Inspection on 25/11/05 for Newton Hall Care Home

This inspection was carried out on 25th November 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

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 11/07/05

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 Announced Inspection 25th November 2005 09:30 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 Newton Hall Care Home DS0000018745.V264758.R01.S.doc Version 5.0 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. Newton Hall Care Home DS0000018745.V264758.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Newton Hall Care Home Address Kingsley Road Frodsham Cheshire WA6 6YA 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) 01928 739270 9999 Kingsview Homes Limited Care Home 34 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (24) of places Newton Hall Care Home DS0000018745.V264758.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of thirty four service users to include: Up to 24 service users in the category of OP (Old age not falling within any other category) Up top 10 service users in the category of DE(E) (Dementia over the age of 65) The registered provider must, at all times, employ a suitably qualfiied and experienced manager who is registered with the Commission for Social Care Inspection. Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any gudinace which may be isued through the Commission for Social Care Inspection. 11/07/05 2. 3. Date of last inspection Brief Description of the Service: Newton Hall is a care home for up to 34 older people who do not require nursing care. Up to 10 of the residents may have a diagnosis of dementia. It is a detached property in it’s own grounds on the outskirts of Frodsham but on the edge of open countryside. Resident’s bedrooms are located on the ground and first floor although the rooms on the first floor are reserved for residents who have been diagnosed with dementia. There is a passenger lift and staircase to the first floor. The doors from the first floor corridor to the stairs are opened through use of a keypad and there is a buzzer that sounds to alert staff that the door has been opened or has not closed properly. There is a large dining room and two lounges on the ground floor, with further seating in the large entrance hall On the first floor there is a smaller lounge and separate dining room, primarily for use of the residents who have dementia. Newton Hall Care Home DS0000018745.V264758.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 8 hours. It covered the standards that had not been looked at on the previous inspection. A number of the standards were checked again in view of the change in service that Newton Hall is now registered to provide. Two residents’ files and two staff files were checked. Eight of the residents were spoken with and four members of staff. The inspection also included a tour of the building, a shared meal with the residents and a direct observation of the deputy manager administering the medication. The manager was present for the first two hours of the inspection and the deputy manager was available throughout and for feedback. 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 DS0000018745.V264758.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Newton Hall Care Home DS0000018745.V264758.R01.S.doc Version 5.0 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 the following standard(s): 1, 2, 3 & 5 The information available to residents and their families and the knowledge of the content of their contract, would ensure that they are aware of what the service offers and whether it could meet their needs. EVIDENCE: The statement of purpose and service user guide had been updated to include the qualifications of the manager and the changes in the service that Newton Hall now offers. Newton Hall can now provide a service to up to ten people who have been diagnosed with dementia. All of the residents now have a contract on their file. These have been updated to reflect any change in room allocation or charges. The resident or their representative had signed the contracts. The manager said that she continues to assess prospective residents before they move in so that she is sure that the service can meet their needs. This has become more essential as she needs to know that the home is able to meet the needs of the residents who have a diagnosis of dementia without impacting on those residents who do not. Newton Hall Care Home DS0000018745.V264758.R01.S.doc Version 5.0 Page 8 Any prospective residents and their families are welcome to visit the home prior to any decision being made. Newton Hall Care Home DS0000018745.V264758.R01.S.doc Version 5.0 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 the following standard(s): 7, 9 & 10 The residents’ care needs, and how to meet them, are clearly recorded so that staff know what they have to do to meet residents’ needs. The staff follow the medicine administration and recording procedures correctly so that residents receive their medicines as prescribed. EVIDENCE: Two of the newer residents’ files were checked and one for a longer term resident. The files were well organised and contained all of the information that staff would need to provide care to the resident. There was evidence of the resident, or their family’s agreement to the care plan as the resident or their representative had signed them. The care plans were being reviewed and signed monthly and any changes were clearly identified. The information in the daily records was now more detailed so that it showed what care had been given to the resident that day. However, the views or comments of the resident had not always been included, although staff were clearly overheard asking residents during the day, how they were, had they enjoyed lunch and had they enjoyed the activity. (See recommendation 1) Newton Hall Care Home DS0000018745.V264758.R01.S.doc Version 5.0 Page 10 Risk assessments were present on the files and were being reviewed monthly. There was evidence on the files of visits from health professionals and two of the residents were due to attend the local dentist the following day. The deputy manager was observed administering residents’ medicines during the inspection. The procedure was followed thoroughly, with the medication trolley being locked each time the deputy had to leave it unattended. The recordings made by the deputy on the medication administration record (MAR) sheets were accurate. It was noticed however, that some of the residents were prescribed medication, as and when required (PRN). If they said they did not need it nothing was being written on the sheet to indicate that they had been asked but refused. After discussion with the deputy manager it was agreed that the code ‘F’ would be used to show it had been refused. (See recommendation 2) The residents’ and relatives’ questionnaires that had been returned to Newton Hall, showed that the staff were always polite and helpful. Relatives had commented, “Staff are friendly and appropriate, knocking on doors and offering visitors a cup of tea as well as the resident.” Another said, “Staff are very professional and caring. They always have a smile when you talk to them and give the home a pleasant atmosphere.” The residents’ comments in their questionnaires were very similar. The staff were seen and overheard talking politely with the residents, asking if they needed help and not rushing them to complete a task. One resident was seen being accompanied back to the privacy of her bedroom to meet with her GP. Newton Hall Care Home DS0000018745.V264758.R01.S.doc Version 5.0 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 the following standard(s): 12 & 15 The residents are kept stimulated and occupied by attending the activities offered by Newton Hall. However, if the activities are not to their taste, there is the possibility of residents not taking part in any activities. EVIDENCE: The activities co-ordinator organises a number of activities each week and there is a copy of the timetable for these activities displayed on the notice board in the main hallway. One resident spoken with said that she found the notice board too cluttered and suggested that the timetable “stand alone” from the other information so that it is clear. (See recommendation 3) One resident spoken with, who likes oil painting, expressed dissatisfaction in that she required additional lighting to assist her to see her work when she is painting. Her friends and another resident join her at Newton Hall each Saturday and they paint in the dining room. This was discussed with the deputy manager and she agreed that a down lighter could be provided but the group would have to sit at the top of the dining room as that is where sockets are available. (See recommendation 4) Newton Hall Care Home DS0000018745.V264758.R01.S.doc Version 5.0 Page 12 The same resident also explained that she and another resident went out to a club each Tuesday afternoon. As there was only one driver for the mini-bus, which is used by three homes, there are times when he cannot take them or if he does he sometimes cannot collect them afterwards. The deputy manager explained that the residents receive free taxi vouchers and have been asked to use these at times when the driver is unavailable but have declined to do so. The deputy manager said she has requested that Newton Hall can book the mini bus for a Tuesday afternoon. On the afternoon of the inspection the residents were asked if they wished to join in cake decorating, which some did. The invitation and whether the resident participated or not was not recorded anywhere. It would benefit the home if they recorded which residents were joining in and in which activities. (See recommendation 5) There was an outside entertainer booked to visit Newton Hall two days after the inspection. The booking of the outside entertainers has to be completed well in advance and this was evidenced in the events diary. The meal was served in the dining room and consisted of soup, a main course and sweet. On the whole the lunchtime was pleasant, the staff were discreet in their service and assistance to residents and it was a good social occasion for many of the residents. However, on occasion the residents on one particular table became argumentative and were indifferent to staff efforts to calm the situation. This meant that for short periods the atmosphere in the dining room was tense. The manager should re-assess the situation and give residents the option to change their seating place if they wish. (See recommendation 6) The food served was well presented, hot and tasty. There had been a choice of main meal and sweet given to each of the residents. Newton Hall Care Home DS0000018745.V264758.R01.S.doc Version 5.0 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 the following standard(s): 18 All staff have now attended awareness training on protection from abuse so that the residents can be protected from abuse, harm and poor practice. EVIDENCE: Since the last inspection 5 members of staff per month are now attending adult abuse awareness training. This includes, night staff, housekeeping and kitchen staff. Newton Hall Care Home DS0000018745.V264758.R01.S.doc Version 5.0 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 the following standard(s): 19, 20 & 26 The home continues to offer a comfortable environment for residents and the garden area will provide them with safe outdoor facilities when the weather improves. However, there are a number of problems that need to be dealt with in order to maintain the safety of residents at all times. EVIDENCE: There have been a number of environmental changes to the home and its surroundings in order to ensure the safety of all of the residents, paying particular attention to the specific needs of those who have dementia and may have lost their awareness of danger. The changes have not affected the quality of furnishings or the appearance of the home in any way. The residents already living at Newton Hall were informed of the possibility of residents who have dementia living with them and their views were sought. There are a number of doors installed which rely on key code access and a buzzer is fitted to each so that staff are aware of when they have been opened and whether they have been left open for people to wander through. Newton Hall Care Home DS0000018745.V264758.R01.S.doc Version 5.0 Page 15 Many of the residents were spoken with regarding their views on the introduction to the home of residents who also have dementia. Most people said they were fine with it as they weren’t even sure who those residents were. During the inspection it was clear that all of the residents interacted well with each other and those residents who had dementia had been assessed as being able to fully integrate within the home. One resident, however, commented that another resident would walk into her room from time to time and sit in her chair if she was on the bed. The manager should re-assess the resident and devise strategies to minimise disruption to other residents. (See recommendation 6) There were a small number of issues identified that would become more apparent once the upstairs dining and living room is operational. Currently all of the residents, with and without dementia, are fully integrated within the main areas of the building. The wall lights in the upstairs dining room and lounge are too low, as the rooms have been converted from bedrooms. These need to be raised to a safe height. The panes of glass in the windows in both of these rooms do not have a kite mark indicating that they are safety glass. The lower panes of glass must be made