This is to ensure the health and safety of people living at the home. Random inspection report Care homes for older people Name: Address: Norton Grange 46 Tern Grove Kings Norton Birmingham B38 9DN two star good 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: Amanda Lyndon Date: 2 2 0 6 2 0 1 0 Information about the care home Name of care home: Address: Norton Grange 46 Tern Grove Kings Norton Birmingham B38 9DN 01216756350 01214581143 Telephone number: Fax number: Email address: Provider web address: Notknown Name of registered provider(s): Name of registered manager (if applicable) Mr John Christopher Wilkins Type of registration: Number of places registered: Conditions of registration: Category(ies) : Birmingham City Council (S) care home 20 Number of places (if applicable): Under 65 Over 65 20 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users who can be accommodated is: 20 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) 20 Date of last inspection Brief description of the care home Norton Grange is a care home, owned and managed by Birmingham City Council. It is located in a residential area of Birmingham, set back from a main road where public transport can be accessed. Shops and community facilities are not located near Care Homes for Older People Page 2 of 12 Brief description of the care home to the home. The home is a two storey building and all accommodation and care is provided on the ground floor. All bedrooms are for single occupancy. Ensuite facilities are not provided. Assisted toilets and bathroom facilities are available for communal use. There is level access for wheelchair users to the front entrance and throughout the home. Corridors are spacious and allow people to move around the home freely and safely. The home has hoisting equipment and adaptations available to support people who require assistance with mobility. An accessible well maintained garden area is available for people to enjoy. Facilities are split into two units, each with a dining room and kitchen. There are separate lounge areas where people can choose to socialise. A separate corridor has the laundry, store rooms, staff room and office accommodation. At the front of the Home there is a ramped access and off road parking space for a number of vehicles. There is a separate Asian Elders Day Centre operating from the Home, this has its own facilities. Inside the home, the reception area has notice boards, which display information about forthcoming events and other articles that may be of interest. The Statement Of Purpose and contracts state the fees charged to live there and what they include. Care Homes for Older People Page 3 of 12 What we found: The focus of inspections undertaken by the Care Quality Commission (CQC) is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provision that need further development. The last key inspection of this service was completed on 30th September 2007. At that time we awarded the service a two star rating. This meant that people living at the home experienced good quality outcomes. We completed an Annual Service Review about the service provided at the home on 6th November 2009. The outcome of this did not change our opinion of the quality of service provided. This random visit was undertaken by one inspector over one day. There were nineteen living at the home and three of these were there for a short stay. The home did not know that we would be visiting. Prior to the visit taking place we looked at all of the information we had received or asked for. This included any notifications received from the home. These are reports about things that have happened in the home that they have to let us know about by law. We sent out surveys to ten people who live at the home and their relatives, ten staff members and health professionals that visit the home. This is to obtain their views about the service provided. Seven people who live at the home, eight relatives, eight staff members and five health professionals returned surveys to us. Their comments are included in this report. The care of two people was case tracked. This involves talking to them and discovering their experiences of living at the home. We focus on the outcomes for these people. We also spent time observing care practices and speaking to four staff members about the care and support they provided to these people. We sampled care, staffing and health and safety records. We looked around the areas of the home used by the people case tracked to make sure it was warm, clean and comfortable for them. We gave all people living at the home the opportunity to be involved in the inspection. These are our findings: The statement of purpose and residents handbooks had recently been updated and were available within the home for people to read. These included information about the services and facilities provided there. We saw that these had been produced in a large print format so that more people could access the information. The home is included within the local authoritys reprovision programme. This means that the home is due to close in early 2011. People living at the home and the staff team told us that they were kept updated about the progress of the home closure. People told us that they were being supported at this time. One person said The staff keep us informed about the closure. We have lots of meetings with social workers and one to ones. I will be sorry to go. We spoke with a person who had recently come to stay at the home. We saw that Care Homes for Older People Page 4 of 12 comprehensive information had been obtained about the persons care needs prior to admission. This is to ensure that their needs could be met at the home. They told us that they visited the home prior to admission. They said Someone came with me to have a look around before I came here. We saw that a comprehensive record of the success of the visit had been written. We saw that comprehensive assessments of peoples individual care needs are undertaken on admission to the home. These are reviewed periodically throughout their time there. Care plans are written from this information. These are individual plans written with the involvement of people and their representatives about what they can do for themselves and in what areas they require support. We found that care plans were personalised