Care Home: Norton Lees Lodge

What the care home does well People are assessed before moving into the home care plans are developed in consultation with the person using the service and their advocates. Peoples health care needs are met and the medication procedures are safe and monitored by the manager. people told us they are treated with respect and dignity and their rights are upheld. This was supported by our observations and by relatives spoken to on the day of the visit. A Range of activities are provided and work is ongoing to develop this further. Contact with family is encouraged and relatives told us they were made welcomed when they visited. people are supported to make as many choices for themselves as they can and staff make an effort to get to know peoples history so they can support people in making choices. In the main people were satisfied with the food provided,there was choice and peoples individual needs were catered for. Complaints were taken seriously and recorded and their were procedures in place including training for staff to make sure people were protected from abuse. The environment was well maintained clean pleasant and hygienic. There were enough skilled staff and arrangements in place to cover shortfalls. Staff received training to help them do their job and the recruitment procedures included checks that reduce risk and protect people from harm. The home is well managed by a competent and experienced manager. people using the service and their advocates and staff are able to comment on the service and suggest ways of improving it. There are procedures in place to make sure peoples finances are managed safely and in the main their are safe working practices in place that ensure the health safety and welfare of the people using the service and the staff. What has improved since the last inspection? Since the last inspection care plans and reviews of care plans have been improved. these reviews include details of the expectations of people using the service and their advocates. Records of care given link to the plan of care, however there are some shortfalls. People are offered a choice of activities and are able to choose to take part or not. All areas of the home were clean and in the main free from offensive odour. People using the service staff and relatives told us in the main appropriate staffing levels are maintained. Since the last inspection the manager has been registered. Over fifty percent of the staff are now trained to National vocational qualification level two in care and the manager has completed the registered managers award. What the care home could do better: Records of care given could be improved this intern would improve the quality of the care plan reviews.Care plans need to be developed further to include details of how staff should manage individual challenging behaviors. Records of complaints should include whether the complainant was satisfied with the outcome or not.To ensure the safety of people wheelchairs must be used with the footrests. If for any reason footplate`s are not to be used this should be recorded in peoples care plans and kept under review. Staff must always use safe handling techniques when helping people out of a chair and supporting them when walking. Records of accidents must be recorded in peoples daily notes. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Norton Lees Lodge 156 Warminster Road Norton Lees Sheffield South Yorkshire S8 8PQ     The quality rating for this care home is:   two star good service 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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Shirley Samuels     Date: 1 7 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. the things that people have said are important to them: They reflect 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Norton Lees Lodge 156 Warminster Road Norton Lees Sheffield South Yorkshire S8 8PQ 08456027471 01142586740 nortonleeslodge@orchardcarehomes.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Karen De La Mare Type of registration: Number of places registered: Orchard Care Homes.Com Limited care home 40 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: Three service users over the age of 60 years may be accommodated at the home. Date of last inspection Brief description of the care home Norton Lees Lodge is situated in the Norton Lees area of Sheffield close to local shops, other amenities and a bus route. The building is purpose built and has two floors accommodating people who require dementia care. The home is registered for 40 places. The home has a sufficient number of baths, toilets and showers. All the bedrooms are single and have en-suite toilets. The home is accessible to service users, ramps and a lift are available, and aids and adaptations are in place. A conservatory has been built in the past few months, which has created additional space for the people who use the service The home has a pleasant enclosed garden. Car parking is available. The manager confirmed that the feees ranged from 363.00 pounds-565.00 pounds per week. Additional charges included hairdressing and private chiropody. Copies of the inspection report are displayed at the home and available on request. Care Homes for Older People Page 4 of 26 Over 65 40 0 Care Homes for Older People Page 5 of 26 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: two star good 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: The quality rating for this service is Two star. This means people who use the service experience good quality outcomes The previous inspection of this service was carried out on 27/11/07. This inspection was carried out by Regulation inspector Shirley Samuels on Monday 17th November 2008 from 9:15-15:15. We sought the view of fifteen people using the service, three relatives and five members of staff. Some people spoke to us on the day of the visit others completed questionnaires. The manager and operations manager was present and assisted with the inspection. At the end of the visit feedback was given to both managers and the deputy. Care Homes for Older People Page 6 of 26 During the visit we looked at the environment and made observations of staff interaction and approach to people using the service and visitors. We checked samples of documents regarding peoples care support and safety. These included assessments, care plans, medication records, staff recruitment files, records of health and safety checks and staff training. We looked at other information before visiting the home. This included the Annual quality assurance assessment (AQAA). This is information provided by the manager about how the service has developed over the last year and what further changes are planned to improve. We have reviewed our practice when making requirements,to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into the report as recommendations- but only when it is considered that people who use the service are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken What the care home does well: What has improved since the last inspection? What they could do better: Records of care given could be improved this intern would improve the quality of the care plan reviews.Care plans need to be developed further to include details of how staff should manage individual challenging behaviors. Records of complaints should include whether the complainant was satisfied with the outcome or not. Care Homes for Older People Page 8 of 26 To ensure the safety of people wheelchairs must be used with the footrests. If for any reason footplates are not to be used this should be recorded in peoples care plans and kept under review. Staff must always use safe handling techniques when helping people out of a chair and supporting them when walking. Records of accidents must be recorded in peoples daily notes. 