Care Home: Norwood House

What the care home does well The home provides a good service, specialising in the care of those people who have a dementia. It is well decorated and kept clean. The needs of people living at the home are well assessed and care needed is written down in a plan for staff to follow. The manager consults with specialist health care professionals in order to offer the most appropriate care. The social and recreational needs of people are assessed and the home employs a person to carry our activities with groups and individuals. The home keeps people safe by training staff in all areas of care, assessing risks to people and good record keeping. There are enough staff to care for the people living at the home and they receive good support from their manager. What has improved since the last inspection? The way in which medication is handled has been improved. Assessments of risk in connection with falls, nutrition, pressure areas, moving and handling have improved. This ensures people are better protected from harm. The assessment process has improved to gain more relevant information about people`s care needs, so these needs may be met. Recruitment has improved, so that new staff all have CRB checks in place and written references on file. The home is also better staffed. This means people benefit from good staff support. The kitchen is improved with a more hygienic and smarter finish. What the care home could do better: The home could record the needs of people regarding their dementia and how these needs may be met in more detail, to improve the quality of care. An audit of loose medication should be carried out to make sure a running total is always available to protect people from errors arising from poor stock management. The manager has identified improvements through the quality assurance system which she is planning to put in place. These include reviewing activities to ensure that they are relevent to people`s interests and needs. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Norwood House 12 Westbourne Grove Scarborough North Yorkshire YO11 2DJ     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: Karen Ritson     Date: 0 6 0 1 2 0 0 9 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. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. 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 23 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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 23 Information about the care home Name of care home: Address: Norwood House 12 Westbourne Grove Scarborough North Yorkshire YO11 2DJ 01723360360 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Comfy Care Homes Ltd Name of registered manager (if applicable) Mrs Catherine Ellwood Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: Date of last inspection Brief description of the care home Norwood House is a large adapted and extended property situated in a residential area of the town. There are many local shops within walking distance including a Post Office. There is a regular bus service that provides transport to the town. The service provided is for personal care for up to 21 residents. People are accommodated by virtue of age or infirmity and who have failing mental health and suffer from varying degrees of dementia. Leisure and recreational activities are offered in-house through the services of a diversional therapist on three afternoons each week and by staff at other times. Accommodation is provided in single and shared bedrooms located on four floors together with suitable bathing and toilet facilities. Some bedrooms have en-suite facilities. There is a passenger lift to all floors. 0 Over 65 21 care home 21 Care Homes for Older People Page 4 of 23 Brief description of the care home A small garden area is available at the side of the building accessed by some steps. The main building has ramped access. The staff also offer day care to a maximum of five people each day. Adequate space, facilities and staffing have been provided to cope with the needs of day care users. Information about the services provided at Norwood House is given to people and their relatives in the form of a brochure. The most recent Commission for Social Care Inspection report is available in the home or individual copies are made available on request. Additional charges are made for hairdressing, chiropody, personal toiletries and newspapers. Care Homes for Older People Page 5 of 23 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 2 star. This means the people who use this service experience good quality outcomes. The inspection for this service took 12 hours. This includes time spent gathering information and examining documentation before and after an unannounced site visit and in writing the report. The site visit took place on 6th January between 09:30 and 14:00. Information for this inspection was gathered from the following: 1. A tour of the premises 2. Observations of care throughout the day of the site visit. 3. Speaking with people living at the home. 4. Speaking with staff on duty at the home. 5. Case tracking people on the day of the site visit. 6. Notifications sent to the Care Homes for Older People Page 6 of 23 commission from the home since the last inspection. 7. Examining policies, procedures and records kept at the home. 8. Examining information regarding the home on the file kept by CSCI. 9. Considering comments made by relatives, health care and social services staff. All key standards were looked at during this inspection. The manager was available throughout the day. 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 this report as recommendations -but only when it is considered that people who use services 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: 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 8 of 23 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 9 of 23 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 their care needs well assessed. Evidence: The home carries out an initial assessment of care needs prior to a person being admitted to the home. These include such areas as mobility, personal care needs, communication, mental capacity and any needs arising from dementia. The needs of the person due to dementia could be more detailed as this is a home specialising in care for this client group. This would help to focus care towards achieving the best quality of life for each person. However, daily routines and individual preferences are well captured and provide a good basis for the plan of care. The manager and staff were clearly knowledgable about the needs of peson in their care and could talk about each person in detail. This ensures that each person is well known to staff and that care needs may be met. Care Homes for Older People Page 10 of 23 Care Homes for Older People Page 11 of 23 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. People have their needs met and are protected by the safe handling of medication. Evidence: Each person has a care plan from the home and most have one from social services also. Specialist health care needs such as pressure areas, continence and district nursing needs are well recorded. The home also makes diary notes three times a day for each individual, where significant events and changes are recorded. GP and other health care visits are recorded separately, so that it is easy to monitor each persons need for and contact with health care workers. The home operates a Boots blister MDS system. Boots provide an external audit and when records were checked all recording was up to date and accurate. The manager provides an internal audit also. The home could provide a running total of medication which is