safe for residents. There was also a cracked pane of glass, which needs replacing in the dining room. The taps on the sinks in some bedrooms do not have any indication on them to identify hot and cold. This should be rectified to ensure the safety of the residents. Some progress has been made to improve the driveway up to the house but this could still pose a hazard for anybody walking up it. Action must be taken to repair the driveway. (See requirement 1) The garden area had been completed and there was a new enclosed lawned area with a path around. There was also a patio area and seating will be provided for the summer. The home was clean and there were no offensive odours anywhere in the building. Newton Hall Care Home DS0000018745.V264758.R01.S.doc Version 5.0 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 The staffing numbers mean that the current residents’ needs are met and constant review of the changing needs of residents would ensure that this is always the case. EVIDENCE: There were sufficient numbers of staff on duty to meet the needs of the residents, including kitchen staff, housekeeping staff, care staff and management. An activities co-ordinator is also employed at the home. Two new staff had commenced that day, one housekeeper and one kitchen assistant. Each were seen being taken around the home with a member of their team and shown the fire escapes and informed of the drill. The staff were using a check list to make sure they covered everything that a new worker would need to know immediately. One resident spoken with said that she felt there were not always enough staff on duty, particularly in the mornings. She said she would be assisted to sit by the sink for a wash but the staff would not always respond immediately when she rang the buzzer so she would be left waiting for assistance to move away from the sink and get dressed. Newton Hall Care Home DS0000018745.V264758.R01.S.doc Version 5.0 Page 17 The rotas seen showed that there were an adequate number of staff on duty each day to meet the current number and needs of the residents. The manager was regularly reviewing the resident’s needs, particularly of those who had a deteriorating condition such as dementia, and said she would ensure that the staffing levels were based on resident’s needs, not numbers, so there would be enough staff to meet those needs at all times. Newton Hall Care Home DS0000018745.V264758.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34, 35 & 37 The residents benefit from the professional and helpful approach of the staff. The comments made by family and visitors of the residents reflect the efforts made by the staff to ensure a warm and homely atmosphere. EVIDENCE: The manager has applied for registration with the Commission for Social Care Inspection and will complete the process by the end of December 2005. The staff spoke highly of the manager and felt that she was very clear and worked for the benefit of both them and the residents. They said they found her to be approachable and this was evident during the inspection when a number of staff spoke with her. The residents too were very aware of who she was and the position she holds within the home. They felt comfortable in approaching her, asking her questions or for assistance. Newton Hall Care Home DS0000018745.V264758.R01.S.doc Version 5.0 Page 19 The staff were all very aware of the individual residents needs and how best to approach these in order that they be met. The manager has ensured that staff training is a high priority, particularly in relation to the needs of people with a diagnosis of dementia, which the home has recently been registered for. Training records were seen and included fire safety, adult abuse awareness, continence management, dementia training, and mental health medication. The manager has recently completed the annual appraisal for each member of staff and said that from this training needs had been identified. Residents’ finances are managed by their relatives or a representative, some having power of attorney. Some of the residents spoken with were unhappy that their newspaper bill was often only given to them when the amount was £70.00 and over. They felt that this was a large sum of money having to be withdrawn at once and also found it more difficult to keep track of when they had and had not had a newspaper. The deputy manager explained that the invoice for their paper bill comes from head office and that this subject had been brought up in the past with them. The manager should negotiate with head office to ensure that the invoice for the paper bill is sent to each resident on a monthly basis. (See recommendation 7) The manager said that the policies and procedures are regularly reviewed and updated by the area manager and proprietor. When they are received by the home the manager said she informs staff of the changes during staff meetings and will also discuss them during supervision, as she wants all staff to be familiar with them and recognise the need for policies and procedures. Newton Hall Care Home DS0000018745.V264758.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 2 3 X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X 3 3 X 3 X Newton Hall Care Home DS0000018745.V264758.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? yes 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 OP19 Regulation 23 • • • Requirement The wall lights in the upstairs lounge and dining room must be re-sited at a safe level. The cracked window in the dining room must be replaced. The lower panes of glass in the windows in the upstairs dining room and lounge must be made safe. The taps in the residents’ bedrooms must have hot and cold indicators on. The driveway requires repair. Timescale for action 31/03/06 • • 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 Refer to Standard OP7 OP9 Good Practice Recommendations The views and comments of the residents should, where possible, be sought and included in the daily records. The code ‘F’ should be used to show that PRN medication has been offered and refused. DS0000018745.V264758.R01.S.doc Version 5.0 Page 22 Newton Hall Care Home 3 4 5 6 7 OP12 OP12 OP12 OP19 OP35 The programme of activities on offer should be displayed more clearly. A down lighter should be provided to assist the residents when they are doing artwork. A record of activities offered to residents and attended by the residents should be made. Residents with dementia should be continually assessed to ensure any specific behaviour would not impact on other residents. The residents should receive their newspaper bill from head office on a monthly basis. Newton Hall Care Home DS0000018745.V264758.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich 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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