CARE HOME ADULTS 18-65
Newgate Street, 67 67 Newgate Street Morpeth Northumberland NE61 1AY Lead Inspector
Hilary Stewart Unannounced Inspection 3rd July & 25th July 2007 10:30 Newgate Street, 67 DS0000000562.V343475.R01.S.doc Version 5.2 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 Newgate Street, 67 DS0000000562.V343475.R01.S.doc Version 5.2 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. Newgate Street, 67 DS0000000562.V343475.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Newgate Street, 67 Address 67 Newgate Street Morpeth Northumberland NE61 1AY 01670 512482 01670 512482 gm.e.ntawnt.newgate@nhs.net 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) Northumberland, Tyne & Wear NHS Trust Vacant Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Newgate Street, 67 DS0000000562.V343475.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 6th July 2006 Brief Description of the Service: 67 Newgate Street is a small residential care home offering accommodation for three male adults with learning disabilities. It is registered to provide personal care, but not nursing care. It is a two-storey terraced house in the centre of Morpeth, close to all facilities and transport networks. There are three single bedrooms on the first floor and two lounges and a dining kitchen downstairs. There is no lift available to the first floor. There is a small garden and patio area to the rear of the premises. The fees range from £823.23p to £908.81p. Inspection reports and information about the home are readily available. Newgate Street, 67 DS0000000562.V343475.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. Before the visit: We looked at: • Information we have received since the last visit on 6th & 12th 2006. • How the service dealt with any complaints & concerns since the last visit. • Any changes to how the home is run. • The provider’s view of how well they care for people. • The views of people who use the service and the staff . The Visit: An unannounced visit was made on 3rd & 25th July 2007. During the visit we: • • • • • • Talked with people who use the service, staff and the manager. Looked at information about the people who use the service & how well their needs are met, Looked at other records which must be kept, Checked that staff had the knowledge, skills & training to meet the needs of the people they care for, Looked around the building/parts of the building to make sure it was clean, safe & comfortable, Checked what improvements had been made since the last visit. We told the senior staff what we found. What the service does well:
Staffs on duty at the time of the visit were approachable and helpful. The people who live at the home are supported by staff to continue to have contact with their friends and family. The relationships between staff and the people were good and personal support was provided in a way that promotes their privacy and dignity. The meals served are varied and nutritious which promote the health of the people at the home. Newgate Street, 67 DS0000000562.V343475.R01.S.doc Version 5.2 Page 6 They all have support plans so the staff know how to meet their needs. This means that people get the care and support they need. The staff team at the home value the differing needs of the people who live there and make sure that they are aware of each person’s preferences. They treat the people as individuals and support them to live the life they choose as much as possible so they will have new experiences and know that their opinions are valued. People who live at the home experience a variety of activities. This gives them choice as well as building their self-esteem and confidence. The staff team make sure that the home is clean, warm and pleasantly furnished so the people who live at the home have a comfortable place to live. Staff support the people to use local services so they are part of the community. The staff are supervised and trained so they know how to provide the people who live at the home with good care. All of the people who live at the home have plans of care and risk assessments. This is so staff have the information they need to support each person and keep them safe. The home has procedures for staff when they administer medication. This makes sure the people who live at the home receive their medication when they need it and at the correct times. The home has procedures for dealing with complaints and protecting the people who live there from abuse. This means that the people who live at the home feel safe, know they can talk to the staff and that their views are listened to. What has improved since the last inspection?
Whoever is in charge of home each day now keeps the key for the medication cupboard so medications can been accessed whenever it is needed. This also means the home is now complying with the pharmacy guidelines. Newgate Street, 67 DS0000000562.V343475.R01.S.doc Version 5.2 Page 7 A new carpet has been laid ion the stairs so the home looks more pleasant and is more comfortable for the people to live in. Care plans are now written with people who live at the home and they are in an easy to read format. 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. The summary of this inspection report can be made available in other formats on request. Newgate Street, 67 DS0000000562.V343475.R01.S.doc Version 5.2 Page 8 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 Newgate Street, 67 DS0000000562.V343475.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a statement of purpose. It is out of date and not available in an easy to read format. This means that people may not get all of the information they need about the home for them to make an informed decision about moving into the home. The needs and wishes of each person who live at the home have been assessed. This means that staff at the home know that they can provide the people with the care and support they require. EVIDENCE: The people who live at the home have their own individual support plans. They show that the people have had their needs assessed and they describe the actions the staff need to take to meet their needs. Records showed and staff said that no one new has moved into the home since the last visit and a person could only move into the home if the manager and staff are certain that the persons needs can be met there. Staff said that before any person moved into the home they would be gradually introduced by having visits before they moved in permanently. The home has a statement of purpose and a guide to give people information so they can decide if the home is where they want to live. Some of the
Newgate Street, 67 DS0000000562.V343475.R01.S.doc Version 5.2 Page 10 information in the statement of purpose was not up to date and it was not written in a way to make it easy for people who may want to use the service to read. Newgate Street, 67 DS0000000562.V343475.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The people who live at the home get personal support and at the same time staff make sure that their privacy, dignity and independence are respected. People who live at the home are supported to become more independent at the same time staff try to reduce the risks so they are kept as safe as possible. EVIDENCE: Staff confirmed that the people who live at the home have had their needs assessed. They take part in writing their own care plan as much as possible so they can record their hopes and wishes for the future. When staff are trained they will have person centred plans in the future. Staff said that the people who live at the home are supported to be as independent as they can be safely. They look at the risk involved and then plan how they can reduce risk as much as possible for people when they for example take part in activities.
