Inspection on 23/02/06 for Newholme

This inspection was carried out on 23rd February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Newholme 19/01/09

Newholme 30/01/07

Newholme 28/07/05

Newholme 08/03/05

Newholme 20/07/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Newholme Bushy Cross Lane Ruishton Taunton Somerset TA3 5JT Lead Inspector Stephen Humphreys Unannounced Inspection 23rd February 2006 09:30 Newholme DS0000036050.V283140.R01.S.doc Version 5.1 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 Newholme DS0000036050.V283140.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 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. Newholme DS0000036050.V283140.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Newholme Address Bushy Cross Lane Ruishton Taunton Somerset TA3 5JT 01823 442298 01823 444338 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) Somerset County Council (LD Services) Mr Kenneth `John` Salter Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Newholme DS0000036050.V283140.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Registered for up to 8 persons in category LD who may have a concurrent physical disability. Refurbishment programme to be completed by 31 December 2005. Date of last inspection 28th July 2005 Brief Description of the Service: Newholme is a spacious bungalow type domestic dwelling located in the village of Ruishton approximately 4miles from Taunton. There are 8 single occupancy rooms. The home is run as two units, with each having its own kitchen / dining room, lounge and bathroom. Residents are able to choose where to spend their day, and may access all communal areas within the home. Staff work in one unit but are available to support staff in the other unit if required. The home is registered with the Commission for Social Care Inspection to provide care for up to eight service users who have a learning disability. Service users admitted to the home may also have a concurrent physical disability. A major refurbishment project has recently been completed at Newholme which has increased the size of the single rooms, and improved facilities at the home. The Registered Manager is John Salter and the Responsible Individual is David Dick. The home is owned and run by Somerset Social Services. Newholme DS0000036050.V283140.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out as part of the planned annual programme of inspection. The inspection was unannounced and carried out by one inspector over one day. The previous inspection was announced and took place on 8 July 2005. On the day of the inspection there were eight service users residing within the home. During the course of the visit service users, relatives, staff members and the Registered Manager were spoken with. Care practice was also observed, records examined and a tour of the premises was made. All the residents and staff have settled back into Newholme following the completion of the refurbishment. What the service does well: What has improved since the last inspection? The Registered Manager continues to review and develop areas of practice. The delivery of care is person centred and individual. All the personal and social care is based on the individual’s choice, likes and abilities. Newholme DS0000036050.V283140.R01.S.doc Version 5.1 Page 6 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. Newholme DS0000036050.V283140.R01.S.doc Version 5.1 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 Newholme DS0000036050.V283140.R01.S.doc Version 5.1 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): 1,2,3,5 Residents are provided with an up to date statement of purpose that provides them all the information about the care home. All residents new to the home will have a comprehensive needs based assessment carried out prior to admission. EVIDENCE: Newholme has an up dated Statement of Purpose and Service User Guide that provide details of the services and facilities available. The admission criteria is detailed and included in the policy is reference to other residents in the home. One relative spoken to confirmed that she was encouraged to visit the home prior to her son being admitted. Residents are supported in spending short periods at the home before moving in on a permanent basis. A copy of the terms and conditions of occupancy in the form of a contract is signed by the relative and filed as part of the care plan record. Newholme DS0000036050.V283140.R01.S.doc Version 5.1 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): 6.7.9 A detailed person centred care plan has been developed for each resident. Residents are enabled to make choices regarding their daily life. Appropriate records are maintained in relation to residents’ finances. Records are stored securely EVIDENCE: Each resident has an individualised care plan that is comprehensive and records their assessed personal, health and social care needs. The inspector reviewed four care plans. All were detailed with a focus on person centred care. The care plans are reviewed monthly and signed. The newly introduced information pack for night staff, providing details of individual residents’ night care needs, including sleeping positions, epilepsy guidelines and emergency procedure is highly commended. Residents are enabled to exercise choice regarding their daily lives. One resident has an advocate. Records are maintained of all financial transactions involving resident’s monies. Newholme DS0000036050.V283140.R01.S.doc Version 5.1 Page 10 The inspector checked three resident’s records. All had been completed correctly. The finance records are audited weekly by the administrator and annually by an auditor from County Hall. Staff enable residents to take reasonable risks. The care plans contain detailed risk assessments pertaining to the individual’s abilities to maintain their daily activities. Newholme DS0000036050.V283140.R01.S.doc Version 5.1 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): 12,13,14,1516,17 Residents are enabled to take part in activities and entertainments within the local community. Residents are able to maintain family relationships within the home. Staff respect residents rights in the daily routines of the home. EVIDENCE: Residents are able to participate in a wide range of activities. A ‘My Day’ plan is developed for each service user. The activities enjoyed by the current service user group include: horse riding, story time, aromatherapy, light room, cooking and music. Residents attend various entertainment venues. One the day of inspection three residents and staff went to the ice show in Exeter. Service users are supported in accessing the local community. One resident is attending college. Trips are also provided. Risk assessments are completed in relation to each activity and are updated as necessary. Residents are provided with a holiday away from the home each year, or a series of day trips, dependent upon their individual needs. Residents and their Newholme DS0000036050.V283140.R01.S.doc Version 5.1 Page 12 families are involved in choosing and planning recreational activities. Residents and their mothers are accompanied by staff on some trips out. A musician and Reiki Therapist continue to visit the home on alternate weeks. A cook has recently been employed to provide residents with a choice of meals. Menus are decided at residents meetings using a pictorial form of