and included peoples preferences regarding their daily lives. They identified what people could and couldnt do for themselves. They gave instructions for staff about the support to be provided. It was evident from our discussions with people living at the home that they were involved in writing and reviewing these. This is important so that people are encouraged to maintain their independence. It means that their preferred routines can be maintained whilst living at the home. We spoke with a person who was at the home for a short stay. They told us that the staff are encouraging them to develop skills so that they can live in their own in the near future. They told us The staff have encouraged me to take my own tablets so I know how to do this when I go home. From our discussions with the staff team it was evident that they had a good understanding of peoples individual care needs. One staff member said I read the care plans. We have the responsibility to do that as I am the key worker to three people. We saw that the home complete risk assessments for people so that consideration is given to supporting them to take responsible risks and promote their independence. We saw that moving and handling assessments identified the specific support and equipment required for each person. In addition staff had undertaken recent training about this and further training was planned. This should mean that people are supported to move safely. People told us that they were happy with the level of personal care provided by the home. We saw that they were clean hair was neatly styled and people were wearing clothing appropriate to their age, gender, religion and the time of year. One person told us that she had enjoyed her shower that morning. One person who completed a survey told us They take good care of me and my needs. We saw that people can retain their own doctor on admission to the home, if the doctor is in agreement. In addition we saw that advice can be sought as needed from a range of other health and social care professionals. One health professional who completed a survey told us that the homes staff always follow up any recommendations that they make. A relative who completed a survey told us They look after my aunts needs very well especially her medical needs. We looked at the system in place for the management of medication and found that there was a robust system in place for this. This should mean that people receive their medication at the times they require. The manager told us that there are no medication trolleys at the home and that peoples medication is administered from the medication cupboards in turn. We discussed the implications of this and the time involved in doing this. However the manager told us that this was a longstanding work practice and that with the home closure being imminent he was happy for this way of working to continue. Care Homes for Older People Page 5 of 12 From records sampled and from our discussions with staff and people living at the home, it was evident that there was a range of activities to join in with. People living at the home told us that they were involved in arranging these. These included competitions, bingo, crafts, fish and chip suppers and recent fathers day celebrations. One person met during the visit said I like some of the games we do here. I choose not to join in with all of them. A carer takes me out so that I can follow my hobby. Arrangements are in place so that people can follow their religious beliefs if they wish. We saw that a copy of the homes newsletter was on display. This was produced in large print so that it was accessible to more people. It included information of interest to people living at the home, for example the success of recent events and updates on the homes forthcoming closure. People are encouraged to maintain contact with their family and other people important to them. They told us that there is an open visiting policy and they can meet with their visitors in private if they wish. People told us that there are no rigid routines and can choose how they spend their time. One person said I can walk around here. I can choose what time to go to bed and get up. Menus identified a variety of nutritious meals and special diets are prepared for reasons of health, religion and personal preference. A choice of meals is always available and people told us that they are made aware of these on a daily basis. People also have the option of choosing snacks at other times. One person met with during the visit said The food is lovely. I have second helpings. Since our last visit we have not received any complaints about the service provided at the home. This includes any incidents of a safeguarding nature. From records held at the home reviewed during our visit, we found that they had not received any complaints since 2001. Since this time there have been a number of low level concerns recorded about the quality of food. This was also identified in a number of surveys returned to us. We saw that actions had been taken in response to these and as a result of this people told us that the quality of food had improved. One person met during the visit said If we suggest anything the staff act on it. We spoke about the food at one time and it has improved. Another person said I have no complaints. There are lots of people here to talk to. They are friendly. They all know me. The staff training matrix identified that all staff had undertaken training about safeguarding. Care staff met with during the visit had a good knowledge about this. This should protect people living at the home from harm. The manager told us that due to the age of the building, it is no longer fit to meet the needs of people living there. However despite the long term plans for the home we saw that efforts continue to be made to ensure that people are provided with a clean and comfortable place in which to live. For example, people had recently been consulted about redecorating their bedrooms and had been involved in improving the garden areas. People met during the visit told us that they particularly enjoyed being involved in planting flowers in the garden. People also told us that a new television had recently been purchased for their use. Care Homes for Older People Page 6 of 12 In addition to care staff, administration, cleaning, maintenance, laundry