Inspection on 15/11/05 for Newcroft

This inspection was carried out on 15th 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 no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Newcroft 23/04/07

Newcroft 03/02/06

Newcroft 28/03/05

Newcroft 28/07/04

Newcroft 03/02/04

Newcroft 26/08/03

Newcroft 12/02/03

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

CARE HOME ADULTS 18-65 Newcroft 1 & 2 Todenham Road Moreton-in-marsh Glos GL56 9NJ Lead Inspector Mr Paul Chapman Announced Inspection 09:00 15 November 2005 th Newcroft DS0000016508.V251680.R01.S.doc Version 5.0 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 Newcroft DS0000016508.V251680.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 Adults 18-65. 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. Newcroft DS0000016508.V251680.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Newcroft Address 1 & 2 Todenham Road Moreton-in-marsh Glos GL56 9NJ 01608 652886 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) Home Farm Trust Mrs Denise Mumford Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Newcroft DS0000016508.V251680.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 1 LD(E) place for named service user within total registered numbers. This condition to be removed once the service user is no longer accommodated. 1 LD/DE place for named service user within total registered numbers. This condition to be removed once the service user is no longer accommodated. 01/03/05 Date of last inspection Brief Description of the Service: Newcroft is two semi-detached properties offering accommodation for seven service users, three in one house, and four in the other. The houses were purpose built for this service user group. All of the service users have had comprehensive assessments completed, and these are supported by care plans to meet needs. The home is well decorated, and personalised with service users processions. The service users lead active lives attending work placements, day centres and being involved in various social activities. The home is staffed twenty-four hours a day, seven days a week. Newcroft DS0000016508.V251680.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was completed over a period of 6 hours on a day in November. The manager was present throughout the inspection. During the day the inspector spoke to all of the service users living at the home. The inspector thoroughly examined the care files for three of the service users to ensure that their needs were being met and that a safe environment was being maintained. Staff records were also examined. The inspector wishes to thank the manager and service users for their time and cooperation during the inspection. What the service does well: Comments from the service users about activities, staff and the home were very positive. The home provides a high quality service that is led by the needs of the service users. The Person Centred plans developed with the service users are well designed making good use of pictures and plain English. Evidence in records showed that service users goals were being achieved, or progress towards them was evident. All of the service users lead active lifestyles and staff support them to do this where it is required. The premises are well maintained and has a maintenance programme that is implemented by HFT. Staff complete training in mandatory topics of food hygiene, first aid, etc. They also complete training to meet the specific needs of the service users living in the home. The majority of the staff have completed their NVQ’s. The regular auditing of the policies, procedures and practice ensures that the quality of the service is maintained and improved where appropriate. Newcroft DS0000016508.V251680.R01.S.doc Version 5.0 Page 6 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. Newcroft DS0000016508.V251680.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Newcroft DS0000016508.V251680.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: None of these standards were inspected on this occasion. Newcroft DS0000016508.V251680.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 Person Centred Plans are developed with or by the service users and identify their hopes, wishes and how they will be met. Comments from the service users about the home confirmed they were satisfied with the service provided at the home. Potential risks to the service users are identified and minimised. Some additional assessments are required to meet the standard fully. EVIDENCE: The home use the Person Centred Plan (PCP) approach to identify and meet the service users needs. The inspector examined three of the service user’s PCPs in detail and these were seen to be comprehensive with varying degrees of service user involvement. One the service users had written their own PCP with the support of the staff. When the inspector arrived at the home the majority of the service users were preparing to leave for their daytime activities but were able to spare the inspector some time to discuss what they thought about living at the home. All of the comments were really positive about activities, staff and the home. Newcroft DS0000016508.V251680.R01.S.doc Version 5.0 Page 10 Service users have decided that they will only have resident meetings when they wish, and not on a regular basis. Minutes of previous meetings were displayed on the notice board in symbols, pictures and writing and showed that service users were able to make their views heard. Risk assessments were comprehensive in the files examined. One shortfall identified related to a service user who suffers from “jerks” which can cause them to fall, or injury themselves. It is recommended that the manager completes a risk assessment to identify potential risks to this person’s safety. Another service user walks to work from the day service they attend. The manager stated that the day service had completed a risk assessment for this activity. The inspector recommends that the manager obtain a copy of this document to ensure that it is comprehensive and minimises the risks to the service user appropriately. If the manager does not feel that it is appropriate they must review it. Newcroft DS0000016508.V251680.