Inspection on 22/11/05 for Newhaven

This inspection was carried out on 22nd November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Newhaven 23/01/07

Newhaven 15/05/06

Newhaven 21/06/05

Newhaven 10/02/05

Newhaven 02/09/04

Newhaven 14/02/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Newhaven Drakes Drive Stevenage Hertfordshire SG2 OEY Lead Inspector Mrs Judith Kent Unannounced Inspection 22nd November 2005 11:00 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 Newhaven DS0000019481.V268313.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. Newhaven DS0000019481.V268313.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Newhaven Address Drakes Drive Stevenage Hertfordshire SG2 OEY 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) 01438 354811 014 38 758223 Quantum Care Limited Kerry Ann Stevenson Care Home 42 Category(ies) of Dementia - over 65 years of age (42), Old age, registration, with number not falling within any other category (42), of places Physical disability over 65 years of age (42) Newhaven DS0000019481.V268313.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st June 2005 Brief Description of the Service: Newhaven was purpose built about 30 years ago in a residential area of Stevenage and provides accommodation on three floors for up to forty-two service users over sixty-five years of age who may also have dementia or a physical disability. Service users occupy single rooms in group living units each unit has an open plan lounge/dining area and kitchenette. Bathrooms and toilets are conveniently situated throughout the home and are fitted with appropriate aids. There is a large activities room on the ground floor, where the kitchen, laundry and administration areas are also located. The garden to the rear of the home is laid to lawn and flowerbeds and offers outdoor space where service users may sit. Newhaven DS0000019481.V268313.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place during over 7 hours during the day and was carried out by two inspectors. The manager was not present initially, but came back to the home later, and the care team managers on duty gave information when needed. The inspectors looked round the home and spoke with about twenty service users, some of whom were unable to respond, as well as with care staff and housekeeping staff. Two visitors to the home also spoke with the inspectors. What the service does well: What has improved since the last inspection? What they could do better: The house is looking ‘tired’ and shabby despite the efforts of the staff - this has been acknowledged by the company, and there are plans for a new home on an identified site in Stevenage. It is hoped that building will start during the early summer months next year. Staffing in the home at night must be maintained at a safe level. Training, especially mandatory topics, has not always been delivered within the appropriate timescales. As a result there continue to be some unsafe practices in the home. Newhaven DS0000019481.V268313.R01.S.doc Version 5.0 Page 6 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. Newhaven DS0000019481.V268313.R01.S.doc Version 5.0 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 Newhaven DS0000019481.V268313.R01.S.doc Version 5.0 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): 3 Prospective service users’ needs are assessed by a member of the home’s management team before they move in to make sure that the home can meet their needs. EVIDENCE: There had been one new person admitted to the home since the last inspection and the records on her file showed that as well as the home manager’s assessment visit, information had been gathered from a variety of people involved with her, including her care manager, Lister hospital and the Homefinder team. Although the home’s own pre-admission form was incomplete, information supplied by other agencies involved with the service user had helped to build a picture of her needs. Newhaven DS0000019481.V268313.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, 8 & 9 Medication records were incorrectly completed which could place service users at risk of harm. Care plans did not always record current care information about service users which could mean that they are not cared for in the right way. EVIDENCE: Service users’ care plans were looked at and although the majority had good and full information, some were found not to have all the necessary information to provide the care needed to meet each person’s needs. One service user was noted to have bruise-like marks on his arm, for which there was a satisfactory explanation, but there was no mention of them in his care plan; another had a graze on his chin and a small cut on his head – again there was no note of these on his care plan - it is important to note health or welfare issues somewhere in the care plan. One person had lost several pounds in weight over about six weeks and the necessity of taking some action to find out why was discussed with the manager. The manager acknowledged that there were no continence management plans on care files - in view of the level of incontinence in the home it would be Newhaven DS0000019481.V268313.R01.S.doc Version 5.0 Page 10 appropriate to seek guidance and advice about management of this area of care from the Hertfordshire Continence Advisory Service. One inspector noted that