and catering staff are employed. This means that people living at the home receive some support in these areas. People living at the home and the staff team told us that there were enough staff on duty to meet peoples needs. It was evident that staff turnover was very low and that agency staff are not used. This is to promote continuity of care for the people living at the home. Due to a staff members retirement, there was currently one staff vacancy. The manager told us that he had been fortunate that five staff members had recently been transferred to the home following the closures of another local authority home. He said that these people had undertaken induction training and had been an asset to the home. One staff member who completed a survey told us I moved here from a home that was in the first phase of the closures. I have worked for the department for 20 years and the managers and staff made moving here a lot easier for me. There had not been any new staff employed directly by the home for a long period of time. One person told us My key worker is marvellous. One relative who completed a survey told us Mum is very happy at Norton Grange. Staff are happy and friendly. From discussions with the staff team and information on the staff training matrix, we identified that staff had recently undertaken a range of training. This included training in a number of heath and safety matters, for example, manual handling, food hygiene and fire safety. Staff also told us that they had undertaken recent training about a number of care topics specific to their job roles. This included the safe handling of medication and dementia care. The vast majority of staff had completed a nationally recognised care qualification (NVQ 2). This should mean that care and support is provided in a competent manner. One staff member told us The manager was really good when I asked him for computer training. He arranged this. We did identify however that a fire drill had not been arranged for the past six months. This means that staff had not had the opportunity to practice what actions to take in the event of a fire. This may not protect people from harm. Staff have the opportunity to put forward their suggestions about the service provided. Evidence of actions being taken in response to these were identified within the minutes of recent staff meetings sampled. The home manager has been in post for the past thirteen years. He is supported by a longstanding team of assistant managers. It was evident that the management team had a good understanding of the individual needs of people living at the home. Positive comments were made about the management team by people living at the home and the staff team. This included It is a lovely home. Very well run with a good management team. One staff member who completed a survey told us The management are all very understanding and professional. There are some systems in place to capture the views of people living at the home. Group meetings involving people living at the home are held regularly and service satisfaction questionnaires are sent out. This means that they have regular opportunities to put forward suggestions about the service provided. We saw that actions are taken in response to suggestions made and that people are made aware of these. We saw that senior external managers undertake regular quality monitoring visits at the home. However from records sampled we could not evidence that people living at the Care Homes for Older People Page 7 of 12 home had been involved in recent visits. This means that they miss the opportunity to discuss their views about what it is like to live at the home with senior managers. The manager had a good knowledge about accidents that had occurred involving people living at the home. We saw that accident records were well maintained and regularly audited so that any trends or patterns in accidents can be identified. This means that measures can be put in place to reduce the risk of further accidents of a similar nature from occurring again. What the care home does well: This is a random inspection and therefore not all the core standards were assessed. People are being supported to plan for the forthcoming closure of the home. People are supported to live their lives pursuing what is important to them. People are supported to keep in touch with their families and friends so that they can maintain relationships that are important to them. People have the information that they need to enable them to decide if they want to live at the home. Prior to coming to stay there people can be confident that the home will be suitable to meet their needs. People told us that they were happy with how the home support them to meet their personal hygiene needs. People are involved in writing their care plan so that care and support can be provided in the way they prefer. People can be confident that they receive their medication at the times they require. People have access to a range of health and social care professionals and this ensures that the appropriate advice is sought to meet their health needs. People are offered a variety of nutritious meals that meet any special dietary requirements. People can be confident that their concerns are taken seriously and their views are acted upon. People can be confident that there are systems in place to protect them from harm. People benefit from being cared for by a staff team that are supported in their job roles. People can be confident that they are supported by people who have received training in order to meet their individual and collective needs. Care Homes for Older People Page 8 of 12 What they could do better: 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 9 of 12 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 10 of 12 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 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 32 Arrangements should be in place so that people living at the home are involved in quality monitoring visits undertaken at the home by senior managers. Fire drills should be arranged regularly so that staff are aware of the actions to be taken in the event of a fire. 2 38 Care Homes for Older People Page 11 of 12 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. 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