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 16, 17 The service provides people with varied, fulfilling lifestyles to meet their needs The food provided at the home is varied, healthy and chosen by the service users. EVIDENCE: Newcroft DS0000016508.V251680.R01.S.doc Version 5.0 Page 12 All of the service users have a home management day where they are supported by staff to complete cleaning tasks, go shopping or take part in other activities on a one to one basis. All of the service users attend Day services, work placements or College. The majority of the service users attend the local HFT Day Services. The horticultural part of this service backs on to the house and the Inspector was able to see what the service users had achieved in these sessions. From the horticulture sessions that the service users are involved in they produce jam, chutney and other preserves, that are then sold. One of the service users works at a local pub. Service users receive cooking/catering lessons in the home from a tutor at the local college who visits weekly. These lessons have been on going on for a quite a while now and have developed over that time. The manager explained that the service users now choose the recipe they wish to cook, go and buy the ingredients from the supermarket and then cook the meal with the tutor. This shows real progress. Service users stated that they enjoyed living in Moreton in Marsh and make use local facilities including the Bank, shops, Post Office, Pub, Library, swimming pool, gym, local church and the take-away. The home has access to a vehicle that enables service users to access facilities in the surrounding areas. The staffing rota that was seen confirmed that the team are flexible about the times they work, enabling service users to take part in activities. All of the service users have been on holiday this year and spoke to the Inspector about how much they enjoyed them. Another service user spoke about playing golf on a regular basis during the summer. Some of the other leisure activities that service users take part in are going to concerts, barbeques, eating out, visiting Pubs and various day trips. The daily routines in the house are led by peoples’ needs and the service users and their records confirmed this. The service users are encouraged to take responsibility for the daily routines within the house and working together to share tasks. The service users are expected to answer the front door. The manager confirmed that the menus are chosen by the service users and the menus confirmed that the meals were offered three times a day. Service users are offered nutritious, varied and balanced meals and staff support the service users to be involved in the preparation of food. One service user is on a diet and it is recommended that the manager makes an appointment with a dietician to ensure the person’s needs are being met. Service users confirmed Newcroft DS0000016508.V251680.R01.S.doc Version 5.0 Page 13 that the food and meals at the home were nice. The menu for the day is displayed on the notice board in the home in pictures and word. If service users do not want what is on the menu they are able to choose something else. When service users are completing their home management day, they are usually responsible for cooking the evening meal for the other service users. Newcroft DS0000016508.V251680.R01.S.doc Version 5.0 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 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, 19 Where staff are unable to meet a service user’s needs other professionals are used appropriately. Guidelines for staff to provide service users with personal care need to be written to ensure a consistent approach by staff. EVIDENCE: The home has appointment sheets that the service users take to appointments with Doctors, Dentists and other professionals. Staff complete a section that identifies the ailment/problem, the Doctor/Dentist, etc complete another section with their diagnosis and treatment. This enables service users to attend appointments independently where possible and allows staff to keep comprehensive records of appointments with other professionals. The majority of the service users at the home do not require support with their personal care. One of the service user’s files examined had a record of the personal care they received but no guidelines to identify the actual input required by the staff. A requirement of this report is that guidelines are developed to ensure that staff provide personal care consistently to service users. These guidelines will also ensure that staff can monitor progress or deterioration in service users skills. Newcroft DS0000016508.V251680.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 The complaints procedure enables the service users to make a complaint if they are not satisfied with the service they are receiving. The last complaint to be made was well managed. EVIDENCE: The home has complaints procedure that has been developed in a format that enables the service users to make a complaint easily. Since the previous inspection one complaint has been made. The inspector and manager discussed the issue and its management. The complaint was brought to a satisfactory conclusion for the complainant and the whole process was completed within 7 days. Staff have not completed any recent training in the protection and the prevention from abuse and later in this report it is recommended that this is addressed. Newcroft DS0000016508.V251680.