the majority of the women on one unit had neither stockings or tights on and brought this to the manager’s attention – the manager agreed to look into this and to make sure that this was by service users’ choice and not by omission. Medication records on two units were looked at this time and there was one instance of mis-recording on both. However, one incident involved a controlled drug and further investigation showed that it had not been followed up and resolved by the management team. This was apparently due to a lack of communication during the handover from night to day shift. Care staff giving medication seem to have no responsibility to notify managers of errors that they spot, saying that ‘downstairs would check up’ and take appropriate action. The manager said that she would reinforce the necessity of recording and reporting incidents of mis-recording or wrong administration, and of making sure that information is passed on. Newhaven DS0000019481.V268313.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 Catering in the home meets people’s dietary needs; meals are nutritious and service users are offered a choice. Activities are organised for service users who wish to participate but people may not know what is available from day-to-day. EVIDENCE: While service users said that there were social activities organised for them, there were sparse records of things they had taken part in on the care plans looked at by the inspectors and there were no programmes of activities posted on units. Daily papers are delivered for several people and were being read; people on one unit told the inspector that there was plenty offered for them but that they did not always want to join in - they were enjoying listening to music on the radio at the time. Activities which had been recorded on care plans were often things which people do alone, e.g. reading the newspaper, watching TV. The manager said that she is hoping to recruit someone on a part-time basis to organise activities in the home. Both inspectors sat with service users during lunch and were generally impressed with how tables were set with serviettes and flowers, although, disappointingly, one unit was using kitchen roll in place of paper serviettes. The lunch was rather late being served in one unit, which meant that people had been sitting at the table for up to 20 minutes waiting. However it was Newhaven DS0000019481.V268313.R01.S.doc Version 5.0 Page 12 appetising and nutritious with fresh vegetables and there was a choice of main course plus the option of salad. One vegetarian service user reported that she was always offered a choice of dish at both lunch and tea times. Service users commented that catering in the home was good. Careworkers need to be reminded to offer help with eating discreetly by sitting next to people rather than standing or crouching on the floor. Newhaven DS0000019481.V268313.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): 16 Service users can be confident that complaints received by the home will be dealt with in accordance with the company’s complaints procedure. EVIDENCE: The complaints log was seen during the inspection and showed that all those received had been dealt with appropriately. The summary of complaints must record the names of service users concerned as it was not possible to identify them from the log. The date when complaints are received should also be recorded. Newhaven DS0000019481.V268313.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, 24 & 26 There has been some decoration and replacement of carpets but the home is shabby in many areas. Bedrooms are mostly clean and comfortable, although there were strong odours in some, which could make them unpleasant for service users to live in. Service users dignity is compromised by the presence of incontinence aids in bathrooms. EVIDENCE: Although the staff try to keep the home in good order, the building is showing its age in the gradual deterioration in many areas. New carpet has been laid recently in some areas and refurbishment and re-decoration do take place and brighten the home up, but there is no disguising that it is difficult to maintain environmental standards in the home. Carpets in several areas were shabby and stained and one toilet floor, although washed by housekeeping staff, was badly stained; the kitchen fittings in some units are damaged, with loose doors. One bathroom showed signs of neglect (dead insects in the bath) and liquid soap and waste bins were missing in one; one bath had a damaged surface. Newhaven DS0000019481.V268313.R01.S.doc Version 5.0 Page 15 Service users bedrooms were generally clean and well cared for although at least three had unpleasant odours which the staff must make concerted efforts to eliminate. Several bathrooms had overflowing baskets of incontinence pads, disposal bags and toilet rolls, which should be stored in cupboards. Newhaven DS0000019481.V268313.