not contained in the blister packs. An audit of loose medication remaining when new stocks arrive should be recorded so that an accurate stock total is achieved. People were seen being treated with respect by staff, and staff said they covered privacy and dignity in their training. Care Homes for Older People Page 12 of 23 Care Homes for Older People Page 13 of 23 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. People are enabled to follow their interests wherever possible. Visitors are made welcome and people benefit from a varied nutritious diet. Evidence: People living at the home have their interests recorded and the home provides entertainment and enables people to become involved in activities that suit them. The home carries out reminiscence quizzes, categories quizzes, sing alongs, aromatherapy, facial and massages, bean bag challenge, quoits and bowls. One person with sensory loss has had a special activity apron devised which provides touch stimulation as she does not have capacity to fully enjoy other activities on offer. The home employs an activities organiser who records individual involvement, preferences and the way people have responded to the activities on offer. The home had a Christmas pantomime and three residents visited the old time music hall, a carol service and for those who did not wish to go out, the home provided a carol service, readings and a Christmas party. Visitors are welcome at any time and several called during the inspection. People said they were always made to feel at home and were offered refreshments. Menus show a wide range of interesting options which are based on good nutrition. The midday meal was very well presented, good quality food with fresh Care Homes for Older People Page 14 of 23 Evidence: vegetables and was of a high standard. Care Homes for Older People Page 15 of 23 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. People are able to express their concerns, and have access to a robust, effective complaints procedure. People are protected from abuse. Evidence: The home has a complaints policy and procedure. People said they knew how to complain and who to approach. one person said: Go to main person and talk to them. Another said Go to office. Information on how to make a complaint is in the service users guide and people are encouraged to voice their concerns. This ensures that people are listened to and their concerns are acted upon. Abuse awareness training updates are planned for all staff in the coming month and staff have already received such training through induction and NVQ courses. A number of staff have also attended dementia awareness course which they said helped them to understand the ways in which people could suffer abuse particularly when they were not able to express their concerns. This ensures people are kept safe from harm. In a recent protection of vulnerable adults case at the home the manager had brought a matter to the attention of social services following the correct procedure. This resulted in a member of staff being suspended from caring duty. Although the findings of the investigation suggested this case could have been handled more quickly and efficiently the people living at the home were safeguarded. Care Homes for Older People Page 16 of 23 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 physical design and layout of the home encourages independence. The home is reasonably decorated. The laundry service is suitable for peoples needs and people are protected from risk of fire. Evidence: A risk assessment has been drawn up for a door from a lounge which leads onto the garden down a flight of steps. Staff said they were vigilant regarding this potential risk and people were always supervised whilst in this lounge. Although the home is an adapted house set out on several floors and therefore not ideal for people with a dementia, doors have picture signs to enable people with a memory difficulty to orientate themselves. Carpets are regularly cleaned to keep odour problems at bay. The home is decorated on a rolling programme and is clean and homely. The kitchen has been refurbished with easier to manage wipeable walls and stainless steel surfaces with a new non-slip floor. Outside lighting is improved and outside steps have been marked with luminous paint to enable people to leave the building safely in case of fire. The laundry facilities are sufficient for the needs of the people living at the home. Care Homes for Older People Page 17 of 23 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. Staff in the home are trained and in sufficient numbers to support the people who use the service, in line with their terms and conditions, and to support the smooth running of the service. Evidence: Staff are well recruited with CRB checks in place, POVA first where necessary and written references on file. Staff have received good training, with induction, foundation training and specialist dementia awareness training. Most have NVQ level 2 in care and several have NVQ level 3 also. This ensures staff have the skills to offer the correct care. A core of staff has worked at the home for a number of years providing consistency of care. There are sufficient staff on duty each shift to protect the welfare of people living at the home. Care Homes for Older People Page 18 of 23 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 management and administration of the home is based on openness and respect, the manager is competent and qualified to run the home. Quality assurance systems are effective and people are protected by safe working practices,good record keeping and risk assessments. Evidence: The manager has the Registered Managers Award, and has a nursing qualification. She consults with professionals with specialist knowledge about the needs of people who have a dementia. She demonstrates a sound understanding of staff management and person centred care. Staff said the manager was approachable and encouraged them to consult her if they had anything they wished to discuss. On said She is very approachable and I could go to her if there was a problem. Another said. We get along mostly although there are bound to be difficult times. The manager carries out her own monthly audits and a quality assurance system is in place where the views of those using the service and others are sought with the results compiled into a report Care Homes for Older People Page 19 of 23 Evidence: which is fed back at meetings. Improvements to the service are planned following this. The home does not handle any personal allowances. The home protects the welfare of people living at the home through training of staff in foundation level care such as moving and handling, first aid, fire safety and infection control. People are protected by risk assessment of safe working practices. Gas safety and electrical safety certificates are up to date. This ensures the safety of those living at the home. Care Homes for Older People Page 20 of 23 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 21 of 23 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 Assessments should contain detailed information about needs particular to dementia for those people with a dementia in order to ensure the care offered maximises quality of life. The home should consider introducing an audit of loose medication to give accurate stock totals across all medication kept by the home. 2 9 Care Homes for Older People Page 22 of 23 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 © (2009) 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. Care Homes for Older People Page 23 of 23 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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