Care Home: The Normanhurst Nursing Home

Similar services:

• The Shelley
• Springfield House
• Sutton Lodge Nursing Home
• St Helier`s Residential Hotel
• St Joseph`s
• Ridgemount
• Wingham Court
• Old Hastings House

What the care home does well Normanhurst Nursing Home is a friendly and welcoming environment with comfortable accommodation to meet the individual needs of the service users. The home develops individual plans of care for each service user focussing on nursing needs. There is a good staff development programme in place with all staff completing the required training within the first 6 months of employment. 7 staff are currently working towards National Vocational Qualifications (NVQ). The home maintains required records in an organised manner and all health and safety, recruitment and financial documents were examined and up to date. There is a good programme of activities and recreation available for service users. The individual wishes of residents are respected and service users stated that they are treated well and with dignity by a caring staff team. What has improved since the last inspection? Three requirements were made at the previous inspection regarding medication issues, all of which have been suitable addressed. The home is currently undergoing some redecoration and hallways and communal areas of the home. It was reported that maintenance issues are dealt with promptly. What the care home could do better: 4 recommendations have been made as a result of this inspection process. The home should consider developing care plans to improve the emphasis on social and recreational needs. Also, where an individual suffers with confusion, short-term memory loss and associated signs of dementia clear plans of care should be developed. Similarly staff should be provided with some additional training focussing on dementia care and awareness. The responsible individual could to establish the quality assurance processes that have been developed including regular monthly monitoring visits and reports and feedback from questionnaires summarised within an annual quality report. The home should also review policies and procedures, in particular those concerned with access to confidential information for service users and nominated representatives in accordance with the Data Protection Act 1998. The manager also needs to progress through the registered manager process. CARE HOMES FOR OLDER PEOPLE The Normanhurst Nursing Home Brassey Road Bexhill On Sea East Sussex TN40 1LD Lead Inspector Joseph Harris Unannounced Inspection 29th February 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 The Normanhurst Nursing Home DS0000014019.V357934.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. The Normanhurst Nursing Home DS0000014019.V357934.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Normanhurst Nursing Home Address Brassey Road Bexhill On Sea East Sussex TN40 1LD 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) 01424-217577 01424 734650 normanhurst@btinternet.com normanhurst@btinternet.com Mr D C Lewis Mr R Hebbes Vacant Care Home 31 Category(ies) of Old age, not falling within any other category registration, with number (31) of places The Normanhurst Nursing Home DS0000014019.V357934.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. That only older people requiring nursing care are to be accommodated Service users should be aged sixty five (65) years or over on admission That no more that thirty one (31) service users are to be accommodated 9th January 2007 Date of last inspection Brief Description of the Service: The Normanhurst Nursing Home is situated on Bexhill seafront and is interconnected with the Normanhurst Annexe and the Normanhurst Residential Care Home. The three homes are independently registered with reference to the category of the residents catered for, although are under the same ownership. They run separately from each other apart from the laundry and catering, which are completed centrally within the residential Care Home. The home comprises of 29 single and 2 double bedrooms over three floors. There is lift shaft available to accommodate those with reduced mobility and/or wheelchair users. There is a lounge for the residents to use on the ground floor, which opens onto the garden at the rear of the home where seating is provided. A dining room is also available on the ground floor. The home is close to local shops with rail and bus services within easy walking distance. Nursing staff and carers are on duty 24 hours a day. The Normanhurst Nursing Home is registered to provide general nursing care to residents who are privately funded and also those who are funded by social services. The home’s fees as of 6th December 2006 range between £550.00 £620.00 per person per week dependent upon needs. Additional costs are charged for hairdressing (from £3.50), chiropody (£10), outings, toiletries and newspapers (£ variable). Prospective residents/representatives are provided with written information regarding the services and facilities provided at the home. Copies of these documents are kept on display in the reception area alongside a copy of the most recent inspection report. The Normanhurst Nursing Home DS0000014019.V357934.