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 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 26 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 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have the information they need and are assessed before moving into the home. Evidence: We were told in the surveys that people received information about the home and were able to visit before moving in. Staff told us in their surveys they were given enough information and communication about peoples needs was good. In the AqAA the manager told us that assessment sheets had been developed to make sure the home has the information they need. People are able to visit and look around the home before making a decision. and people are given information about the home in the form of a service user guide. Care Homes for Older People Page 11 of 26 Evidence: The records showed that people were assessed before moving into the home. Staff told us they had enough information to make a judgement about whether or not they were able to meet peoples needs. People using the service and their relatives told us they were given written information about the home and these were seen in peoples bedrooms and available in the entrance to the home on the day of the visit. Care Homes for Older People Page 12 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person had a plan of care, their health care needs were met and the medication system was safe. Evidence: In the improvement plan and the AQAA the manager told us care plans had been rewritten and kept under review. Care plan training has been provided for staff. There is a monitoring system in place that highlights shortfalls and ensures action is taken to improve. She also added that relatives are invited to contribute to writing the plan of care. All relatives on behalf of the people using the service told us peoples health care needs were being met and that people received the care and support they needed. One person commented that they would like a little more contact with the key worker. In the AQAA the manager told us people are respected, contact with family and friends is maintained and the staff make sure that next of kin are kept up to date on people Care Homes for Older People Page 13 of 26 Evidence: changing condition. Each person had a plan of care which detailed there needs and the action staff needed to take to meet peoples needs. The overall plan of Care was summarised so that staff had easy reference and guidance. This summary also included expectations of the person using the service and their representatives this was also supported by a detailed life history. There were some individuals who displayed challenging behavior. Staff were observed to manage this well however this need and the action required by staff was not recorded in the care plan. The records of care given were adequate but lacked some detail that would give the reader a more detailed account not just of the care given but the response and impact the care given had on the person. This would give a more holistic and overall view of the person and the quality of the care being provided for them. Care plans were reviewed monthly and more often if necessary. Improvement of daily recording would improve the content of the monthly reviews and enable changes in care needs to be identified more clearly. People told us they were supported with their health care needs records were kept of visits to the GP, dentist, optician and other interaction from health care professionals. Medication was stored appropriately. Staff responsible for administering medication were trained and competent. Records of administration was clear and correct and there were procedures in place to monitor the medication system and to address any problems quickly. Controlled drugs were received, stored, recorded and administered safely. This made sure that people were protected from harm. We observed the interaction between staff and people using the service. This was done in a professional and friendly manner. Staff were seen offering reassurance to people, joking and engaging people in meaningful conversation and activity. People told us the staff are respectful and spoke to them in a polite manner people were relaxed with staff. this view was supported by the relatives spoken to who spoke positively about the service provided. Staff were able to give us examples of how they promoted peoples rights and choices. Care Homes for Older People Page 14 of 26 Evidence: This showed that people where treated with respect and their rights upheld. Care Homes for Older People Page 15 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Activities were provided contact with family and friends was encouraged and people were happy with the meals provided. Evidence: Relatives told us in the surveys on behalf of people using the service that activities were provided and people were encouraged to take part. In the AQAA the manager told us all activities are recorded. There is a good activities programme and regular meetings are held with people using the service. In the AQAA the manager told us that staff make sure mealtimes are not rushed, there are a variety of meals provided. People told us they are happy with the opportunities they had to take part in activities. Staff were aware of their responsibilities for providing meaningful stimulation for people. On the day of the visit people were taking part in singing ,listening to music taking part in discussion about what was on the news and in the news papers. people were given information about what was on television and being encouraged to make choices. The home does employ an activities co ordinator there is a plan of activities Care Homes for Older People Page 16 of 26 Evidence: and people are encouraged to take part. The records give details of the activities provided and who took part. This shows that people are given the opportunity to take part in meaningful activities. Relatives told us they are made welcome and are able to visit at any reasonable time. Staff told us contact with family and friends was important to the overall wellbeing of people using the service. Staff encouraged people to make choices and for those less able to make choices the staff told us it was important to have a life history and contact with family who could help them to make choices on peoples behalf. This made sure that as much as possible people had control over their lives. People told us they were happy with the food provided, there was choice and individual dietary needs were catered for. On the day of the visit people who were reluctant to eat were appropriately encouraged and support was provided where needed. Peoples food likes and dislikes were recorded in the care plan and it was clear that staff were aware of this information. Mealtime was relaxed and unhurried and people were asked if they wanted more. During the day people were constantly