Inspection on 21/10/05 for Newington Court Nursing Home

This inspection was carried out on 21st October 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Newington Court Nursing Home 08/07/08

Newington Court Nursing Home 26/07/07

Newington Court Nursing Home 05/02/07

Newington Court Nursing Home 28/04/05

Newington Court Nursing Home 13/09/04

Newington Court Nursing Home 24/05/04

Similar services:

Springfield House

The Shelley

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Newington Court Nursing Home Keycol Hill Newington Sittingbourne Kent ME9 7LG Lead Inspector Sue McGrath Announced Inspection 21st October 2005 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Newington Court Nursing Home DS0000026184.V260626.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Newington Court Nursing Home DS0000026184.V260626.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Newington Court Nursing Home Address Keycol Hill Newington Sittingbourne Kent ME9 7LG 01795 843033 01795 843662 newington@barchester.com 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) Barchester Healthcare Homes Limited Care Home 50 Category(ies) of Dementia - over 65 years of age (22), Old age, registration, with number not falling within any other category (23), of places Physical disability (5) Newington Court Nursing Home DS0000026184.V260626.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. To include one Service User (MD(E) Over 65) whose date of birth is 23.10.33. 28th April 2005 Date of last inspection Brief Description of the Service: Newington Court is a 50-bedded care home providing 24-hour nursing care to older people, some of whom have mental health needs. The home also provides care to one younger adult with physical disabilities, although their registration is for five.The home is an attractive, purpose built property on the main road between Newington and Sittingbourne. The accommodation is located over three floors, accessible via a passenger lift, and comprises of forty-six single rooms and two double rooms. There is ample communal living space within the home. The home has attractive gardens and a large car park. The home is within easy access of the M2. Newington Court Nursing Home DS0000026184.V260626.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, which took place on 21st October 2005 and lasted for 5.5 hours. The focus of the inspection was on reviewing progress towards meeting requirements of the last inspection and talking to Residents and staff on duty to monitor ongoing health, safety and wellbeing of the Residents. Records were viewed including care plans and some policies and procedures. Staff files were also viewed as well as staff training and support. Time was spent talking to Residents and all of their rooms were viewed. Discussion took place with several members of staff and some visiting relatives. A tour of the building was also undertaken. What the service does well: What has improved since the last inspection? What they could do better: Some areas of the recording of the administration of medication need to be reviewed to ensure full compliance with the guidelines from the Royal Pharmaceutical Society of Great Britain. Better control of the ordering of medication needs to be implemented. Newington Court Nursing Home DS0000026184.V260626.R01.S.doc Version 5.0 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Newington Court Nursing Home DS0000026184.V260626.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Newington Court Nursing Home DS0000026184.V260626.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5 and 6 Residents and families are provided with detailed information on Newington Court, which enables them to make an informed choice about the home. Prospective residents are fully assessed prior to moving into the home to ensure assessed needs can be met. A written statement of terms and conditions protects Resident’s legal rights to occupancy. Prospective residents benefit from being offered trial visits to admission so as to ensure that the home will be suitable for them. EVIDENCE: The Statement of Purpose and Service User Guide were seen and contained all the information required under regulations and were presented in a clear format. Several care plans were inspected and these contained full pre-admission assessments. Residents had had been provided with a written contract of terms and conditions. Evidence was also seen that residents or their representatives had agreed and signed the contract. Newington Court Nursing Home DS0000026184.V260626.R01.S.doc Version 5.0 Page 9 As discuss at the last inspection the manager will be applying to increase the number of dementia beds within the home. Working practises and staff training records seen on the day, confirmed that staff had the skills and experience to deliver the services and care which the home offers to provide. Discussion with some of the residents again confirmed that they visited the home prior to admission to ensure the home could meet their needs. The home does not provide intermediate care. Newington Court Nursing Home DS0000026184.V260626.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Whilst residents benefited from detailed care plans some areas of the plans need to improve to ensure that the needs of residents are fully addressed. The health needs of individual’s were mainly well met and residents benefited from good multidisciplinary working. The residents cannot always be confident that some areas of the administration of their medication are being properly recorded and this could put some of them at risk. EVIDENCE: Several care plans were inspected and had improved since the last inspection, however some areas of concern still remain in the recording of some information. For example, nutritional assessments had been completed but the outcome was not always followed up and residents who had lost weight did not appear to be monitored very well. This indicates that although the records are maintained they are not acted upon. Generally