Newgate Street, 67 DS0000000562.V343475.R01.S.doc Version 5.2 Page 12 The people are encouraged to make choices and decisions about what they want to do. There are house meetings where they talk about what meals they would like and other things such as activities and holidays. Records showed that staff try to carry the meetings out every month. One person had said that they wanted to go on holiday to Scotland another wanted to go to the Eden Project. Plans have been made to arrange this. Staff said that at one meeting the people discussed the need for transport at the home and the daily tasks that need to be carried out. One person said “yes we have meetings to talk” Newgate Street, 67 DS0000000562.V343475.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The people who live at the home lead healthy stimulating lifestyles, supported by staff so they know there opinions are taken seriously and they feel valued. People who live at the home are supported to continue their links with their families and friends so they don’t become isolated. The meals provide by the home are varied and nutritious so the health of the people who live there is promoted. EVIDENCE: Staff said that the people who live at the home have the same rights as everyone else to make choices but they have to look at the risks at the same time. Sometimes for instance some people may want to go out on their own, but may not be able to keep themselves safe. Information is keep in the peoples individual files so staff know how to support them to be as independent as possible at the same time reduce to risk ands keep them as safe as possible.
Newgate Street, 67 DS0000000562.V343475.R01.S.doc Version 5.2 Page 14 The staff said that they regularly look at the options open to the people in relation to work, leisure and social activities. At the same time they have to be realistic about the choices. Some people go to a gardening project, others to college. One person hopes to start a cookery course. Every year they decide individually where they would like to go on holiday. One person is training so they can take part in the great north walk. Staff said that the people who live at the home use the local shops and the neighbours say “hello” when they are out. One person said, “I go shopping”. The friends and family of the people who live at the home are encouraged to keep in contact with them. They can visit the home or staff will support the people to visit them. Staff said that they work with the people who live at the home around enabling them to have appropriate relationships and behave in ways that will help them get on with people. The staff were observed and they said that they always ask before they enter people’s bedrooms. Staff said that the people who live at the home could always have privacy if they want. The people who live at the home plan the meals at the house meetings. Staff said that they are always trying to find new menus and to provide interesting things for them to try. The staff said that at least three meals are served to the people, which are varied and nutritious. One person said, “I like pasta and mince” and that their favourite was “hotdogs”. Another person said that their favourite was “melon” and “ we get a banana in our packed lunch”. Fresh fruit and vegetables were in the kitchen. . Newgate Street, 67 DS0000000562.V343475.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The people who live at the home have personal support when they need it so they can be as independent as possible. The staff monitor and promote the health of the people who live in the home to maintain their well-being. EVIDENCE: The health needs of the people at the home are written up in detail so the staff have accurate information and know how to care for the people. The staff said that the health and welfare of the people who live at the home is constantly being monitored. Their health and well-being is discussed in staff meetings. If there are concerns about a person’s health appropriate action is taken. The staff could describe and records showed how people are provided with personal support when they need it. The staff said that the medication procedures in the home make sure that the people who live their get their medication when they need it. All of the medication is checked weekly. Medication records were up to date. Any
Newgate Street, 67 DS0000000562.V343475.R01.S.doc Version 5.2 Page 16 discrepancies are taken very seriously and the staff have a procedure to follow to make sure medication is given correctly. The staff said and records showed that they have had training in how to administer medication. If it is thought to be safe following a risk assessment the people who live at the home can control their medication. Details of health checks, visits to their GP and hospital appointments are recorded in each individuals file. One person said that they go to the hairdressers and the dentists. Newgate Street, 67 DS0000000562.V343475.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home has a complaints procedure, it is clearly displayed. This means that complaints can be dealt with effectively and to the satisfaction of the person who made the complaint. The complaints procedure is not presented in a way that would make it easy for the people who use the service to read and understand. Staff know about adult protection procedures, so the people who live at the home are kept safe. EVIDENCE: Staff said and records showed that they have had training in how to protect vulnerable people from abuse. Staff could describe the procedure to be followed if an allegation of abuse was made. One person who lives at the home when asked if they felt safe living there said, “I would tell my care manager if I wasn’t happy”. The people who live at the home looked comfortable and relaxed during the visit. They approached staff and talked with them easily. The home has a complaints procedure. Staff said that they would support the people who live at the home if they wanted to make a complaint. One person who lives at the home said that they knew how to make a complaint and would tell the staff if they were worried about anything. Staff had supported the people who live at the home to make a complaint to the providers about not
