Inspection on 28/07/05 for Newholme

This inspection was carried out on 28th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 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 23/02/06

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 Sally Murphy Announced 28 July 2005 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 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 Stationary 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 D53 - D02 S36050 Newholme V231633 280705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Newholme Address Bushy Cross Lane Ruishton Taunton Somerset TA3 5JT 01823 423126 01823 444338 Telephone number Fax number Email 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 Personal Care Home Only 8 Category(ies) of Learning Disability registration, with number of places Newholme D53 - D02 S36050 Newholme V231633 280705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registered for up to 8 persons in category LD who may have concurrent physical disability. 2. Refurbishment programme to be completed by 31 December 2005. Date of last inspection 8 March 2005 Brief Description of the Service: Newholme is a spacious, single storey building located in the village of Ruishton. All service user rooms are single occupancy. The home is run as two units, with each having its own kitchen / dining room, lounge and bathroom. Service users 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 service user 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 D53 - D02 S36050 Newholme V231633 280705 Stage 4.doc Version 1.30 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 announced and carried out by one inspector over one day. The previous inspection was unannounced and took place on 8 March 2005. On the day of the inspection there were eight service users residing within the home. Prior to the announced inspection Comment Cards were sent to service users, relatives and healthcare professionals. Seven cards were returned and each of these commented positively on the service provided. 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. What the service does well: What has improved since the last inspection? What they could do better: Due to the needs of the current service user group, the Registered Manager must ensure that all staff receive an update in manual handling training. Newholme D53 - D02 S36050 Newholme V231633 280705 Stage 4.doc Version 1.30 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. Newholme D53 - D02 S36050 Newholme V231633 280705 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Newholme D53 - D02 S36050 Newholme V231633 280705 Stage 4.doc Version 1.30 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 standard(s) 1,2,3,4 & 5 Service users and their families are provided with appropriate information to make a decision regarding admission to the home. An assessment is completed prior to any service user moving in to ensure that the home will be able to meet their identified needs. EVIDENCE: The home has a Statement of Purpose and Service User Guide that provide details of the services and facilities offered at Newholme. The home has an Admissions Policy, which states that consideration must also be given to the needs of the current service user group. Pre-admission assessments were seen within service user files. Prospective service users and their families are encouraged to visit the home to assess the facilities provided. Service users 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 is provided for each service user. Newholme D53 - D02 S36050 Newholme V231633 280705 Stage 4.doc Version 1.30 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 standard(s) 6,7,8,9 & 10 The home has developed a detailed care plan for each service user. The Registered Manager has further developed the care plans. Service users are supported in making choices regarding their daily life. Appropriate records are maintained in relation to service users’ finances. Records relating to service users are stored securely. EVIDENCE: Care plans are maintained for each service user. Three care plans were examined. Care plans provided details of service users needs, daily routines and preferences. The Registered Manager has revised service user plans. He has introduced a Night Care Folder providing details of individual service user’ nighttime needs, including sleeping positions, epilepsy guidelines and emergency procedure. He has also developed a new format to ensure that care plans are systemically reviewed. Service users are encouraged to exercise choice regarding their daily routines. One service user has an advocate. Independence is promoted. Service users are supported in developing and maintaining daily living skills. Newholme D53 - D02 S36050 Newholme V231633 280705 Stage 4.doc Version 1.30 Page 10 The home will keep money securely for any service user that wishes them to. Records are maintained of all transactions involving service user finances. Service user monies were examined, and all seen tallied with records kept. Records relating to service users are stored securely in accordance with the Data Protection Act 1998. Newholme D53 - D02 S36050 Newholme V231633 280705 Stage 4.doc Version 1.30 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 standard(s) 11,12,13,14,15,16 & 17 Service users are provided with a range of opportunities, and are supported in accessing the local community. Service users are supported in maintaining contact with friends and family. Service users are provided with a well balanced diet, and are provided with assistance as required. EVIDENCE: Service users 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, cooking, aromatherapy, light room, cooking, music, sand play and paddling pool. Service users are supported in accessing the local community. One service user will shortly begin attending college. Trips are also provided. Service users have also recently visited the London Eye, Minehead and Exmouth. Risk assessments are completed in relation to each activity and are updated as necessary. Newholme D53 - D02 S36050 Newholme V231633 280705 Stage 4.doc Version 1.30 Page 12 Service users are provided with a holiday away from the home each year, or a series of day trips, dependent upon their individual needs. Three service users from the home will be spending a week in Cornwall. Service users and their families are involved in choosing and planning recreational activities. Service users are assisted in maintaining contact with family and friends. Visitors are welcomed at the home. A musician and Reiki Therapist visit the home on alternate weeks. Meals are prepared by care staff as part of their role. Service users are provided with a choice of meals. Staff are aware of individual service users dietary needs and preferences. Two service users 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. Newholme D53 - D02 S36050 Newholme V231633 280705 Stage 4.doc Version 1.30 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 