Care Home: Norway Lodge Nursing Home

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What the care home does well The home provides a well trained and competent staff team to provide care to the service users. The fabric of the building continues to improve through a programme of redecoration and refurbishment to give service users a pleasant, bright and homely environment for service users, staff and visitors to the home. Health and safety issues are addressed and the home is maintained to a good standard. The home is clean and fresh throughout. What has improved since the last inspection? Training has now been given to all staff on the protection of vulnerable adults to ensure that service users are protected from harm or abuse. Staff training has increased and all staff now receive a high level of training which is evidenced in their files. Staff recruitment has improved to ensure that all relevant checks are made to protect the service users. This is clearly recorded in the staff files. Regular supervision is given to all staff to ensure that a good level of care is given to service users. CARE HOMES FOR OLDER PEOPLE Norway Lodge Nursing Home 10 Reservoir Road Prenton Birkenhead Wirral CH42 8LJ Lead Inspector Jeanette Fielding Key Unannounced Inspection 3rd September 2008 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Norway Lodge Nursing Home DS0000020924.V368751.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Norway Lodge Nursing Home DS0000020924.V368751.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Norway Lodge Nursing Home Address 10 Reservoir Road Prenton Birkenhead Wirral CH42 8LJ 0151 608 8164 0151 608 8164 chrisaread@btconnect.com 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 Elizabeth Mary Coquelin Deanna Ann Holmes Care Home 29 Category(ies) of Old age, not falling within any other category registration, with number (29) of places Norway Lodge Nursing Home DS0000020924.V368751.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 29 beds nursing / 10 beds personal care in an overall total of 29. 2 named adults under 65 years of age within the overall total of 29. 1 named service user over 50 years old, within the overall number of 29 places. 15th June 2007 Date of last inspection Brief Description of the Service: Norway Lodge is a large detached property in the Prenton area of the Wirral. It has large car parking area to the front of the property with garden benches where the service user’s can sit. The home provides both nursing and personal support to older people. The accommodation is provided on three floors which are easily accessible by passenger lifts. On the ground floor there is a large lounge and dining room and some bedrooms. Accommodation is provided in both single and shared bedrooms and many of the bedrooms have a toilets ensuite. To the rear of the property there is a secluded garden, which is used frequently by the service users. It costs between £360 and £419.58 per week inclusive of the nursing element dependent on the level of care required. Norway Lodge Nursing Home DS0000020924.V368751.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that people who use the service experience good quality outcomes. This unannounced key inspection was undertaken in one day over a period of six hours. As part of the inspection process, all areas of the home were viewed including many of the service users bedrooms. Assessments and care plans were inspected together with staff records and certification to ensure that health and safety legislation was complied with. Observation of the interaction between staff and people who live at the home provided evidence of the actual care given. Discussion took place with the manager, care staff, service users and visitors to the home. A pre-inspection questionnaire was sent to the home to provide inspectors with information regarding staff, service users and the premises and was completed and returned in a timely manner. What the service does well: What has improved since the last inspection? What they could do better: The home should continue to develop and improve to provide a high level of care within a pleasant and homely environment. Norway Lodge Nursing Home DS0000020924.V368751.R01.S.doc Version 5.2 Page 6 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. Norway Lodge Nursing Home DS0000020924.V368751.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Norway Lodge Nursing Home DS0000020924.V368751.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A detailed pre-admission assessment is undertaken on all prospective service users to enable the home to identify the individual care needs necessary to provide the appropriate level of care. EVIDENCE: The home has prepared a detailed welcome pack for prospective service users. This includes the Service User Guide which gives full information regarding the services and facilities offered by the home. Additional copies of these are available from the home on request. Prospective service users, and their families, are invited to view the home and the rooms available and to meet with staff and other service users. Norway Lodge Nursing Home DS0000020924.V368751.R01.S.doc Version 5.2 Page 9 All prospective service users are assessed prior to their admission by the manager or one of the qualified nurses. This is to enable the home to identify the service users individual care needs and preferences. The pre-admission assessments of two recently admitted service users were inspected and were found to contain full details of the service users health, care and social needs and preferences. The form used for recording the information at the assessment has been reviewed and updated to allow full information regarding service users health, care and social needs to be identified. The assessment provides the home with information regarding any moving and handling or specialist equipment that may be necessary to meet the service users needs. The home does not offer intermediate care. Norway Lodge Nursing Home DS0000020924.V368751.