Inspection on 23/02/07 for Newholme House

This inspection was carried out on 23rd February 2007.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Newholme House 05/03/09

Newholme House 20/12/05

Newholme House 25/02/05

Newholme House 29/11/04

Newholme House 12/02/04

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 Newholme House 440 Baddow Road Great Baddow Chelmsford Essex CM2 9RB Lead Inspector A Thompson Unannounced Inspection 23rd February 2007 10:15 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Newholme House DS0000017896.V331664.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 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. Newholme House DS0000017896.V331664.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Newholme House Address 440 Baddow Road Great Baddow Chelmsford Essex CM2 9RB 01245 476691 01245 478083 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) Mr Tony Appleton Miss Carmel Walsh Care Home 18 Category(ies) of Dementia - over 65 years of age (7), Old age, registration, with number not falling within any other category (18) of places Newholme House DS0000017896.V331664.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th December 2005 Brief Description of the Service: Newholme House was built in the 1920’s as a family home. It is a two-storey building. Residents can access each floor by a passenger lift. There are six single and six double rooms. Four of the rooms have ensuite facilities. Communal areas consist of a lounge and separate dining room. There is also a small conservatory which overlooks the garden. To the rear of the home is a large accessible garden with areas for residents to sit in and an aviary. The rear garden backs on to a large public park, which is overlooked by some of the first floor rooms in the home. Parking for approximately 3-4 cars is available to the front of the home. Street parking is available outside. Newholme House is in a residential area. It is close to local shops in Great Baddow, and on a regular bus route to Chelmsford town centre. Newholme House DS0000017896.V331664.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took place on Friday 23rd February, with a second announced visit taking place to on Thursday 8th March. The second visit was to speak with residents, staff and to collect survey forms left on 23rd February. The content of this report reflects the inspector’s findings on the day/s of the inspection along with information provided by the service and feedback by service users, relatives, staff and other parties. Practice and procedures occurring after this inspection will be reported on in future inspection reports. Discussions took place with five residents, the registered manager, registered provider, three members of staff and three visitors. Random samples of records, policies and procedures were inspected and a tour of parts of the premises and grounds took place. All residents spoken to expressed full satisfaction with the care they received and with the quality of the food and accommodation offered. Visitors spoken with were complimentary of the care and support provided to residents by the staff and manager. Questionnaires were left at the home so that relatives not spoken with on the day had the opportunity to make their views on the service known to the Commission. Staff confirmed they received good support from management. They also confirmed that they had been offered training appropriate to their role. Twenty-seven standards were inspected with twenty-three met and four almost met. What the service does well: Newholme house provides a homely, relaxed environment for the residents, which is clean and tidy. From evidence over several inspections the home provides a consistently high standard of care. The home benefits from an established, stable and experienced staff team, who are well supported by the manager. Newholme House DS0000017896.V331664.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Daily records should be kept of activities offered to residents. Some communal corridors and doorways would benefit from re-decoration. Staff would benefit from update training on infection control guidance. ---------------------------- 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. Newholme House DS0000017896.V331664.R01.S.doc Version 5.2 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 Newholme House DS0000017896.V331664.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home’s assessment format and process ensured that initial perceived needs were identified upon admission. EVIDENCE: Care plans evidence that pre-admission assessments are carried out by the manager. Assessment headings included personal and healthcare needs. Residents and their families/representatives are encouraged to visit the home as many times as they like before agreeing to admission, which is initially on a month’s trial. Lunch and half day stays are available as part of this process. Newholme House DS0000017896.V331664.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The health, personal and social care needs of residents were adequately detailed in individual plans of care. Health care needs of residents were met and residents felt they were treated with respect. EVIDENCE: Three care plans were inspected. Each included background information, personal details and next of kin contacts. The residents’ needs/action sheet included desired outcomes. Also included were risk assessments (including nutrition screening), records of residents’ weight, consultations and evidence of regular reviews. Residents had been included in the care planning process and had signed (or their advocates) to confirm they agreed with the plan of care recorded. Newholme House DS0000017896.V331664.R01.S.doc Version 5.2 Page 10 District Nursing services support the home in pressure sore assessment and will also supply appropriate aids and treatment, the home had purchased some pressure relieving mattresses. Pressure care needs were recorded in care plans. A dentist visits the home, as does a chiropodist, optician and a hairdresser. Some residents continue to see their dentist in the community. Residents have the choice of three local GP practices to register with. The homes medication policy and procedure covered