the plans had improved from the last inspection but the improvement needs to be maintained and continued. Newington Court Nursing Home DS0000026184.V260626.R01.S.doc Version 5.0 Page 11 Good working practises regarding the treatment of pressure ulcers was seen. It was evidenced that some residents had been admitted from hospital with pressure sores and that the home had consulted the Tissue Viability Nurse to confirm appropriate treatment. One visiting family member was concerned that staff were not competent when dealing with her mothers diabetes as the resident had experienced a possible hypo the previous weekend and staff did not appear to know what to do. This incident had not been recorded in the residents care plan. It will be a recommendation that all staff be trained in the care of diabetes. Several residents stated that they felt well cared for and that the staff were polite and caring. Medication was inspected and several errors were found mainly around the counting of medications in. A visiting family member was concerned that eye drops that had been ordered at least two weeks previously had not been administered. When the records were checked there was confusion about whether the prescription had been collected from the doctor or was at the Pharmacists. The home must instigate a procedure to ensure that any new drugs prescribed by the GP are tracked until the actual drugs are in the home and being used. This error resulted in a resident being without eye drops for over two weeks. All signatures for the administration of medication must be recorded, including agency staff signatures. Newington Court Nursing Home DS0000026184.V260626.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,and 15 Residents are supported to maintain contact with family and friends, which ensures they continue to receive stimulation and emotional support. The residents benefit from the appetising meals and balanced diet offered by the home and those residents requiring specialist diets are well catered for. Residents’ social and recreational interest and needs are well provided for with a wide range of activities organised. EVIDENCE: The home offers a variety of activities for the residents to enjoy and designated activity staff arranged the activities and several outings. The residents had particularly enjoyed going out for a fish and chip supper. Fresh vegetables were grown in the garden as part of the activities, with the residents being fully involved. The home had also been instrumental in organising the Newington in Bloom competition this year and had involved the local community in that and other activities including a summer fete. Local schools now come into the home to meet with and sometimes entertain the residents. This was very much enjoyed by the residents Several visitors spoken to confirmed they could visit at any reasonable time and that they were always made welcomed and usually offered refreshments. The home had a very pleasant quiet area called ‘the retreat’ that residents and Newington Court Nursing Home DS0000026184.V260626.R01.S.doc Version 5.0 Page 13 visitors could use for private meetings. Residents could also use this room for spiritual reflection. The bedrooms were well personalised with items brought in by the residents and their families. As far as possible, residents were seen to be exercising personal autonomy and choice. A new cook was in the process of being appointed and some changes to the menu had already taken place. The residents spoken to all stated that the food was always very nice. The menu boards however did not reflect the day’s menus and if they are to be used they must be kept up to date with current menus. The dining rooms were well decorated and very pleasant. Specialist diets were catered for and were well presented. Staff were seen to assist residents with feeding where necessary in a very professional and caring manner. Newington Court Nursing Home DS0000026184.V260626.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The residents and their families can be confident that their complaints are listened to and acted upon because of the home’s written complaints procedure. The residents are protected by the home’s has robust adult protection policies and procedures. EVIDENCE: The home has a written complaints procedure, which was seen with the Service User Guide. A copy of which was also on display in the foyer. Visitors spoken too were aware of the procedure although had not needed to use it. They had found that the manager had always acted on any minor issue before they needed to make a full complaint. The home had nine complaints in the last year, two of which were substantiated with suitable action taken. Staff spoken to could demonstrate an understanding of the Adult Abuse policy and of the effects of such abuse. The home would arrange for any resident to vote in any local or general election if required. Newington Court Nursing Home DS0000026184.V260626.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23, 25 and 26. Other standards were met at the last inspection Residents benefit from living in a clean, safe, well-maintained environment and have safe access to comfortable indoor and outdoor communal areas. Residents are encouraged to maximise their independence by having access to the range of specialist equipment supplied by the home. EVIDENCE: Several items of specialist equipment were seen throughout the home, which would maximise the residents’ independence. The bathrooms were large and airy and all had specialist bath hoists. The resident’s bedrooms were large and comfortable and most were well decorated and personalised. One of the rooms still had all the nails in the walls from previous residents pictures and these should either be utilised or removed. Each resident had a lockable drawer and could have access to keys to their bed door if required. Newington Court Nursing Home DS0000026184.V260626.R01.S.doc Version 5.0 Page 16 All of the bedrooms were individually and naturally vented with windows conforming to recognised standards. Pipe work and radiators were guarded. Emergency lighting was provided throughout the home. The home was considered safe and comfortable. The home was very clean and fresh on the day of the inspection. Newington Court Nursing Home DS0000026184.V260626.