offered drinks, tea coffee or cold drinks. Care Homes for Older People Page 17 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints are taken seriously and there are procedures in place to protect people. Evidence: In the AQAA the manager told us there had been one complaint and one referral to safeguarding since the last inspection. People using the service and their relatives told us they knew how to make a complaint and that they had written details explaining the procedures. Records of complaints were seen and included the majority of information required. The record did not detail whether the complainant was satisfied with the outcome of the complaint. There are no outstanding safeguarding issues. This shows complaints are listened to and taken seriously and there are procedures in place to protect people from harm and to show procedures are followed when necessary. Care Homes for Older People Page 18 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well maintained clean and hygienic Evidence: In the AQAA the manager told us the environment is monitored to make sure good standards are maintained. She told us there are some issues regarding laundry that need to be improved. In the AQAA the manager told us that they listen to people using the service and their families about ideas on how to improve the home and its environment. She added that people are encouraged to personalise their rooms and staff receive training on hygiene and infection control. Since the last inspection there have been refurbishment of some areas of the home. The manager told us there is a maintenance and refurbishment plan in place. This will make sure the environment is well maintained and comfortable for people. Staff told us they had the equipment and materials to maintain a clean and hygienic environment. Staff had received training on infection control and were able to tell us the action they took to maintain good hygiene standards. This made sure the home was clean pleasant and hygienic. Care Homes for Older People Page 19 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The recruitment procedures are robust and the staff receive the training they need. Evidence: In their surveys staff told us that if staff ring in sick the manager always tries to get cover. In the AQAA the manager told us training is provided for staff,recruitment procedures are thorough, the home does not use agency staff but is trying to build up bank staff who will be familiar with the people using the service. She added that managers listen to staff and regular staff meetings are held. People using the service and relatives spoke positively about the staff. One relatives told us staff are very caring I visit most days and hear what the staff say to other residents and how they care for them and they are always treated with respect and cared for. One relatives said they would like a little more contact with the key worker. One relatives told us in the main there were enough staff on duty but there were times during the evening when people in the lounge were not supervised. Staff told us that handovers were held at the start of each shift communication between staff was in the main good and that the staff worked well together as a team. Staff also added that if Care Homes for Older People Page 20 of 26 Evidence: staff ring in sick the manager will always try to get cover but this is not always possible. The manager told us that The home employs 26 staff and 16 staff are trained to national vocational Qualification level two in care and that a further four staff are working toward this. This showed that peoples needs were met by the numbers and skill mix of the staff. The home had a robust recruitment procedure. This included checking identification , obtaining references,criminal records checks, interviews and induction. This made sure the recruitment procedures protected people from harm. Care Homes for Older People Page 21 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and in the main there are safe working practices. Evidence: In their surveys staff told us the manager was approachable and communicated well with them. The cook said the manager always comes to the kitchen to communicate with catering staff other staff told us the manager is always supportive and available will work alongside us on the floor, nothing is too much trouble for her. Since the last inspection a new manager has been registered. The manager has completed her registered managers award and is keen to attend further training. Staff people using the service and relatives spoke positively about the manager and added that she ensures the home is run in the best interest of the people using the service. Meetings are held people using the service and their relatives are able to comment on the way the service is run and bring about change and improvement. Care Homes for Older People Page 22 of 26 Evidence: There were procedures in place for the safe keeping of peoples monies. The manager told us that peoples representatives are encouraged to take care of financial arrangements therefore the home managers only a few peoples monies. Account sheets, cash balances and receipts were checked on the day of the visit and were correct. This shows that peoples financial interests are safeguarded. Staff received training in health and safety. There was a fire risk assessment in place and staff were able to tell us the action they took on a daily basis to protect people from injury and harm. There was a mixture of moving and handling techniques seen the majority was good. A member of staff however was seen using a wheelchair without the foot rest and tilting the chair back. Another member of staff was seen using unsafe methods when supporting people to raise from the chair and inappropriate support when walking. This could place people at risk of injury. Accident forms were completed but the information was not transfered into peoples daily notes this resulted in accidents not being followed up and some staff not knowing about them. Staff were able to tell us what their responsibility regarding the health safety and welfare of the people they supported and for themselves and said that reports of hazards and safety issues were addressed quickly. Care Homes for Older People Page 23 of 26 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 24 of 26 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 1 38 13 Wheelchairs must be used with footrest unless otherwise stated in the care plan. To reduce the risk of injury. 23/12/2008 2 38 13 Manual handling and support 23/12/2008 must be provided to people in a safe way To reduce the risk of injury and accidents. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 7 7 Care plans should include details of how to manage individual challenging behaviour. Records of care given should be developed further to include more detail and used to inform the care plan review. Records of complaints should include whether the complainant was satisfied with the outcome. Records of accidents should be detailed in peoples daily recordings as well as on the accident forms. 3 4 16 38 Care Homes for Older People Page 25 of 26 Helpline: 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 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 © (2008) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. 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