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Detailed care plans provide staff with a good level of information to enable them to meet the service users care and social needs to promote good health. EVIDENCE: Detailed care plans are prepared for all service users following their admission to the home. A random selection of care plans were inspected. Care plans were found to be informative and provided staff with sufficient information to enable them to provide the appropriate level of care to the service users and to meet their individual preferences. The manager has reviewed all care plans which were seen to be greatly improved since the last inspection. Each plan is reviewed on a monthly basis or more frequently as needed and the manager audits the files regularly to ensure that standards are maintained. The plans include information regarding personal care, nutrition and specialist health care. Risk assessments are undertaken and risk management plans are put in Norway Lodge Nursing Home DS0000020924.V368751.R01.S.doc Version 5.2 Page 11 place to protect the service users. Wounds are clearly recorded, mapped and photographed to provide evidence of improvement or deterioration. The advice of the Tissue Viability Nurse Specialist is sought whenever necessary. Information for staff is recorded regarding moving and handling to protect both the service users and the staff, and the home provides appropriate moving and handling equipment. All staff have been given training in the use of this equipment. Other specialist healthcare professionals are contacted whenever necessary i.e. GP’s, dietician, speech and language therapists and the records are updated to reflect the recommendations of these specialists accordingly. Risk assessments are undertaken and risk management plans put in place to ensure that service users are protected from harm. Medications are dealt with in accordance with the home’s policy and inspection of the medications provided evidence that the procedure is followed by the staff. Medication Administration Record sheets were completed accurately and were found to be up to date. All medications are stored safely and the storage areas were clean and organised. The manager undertakes regular audits of the medications to ensure that staff follow the home’s policy and procedure. No unwanted or unnecessary medications are stored and arrangements are in place for the disposal of medications that are no longer required. Service users spoken to on the day of the site visit confirmed that the staff respected their privacy and dignity at all times. Personal and nursing care is given in service users own bedrooms or in the bathroom as appropriate. Norway Lodge Nursing Home DS0000020924.V368751.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home offers a high number of activities to provide service users with social interactions, entertainment and stimulation. EVIDENCE: Service users are asked on admission about their lifestyle, choice of foods, and choices and preferences of the social activities they would like to participate in. The home employs an activities co-ordinator who arranges and provides activities and social stimulation for the service users and a record of the activities that service users participate in is held. Service users confirmed that they enjoyed a high number of activities which includes bingo, reminiscence, newspapers, chair aerobics, movies, art and crafts, quizzes, puzzles, music and singing. Trips out are made available for those who wish to go. Clergy visit the home on a weekly basis and will provide communion for service users on request. Norway Lodge Nursing Home DS0000020924.V368751.R01.S.doc Version 5.2 Page 13 Visitors are welcomed at the home at any reasonable time of day and service users may meet with their visitors in the privacy of their bedroom or in one of the communal areas. It is appreciated by the home if visitors would avoid mealtimes as this occasionally results in service users rushing or leaving their meals to meet with their visitors. A choice of meal is offered at each mealtime and the menus provide evidence that a varied and balanced diet is provided. Service users are encouraged to take their meals in the dining room but can take them in the lounge or in their own bedroom on request. The dining tables are attractively laid and the meal served on the day of the visit looked and smelled appetising. The chef is qualified and uses fresh foods as much as possible, supplemented by frozen foods to enable a range of out of season foods to be offered. The kitchen was seen to be clean and organised and the chef confirmed that all necessary equipment was provided and in good working order. Special diets can be provided on the advice of the dietician, GP or on the service users request to meet health or cultural needs or individual preferences. Norway Lodge Nursing Home DS0000020924.V368751.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff have been given training on the protection of vulnerable adults to ensure that service users are protected from harm or abuse. EVIDENCE: The home has an informative and robust complaints procedure which is detailed in the statement of purpose and is also displayed on notice boards within the home. No complaints have been made by service users or relatives since the last inspection. Staff have been given training on the home’s whistle blowing policy to enable them to report concerns regarding poor practice. All staff have now been given training on the Protection of Vulnerable Adults to protect service users from harm or abuse. Staff spoken to during the inspection were able to demonstrate that they were aware of the different types of abuse and were knowledgeable of the action they should take in the event of abuse being suspected. Norway Lodge Nursing Home DS0000020924.V368751.