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29, 30 The environment meets the current needs of the service users. The home is personalised by the people who live there. EVIDENCE: Since the previous inspection the rear garden has decreased in size due to a new housing development at the bottom of the garden. Some of the garden is a little overgrown in places and would benefit from some attention. The manager stated that the service users are not interested in gardening. The inspector completed a tour of the property with the manager and two of the service users showed him their bedrooms. Whilst completing the tour of the property the manager explained that they have requested that the provider complete a number of maintenance tasks. These include: • Replacing the carpets in the two lounges • House one – new flooring covering to be fitted in the dining room. • House two – Kitchen to be decorated. Maintenance issues identified at the previous inspection have been addressed. Newcroft DS0000016508.V251680.R01.S.doc Version 5.0 Page 17 The communal areas of the home are personalised with the service users interests. Examples of this were a jigsaw puzzle that was being completed, pictures of places and posters of pop groups. Service users’ bedrooms were seen to be decorated to a high standard and personalised with their possessions. One service user who has moved in since the previous inspection showed the inspector their bedroom. He commented that he really liked it. All of the toilets and bathrooms were seen to be clean, hygienic and well decorated. Notice boards around the home showed examples of picture job rotas for the service users, a picture staff rota, menus and shopping rota. This is a really good practice and enables the service users to understand what maybe complex documents easily. Newcroft DS0000016508.V251680.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35 Risks to the service users are minimised by thorough recruitment procedures. Staff training includes mandatory courses as well as needs led training and this ensures that service users needs are met and a safe environment is maintained. EVIDENCE: HFT provide all of the staff with job descriptions and contracts. In addition to this staff within the home have different responsibilities. Currently there is 6 staff with 1 vacancy. All but 2 of the staff have completed an NVQ in care or management. A new member of staff is currently completing their induction and will start their Learning Disability Award Framework after this. Staff files were examined and seen to be in order containing all the documents required by the regulations. Staff training records were seen. The new staff member had completed the majority of the courses required as part of their induction and was booked to Newcroft DS0000016508.V251680.R01.S.doc Version 5.0 Page 19 complete the other mandatory training courses as required. All of the staff have completed training in dementia and a course in risk assessment. Two requirements of this report are that staff complete training in protection/prevention from abuse and a manual handling course. Newcroft DS0000016508.V251680.R01.S.doc Version 5.0 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39, 41, 42 Regular audits/reviews of the service ensure that the service continues to provide a high quality service that meets the needs of the people living there. Risks to the service users are minimised by comprehensive health and safety procedures which are followed by the staff team. EVIDENCE: The home’s insurance and registration certificates were appropriately displayed. The HFT assistant regional director was due to complete a Quality Assurance audit in the week following this inspection. The information received by the manager showed that the audit was going to focus on auditing service users’ finances, staff welfare, Person Centred Plans, staff practices and previous audit findings. The CSCI consider this is good practice as it supports the continuous improvement of the service provided in the home. Newcroft DS0000016508.V251680.R01.S.doc Version 5.0 Page 21 Examination of records relating to the health and safety showed that a food safety officer had visited the home this year and was satisfied that the environment and practices were safe. In addition to this HFT’s health and safety officer had completed an audit in June this year where the home scored 97 . A fire risk assessment needs to be completed and the manager stated that the health and safety officer was writing this document for the home. Fire equipment is regularly checked by the staff and qualified engineers as prescribed by the regulations and staff training is completed appropriately. COSHH sheets have been developed by the health and safety officer and cover a comprehensive list of products and identify the level of risk poised by each product. Portable Appliance Testing had not been completed but the manager explained that this had been arranged and would be completed in the near future. The manager has written a contingency plan for the home that identifies what steps will be taken if electricity and heating fail this winter. Newcroft DS0000016508.V251680.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 2 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Newcroft Score 3 2 X X Standard No 37 38 39 40 41 42 43 Score X X 3 X 3 3 X DS0000016508.V251680.R01.S.doc Version 5.0 Page 23 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 YA19 Regulation 12(2, 4), 15 Requirement The manager must ensure that where a service user requires staff support to maintain their personal care guidelines are available detailing the service users preferences. Staff must complete training in abuse awareness and manual handling. Timescale for action 24/02/06 2. YA35 13(6) 26/05/06 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 YA9 YA17 Good Practice Recommendations The manager should complete the risk assessments identified in the body of the text The manager should seek advise about a service users diet. Newcroft DS0000016508.V251680.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB 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. Extracts may not be used or reproduced without the express permission of CSCI Newcroft DS0000016508.V251680.R01.S.doc Version 5.0 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. 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