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, 29 & 30 Staffing levels at night are not always sufficient to ensure that service users are not at risk. Training for all staff needs to be reviewed and up-dated to make sure that they have the skills and knowledge to meet service users’ needs safely. EVIDENCE: The inspectors spoke to several members of staff and asked about training received by them – responses showed that some housekeeping staff had not had any adult protection or dementia training, and while they may not need the same training as care staff, they must have an awareness of basic principles. They reported, though, that they had had mandatory training in health and safety, fire safety and moving and handling. Training records showed that mandatory training needed updating for a number of staff members, as well as in other areas of care practice such as food hygiene, dementia awareness, adult protection and pressure sore care. The night duty rota sent to the inspector showed that there were sometimes only two waking care staff on duty each night and checking during the inspection confirmed this. The home has bedrooms on three floors and cares for a number of people with dementia who sometimes walk about or are wakeful at night; in addition there are people who may need two careworkers to assist them. Having only two care staff on duty could place service users at risk and the manager must ensure that there are at least three waking care staff every night. An Immediate Requirement was made to this effect. Newhaven DS0000019481.V268313.R01.S.doc Version 5.0 Page 17 The recruitment file of one new member of staff was looked at and discussion took place with the manager about the necessity to seek references from immediate past employers even if the applicants have not named them as a referee. Service users spoken with at the inspection were unanimous in their satisfaction with the staff in the home commenting that they were responsive and kind. Newhaven DS0000019481.V268313.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): 33, 35, 36 & 38 There is some poor health and safety practice in the home, which could result in harm to service users and staff. The home looks after service users’ money safely. EVIDENCE: There were instances of care workers using wheelchairs with only one, or no footplates attached - this could result in accidents happening and the manager must make sure that staff use equipment safely. It was also noted that one bedroom door was held open with a walking frame and a wedge – there are a number of sound operated door closers around the home and one must be used on this door too, to comply with fire safety guidelines. The last inspection report had highlighted several instances of poor practice in the home and the manager reported this time that safe practice issues had been brought to the attention of staff at team meetings – there is a clear need for constant vigilance and guidance by the management team to make sure that both service users and staff are protected from harm. Newhaven DS0000019481.V268313.R01.S.doc Version 5.0 Page 19 Careworkers reported that they have regular supervision with a member of the management team. The home holds small amounts of cash for some service users and several of accounts were checked at this inspection. All were found to be correct and had receipts for the transactions recorded. These accounts are audited annually by the company Newhaven DS0000019481.V268313.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 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 x 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 2 17 x 18 x 3 x x x x 3 x 2 STAFFING Standard No Score 27 1 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 3 x 2 Newhaven DS0000019481.V268313.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 OP9 2 13 (2) Standard OP7 Regulation 15(1) Requirement Care plans must note anything, e.g. weight loss, cuts, bruises. which affects the health or welfare of service users. Medication must be administered and recorded accurately. (This has been a requirement in the last two inspection reports.) The record of complaints must identify the service user concerned. Unpleasant odours must be eliminated from all areas in the home. There must be at least three waking night staff on duty each night (This was made an immediate requirement at the inspection) i. Mandatory training must be kept up to date for all staff in the home. ii. Other appropriate care practice training must be provided and a record kept. Housekeeping staff working in the home must have some training in adult protection and DS0000019481.V268313.R01.S.doc Timescale for action 22/11/05 31/12/05 OP16 3 OP26 4 OP27 5 17 & Schedule 4.11 16(2)(k) 18(1)(a) 22/11/05 31/12/05 22/11/05 OP30 6 18(1)(a) & (c) 28/02/06 OP30 7 18(1)(c) (i) 31/01/06 Newhaven Version 5.0 Page 22 OP38 8 13 (4) dementia Safe practice must be followed in the home to protect service users from harm. 31/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 OP7 2 OP12 3 OP26 4 OP29 5 Refer to Standard OP3 Good Practice Recommendations The homes own pre-admission assessment form should be fully completed for each service user The manager is strongly urged to seek continence advice from the Continence Advisory Service Notices about the planned programme of activities should be posted in each unit. Continence aids etc should be kept in cupboards in bathrooms Immediate past employers should always be asked for references for job applicants. Newhaven DS0000019481.V268313.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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 Newhaven DS0000019481.V268313.R01.S.doc Version 5.0 Page 24 - 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. 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