Inspection on 11/07/05 for Newton Hall Care Home

This inspection was carried out on 11th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Newton Hall Care Home 08/05/08

Newton Hall Care Home 11/07/07

Newton Hall Care Home 06/09/06

Newton Hall Care Home 25/11/05

Newton Hall Care Home 15/12/04

Newton Hall Care Home 18/08/04

Newton Hall Care Home 26/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Newton Hall Care Home Kingsley Road Frodsham Cheshire WA6 6YA Lead Inspector Judith Morton Unannounced 11th July 2005 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 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. Newton Hall Care Home F51 F01 S18745 Newton Hall V227175 110705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Newton Hall Care Home Address Kingsley Road Frodsham Cheshire WA6 6YA 01928 739270 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Kingsview Homes Limited Mrs Sarah Kaye Care Home 36 Category(ies) of OP Old age (36) registration, with number of places Newton Hall Care Home F51 F01 S18745 Newton Hall V227175 110705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 The total number of service users must not exceed 36 2 No more than 36 service users in the category OP may be in receipt of personal care only Date of last inspection 15 December 2004 Brief Description of the Service: Newton Hall is a care home for up to 36 older people. It does not provide nursing care. It is a two storey detached property its own grounds on the outskirts of Frodsham, on the edge of open countryside. Frodsham has a railway station which is on the main Chester to Manchester line, and bus services. Residents’ bedrooms are on both floors and there is a passenger lift and staircase between the floors. There are 28 single rooms and 11 of these have en-suite facilities. There are 5 rooms for 2 people sharing although one of these is being used as a single room at the moment. Four of these rooms have en-suites. There are 5 shared bathrooms and toilets and two of these have been adapted for more dependent residents to use more easily. There are two lounges and a dining room. There is also a large hallway/ reception area that people can sit in. The gardens are at the side and front of the house and there is car parking space at the front. Newton Hall Care Home F51 F01 S18745 Newton Hall V227175 110705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place from 7.40am until 1.45pm. This enabled the inspector to meet the night staff and sit in on the morning handover. Four members of staff were spoken with and 5 of the residents. Five care files were reviewed along with other relevant documentation. What the service does well: What has improved since the last inspection? 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. Newton Hall Care Home F51 F01 S18745 Newton Hall V227175 110705 Stage 4.doc Version 1.30 Page 6 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 Standards Statutory Requirements Identified During the Inspection Newton Hall Care Home F51 F01 S18745 Newton Hall V227175 110705 Stage 4.doc Version 1.30 Page 7 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 4 & 5 The information available about the home is detailed enough so that residents and their families know what it provides. The home’s staff gather thorough information about a resident’s care needs before they move in so that they and their families know their needs can be met at the home. EVIDENCE: There was a service user’s guide available in each of the bedrooms plus a statement of purpose for the home in the reception hall. The documents had last been reviewed in April 2004. The majority of information required is included in the document but there has since been a new manager and her name and details, ie qualifications, experience etc needed adding. See recommendation 1 There were no contracts available on the files as the manager was in the process of updating them. See requirement 1 All of the residents had an assessment on their file, which gave information about their care needs from which their care plan was designed. Newton Hall Care Home F51 F01 S18745 Newton Hall V227175 110705 Stage 4.doc Version 1.30 Page 8 There was information in each file about the resident’s preferences such as what time they liked to get up in the morning, what their likes and dislike were, so staff could help them continue their preferred lifestyle. The manager said that the home welcomed visits from prospective residents and their families and would also encourage them to call unannounced on at least one occasion so they could see what the home was like before deciding to move in. New residents would be able to stay for a trial period of six weeks, after which a review would take place, giving them an opportunity to change their mind. The home does not provide intermediate care so standard 6 above does not apply. Newton Hall Care Home F51 F01 S18745 Newton Hall V227175 110705 Stage 4.doc Version 1.30 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10 &11 All aspects of the residents needs are being met at the home. Their care needs and how to meet them are clearly recorded so that even new staff would be able to know what they had to do to meet residents’ needs. The manager checks the medication regularly and has organised the medication trolley and room very well so that residents received all the medication as prescribed. EVIDENCE: Five of the residents’ files were checked as part of the inspection. Since the current manager has been in post, the care plans had been reviewed and new documentation added to make sure all aspects of a resident’s care would be covered. Particular attention had been taken on ensuring that problems with the care plans identified at the last inspection have been resolved and residents/their relatives had signed their care plans to show they were aware of them and agreed with them. For example, the care file for one resident who has difficulty communicating verbally includes a clear description of her facial expressions or movements so that staff can interpret them and provide the help she needs. The manager is also introducing the use of photographs on a communication board so that the resident can communicate her wishes more clearly. Newton Hall Care Home F51 F01 S18745 Newton Hall