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection process culminated in a site visit to the home on 29th February 2008. The site visit commenced at approximately 10am and concluded at 4.30pm, lasting for around 6.5 hours. During the course of the visit a tour of the premises was undertaken and discussions were held with the registered manager, staff members and service users. A range of documentation was examined relating to the residents, staff, medication, health and safety and the day-to-day running of the home. What the service does well: What has improved since the last inspection? Three requirements were made at the previous inspection regarding medication issues, all of which have been suitable addressed. The home is currently undergoing some redecoration and hallways and communal areas of the home. It was reported that maintenance issues are dealt with promptly. The Normanhurst Nursing Home DS0000014019.V357934.R01.S.doc Version 5.2 Page 6 What they could do better: 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. The Normanhurst Nursing Home DS0000014019.V357934.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 The Normanhurst Nursing Home DS0000014019.V357934.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): 3 and 6. Quality in this outcome area is good. Good systems are in place to ensure that only residents whose needs can be met are admitted to the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Many of the current residents have been admitted from the adjoining care home. 3 service user pre-admission assessments were examined, which demonstrated that all residents have a thorough assessment of need undertaken by the Manager of the home prior to admission. The assessment covers all key areas of need, preferences and risk. This is used in conjunction with care management assessments where required. Some residents spoken to recalled that they had the opportunity to meet with the Manager and care staff The Normanhurst Nursing Home DS0000014019.V357934.R01.S.doc Version 5.2 Page 9 of the home prior to moving in. They also stated that they had visited the service before choosing whether to move in. Intermediate care is not provided. The Normanhurst Nursing Home DS0000014019.V357934.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. Individual plans of care are in place. Medication and healthcare needs met. Service users are treated with dignity and respect. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three individual service user plans were examined all of which are completed in sufficient detail and regularly reviewed. The focus of the plans is on nursing needs and some further development could be considered surrounding social and recreational needs, mental health and dementia care issues. These topics are addressed, but could be developed in greater detail with the focus on individual preferences and needs. Refer to recommendation 1. Appropriate risk assessments are developed and reviewed regularly. There is a key worker system in place. The Normanhurst Nursing Home DS0000014019.V357934.R01.S.doc Version 5.2 Page 11 Healthcare needs are appropriately recorded and guidance given to staff. A range of assessment tools are in use covering areas such as nutrition, manual handling and pressure area care. There is evidence to support the fact that healthcare issues are referred appropriately to specialist care when required. There is a Registered Nurse on duty at all times. All service users are registered with a local GP. It was stated by the nurse in charge that there can sometimes by a delay of a few days for residents new to the area, but on-call medical support and emergency services are available in this period. The home addresses identified healthcare needs through the care planning system including issues such as catheterisation, continence, Parkinson’s disease and diabetes in suitable detail with specialist input sought as required. The medication systems in the home were examined and are managed safely. There are suitable policies and procedures in place. Medication is only administered by Registered Nurses; a number of care workers have also received medication training. Administration records were up to date including receipt and disposal of medications. Controlled drugs are stored appropriately and records maintained. There is a dedicated, secure medication room maintained at an appropriate temperature with adequate working space. Issues identified at the previous inspection have been suitably resolved. A number of service users were spoken to throughout the course of the day all of whom spoke highly of the service and the attitude and support of the care staff. One person said, “It’s lovely here, the carers are lovely and we can have a laugh and joke.” Residents indicated that care staff are respectful of their needs and wishes and it was evident that some positive relationships have been developed. Staff were knowledgeable about the needs and preferences of individual residents. The Normanhurst Nursing Home DS0000014019.V357934.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. Service users have a lifestyle that suits there needs and wishes including contact with family and friends. A healthy balanced diet is provided. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home offers a reasonable range of activities both organised and informal to suit the needs of the residents. There are regular weekly activities like bingo, hairdressing, film nights and sing-alongs. Additional activities are available in the adjoining residential care home should residents wish to participate. Outside entertainers visit regularly. The religious observances of service users are respected. Some residents choose to spend their time in their bedrooms and others socialise in the main lounge. The wishes of each person on any given day are respected. Friends and family are welcomed into the room and people who use the service are able to choose who they wish to see. There is adequate space to enable The Normanhurst Nursing Home DS0000014019.V357934.R01.S.doc Version 5.2 Page 13 people to meet in private should they wish to do so. It was reported that staff attempt to foster positive relationships with visitors, which was confirmed by residents spoken to. It was not possible to talk to any visitors on the day of the site visit. People who use the service are able to exercise choice and control over their lives through different means. Residents spoke about the fact that staff in the home respect their wishes regarding all aspects of their daily lives including times for getting up and going to bed and choice of food amongst other things. There is information available regarding advocacy and self-help groups. The vast majority of residents were complimentary about the quality of food. One person said, “They cook me whatever I want, I have a different option every day.” One gentleman said that he didn’t like the cabbage served on the day of the visit and staff said they would let the cook know. Meals are prepared in the adjoining home and transported on a heated trolley. No service users chose to have lunch in the dining room preferring it in their rooms or at armchair tables. Staff were observed to spend time with residents providing support with feeding as required. The kitchens weren’t inspected, but it was reported that they meet the requirements of the environmental health department. The Normanhurst Nursing Home DS0000014019.V357934.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. Resident’s views are listened to and acted upon. Service users are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a clear complaints process in place with the intention to deal with all issues on an informal level if possible. There is a complaints book in place, which contains details of complaints and concerns raised by residents and evidence of how the home had responded. Service users stated that they felt able to make their views known and were confident that they would be acted upon. 1 concern was raised with the Commission for Social Care Inspection over the past year, but the individual did not want this opened as a formal complaint. The issues of concern raised were inspected during this inspection process. They were discussed with the nurse-in-charge. No recommendations or requirements have been made in relation to this issue. The home has policies and procedures relating to safeguarding against abuse and staff demonstrated a good understanding of this topic. All staff are provided with training in Adult protection protocols within the first 6 months of The Normanhurst Nursing Home DS0000014019.V357934.R01.S.doc Version 5.2 Page 15 employment and the home has a trained trainer in this subject. One Safeguarding Vulnerable Adults Alert has been investigated in the past 12 months. The outcome of this has raised some procedural issues that are being addressed. The Normanhurst Nursing Home DS0000014019.V357934.R01.S.doc Version 5.2 Page 16 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 and 26. Quality in this outcome area is good. The environment of the home is suitable for the individual and collective needs of the service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home comprises of 29 single rooms and two double rooms set out over three floors. There is a main lounge and a separate dining room on the ground floor and access to a well-maintained garden to the rear. A large number of the bedrooms were viewed all of which provide suitable space and show evidence of being personalised. Cushioned vinyl flooring has been laid in a number of the bedrooms for the purposes of cleanliness and hygiene, but these do not The Normanhurst Nursing Home DS0000014019.V357934.R01.S.doc Version 5.2 Page 17 detract significantly from the homeliness of the rooms. Both double rooms are currently being used for single occupancy. The office and medication rooms are located centrally in the building and there are sufficient numbers of toilets and bath/shower rooms on each floor. All hazardous (COSHH) products are stored securely and there are suitable aids and equipment to meet the needs of the resident group including mobile hoists and wheelchairs, etc. It was reported that the home meets with the requirements of the fire and environmental health departments. There are sluice facilities available on each floor and adequate laundry facilities. There is a servery/small kitchen in the building, but the main meals are prepared in the adjoining home. The Normanhurst Nursing Home DS0000014019.V357934.R01.S.doc Version 5.2 Page 18 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. There are suitable numbers of appropriately qualified staff on duty at all times. The home’s recruitment processes are robust. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home operates with at least one qualified registered nurse on duty at all times supported by a team of care workers. Additional staff are employed including a maintenance man, housekeepers and administrative staff. Residents commented on the fact that staff respond promptly to call bells and generally have time to talk. Excluding the Registered Nurses, 3 of the current care staff have achieved a National Vocational Qualifications level 2 or above and an additional 7 care staff are currently working towards these awards. There is an up to date training matrix that provides evidence that staff training in all mandatory topics and additional service specific subjects is provided to staff within the first 6 months of employment. The home uses the Common Induction Standards as part of the introduction for new employees. The nurseThe Normanhurst Nursing Home DS0000014019.V357934.R01.S.doc Version 5.2 Page 19 in-charge stated that there are opportunities for the qualified nurse to update their training needs including training on topics such as catheter care, diabetes, IV procedures and bereavement. However it is advised that further training regarding dementia care is considered. Refer to recommendation 2. Three staff personnel files were examined, which contained all the required documentation. Some advice was given regarding obtaining employment histories and that the application form could be more specific in requesting details about all past employment and reasons for leaving. Staff are recruited following a satisfactory POVA checks and subject to an appropriate CRB disclosure. The Normanhurst Nursing Home DS0000014019.V357934.R01.S.doc Version 5.2 Page 20 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, 37 and 38. Quality in this outcome area is good. The home is well managed and in the best interests of service users. Quality assurance processes can be strengthened. The financial interests of service are safeguarded and health and safety issues addressed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The current manager has been in post for approximately 6 months since the previous Registered Manager left the employment of the home. She is currently in the process of applying for Registered Manager status and is The Normanhurst Nursing Home DS0000014019.V357934.R01.S.doc Version 5.2 Page 21 completing her NVQ 4/Registered Manager’s Award. The manager was not at the home on the day of the site visit. It was reported that she has a number of years of experience in the healthcare field and is a Registered Nurse. The home has developed quality assurance processes, which have not been completed for a number of months. It is expected that the Responsible Individual conducts a monthly monitoring visit looking at quality issues such as environment, food, records, medication and canvassing staff and service user views. A number of quality review templates have been developed but are infrequently completed. A series of questionnaires have been sent out in the past to relatives, professionals and service users, but it was reported that there was a poor response to this. It is advised that this exercise is carried out again and the results of the surveys collated into an annual quality report with an action plan for any issues noted. Refer to recommendation 3. It was evident that steps have been taken to address quality issues in the home. Some redecoration was on-going in the home and service users confirmed that suggestions are taken on board. The home does not take on an appointee role in respect of any service user’s finances, but a safekeeping facility is securely provided. Written records are maintained of all incoming and outgoing transaction and counter-signed by the resident/relative involved. The home has a range of policies and procedures in place that would, in part, benefit from updating. In particular clear guidance in respect of access to information for service users and their appointed representatives should be reviewed and developed. Refer to recommendation 4. A range of health and safety documents and records were viewed including fire logs, service checks and certificates. All information was found to be up to date and well organised. Safe systems of practice are in place. The Normanhurst Nursing Home DS0000014019.V357934.R01.S.doc Version 5.2 Page 22 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X 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 3 X 3 X 3 X 3 3 The Normanhurst Nursing Home DS0000014019.V357934.R01.S.doc Version 5.2 Page 23 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. 1. Refer to Standard OP7 Good Practice Recommendations Service user plans could be developed to include social and recreational needs. Other specific needs surrounding mental health issues could be individualised in greater depth. To provide training for staff in dementia care and awareness. Quality assurance processes should be strengthened to include monthly monitoring reports and an annual quality report based on feedback from service user, relatives, professionals and staff. To review and update policies and procedures, in particular the policy regarding access to records and information in accordance with the Data Protection Act 1998. 2. 3. OP30 OP33 4. OP37 The Normanhurst Nursing Home DS0000014019.V357934.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone, Kent ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Normanhurst Nursing Home DS0000014019.V357934.R01.S.doc Version 5.2 Page 25 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!