Inspection on 23/01/06 for Newent House

This inspection was carried out on 23rd January 2006.

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

Newent House 25/09/08

Newent House 26/10/07

Newent House 24/08/06

Newent House 22/06/05

Newent House 23/03/05

Newent House 18/06/04

Newent House 05/02/03

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Newent House 8 - 10 Browns Road Surbiton Surrey KT5 8SP Lead Inspector Diane Thackrah Unannounced Inspection 23rd January 2006 11:15 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 Newent House DS0000034120.V279662.R01.S.doc Version 5.1 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. Newent House DS0000034120.V279662.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Newent House Address 8 - 10 Browns Road Surbiton Surrey KT5 8SP 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) 020 8547 6311 020 8399 9002 Community Care Services Michael Twigg Care Home 38 Category(ies) of Old age, not falling within any other category registration, with number (38) of places Newent House DS0000034120.V279662.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22 June 2005 Brief Description of the Service: Newent House is part of a large resource centre for older people, owned and managered by the Royal Borough of Kingston Upon Thames. The centre provides residentail care and a day service for older people living in the community. The residential service provides accomodations for up to 38 older people. The accomodation is arranged over three floors. There are a number of communal lounges, a conservatory, licenced bar and dining room. Each sevice user has a single bedroom. There are kitchenettes on the first and second floors. Bathrooms and toilets are available on each floor. There is a well maintained garden. Newent House DS0000034120.V279662.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on 23rd January 2006 between 11.15 and 15.00. Care records were examined and a partial tour of the premises took place. A number of service users were spoken with, as were two visitors, staff members and the Deputy Manager. What the service does well: What has improved since the last inspection? There have been a number of environmental improvements since the last inspection. The bar area has been redecorated, as have a number of bedrooms. Newent House DS0000034120.V279662.R01.S.doc Version 5.1 Page 6 There has been continued staff training and development. A Requirement made at the last inspection of the home regarding the need for moving and handling risk assessments to be in place at the point of a service user moving into the home has been met. Staff recruitment files have been made available for inspection, and found to be generally in good order. 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. Newent House DS0000034120.V279662.R01.S.doc Version 5.1 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 Newent House DS0000034120.V279662.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 4 and 5. There are good arrangements for ensuring that service users have their assessed needs met. There are good opportunities for service users to visit the home before making a decision to live there which allows them to maintain control over were they live. EVIDENCE: There was very positive feedback from service users about the home from all service users spoken with, and also two visitors. Service user’s comments included “The home is excellent” “We are very well cared for” “There is always staff members about to help you” “We are very lucky to live here, the staff members are very kind” A visitor said “I have no problems at all with the home” and a visiting health care professional said that the home was well run with a caring staff team. A staff handover session was observed and it was evident that staff members are professional and well aware of individual service users’ needs. Newent House DS0000034120.V279662.R01.S.doc Version 5.1 Page 9 Service users are enabled to visit the home and have a look around before they make a decision to live there. There was one service user on a trial visit to the home on the day of this inspection. This person reported that they were happy with what they had seen of the home and were looking forward to sampling a meal. Another service user said that they had been given an opportunity to look around the home with a social worker before they made a decision to move in. This service user said, “I was given a lovely meal and had a look around, but didn’t get to see the bedroom that I would be given” Newent House DS0000034120.V279662.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 and 9. There are, in general, good arrangements for planning for care, however, there is a need to review care regularly to ensure that the individual health, personal and social care needs of service users continue to be well met. Medication is, in general handled safely; however there has been some ongoing poor recording in relation to medication which has potential for placing the well being of service users at risk. EVIDENCE: There was feedback from a number of service users spoken with that staff members were well able to meet their needs. Individual service users have a plan detailing how staff members should address their needs. Service User Plans for two service users were examined. These set out in detail how staff would meet all aspects of their needs. There were daily observation notes that indicated that staff members provided care in accordance with Service User Plans. Service User Plans detailed how staff members should observe dignity and privacy and promote independence. The last inspection of the home highlighted that one service user did not have a moving and handling risk assessment in place. Moving and handling risk assessments were documented Newent House DS0000034120.V279662.R01.S.doc Version 5.1 Page 11 in each of these service users personal records. There were no records detailing that one Service User Plan had been reviewed. It is necessary to review care at least monthly and maintain a record of this. A Requirement has been made in relation to this issue. The service user, or their representative had signed neither of the Service User Plans examined. The Deputy Manager said that service users are consulted with during the care planning process. However, it is strongly recommended that that service users, or their representative be given further opportunities for signing their Service User Plan. The health needs of service users are taken seriously. All service users are registered with a local General Practitioner and some service users said that a General Practitioner was always made available if they requested this. There is a medical room were service users can see the General Practitioner in private. There were a number of health care professionals visiting service users