communication. Residents are able to see a photo of the meal to help them choose. The cook is aware of individual residents dietary needs and preferences. Two residents at the home have PEG feeds. Staff confirmed that they have received appropriate training from the District Nursing Team, and there are clear guidelines for each individual’s care. A dietician visits the residents and reviews their feeding regime with staff. The main meal of the day is the evening meal. Care staff prepare breakfast and lunch. Newholme DS0000036050.V283140.R01.S.doc Version 5.1 Page 13 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): 18,19,20 Care staff carry out personal care in a sensitive and respectful manner. Staff are able to meet individual personal and psychological needs through a person centred approach. Medication procedures are carried out by competent staff. EVIDENCE: Residents are provided with assistance to undertake personal care tasks as required. Personal care is carried out in private at all times. Staff support residents in accessing health care services by attending the GP surgery or the dentist, and ensure that specialist advice is sought as required. A physiotherapist regularly visits the home. Care plans included details of epilepsy and nutritional guidelines. Food and fluid charts are completed as required. Residents weight is measured regularly and recorded in the care plan. Staff have been provided with appropriate training to meet the health needs of the residents. This has included training on the administration of enemas, and PEG feeds and administration of Midazalam. Staff are provided with medications training. All medications are stored securely. Medication Administration Records include a photograph of the Newholme DS0000036050.V283140.R01.S.doc Version 5.1 Page 14 resident. A record is maintained of all medications received and leaving the home, including the reason for medications being returned to the pharmacy. All hand transcribed entries and amendments to MAR sheets are supported by two staff signatures. Newholme DS0000036050.V283140.R01.S.doc Version 5.1 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): 22,23 There is a detailed complaints procedure included in the statement of purpose. Staff are aware of there responsibilities regarding vulnerable adults. EVIDENCE: Somerset Social Services have a complaints procedure that includes details of external agencies that may be contacted, including CSCI. Somerset Social Services Department have also produced a video providing details of how to make a complaint. There have been no complaints received by the home or CSCI. There are appropriate policies relating to the Protection of Vulnerable Adults and whistle blowing. Staff spoken to showed their awareness through discussion with the inspector. Newholme DS0000036050.V283140.R01.S.doc Version 5.1 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): 24,30 Newholme has recently been refurbished and extended. The home was warm and clean at the time of the visit. EVIDENCE: The home was warm and very clean at the time of this visit. No other environmental standards were assessed at this inspection. Newholme DS0000036050.V283140.R01.S.doc Version 5.1 Page 17 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): 32,34,35 The staffing complement includes registered nurses and NVQ qualified staff. Recruitment and selection procedures are robust. Staff are competent and appropriately trained to meet residents needs. EVIDENCE: Duty rotas were checked and identified the number of staff on each shift Staffing levels are maintained at 4 staff through out the day until 8pm. One waking and one sleeping–in member of staff at night. The Registered Manager is supernumerary to the staff team, and is supported by a senior support worker. Agency staff have been used to cover one shift since Christmas time. A cook has been recruited in order to provide staff with additional time to spend directly with service users. The staff group work within four teams, with each being lead by a senior member of staff. Each team acts as co-ordinator for two residents, and takes lead responsibility for certain areas of practice within the home. Staff are encouraged to attend training. 60 of the staff employed have obtained the NVQ level 2 qualification or its equivalent. Three staff are studying for the NVQ level 3 qualification. Nearly all of the staff team have received First Aid training. Training records relating to manual handling showed that some staff had not received updated training since 2001. The Newholme DS0000036050.V283140.R01.S.doc Version 5.1 Page 18 Registered Manager has advised that dates are being arranged for all staff to receive an update in manual handling training. A staff meeting is held every six weeks. Staff confirmed that they receive regular supervision and that appropriate records are maintained. Two staff recruitment files were examined and both were found to contain the documentation required under Schedule 2 of the Care Home Regulations 2001. Newholme DS0000036050.V283140.R01.S.doc Version 5.1 Page 19 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): 37,39,42 The Registered Manager is an experienced and competent manager who provides strong leadership to the staff team. There are appropriate systems in place to seek the views of residents and their families. Service records relating to health and safety equipment have been appropriately maintained. EVIDENCE: The Registered Manager, John Salter is a registered nurse in learning disabilities. He has been the manager at Newholme for two years and has many years experience in the specialty. Feedback obtained from one relative and staff members stated that he was approachable and that their views were listened to. The Registered Manager ensures that the family of each resident is provided with a copy of the inspection report. Due to the needs of the client group, feedback from residents is sought on an individual basis, or via their key group. Health and safety records were examined. The service records relating to the assisted baths, lifting equipment and portable appliances were up to date. Fire safety equipment had been serviced and tested as required. Staff have been Newholme DS0000036050.V283140.R01.S.doc Version 5.1 Page 20 provided with regular updates in fire safety training. All accidents have been recorded and reported as required. Newholme DS0000036050.V283140.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 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 3 2 3 3 3 4 X 5 3 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 4 33 X 34 3 35 2 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 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 X 3 X 3 X X 3 X Newholme DS0000036050.V283140.R01.S.doc Version 5.1 Page 22 yes 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 YA35 Regulation 13(4)© 13(6) Requirement The Registered Manager must ensure that staff are provided with regular updates in manual handling training. Not met from last inspection Timescale for action 30/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Newholme DS0000036050.V283140.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Newholme DS0000036050.V283140.R01.S.doc Version 5.1 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. 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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