Newgate Street, 67 DS0000000562.V343475.R01.S.doc Version 5.2 Page 18 having transport at the home. This has been responded to and the home should get a car in the near future. Newgate Street, 67 DS0000000562.V343475.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People live in a safe, comfortable and clean home, although some repairs are necessary. EVIDENCE: There are enough bathrooms and showers for the people who live at the home. The downstairs toilet was not working during the visit but it was to be repaired that day. The bedrooms looked comfortable and the people who live at the home had personalised them. They had been made very individual. The home looked in a good state of repair and was odour free. Newgate Street, 67 DS0000000562.V343475.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Staff are supervised and get training so they know how to give the people who live at the home good care and meet their needs. The home has a recruitment procedure. This makes sure that only suitable people come to work there. Some areas had not been needed more detail. . There are enough staff working at the home so the people who live there are provided with the care they need. EVIDENCE: Records showed and staff said that they receive training, which helps them with their work. All have mandatory training such as first aid and food hygiene. The manager said that 5 staff have vocational qualifications. Staff said that they felt supported by their management team. They said and records confirmed that staff are supervised when they should. Records showed that one staff meeting had taken place in April 2007. Newgate Street, 67 DS0000000562.V343475.R01.S.doc Version 5.2 Page 21 Sufficient staff were on duty at the time of the visit. Records showed that enough staff had been on duty at the home during the previous few days. Staff said that they have enough people working at the home. however if someone goes sick staff then have to work overtime but most staff don’t mind and are flexible. The manager said that all staff have been CRB (Criminal Records Bureau) checked at an enhanced level to make sure they are suitable people to work at the home. Some records were looked at and they showed that staff had been checked to make sure they are suitable people to care for vulnerable people before they started to work at the home. Work history of some staff was not in enough detail and did not show the exact dates of their previous employment. Newgate Street, 67 DS0000000562.V343475.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The new manager at the home is not yet registered. The opinions of the people who live at the home are sought about how the home is run so they know their views are valued and are used to improve the service. Monitoring visits of the home take place to check that the people who live there get the care they need and their health, safety and welfare is always promoted reports from the visits did not confirm that they happen monthly. EVIDENCE: Staff said that the people who live at the home are asked their views about the running of the home as much as possible. They said that the Trust had sent a
Newgate Street, 67 DS0000000562.V343475.R01.S.doc Version 5.2 Page 23 survey called “tell us what you think about our services”. One person said, “Yes” when asked if they felt safe at the home and another said, “the staff are nice”. Safety checks have been carried out on the equipment in the home; such as testing electrical equipment and the servicing the central heating boiler. Fire safety risk assessments had been completed. The fire logbook showed that regular fire drills and fire instruction take place. Staff said that they have fire drills and instruction. One person who lived at the home when asked what they would do if there were a fire said, “ Go outside because there would be smoke”. Records showed that regular training is provided for staff in fire safety, food hygiene and first aid. Records showed that some monitoring visits take place at the home. Reports from the visit did not show that they happened every month. Newgate Street, 67 DS0000000562.V343475.R01.S.doc Version 5.2 Page 24 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 Standard No Score 1 2 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 2 X 2 X X 3 X Newgate Street, 67 DS0000000562.V343475.R01.S.doc Version 5.2 Page 25 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 YA37 Regulation 9 Requirement The registered person must notify the Commission of the person appointed as manager of the home and confirm that they are fit to do so. The registered person must have proof of identity including a recent photograph of the person employed to manage the home. The registered person must make sure that all copies of the reports from the monitoring visits are lodged at the home. Timescale for action 01/09/07 1. YA34 9 01/10/07 3. YA39 26 01/09/07 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 YA1 YA34 Good Practice Recommendations The homes statement of purpose should be updated and made more easy to read for the people who may seek information about the service. The registered person should consider asking for more detail about the previous employment of staff when they are being recruited. For example staff should supply the
DS0000000562.V343475.R01.S.doc Version 5.2 Page 26 Newgate Street, 67 month as well as the year when listing their work history. Newgate Street, 67 DS0000000562.V343475.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Newgate Street, 67 DS0000000562.V343475.R01.S.doc Version 5.2 Page 28 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