ordering, receipt, storage, administration and returns of unused stocks. Staff who administer medication had received training, the most recent course was in 2006, this covered safe handling practice and a competency assessment. There were records of the training but not of the competency assessment. The manager undertook to keep these for evidence at future inspections. Medication administration records were inspected no shortfalls were noted. Discussions with individual residents indicated that they were treated with respect by staff, as did observation of staff going about their duties and interactions with residents. Staff on duty were seen to be courteous, caring and professional in their dealings with residents, and residents spoken with said staff were helpful and considerate. Visitors spoken with were also complimentary regarding staff attitudes and the care provided. Treatments and consultations are provided in private, residents’ also confirmed that they wear their own clothes and that staff use their preferred term of address. Newholme House DS0000017896.V331664.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The lifestyle experienced within the home matched the expectations of residents. They were able to maintain contact with family, friends and participate in the local community. Residents were offered a varied, appealing balanced diet and were supported to exercise choice in their daily lives. EVIDENCE: The home had an activities coordinator who works with residents two days a week. The manager advised that on other days care staff offered activities to residents. Records of the actual interests participated in had not been completed on a daily basis. There is a good practice recommendation on this point. (It should be noted that at the second inspection visit improved recording had taken place). Newholme House DS0000017896.V331664.R01.S.doc Version 5.2 Page 12 Records that were in place included monthly entertainers visits, various indoor pastimes, gardening (summer), and walks to the park (at the rear of the home), where residents watch bowls and tennis. The manager advised that an armchair exercise session was due to start in March and she had plans to arrange summer outings using a hired mini bus. Residents meetings had taken place and minutes inspected recorded that items discussed included activities, food and possible improvements to the garden. Local clergy will visit to provide for residents religious needs, and information on access to independent advocacy services was seen. In 2006 the home hosted a falconry display. This was open to residents and their relatives, friends and neighbours. Photographs of this event were shown to the inspector. Residents spoken with were positive about the meals provided and confirmed that a choice of food was available. Specialist diets are available for example, for people who are diabetic. Menus are displayed in he main lounge and in the dining room. A water dispenser is provided in the dining room so residents can have fresh water whenever they wish. The cook asks residents each day what they would prefer for lunch and tea. Fresh fruit is offered to residents daily. Residents spoken with confirmed they were satisfied with the choices and options made available to them regarding daily routines and leisure interests on offer. Visitors spoken with said they were always made welcome by staff. Inspection of private rooms confirmed that residents had been permitted to bring their own personal items with them on admission. There was also confirmation of this direct from residents, who told the inspector of the furniture and personal items they had been permitted to bring in with them. Newholme House DS0000017896.V331664.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents knew how to complaint and the home’s complaints procedure allowed for residents and relatives to formally raise any concerns or areas of dissatisfaction with the service. The home’s adult protection policies, procedures and practices were aimed at ensuring residents welfare. EVIDENCE: The home’s complaints procedure contains guidance on how to make a complaint and who to complain to. Also included were timescales for responses from the home. There had been no complaints since the last inspection but the procedures in place included a guidance flowchart for dealing with complaints and a standard template for recording concerns. Residents spoken with said they knew who to speak to in the home if they any concerns, and that in the past management had responded positively to any queries/issues they had raised. Newholme House DS0000017896.V331664.R01.S.doc Version 5.2 Page 14 The homes policy on adult protection was inspected, there was written guidance for staff on recognising and reporting abuse and action to be taken by staff and the person in charge if abuse is suspected. On site were the Essex Vulnerable Adults Protection Committee guidance booklets, reporting and recording templates, guidance on the POVA process and a staff training pack. The home also had a ‘whistle blowing’ policy which provided guidance to staff on their responsibilities to report any concerns to management. Newholme House DS0000017896.V331664.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,24,25,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Furnishings in the home looked comfortable and areas of the premises seen were maintained. Private accommodation was comfortable and suited to needs and preferences. The home appeared safe, accessible, clean and was considered to be hygienic. EVIDENCE: Newholme House DS0000017896.V331664.R01.S.doc Version 5.2 Page 16 The home was clean, tidy and free from unpleasant odours. Those bedrooms seen were comfortable and made homely with people’s personal possessions. Some areas of communal corridors and doorways had damaged /chipped paintwork. This report includes a recommendation that re-decoration takes place to improve the appearance of these areas. The home has sufficient toilet facilities. There is a large bathroom on the ground floor with a Parker Bath for bathing, which also has a shower attachment. On the first floor is a smaller bathroom with a bath and separate step into shower. Neither of these facilities were suitable for any residents in the home at the time and were therefore of use. The laundry, which is sited in the garden, was small with restricted workspace for staff, but did have appropriate equipment for the home’s laundry needs. A discussion took place with the manager who acknowledged that the laundry would benefit from refurbishment. She advised that plans were in hand to improve this area. Progress on this issue will be assessed at the next inspection. Communal space is sufficient with a large lounge, a dining room and a small conservatory. There is a large well maintained garden to the rear with access to a local park. Newholme House DS0000017896.V331664.