V227175 110705 Stage 4.doc Version 1.30 Page 10 Each item of care had a monthly review sheet attached and these were being carried out accordingly. There were records of past and current health problems and evidence of input from health care practitioners was recorded on the ‘visits from other professionals’ form. Risk assessments included nutrition, use of metal bedsides, falls and skin/pressure sores. These were being completed only if required. The falls risk assessment should state previous history of falls and should also reflect that the resident has not had any falls since living at the home so that it is clear that management of that specific risk is adequate. See recommendation 2 The continence management plan should cover both day and night so that night staff are aware of what is required of them also. See recommendation 3 Since the last inspection the medication storage, recording and administration has been reviewed. The medication room is very well organised and tidy with everything in place on the appropriately labelled shelves. The medication records were all accurate and medication was recorded when returned to the pharmacy. Each resident’s photograph was attached to their medication sheet to aid identification. Staff were seen to address the residents in a polite and respectful manner. All of the residents spoken with spoke highly of the staff. The residents’ wishes in the event of their death had been recorded on their individual files. This was observed to be used effectively as a gentleman passed away unexpectedly during the inspection and his family were contacted immediately. The staff were able to take appropriate action based on the information in the file and the manager was sensitive that the staff were also upset by this unexpected death. Newton Hall Care Home F51 F01 S18745 Newton Hall V227175 110705 Stage 4.doc Version 1.30 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 & 15 Much effort has been put into the varied daily activities programme to make sure that there is something of interest to all residents so they keep active and stimulated. The atmosphere in the home is lively, happy and relaxed with plenty of opportunities for the residents to make choices and so influence the way the home is run. EVIDENCE: Newton Hall Care Home F51 F01 S18745 Newton Hall V227175 110705 Stage 4.doc Version 1.30 Page 12 An activities co-ordinator is employed at the home to arrange day trips, entertainers, craft projects, games and quizzes to ensure that the residents have activities available to them to break their day and provide stimulation. There was a weekly programme of activities displayed in the entrance hall for the residents. The co-ordinator was arranging for photographs of the various activities to be put up to help residents choose what they would like to do. The co-ordinator uses the information in the files about the residents’ likes and dislikes, including their hobbies and interests, to plan the activities programme. The care home has a minibus, shared with two other homes within the care home group, to take residents out. A small number of residents from one of the other homes were due to visit Newton Hall for lunch. The cub scouts, Brownies and other community groups also visit from time to time. A mobile library visits every month and there is an extensive video library at the home. The spiritual needs of service users were met. Residents’ families and friends can visit at any reasonable time and some residents go out with their relatives for short trips. There was plenty of evidence of the residents making choices and decisions about things that affect them. These include whether or not to join in activities, meals and what time they went to bed or got up in the morning. Residents’ meetings had been re-introduced and questionnaires for residents and relatives about their views on all aspects of care at the home had been completed. The main meal is served at midday and there is usually a hot and cold choice in the evening. There is also mid morning and afternoon coffee/tea and biscuits. The menu of the day, including alternatives, is displayed in the reception area of the home for residents and their relatives to see. There is also a file containing photographs of each of the meals offered to help residents choose what they would like to eat. Records are maintained of what service users have eaten so that staff can make sure that all residents are receiving a varied, nutritious diet, and the cook uses mainly fresh produce. The new dining room provides a pleasant environment for residents to enjoy their meals in. Newton Hall Care Home F51 F01 S18745 Newton Hall V227175 110705 Stage 4.doc Version 1.30 Page 13 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18 There is clear information so that residents and their relatives know how to make complaints and who to make them to. Although there are policies and procedures to protect residents from abuse, staff have not received training on awareness of abuse of vulnerable people so that they can fully protect residents from harm and poor practice. EVIDENCE: The complaints procedure for the home was displayed in the reception area and was also included in the statement of purpose and service user guide. There were policies on adult protection and on whistle blowing but not all staff had received training on awareness of abuse of vulnerable people. All staff need to have this training so that they can protect the residents from any possible abuse and poor practice. See requirement 2 Newton Hall Care Home F51 F01 S18745 Newton Hall V227175 110705 Stage 4.doc Version 1.30 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 23, 24,25 & 26 The home is very well maintained and soft furnishings are of a very high standard, providing a safe, comfortable environment for residents. EVIDENCE: The home is decorated and furnished to a very high standard with regular maintenance checks being carried out. Every area of the home was very clean and there were no offensive odours or signs of sprays being used to mask them. Newton Hall Care Home F51 F01 S18745 Newton Hall V227175 110705 Stage 4.doc Version 1.30 Page 15 There are 5 bathrooms, 2 of which are specifically used for residents who need help from to bathe. They have specialist