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 The residents benefit from staff that are trained and competent to do their jobs and who enjoy good morale. EVIDENCE: Staffing levels had improved since the last inspection and the home now had 9 RGNs. With 22 care staff giving 924 hours of care hours per week improvements had also happened in this area. There had also been fewer turnovers of staff recently. The manager also confirmed that staffing would be increased if dependency levels increased and that the dependency level is continually monitored. Nineteen of the twenty-two care staff had obtained NVQ two or above, giving a figure of 86 which is well above the required level of 50 . Staff had attended mandatory training as well as a variety of other training courses relevant to the tasks undertaken within the home. It will be recommended that diabetes training is included in the list of courses offered. The home follows Barchesters Recruitment policies and all staff had a CRB check completed prior to starting employment. Staff also completed an induction course within six weeks of appointment. Catering staff also have the opportunity to complete NVQ’s in catering. Newington Court Nursing Home DS0000026184.V260626.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32, 33,34,35,36,37 and 38 Residents benefit from having a manager who has a clear development plan and vision for the home, which she effectively communicates to the residents, staff and relatives. The residents also benefit from having a manager who is well supported by the senior staff in providing leadership throughout the home and from staff who demonstrate an awareness of their roles and responsibilities. Residents also benefit from staff who are appropriately supervised by senior members of staff. EVIDENCE: The manager had recently completed her registration with the Commission and had many years of experience in managing a residential home. There were Newington Court Nursing Home DS0000026184.V260626.R01.S.doc Version 5.0 Page 19 clear lines of accountability within the home, which had improved recently with a more stable senior staff group. Staff spoken to confirmed that the registered manager communicates a clear sense of direction and leadership within the home. The company had made a clear commitment to equal opportunities within the organisation. The manager completes regular care audits and with announced and unannounced visits from both Regional and Head Office, there is continuous self-monitoring process being undertaken to ensure high standards of care are maintained. Yearly resident and relatives meetings were arranged and there was the opportunity to meet with the Manager and or Senior Nurse with or without appointment. Comment cards returned from relatives were mainly very complimentary with no issues raised. A comment card returned from local GP’s stated that that one enjoyed clear and thorough communications with well prepared staff and another commented that it was the best home in his area. Four comment cards were received from residents who all said they liked living at Newington Court and they felt safe and well cared for and that their privacy was respected. The home has a wealth of financial policies and procedures to ensure there was an effective and efficient management of the business. Evidence was seen that sufficient insurance was in place against loss or damage to the business as was public liability insurance. Although not inspected the manager confirmed that there was a business and financial plan in place that was reviewed annually. Residents or their families were encouraged to maintain their own monies. Evidence was seen that the home maintained excellent records of any financial transaction taken on behalf of the residents i.e. hairdressing or chiropody. The families were billed individually for the extra services provided. The home had secure facilities within the office for the safe keeping of monies and valuables and an inventory was kept of any possessions handed over for safekeeping. Staff were now appropriately supervised with two RGN’s trained in giving supervision. Other staffs were to be trained in supervision skills next year. Records required for the protection of Residents and for the effective and efficient running of the business were accurate and up to date. The Manager was able to produce certificates and documentation to ensure that so far as is reasonably possible, the health, safety and welfare of residents and staff were promoted and protected. Newington Court Nursing Home DS0000026184.V260626.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 4 4 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 X X X 3 X 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 3 3 Newington Court Nursing Home DS0000026184.V260626.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15 Requirement Recording in care plans needs to be more comprehensive. This requirement was carried over from the last inspection. The registered person ensures that there is a policy and staff adhere to the procedures for the receipt, recording, storage, handling administration and disposal of medicines Timescale for action 01/12/05 2 OP9 13(2) 01/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP15 OP30 Good Practice Recommendations It is recommended that daily menus displayed in the dining rooms are kept current. It is recommended that all staff be trained in the care of residents with Diabetes. Newington Court Nursing Home DS0000026184.V260626.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Newington Court Nursing Home DS0000026184.V260626.R01.S.doc Version 5.0 Page 23 - 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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