Inspection on 28/04/05 for Newington Court Nursing Home

This inspection was carried out on 28th April 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 21/10/05

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 HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Newington Court Nursing Home Keycol Hill Newington Sittingbourne ME9 7LG Lead Inspector Sue McGrath Unannounced 28 April 2005 10:00 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 Older People and Care Homes for Adults 18 – 65*. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Newington Court Nursing Home v223485 h56-h06 s26184 newington court v223485 280405 stage 41.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Newington Court Nursing Home Address Keycol Hill Newington Sittingbourne Kent ME9 7LG 01795 843033 01795 843662 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) Barchester Healthcare Homes Limited Care Home with Nursing 50 Category(ies) of OP Old Age (23) registration, with number DE(E) Dementia - over 65 (22) of places PD Physical disability (5) Newington Court Nursing Home v223485 h56-h06 s26184 newington court v223485 280405 stage 41.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: To include one Service User (MD(E) Over 65) whose date of birth is 23.10.33 Date of last inspection 13 September 2004 Brief Description of the Service: Newington Court is a 50-bedded care home providing 24-hour nursing care to older people, some of who have mental health needs. The home also provides care to one younger adult with physical disabilities, although their registration is for 5.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 46 single rooms and 2 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 v223485 h56-h06 s26184 newington court v223485 280405 stage 41.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over four and a half hours. The manager was not at the home on the day of the inspection so the senior nurse, Bonga Mzamo, assisted with the inspection. 15 residents, several visitors and staff were also spoken to. Due to the condition of some of the residents it was difficult to incorporate accurate reflections of some areas of the service in the report. Many judgements about quality of life were taken from observations, speaking with staff and records. A tour of the premises was made which included several of the resident’s bedrooms and all the communal areas. What the service does well: The home generally is decorated and furnished to a high standard and is clean, bright and airy. The people living at the home said they were satisfied with the care they received. Several family members confirmed that they were also happy with the level of care offered. The admission process is sound and ensures assessed needs on admission can be met. The food is of a high standard with most of the residents saying that the food was tasty and well presented. It was clear a choice was offered. Relatives spoke highly of the positive contact and feedback from senior staff, regarding the care of their loved ones. The laundry service is of a high standard. The resident’s health care requirements are well managed and resident’s have full access to specialist medical services according to need. The home has a robust procedure for the protection of vulnerable adults and a comprehensive complaints procedure. Newington Court Nursing Home v223485 h56-h06 s26184 newington court v223485 280405 stage 41.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Newington Court Nursing Home v223485 h56-h06 s26184 newington court v223485 280405 stage 41.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Standards Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6-10 and 18–21) (Standards 11–17) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37–43) Newington Court Nursing Home v223485 h56-h06 s26184 newington court v223485 280405 stage 41.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. 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. Prospective service users have an opportunity to “test drive” the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,3,, Residents and families are provided with detailed information on Newington Court, which enable 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. Resident’s legal rights to occupancy are protected by a written statement of terms and conditions. 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. A visiting family confirmed they had been encouraged to visit the home prior to the admission of their Mother and that a member of staff from the home had visited their Mother in hospital, also prior to admission, to carry out an assessment. Newington Court Nursing Home v223485 h56-h06 s26184 newington court v223485 280405 stage 41.doc Version 1.30 Page 9 Several care plans were inspected and these contained full pre-admission assessments. The family also confirmed that their Mother 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 said contracts in other care plans. During discussion with many of the residents it became apparent that a high percentage were suffering some degree of dementia and it will be a requirement that the manager completes a needs assessment to confirm whether the registration of the home reflects the true needs of the residents. Newington Court Nursing Home v223485 h56-h06 s26184 newington court v223485 280405 stage 41.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6-10 and 18 –21 (Adults 18-65) 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. Including their physical and emotional health needs. 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. 