baths and there is a mobile hoist available. One of the bathrooms doubles up as a hairdressing salon. There are grab rails in toilets/bathrooms and along corridors. Call bells with cords that can be reached easily are installed in each room. When the one in the dining room was tested, three of the staff responded immediately. There is a passenger lift to the first floor and ramps at the front of the home for easier access. People who use wheelchairs can reach the garden via one of the doors at the back of the house. Pressure-relieving equipment is provided for those residents at risk of developing pressure sores. The resident’s rooms were furnished to a high standard and had been decorated with personal items, including pictures, ornaments and small items of furniture, that residents had brought with them when they moved in. The day of the inspection was hot and sunny and it was noticeably hot in the bedrooms on the first floor. Consideration should be given to providing ways of alleviating the heat in all the rooms on the first floor in such weather. See recommendation 4 Some progress has been made in improving the areas outside the house but the driveway up to the house had potholes that could be a hazard for anybody walking up it. Action must be taken to repair the driveway. See requirement 3 Newton Hall Care Home F51 F01 S18745 Newton Hall V227175 110705 Stage 4.doc Version 1.30 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 &30 The staff spoken with and observed throughout the inspection had a good understanding of the residents’ needs and how they were to be met so residents received all the care they needed. Thorough checks are carried out on all new staff so that residents are protected from possible harm. EVIDENCE: On the day of the inspection there were more than enough staff on duty to manage the care needs of the residents. The manager was not included in the rota to provide care, and the junior care staff were supported by the deputy manager and a senior member of the care team. The staff had all received induction training, which is linked to an accredited NVQ training programme. New staff are given a two-day introduction to the care home and are also given an induction booklet which includes the philosophy of care of the home and care practices. Policies and procedures were available to the staff members to read. Staff had also completed required training and 60 of them had NVQ level2 and above. Two existing staff files were viewed together with an additional two files of new staff that were due to start work at the home the following week. The recruitment procedure had been followed in each instance and the manager had telephoned to confirm the references provided. Additional training is required in adult abuse awareness (See previous requirement made on standard 18). Newton Hall Care Home F51 F01 S18745 Newton Hall V227175 110705 Stage 4.doc Version 1.30 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33, 36 &38 The new manager has made changes so the home is run in the best interests of the residents. The manager is approachable and responsive so that residents feel they can raise any issues of concern. Health and safety is well managed so that residents and staff are safe. EVIDENCE: The manager was fairly new to the home and has applied to become registered with The Commission for Social Care Inspection. The staff spoken with say they know what is expected of them by the direction she gives. The changes that the manager has already made have been beneficial in ensuring that the residents’ needs, wishes, likes and dislikes are being met. The service users and their relatives have been consulted via a questionnaire about the care given at the home and resident’s meetings have been re-introduced. Some, but not all, staff have received formal supervision. Newton Hall Care Home F51 F01 S18745 Newton Hall V227175 110705 Stage 4.doc Version 1.30 Page 18 The manager may consider developing a questionnaire for the staff team also so that they can have a say and contribute to the changes being made within the home. Routine safety checks and maintenance were being made in respect of gas, electricity, the lift, hoists, fire alarm system and self-closing devices on doors. Newton Hall Care Home F51 F01 S18745 Newton Hall V227175 110705 Stage 4.doc Version 1.30 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 2 3 3 4 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 4 10 3 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 3 3 3 3 3 3 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 Standard No 16 17 18 Score 3 x 2 3 3 3 x x 3 x 3 Newton Hall Care Home F51 F01 S18745 Newton Hall V227175 110705 Stage 4.doc Version 1.30 Page 20 no Are there any outstanding requirements from the last inspection? 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. 1. Standard 2 Regulation 5 Requirement Contracts of the terms and conditions of living in the home must be kept in the residents care files. All staff should receive training on adult abuse awareness. The driveway requires attention to make it safe for anyone walking up to the home. Timescale for action 01/10/05 2. 3. 4. 5. 18 19 13 23 01/10/05 01/10/05 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. 2. 3. 4. Refer to Standard 1 7 7 24 Good Practice Recommendations The statement of purpose and service user guide should be updated to include the managers details and qualifications. The falls assessment should include the persons history of falls at home and clearly indicate how many falls have since living at the home. The continence plan for those residents who require them should extend to both day and night time plans. Consideration should be given to methods of keeping rooms on the first floor cool during hot weather. F51 F01 S18745 Newton Hall V227175 110705 Stage 4.doc Version 1.30 Page 21 Newton Hall Care Home 5. 6. 36 All staff should receive formal, recorded supervision at least 6 times a year. Newton Hall Care Home F51 F01 S18745 Newton Hall V227175 110705 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Unit D, Off Rudheath Way Gadbrook Park Northwich Cheshire CW9 7LT National Enquiry Line: 0845 015 0120 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. 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