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels met the needs of residents. Staff had been provided training opportunities to equip them with the skills for their role. Staff recruitment procedures aimed at the protection of residents had been followed EVIDENCE: The home’s staffing rota was inspected and confirmed that staffing levels are being maintained at three staff on duty throughout the day and one awake and one asleep staff at nights. Staff spoken with felt the current levels are adequate to meet residents’ needs. In addition, the home employs two cooks, two housekeepers, an activities coordinator, a gardener/handyperson and an administrator (every Friday). Discussion with staff and records confirmed that regular staff meetings are held. Agenda items included care plans, allocations, equipment, medication, shifts, training and health & safety. Newholme House DS0000017896.V331664.R01.S.doc Version 5.2 Page 18 Staff records and discussion with staff evidenced that application forms had been completed, interviews held, written references obtained, written terms & conditions issued and criminal records checks undertaken. Copies of proof of ID and photographs were also on file. The manager advised that four carers have the NVQ 2 award but this did not meet the recommended 50 of carers with this qualification (the home had eleven carers employed at the time of this inspection). Evidence of qualification certificates were seen for those who had passed this training. New staff undergo the home’s own induction programme. Records of this were seen, and staff spoken with who had employed since the last inspection confirmed they had received induction training. In future all new employees would undertake the new Skills for Care Common Induction Standards. This involves a six modular package of training overseen by the manager. Records of this process will be checked at the next inspection. Records of staff training and discussion with staff confirmed that staff had been trained in first aid, POVA and abuse awareness, dementia, food hygiene, manual handling, personal safety, medication and health & safety. The manager had been trained on carrying out environment occupational therapy assessments and on implementing the new induction training format. Newholme House DS0000017896.V331664.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36,37,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had been run and managed efficiently and effectively. Procedures for gaining the views of residents and relatives were in place and had been implemented. Records required by regulation were in place. Financial practices in the home appeared to have been competently managed. The health and safety of residents and staff appeared to have been assured. Newholme House DS0000017896.V331664.R01.S.doc Version 5.2 Page 20 EVIDENCE: The registered manager has worked in the home for 17 years with two years previous experience in social care. She is undertaking the Registered Managers Award (NVQ level 4 in Management & Care). Staff and residents were very positive about the way the home is managed. Some residents personal allowance monies were held for safe keeping by the home. Records of transactions and balances held were inspected, no shortfalls were noted. The annual quality assurance process was due to take place with questionnaires issued to residents and relatives. A summary of the last exercise was seen, as were survey templates. Topics covered included environment, staff attitudes, care provided, information provided, the food and day-to-day choices available. Staff receive regular recorded 1-1 supervision from the manager. Those staff spoken with said they found supervision very useful. Records sampled during the inspection were generally well maintained and securely stored in the office. The manager is aware of her duties for health and safety and all staff have received health and safety training. Random samples of records required by regulation were checked and found to be in order. Certificates and service records were available for inspection to confirm that the home’s fire equipment, passenger lift, hoists, call alarms, emergency lights, gas supply, portable electrical appliances and electrical installation supply had all been tested/serviced within recommended timescales There was a premises risk assessment in place. Staff had been trained in first aid, food hygiene, manual handling but infection control training was due. There is a recommendation on this issue in this report. Hot water is regulated at or near to 43 degrees celcuis. The home also carries out manual checks to try to ensure valve accuracy. Evidence of manual checks were seen. Newholme House DS0000017896.V331664.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 X X X 3 3 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 3 2 Newholme House DS0000017896.V331664.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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 OP12 OP19 Good Practice Recommendations Records should be kept of daily activities offered to residents. Internal re-decoration should include areas of communal corridors and doorways with chipped and damaged paintwork. 50 of care staff should be trained to NVQ level 2 standard or equivalent. Staff should be provided update training on infection control procedures and guidance. 3 4 OP28 OP38 Newholme House DS0000017896.V331664.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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 Newholme House DS0000017896.V331664.R01.S.doc Version 5.2 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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