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. Service users receive personal support in the way they prefer and require. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 7, 9, 18, 19 and 20 (Adults 18-65) are the key standards to be inspected at least once during a 12 month period JUDGEMENT – we looked at outcomes for standard(s) 7,8,9 Whilst residents benefited from detailed care plans some areas of the plans need to improve. The health needs of individual’s were mainly well met and residents benefited from good multidisciplinary working. The number of residents with dementia needs to be assessed to ensure that the home is not in breach of its registration conditions. The service users’ welfare was protected by the home’s policy and procedures with regard to the handling and administration of medication. Newington Court Nursing Home v223485 h56-h06 s26184 newington court v223485 280405 stage 41.doc Version 1.30 Page 11 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 fluid charts had been filled in erratically. Recent changes in staff meant that many of the named nurses or key workers were no longer working at Newington Court. Service users spoken to were also unaware of whom their named nurse was. This was an area discussed with the manager who was aware of the problem and was working towards resolving the issue. Good working practises regarding the treatment of pressure sores 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. Good evidence was seen in care plans of regular medication reviews with G.Ps, as required from the last inspection. Requirements from the last inspection regarding to the procedures for receipt, recording and administration of medication had been met. Several residents stated that they felt well cared for and that the staff were polite and caring. One relative confirmed that she was always consulted with any changes in her Mothers condition and her plan of care. Other visitors spoke highly of the care offered and were happy for their relative to live at Newington Court. The home will be required to assess the number of residents with a diagnosis of dementia to ensure the homes registration is correct. Newington Court Nursing Home v223485 h56-h06 s26184 newington court v223485 280405 stage 41.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 11 – 17 (Adults 18-65) are: 12. 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. Including opportunities for personal development. Service users engage in appropriate leisure activities. Service users maintain contact with family/ friends/ representatives and the local community as they wish. And have appropriate personal, family and sexual relationships. 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. 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15, 16 and 17 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13,15 Residents are able to maintain contact with family and friends as they wish. Residents receive a wholesome appealing balanced diet in pleasing surroundings. EVIDENCE: 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 visitors could use for private meetings. Residents could also use this room for spiritual reflection. Several residents stated that the food was very good. The meal seen looked wholesome and appetising. Residents confirmed that they were given a full choice over meals and visitors confirmed they could purchase a meal if required. Specialised diets were offered including diabetic diets and pureed meals. The cook confirmed that pureed meals were presented in a pleasing way with different foods kept separate to enhance appearance. Newington Court Nursing Home v223485 h56-h06 s26184 newington court v223485 280405 stage 41.doc Version 1.30 Page 13 Newington Court Nursing Home v223485 h56-h06 s26184 newington court v223485 280405 stage 41.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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. Including neglect and selfharm. The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 The home has a robust complaints system and service users and relatives feel their views are listened to and acted upon. The home has robust adult protection policies and procedures to ensure that residents are protected from abuse. 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 to 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. Staff spoken to could demonstrate an understanding of the Adult Abuse policy and of the effects of such abuse. Newington Court Nursing Home v223485 h56-h06 s26184 newington court v223485 280405 stage 41.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) 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. Shared spaces complement and supplement service users’ individual rooms. Service users have sufficient and suitable lavatories and washing facilities. Provide sufficient privacy and meet their individual needs. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. And lifestyles. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,24,26 Whilst the majority of residents benefit from living in a safe, clean and comfortable environment, the upper floor of the home is not odour free and is in need of refurbishment. Residents benefit from occupying bedrooms are clean and appropriate to their needs. The residents benefit from having access their own en-suite rooms with sufficient additional toilets and specialised bathrooms. The residents benefit from home’s laundry services which are well organised and designed to control the spread of infection. Newington Court Nursing Home v223485 h56-h06 s26184 newington court v223485 280405 stage 41.doc Version 1.30 Page 16 EVIDENCE: The manager discussed the programme of planned maintenance that included redecoration and some new carpets on the upper floor. The grounds were seen to be in good order and provided safe access to pleasant seating areas. The communal areas were pleasant and comfortable. Several residents commented that they liked their bedrooms. Relatives spoke highly of the environment within the home. All of the bathrooms inspected were clean, airy and suitable for use. The home had sluice disinfectors in place. Some residents had cot sides in place with padded protestors also in place. All areas were centrally heated with appropriate safety measures in place. Emergency lighting was provided and generally the lighting was sufficient to meet the needs of the residents. The cleanliness within the home was to a high standard. The laundry area was also clean and well organised. Newington Court Nursing Home v223485 h56-h06 s26184 newington court v223485 280405 stage 41.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 36 (Adults 18-65) are: 27. 28. 29. 30. • • • Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. 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. Service users benefit from clarity of staff roles and responsibilities. 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 27, 29 and 30 (Older People) and Standards 34 and 35 (Adults 18-65) the key standards to be inspected at leat once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 Instability in staffing levels, particularly in trained nurses has meant that residents have not had always had a consistency of care. Service users do not benefit from having staff who receive regular supervision. EVIDENCE: Discussion with the senior nurse indicated that recently several nurses had left or gone onto maternity leave. The home has used agency staff to cover these gaps. The senior nurse had been in post for approximately eight weeks and was able to demonstrate a good understanding of the residents needs and of the needs of the service generally. Residents were happy with the staff group, although several commented on seeing lots of different faces. Phone communication has improved at the weekends, as required from the last inspection. Visitors stated that staff were caring and hard working. Discussion with the manager confirmed that she was aware of the problems of instability in the staff group and was actively encouraging a more stable workforce. Newington Court Nursing Home v223485 h56-h06 s26184 newington court v223485 280405 stage 41.doc Version 1.30 Page 18 The senior nurse and manager were reviewing staff supervision and a new system was being introduced. Newington Court Nursing Home v223485 h56-h06 s26184 newington court v223485 280405 stage 41.doc Version 1.30 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 37 – 43 (Adults 18-65) are: 31. 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 a well run home and from competent and accountable management of the service. 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. Service users are confident their views underpin all self-monitoring, review and development by the home. 32. 33. 34. 35. 36. 37. 38. • The Commission considers standards 33, 35 and 38 (Older People) and Standards 39 and 42 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33 The 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. EVIDENCE: Although the manager was not on duty on the day of the inspection, discussion did take place with the inspector and feedback was given. Newington Court Nursing Home v223485 h56-h06 s26184 newington court v223485 280405 stage 41.doc Version 1.30 Page 20 The manager has recently returned from Maternity Leave and it was evident she was aware of the issues that had arisen during her absence. The manager was aware that she needed to complete her registration with Commission as soon as possible. Newington Court Nursing Home v223485 h56-h06 s26184 newington court v223485 280405 stage 41.doc Version 1.30 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 3 2 3 3 3 4 x 5 x 6 x HEALTH AND PERSONAL CARE ENVIRONMENT Standard No 19 20 21 22 23 24 25 26 STAFFING Score 3 3 3 x x 3 x 3 Score Standard No 7 8 9 10 11 Score 2 3 3 x x Standard No 27 28 29 30 2 x x x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 3 COMPLAINTS AND PROTECTION Standard No 16 17 18 Score 3 x 3 MANAGEMENT AND ADMINISTRATION Standard No Score 31 3 32 3 33 3 34 x 35 x 36 x 37 x 38 x Newington Court Nursing Home v223485 h56-h06 s26184 newington court v223485 280405 stage 41.doc Version 1.30 Page 22 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. Standard OP7 OP36 OP3 Regulation 15 18 14 Requirement Recording in care plans needs to be more comprehensive. Records of supervision to be maintained to monitor the dates of supervision for all staff.. An assessment is required of all residents to ensure that the home is not providing care outside of its registration figures Timescale for action Action plan by 03/05/05 Action plan by 03/05/05 Action Plan by 03/05/05 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. Refer to Standard OP15 Good Practice Recommendations It is recommended that daily menus are made avaliable in the dining rooms. Newington Court Nursing Home v223485 h56-h06 s26184 newington court v223485 280405 stage 41.doc Version 1.30 Page 23 Commission for Social Care Inspection The Oast Hermitage Court Hermitage Lane Maidstone Kent. 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 v223485 h56-h06 s26184 newington court v223485 280405 stage 41.doc Version 1.30 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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!