Enter and view: Norfolk House Residential Care Home

Healthwatch Wigan conducted an enter and view visit to Norfolk House Residential Care Home on 12th January 2015. The purpose of the visits was for Healthwatch Wirral to seek, identify and disseminate good practice wherever possible. This was a planned unannounced visit, partly prompted by a discussion with the Wigan Council Quality Assurance Team, to assess the services provided to residents around mealtime at both homes. The report focuses on the observations of the environment and meal time at Norfolk House Residential Care Home. The team engaged with the duty manager, staff member and four patients on the day of their visit.

Unfortunately Healthwatch Wigan arrived too late to observe the meal at dinner. The kitchen was dated, but serviceable and appeared to be clean and tidy. There was an abundant supply of cake and biscuit snacks in a cupboard. Although unable to observe the mealtime, Healthwatch Wigan did speak to staff and details of those conversations can be found in the full report. There were no relatives present during the visit to Norfolk House. Generally, the residents Healthwatch Wigan saw, and those residents who were able to communicate either in words or body-language appeared to be content. The residents appeared clean, gentlemen shaved, the ladies hair brushed, and dressed in their own clothes. The clothes were clean and coordinated.

Recommendations:

The lighting at the front of the home should be addressed to improve security and safety.

We didn’t see a name plate at the entrance, identifying the home, so this might be something to consider.

Catering staff should be appointed, or an extra member of staff should be added to the rota to enable consistency at mealtimes.

Fruit should be available, in view, so that residents can see it and be able to access it easily.

Resources to help residents choose or decide what they would like to eat for example photos of the different meals.

A survey to be undertaken for residents, family & friends around food.

Weighing chair for residents who can’t weight bear.

Decor needs updating in all areas, especially hall, stairs and landing, but the lounge seemed bright and more modern.

Tidy the office space.

More rigorous security when allowing access to visitors i.e. signing in/out book.

Brighter, more personalised bedrooms if residents want them.

The response from the provider:

Office: We do apologise for the state of the office at the time of your visit. The daily pressures of work, deliveries, emergencies, reviewing of care plans and other dailyduties within a care home sometimes makes it not so easy maintaining a tidy office at all times. But we would work towards this.

Lighting at the front: There is flood lighting at the front of the home which lights up the whole car park. We suspect that on the day of your visit, there was a malfunctioning or it might have been switched off.

Staffing issues: Considering the size of the home, where 18 residents are cared for, the number of staff on duty as reflected are sufficient to attend to the needs of residents. The number of staff required on the floor at weekends is 3 staff at all times which is adequate. Out of the 3 staff, there is always a designated person who is in chargeal though it might not have been reflected on the rota. We would from now, include thison the rota. There is always a member of management on call to assist in emergencies at any given time. Rotas are made based on assessments of the needs of residents.

Fruit in view: Although it would be good to keep fruit in view of residents, this might be an issue because we have a mixed clientele of EMI and residential, some who pick on things indiscriminately. This might be difficult to control, or keep an eye on which may lead to health and safety issues. Fruits are kept in view in the kitchen.

Resources to aid choice of food: At the moment, menu choices are displayed on a white board in the dining room from which residents make a choice of food they prefer before meals are served. However, we want to introduce images of a variety of food on flash cards which will aid residents' choice of food. We are also at the point of revising our 12 menu. We provide alternative choices to suit each resident's taste whenever it's necessary. Residents have always enjoyed their meals.

Food Survey by families: This is already in place. A questionnaire survey is regularly sent out to families and friends who also eat with us and residents at parties and special events like birthdays. Results collected from the food surveys are on file and contain very good

comments. Nothing negative has been mentioned. Our next family and friends residence meeting is on the 9th of February.

Weighing chair: Weighing chair may not be necessary because a different method is used where biceps are measured. This is a method which is acceptable by the dietitian and CQC.

Decor: There were plans already made to renew the decor on some parts of the building. For instance, we are repainting the hall way, the entrance and other identified areas of the building. We carry out audits on every aspect of the home and from time to time redo our decor based on our findings where and when necessary. We have recently redecorated the big dining room and the small dining room, the conservatory and some bedrooms.

Security: We have a signing in book but we will as suggested, instruct staff to reinforce security procedures by ensuring that all visitors sign in and out. We have coded doors which disallows any entry or exit without staff assistance.

Brighter and more personalised bedrooms: We encourage residents to bring in personal items they value and would love to use as decoration and as memorable pieces. We also involve residents in the process of redecorating by finding out their choice of colour or taste which we try to meet.