Inspection on 05/03/09 for Newholme House

This inspection was carried out on 5th March 2009.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Newholme House 23/02/07

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 15/11/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Newholme House 440 Baddow Road Great Baddow Chelmsford Essex CM2 9RB     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: June Humphreys     Date: 0 5 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Newholme House 440 Baddow Road Great Baddow Chelmsford Essex CM2 9RB 01245476691 01245478083 carmelwalsh@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Tony Appleton Name of registered manager (if applicable) Miss Carmel Walsh Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 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 en-suite 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. Care Homes for Older People Page 4 of 28 care home 18 Over 65 8 18 0 0 Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 stars. This means that people who use this service experience good quality outcomes. This was a routine unannounced inspection, which included a visit to the home on the 5th March 2009. One inspector undertook the site visit, and all of the key national minimum standards were addressed. Opportunity was taken to speak with residents, relatives, staff, and the registered Manager. The Manager completed and returned the Annual Quality Assurance Assessment to the Care Homes for Older People Page 6 of 28 Commission, which is a self-assessment of how the service is doing. Information from the document has been included in the report. As part of the inspection 7 staff surveys, and 12 residents/relatives surveys were returned. The comments made have been useful, and have helped in understanding what it is like to live at the home. Records and documents were looked at in detail, including a sample of care plans, Two staff files and supervision records, the staff rota, complaints, medication and accident records. What the care home does well: What has improved since the last inspection? What they could do better: The home has a large number of shared bedrooms. Prospective residents are made aware of this prior to admission. Generally when asked about this residents said It was fine or I am very happy here. However some residents needs had increased making it more difficult for the person they shared with. One resident spoke of how they no longer could have a relationship with the other person. The service must clearly demonstrate that at assessment prospective residents are compatible with the person they will share with, and that this is regularly re assessed. Whilst residents were clear on how to complain the current homes procedure is out of date, and not written in a user friendly format. The registered manager needs to reassess the current laundry provision, as it is located outside of the main building and limited due to size ;not allowing to be upgraded when necessary. There is currently no separate room which can be offered to residents who would like Care Homes for Older People Page 8 of 28 greater privacy when relatives and friends visit them in the home. The service must try to improve the facilities offered. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People moving to Newholme can be confident that a place in the home will only be offered if the persons needs can be met. Evidence: The registered manager ensures that assessments are carried out with prospective residents prior to their admission to the home. Two initial assessments were looked at as part of the inspection and were of a good standard, but evidence was not available to demonstrate that consideration was given to the matching process of the people sharing bedrooms. This should be included in the assessment as there is a higher than usual number of shared bedrooms. Once the assessment is completed this extends to a trial period staying within the home. The trial period within the home ensures that the service can meet the persons individuals needs, and also enables and empowers the person to make a choice about Care Homes for Older People Page 11 of 28 Evidence: if this is the right home for them. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. All residents can expect to have a care plan, and to be supported by staff to maximize their opportunities to remain independent. Evidence: Three care plans were looked at as part of the inspection process. The information is written in a clear, precise way, which enables staff to provide a consistent level of care. The care plan identifies individual needs, and personal preferences, relating to personal care, safety, physical health, communication, sleep, leisure and religion. Assessments for moving and handling/mobility, risk of falls, pressure areas and continence needs were recorded in all of the files inspected. The health care needs of residents were well met. There was clear, recorded evidence of district nurse visits, health checks, chiropodist visits, GP interventions, emergency services being called when required and opticians visit. The service encourages involvement from families, who both visit the home, but also Care Homes for Older People Page 13 of 28 Evidence: invite their relatives home, or take them out for tea or lunch. Several relatives were spoken to has as part of the inspection and all said that they were made welcome. One person said We are always made welcome, offering us tea and cake. Its nice to sit and talk. Another person felt there was not enough privacy. We are unable to sit in Mums bedroom as it is shared, and so usually we sit in the dining room which is an open space. The home does not currently have a visitors room, and because of the shared bedroom facilities it would be beneficial to consider how best visitors space could be improved. However despite this the relative said that the service provided by the home was very good, and there was nothing to compare it with. Medication was examined as part of the inspection. Booking-in sheets were in place for new admissions and this information was then transferred onto the Medication Administration Record (MAR). Medication profiles, resident photos for identification purposes and PRN (as and when required) protocols were in place. All boxes and bottles were dated when opened. Inhalers were labeled on both the device and the box. There were no gaps on the sample of MAR sheets looked at, and controlled drugs were stored appropriately. There were no gaps witnessed on the MAR sheets. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care planning process ensures that service users personal preferences are identified and met; including the choice of food, the activties that are offered, and flexibility about when relatives and friends visit. Evidence: The home employs an activities coordinator for two days per Week. Care staff also involve themselves with residents individual personal activities. A range of activities are offered to try to ensure that peoples individual needs and preferences are met. A number of residents were able to talk about the activities they enjoyed and give examples. One person said I enjoy the film shows, both the old films and the new ones. Another person said Ive won the bingo several times, its usually on a Friday. Recording has improved since the last inspection and it was possible to track when individual people had taken part, and what their response had been. Family and friends were observed visiting residents on the day of inspection. Staff welcomed them, offering tea and talking to them. Several residents sat in the dinning area, which is an open space and therefore lacks privacy. The home does not currently have a visitors room, and because of the shared bedroom facilities it would be beneficial to Care Homes for Older People Page 15 of 28 Evidence: consider how best visitors space could be improved. The above concern was raised with two other visitors who both stated that despite the lack of space they are welcomed. The service provided by the home is very good, and relatives are able to visit when they wish. The home has a four week menu, which is regularly changed when discussed as part of residents meetings. A copy was viewed as part of the inspection and a range of well balanced meals were offered which residents said were well presented and appetizing. Care Homes for Older People Page 16 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents and their relatives are encouraged to make their concerns and complaints known, and every effort is made to try to ensure individuals feel safe. Evidence: The homes complaints procedure was looked at as part of this inspection and requires updating. The service has not updated the policy for several years and it would benefit from being presented in an easy read format which outlines clearly how residents or relatives make a complaint and how the service investigates and responds. Despite this residents and relatives spoken to did appear to know how to make a complaint, and said that they were actively encouraged by staff to make their concerns know. One relative said that they had asked for a single room when it became available, as there was limited space to talk privately when visiting because the resident had a shared room. The manager acknowledged that this was the case, but that the prospective resident and family members were advised that only a shared bedroom was available at the time of assessment prior to admission. The manager stated that space was limited in the home, but every effort was made to offer residents personal space with their friends and relatives when they visited i.e. the dinning area. The manager and proprietor were currently looking at ways to extend the accommodation to provide a separate conservatory area, which may help with the current concern relating to privacy when residents have visitors. Care Homes for Older People Page 17 of 28 Evidence: All staff has received safeguard training, the last course for staff being undertaken on the 19th March 2009. Regular updates are offered to staff, and evidence of training had been recorded. Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Whilst there is limited space available within the home residents are provided with a good standard of accommodation, which is safe, homely and clean. Evidence: The home is an older style building which limits the space available. However every effort has been made to create a homely, safe and clean environment. The manager has used space to its maximum in an effective and creative way. A plan for renewal and redecoration is in place, and the Communal corridors and areas which required redecoration at the last inspection, has now been completed. The home has sufficient toilet facilities, but limited available bathroom space. On the ground floor there is a large bathroom with a Parker Bath for bathing, which also has a shower attachment. The first floor has a smaller bathroom with a bath, and separate shower. These facilities were not suitable for any residents in the home at the time of inspection has the bathroom is currently being used for storage, which could be a safety hazard. The manager should re assess how best to adapt the current facility to enhance, and increase the homes current resources. The laundry, which is sited in the garden, is small with restricted workspace for staff. Appropriate equipment to meet the homes laundry needs is in place. At the last inspection the manager acknowledged that the laundry space would benefit from refurbishment/ relocation into a larger space. Care Homes for Older People Page 19 of 28 Evidence: This has yet to happen, and is now a priority as residents incontinence needs are increasing and the current facilities will not be able to cope with increased demand. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be assured that staff in sufficient numbers, with suitable skills and experience, will be available to meet their needs. Evidence: The homes staffing rota confirmed that staffing levels are being maintained at three staff on duty throughout the day, and one awake and one asleep (on call) staff at night. The home employs cooks, housekeepers, a gardener/handy person and also a activities coordinator. Residents spoken to were very positive about the level and quality of support received. One resident said I am very happy with the care and support of the staff who work here. A relative said The quality of care offered is always of a very good standard. Staff spoken with said they were very well supported both by senior staff and the current manager. There was a good atmosphere within the home, and staff were observed to work well together and also when seen interacting with residents. Regular staff meetings, and handovers were held, to ensure that staff were aware of current information relating to residents changing needs, and also as an opportunity to openly discuss experiences and any concerns. Two staff recruitment files were examined and demonstrated that the homes recruitment practices do satisfactorily protect residents. Both files contained all of the specified information required including, employee evidence of Care Homes for Older People Page 21 of 28 Evidence: employment history, medical questionnaires, declarations of criminal record, and evidence of ID. New staff files contained evidence of training including induction, based on the Skills for Care Common Induction Standards. Records of staff training and discussion with staff confirmed that staff had been trained in first aid, safeguarding and abuse awareness, dementia, food hygiene, manual handling, medication and health & safety. Infection control which was recommended at the last inspection had also been completed by all staff. A training matrix was seen that demonstrated that despite being a small team staff were completing a range of different training. The number of staff completing N.V.Q has increased since the last inspection, and approximately 60 of staff are now qualified. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well-managed, and run in the best interests of residents, with health and safety practices that protect both the people who live, and work at the home. Evidence: Residents and relatives spoke highly of the manager of the home, and felt there was good communication. The manager demonstrated a good awareness of the needs of older people, and a positive approach to promoting a supportive environment that encouraged people to be independent within the home for as long as is possible. Since the last inspection the manager has completed the Registered Managers Award (NVQ level 4 in Management & Care). The home regularly consults residents through monthly meetings, and open discussion by the manager to residents, carers and visitors to the home. A survey form is distributed to residents and relatives on a yearly basis to seek their feedback on the home. A summary of the last feedback from surveys had been recorded, and discussed Care Homes for Older People Page 23 of 28 Evidence: with both residents and staff. Staff receive regular recorded 1-1 supervision from the manager. Included in this process is group supervision and appraisals. Staff surveys returned were very positive about the manager and confirmed that sufficient supervision and support was available to enable them to undertake their role with confidence. Random samples of records required by regulation were checked and found to be in order. Residents money is accurately recorded, and the two residents finance records that were viewed showed that expenditure had been itemized and dated. Certificates and service records were available for inspection to confirm that the homes fire equipment, passenger lift, hoists, call alarms, emergency lights, gas supply, portable electrical appliances and electrical installation supply had all been tested/serviced within the required timescales . Essex fire service had inspected the service on the 30/01/09 and advised that at the time of visit a satisfactory standard of fire safety was evident. The home has a clear Health and Safety policy and procedure, and most staff had attended relevant health and safety training (see previous section on staffing). Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 16 22 The registered manager 01/08/2009 must ensure that there is a simple, clear complaints procedure which includes the stages and timescales of investigating and recording complaints which relates to the service described in the homes statement of purpose. To ensure the protection of residents. 2 21 23 The registered manager must review the current bathing facilities to demonstrate that current facilities adequately meet residents needs. to ensure bathing facilities are available to meet individual preferences and needs. 01/09/2009 Recommendations Care Homes for Older People Page 26 of 28 These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 4 4 The assessment process should be reviewed, and demonstrate that the assessment has considered the compatibility of the new prospective user with the person already living in the house when a shared bedroom is offered. The registered manager should review the current laundry facilities, to ensure they are suitable to meet the needs of the current residents. 3 26 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!