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is decorated and furnished to a good standard and provides service users with a pleasant, comfortable and homely environment. EVIDENCE: The programme of redecoration and refurbishment of the home continues to take place. Since the last inspection, the lounge and dining room have been redecorated and provide service users with a pleasant environment. Pictures and ornaments help to provide a homely atmosphere. The home is decorated and furnished to a good standard. Maintenance issues are addressed as soon as they are identified and all staff hold responsibility for ensuring that health and safety issues are reported and Norway Lodge Nursing Home DS0000020924.V368751.R01.S.doc Version 5.2 Page 16 dealt with. Moving and handling equipment is provided together with bathing aids to assist service users who have mobility difficulties. Bedrooms are bright and welcoming and every effort has been made to assist service users to make their room homely. Service users and their families are encouraged to bring pictures, photographs and items of memorabilia. The garden provides seating and has trees, plants and shrubs. The garden is accessible to service users who are free to use this area at any time. All areas of the home were found to be well lit, tidy, clean and fresh and no unpleasant odours were evident. The home has recently purchased a carpet cleaning machine which has assisted the housekeeping staff in maintaining a high standard of cleanliness. Norway Lodge Nursing Home DS0000020924.V368751.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home employs a well trained staff team to provide care and support to the service users to ensure that their individual needs are met. EVIDENCE: The home employs a registered manager, qualified nurses, senior carers, carers, housekeeping, activities, catering, laundry, administration and maintenance staff to ensure the smooth running of the service. The staff rota provides evidence that sufficient nursing and care staff are on duty at all times to meet the needs of the service users. The home has a robust recruitment procedure and inspection of a selection of staff files provides evidence that the procedure is followed. All prospective staff are required to complete an application form prior to being called for interview. Records are held of the interview. Checks are made through the criminal records and protection of vulnerable adults bureau to ensure that service users are protected. Two references are taken and evidence of qualifications and training are required to be produced. The files inspected were found to contain full information as required. Norway Lodge Nursing Home DS0000020924.V368751.R01.S.doc Version 5.2 Page 18 A high level of staff training has been provided and 95 of the care staff now hold NVQ qualifications. All remaining care staff are now working towards this qualification. Recent training includes manual handling, protection of vulnerable adults, infection control, health and safety, nutrition, food hygiene, first aid and fire safety. Qualified nurses have undertaken additional training to update their knowledge and skills and this includes, PEG feeds, tissue viability and wound care. Supervision is given to all staff to give them the opportunity for staff to speak to the manager on an individual basis and for training needs to be identified. Detailed records of these are now held. Annual appraisals are currently being undertaken. Staff meetings provide a forum for staff to identify improvements they would like to be made and for the dissemination of information. Norway Lodge Nursing Home DS0000020924.V368751.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered manager is well supported by staff to ensure that service users are protected and provided with a quality lifestyle within a safe environment. EVIDENCE: The registered manager is a qualified nurse and holds an NVQ in management at level 4. She is supported by a strong and well trained staff team and by the owner who visits the home regularly. Staff spoke highly of the manager, her open approach and her enthusiasm to improve the service. Norway Lodge Nursing Home DS0000020924.V368751.R01.S.doc Version 5.2 Page 20 The records show that the home is run in the best interests of the service users. Service users are offered choices in all aspects of daily life and their individual preferences are respected and supported. The home holds only small amounts of service users’ money at the relatives’ request. Detailed records are held of all money held on service users behalf and receipts are held for all purchases made on their behalf. All money is securely held within the home. Questionnaires have been issued to service users, relatives and healthcare professionals to gather their views of the home. Health and safety issues are reviewed and dealt with as soon as they are identified to ensure the protection of service users, staff and visitors to the home. Housekeeping and laundry staff have full information regarding the products they use and of COSHH. All fire detection equipment is checked on a regular basis and are recorded appropriately. Safety certificates are in place to ensure that all equipment and facilities are safe. Certificates inspected were found to be in order and up to date. Norway Lodge Nursing Home DS0000020924.V368751.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 3 Norway Lodge Nursing Home DS0000020924.V368751.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Norway Lodge Nursing Home DS0000020924.V368751.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Regional Contact Team Unit 1, 3rd Floor Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries.northwest@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 Norway Lodge Nursing Home DS0000020924.V368751.R01.S.doc Version 5.2 Page 24 - 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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