in the home during this inspection, including a General Practitioner, Physiotherapist and District Nurse. A health care professional spoken with spoke positively about the home and said that staff members consulted with them about service users health care needs. One service user said that staff members had arranged a hospital appointment for them and that a staff member would be accompanying them to the hospital. Medication handling was examined at the last inspection of the home and found, in general, to be good. The Deputy Manager said that all senior care staff members have recently undertaken refresher training in the safe handling of medication. Medication Administration Records and medication for three service users were examined. These were found to be in good order for two service users. One Medication Administration Record however contained gaps in recording and staff members had failed to sign to indicate whether medication had been administered. The last inspection of the home highlighted that some Medication Administration Records had not been completed accurately and action must be taken to ensure that all medication is handled safely. A repeat Requirement is made regarding the need for Medication Administration Records to be completed accurately. Newent House DS0000034120.V279662.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Social activities are well organised and provide stimulation for service users. Service users are given opportunities for exercising personal choice and therefore retain some control over their lives. Meals are nutritious and balanced and offer a healthy and varied diet for service users. EVIDENCE: There is a varied activities programme, based on the likes and dislikes of individual service users. The home employs an activities coordinator to consult with service users about how they would like to spend their leisure time. Service users spoken with said that they were happy with the activities provided and that they only joined in if they wanted to. One service user said that they were going out shopping with their key working on the day of this inspection. Another service user said that a group of singers would be visiting the home the day following the inspection and that they were looking forward to this. There have been recent visits to the London Eye and to the theatre and some service users have been involved in quiz nights. There is a bar in the home which a number of service users were noted to be enjoying during this inspection. There are monthly church services held and some service users receive weekly communion in the home. Newent House DS0000034120.V279662.R01.S.doc Version 5.1 Page 13 It was evident that the home has a positive approach to visiting and visits are encouraged. Two service users were able to enjoy a meal in private with their visitor during this inspection. Three service users spoken with said that they were consulted with and that their views were respected. Monthly service user meetings occur and these are well attended. One service user said, “Meals are very good” There was a menu displayed in the dining room and this detailed that there is a choice available. A meal of pizza and chips was served during this inspection. Staff members were available at lunchtime and were noted to provide appropriate support, and to be aware of the individual dietary preferences of service users. There is a pleasant dining area and tables were set attractively. The kitchen was well organised, clean and hygienic. Some specialist diets are catered for. Newent House DS0000034120.V279662.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. There is a system in place for the effective handling of complaints and service users and their relatives are encouraged to raise any concerns they have. Service users therefore know that their concerns will be acted upon. Arrangements are in place for handling allegations and instances of abuse. This ensures that service users will be protected from harm. EVIDENCE: Information is made available in the Service User Guide about how a compliant, concern or suggestion should be made, and how this will be handled. This information also includes details about how a complaint may be made to the Commission for Social Care Inspection. No complaints have been made since the last inspection of the home. Staff members spoken with confirmed that they had undergone training in the protection of vulnerable adults and the home has a copy of the Royal Borough of Kingston Upon Thames vulnerable adult protection procedures. Newent House DS0000034120.V279662.R01.S.doc Version 5.1 Page 15 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): 24 and 26. Service users bedrooms are decorated and furnished to a good standard and facilities are generally clean and safe. This ensures that service users live in a pleasant, homely and comfortable environment. EVIDENCE: Four bedrooms were viewed. All were furnished and equipped to ensure comfort and privacy. All bedrooms are for single occupancy and meet minimum space requirements. All service users spoken with said that they were happy with their bedrooms. One service user said that they were afforded privacy when in their bedroom, and that staff members knocked before entering. Another service user said that they had recently moved into the home and that they had been able to bring some of their own furniture with them. Keys are provided if a service user requests this and each bedroom has a lockable draw. Bedrooms were noted to be homely and had been personalised. One service user said that their bedroom had recently been redecorated and that they had been able to choose the colour scheme for the room. Newent House DS0000034120.V279662.R01.S.doc Version 5.1 Page 16 The home was noted to be generally very clean and hygienic. There were cleaning staff members on duty. One service user said that they were happy with hygiene standards in the home. Another service user said “They keep my bedroom nice” There was a very dirty toilet brush in a ground floor communal toilet, however, his was removed at the time of inspection. Efforts should be made to ensure that all areas of the home remain clean and hygienic at all times. There are suitable laundry facilities. One service user said that they received a good laundry service from the home. Newent House DS0000034120.V279662.R01.S.doc Version 5.1 Page 17 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, 29 and 30. Staff members are employed in sufficient numbers and, in general, receive training necessary for meeting the needs of service users. However, one staff member was not suitably trained to do their job, and this does not ensure that service users are fully protected. The procedures for the recruitment of staff are robust and provide the safeguards to offer protection to people living in the home. EVIDENCE: Staffing levels, evidenced in staff rotas, and in numbers on shift at the time of this inspection were found to be appropriate and safe, in accordance with the care and social needs of the service users. There was a skills mix of staff on shift, including management and care staff, cleaners, a laundry worker, a kitchen assistant and cook and administration staff. All service users spoken with spoke very highly about staff members. They indicated that they were listened to, respected and well cared for. A visitor reported the staff team to be “very caring” staff members were observed to engage in respectful interactions with service users and a handover session highlighted that staff members take a holistic approach to addressing service users needs. Staff recruitment files have not been available at the last two inspections of the home. However, the files of four staff members, chosen at random were examined during this inspection. Files were in good order and contained most of the documentation required by regulation, including Criminal Records Bureau checks and two written references. One staff file did not contain a Newent House DS0000034120.V279662.R01.S.doc Version 5.1 Page 18 Criminal Records Bureau check. The Principal Manager of the home has however given assurances that a satisfactory Criminal Records Bureau check is in place for this staff member, and is held by the Human Resource section of the Royal Borough of Kingston Upon Thames council. Previous inspections of the home have highlighted that there are good arrangements for staff training and induction. There has been training for some staff members in the safe handling of medication and in infection control since the last inspection of the home. Some staff members are currently undertaking NVQ in care training and an NVQ Assessor was working in the home at the time of this inspection. The cook said that all permanent staff members who work in the kitchen have undertaken food hygiene training. There were certificates to back this up. There was a kitchen assistant who said that they had not undertaken food hygiene training. This staff member was an agency worker, working in the home on a temporary basis. However, it is necessary that all staff members involved in handling food that is to be eaten by service users, receive at least foundation level training in food hygiene, in order to ensure that service users are protected. Newent House DS0000034120.V279662.R01.S.doc Version 5.1 Page 19 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): 33, 35 and 38. Service users have their finances safeguarded and their views listened to. There are good systems in place for maintaining safety in the home. This ensures that service users are protected and that their wellbeing is prompted. EVIDENCE: The Deputy Manager said that service user meetings are held on a regular basis in order to allow service users to provide feedback about the service they receive. Annual meetings are held for families. Respite service users are provided with a questionnaire following their stay in the home. There is a need to ensure that formal quality monitoring occurs in relation to gaining feedback from service users, their representatives and other stakeholders. The results of this monitoring should be published and made available to service users. There is regular monitoring in the home by the Principal Manager, with monthly reports of this monitoring being made available to the Commission for Social Care Inspection. The Deputy Manager said that some policies and procedures are currently in the process of being reviewed. Newent House DS0000034120.V279662.R01.S.doc Version 5.1 Page 20 The home keeps some money for service users. Records examined in relation to service users money appeared to be in good order. Receipts are maintained and signatures are recorded for all transactions. All permanent staff members undergo induction training, which ensures safe working practices. There are environmental risk assessments in place, including a risk assessment in relation to fire. Records indicate that the fire alarm and emergency lighting is tested on a regular basis. Fire fighting equipment is situated throughout the home and emergency exits were clear. There was a landlord’s gas safety certificate and records detailing that the electrical system in the home has recently been serviced. There was an Environmental Health inspection on 29th September 2005, action has been taken to address the one Requirement made during this inspection. Certificates were available detailing that regular safety checks are made on hoists, assisted baths and the lift. Records were available detailing that senior staff members carry out a detailed ‘Indoor Workplace Assessment’ on a regular basis. The Deputy Manager was unclear whether systems were in place for reducing the risk of legionella. Records of legionella testing in the home must be made available at the next inspection of the home. Newent House DS0000034120.V279662.R01.S.doc Version 5.1 Page 21 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 X 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 X 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 X X X X X 3 X 3 STAFFING Standard No Score 27 3 28 X 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X 3 Newent House DS0000034120.V279662.R01.S.doc Version 5.1 Page 22 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 OP7 Regulation 15 (2)(b) Requirement The Registered Provider must ensure that Service User Plans are reviewed at least monthly, with records kept of these reviews. The Registered Provider must ensure that Medication Adminisration Records are completed accuratley. Repeat Requirement. Timescale of 01/10/05 not met. The Registered Provider must ensure that all staff members who are responsible for handling food, are trained to at least foundation level in food hygiene. Timescale for action 01/03/06 2 OP9 13 (1)(a) 23/01/06 2 OP30 18 (1)(C)(i) 01/04/06 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 Refer to Standard OP7 Good Practice Recommendations The Registered Provider should ensure that further DS0000034120.V279662.R01.S.doc Version 5.1 Page 23 Newent House 2 OP33 opportunities are made available to service users and their representatives for signing the Service User Plan. The Registered Provider should ensure that formal quality monitoring occurs in relation to gaining feedback from service users, their representatives and other stakeholders. The results of this monitoring should be published and made available to service users. Newent House DS0000034120.V279662.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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 Newent House DS0000034120.V279662.R01.S.doc Version 5.1 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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