standard(s) 18,19 & 20 Service users are provided with appropriate assistance to meet their personal care needs. The home supports service users in accessing healthcare services. The home has followed good practice in relation to the recording and administration of medications. EVIDENCE: Service users are provided with assistance to undertake personal care tasks as required. Personal care is provided in private. Staff support service users in accessing health care services, 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. The home is in the process of replacing the sit-in scales, to ensure that service users weight may be regularly monitored. Staff have been provided with appropriate training to meet the needs of the service users. This has included training on the administration of rectal diazepam, enemas, and PEG feeds. Staff are provided with medications training. All medications are stored securely. Medication Administration Records include a photograph of the Newholme D53 - D02 S36050 Newholme V231633 280705 Stage 4.doc Version 1.30 Page 14 service user. 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 D53 - D02 S36050 Newholme V231633 280705 Stage 4.doc Version 1.30 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 standard(s) 22 & 23 The home has taken appropriate actions to safeguard vulnerable adults. EVIDENCE: The home has a complaints procedure that includes details of external agencies that may be contacted, including CSCI. Somerset Social Services Department has also produced a video providing details of how to make a complaint. There have been no complaints received by the home or CSCI. The home has appropriate policies relating to the Protection of Vulnerable Adults and whistle blowing. Newholme D53 - D02 S36050 Newholme V231633 280705 Stage 4.doc Version 1.30 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 standard(s) 24,25,26, 27 28 29 & 30 The home has been decorated and furnished to a high standard. The recent refurbishment program at the home has improved facilities for service users. Appropriate adaptations have been provided. The home has sufficient communal areas and bathrooms to meet service users’ needs. The home was found to have a high standard of cleanliness. EVIDENCE: A major refurbishment program has taken place at Newholme to increase the size of service user rooms and improve the facilities available. All service user rooms are spacious, and have been decorated to reflect individual service users tastes and preferences. Rooms are used for single occupancy and two have en suite facilities. As previously mentioned the home consists of two units, with each having its own kitchen / dining room, lounge and bathroom. Communal areas have been decorated and furnished to a high standard. Service users are able to choose where they spend their day, and may access all communal areas within the home. The home is set within enclosed gardens, which have seating areas provided. Newholme D53 - D02 S36050 Newholme V231633 280705 Stage 4.doc Version 1.30 Page 17 The Registered Manager has ensured that appropriate adaptations are installed to meet service users needs. There are two assisted bathrooms at the home. Hot water outlet temperatures were tested and found to be within appropriate limits. Radiators have guards fitted. The laundry and kitchens are locked when not in use. The laundry was found to be tidy and well organised. The washing machines have a sluice facility. Red alginate bags are used as necessary. The home follows good practice with regard to infection control. Newholme D53 - D02 S36050 Newholme V231633 280705 Stage 4.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35 & 36 Staffing levels are appropriate to meet service users’ needs. Staff are competent and provide a good standard of care. Staff are provided with regular opportunities to attend training. Staff receive appropriate support and supervision. The home operates a robust recruitment procedure. EVIDENCE: Duty rotas are maintained. There are generally four staff on duty during the day and 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 Deputy Manager. Agency staff have been used for a small number of shifts. The home plans to recruit a cook 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 service users, and takes lead responsibility for certain areas of practice within the home. Staff are encouraged to attend training. 54 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 Newholme D53 - D02 S36050 Newholme V231633 280705 Stage 4.doc Version 1.30 Page 19 showed that some staff had not received updated training since 2001. The 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 D53 - D02 S36050 Newholme V231633 280705 Stage 4.doc Version 1.30 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,39,40, 41 & 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 service users and their families. Servicing records relating to health and safety equipment have been appropriately maintained. EVIDENCE: The Registered Manager is John Salter. He has many years of providing care to people with a learning disability and is currently studying for the Certificate in Management Studies. Feedback obtained from relatives and staff members stated that he was approachable and that their views were listened to. The Registered Manager ensures that the family of each service user is provided with a copy of the inspection report. Due to the needs of the service user group, feedback from service users is sought on an individual basis, or via their key group. Newholme D53 - D02 S36050 Newholme V231633 280705 Stage 4.doc Version 1.30 Page 21 Health and safety records were examined. The servicing records relating to the assisted baths, electrical hardwiring and portable appliances had been appropriately maintained. Fire safety equipment had been serviced and tested as required. Staff have been provided with regular updates in fire safety training. All accidents have been recorded and reported as required. Newholme D53 - D02 S36050 Newholme V231633 280705 Stage 4.doc Version 1.30 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 4 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 2 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Newholme Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 4 3 3 3 3 3 x D53 - D02 S36050 Newholme V231633 280705 Stage 4.doc Version 1.30 Page 23 Are there any outstanding requirements from the last inspection? na 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) Requirement The Registered Manager must ensure that staff are provided with regular updates in manual handling training. Timescale for action 02.12.05 2. 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 Good Practice Recommendations Newholme D53 - D02 S36050 Newholme V231633 280705 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Riverside Chambers Castle Street Tangier 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. 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