Inspection on 15/12/05 for Newland House

This inspection was carried out on 15th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Newland House 30/08/07

Newland House 10/11/06

Newland House 11/07/05

Newland House 11/03/05

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Newland House 50 Newland Witney Oxfordshire OX28 3JG Lead Inspector Philippa MacMahon Unannounced Inspection 15th December 2005 12.00 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 Newland House DS0000062675.V273224.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. Newland House DS0000062675.V273224.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Newland House Address 50 Newland Witney Oxfordshire OX28 3JG 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) 01993 702525 01993 702530 Crispin Homes Limited Mrs Elizabeth, Ann Bird Care Home 24 Category(ies) of Dementia - over 65 years of age (6), Learning registration, with number disability over 65 years of age (1), Old age, not of places falling within any other category (24), Physical disability over 65 years of age (3) Newland House DS0000062675.V273224.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The number of service users accommodated at any one time must not exceed 24. 11th July 2005 Date of last inspection Brief Description of the Service: Newland House is situated on the outskirts of Witney, which is a short walk away. The building is listed, built around 400 years ago and has been sensitively adapted so as to retain many of the original period features. The interior is of a high standard and offers a comfortable environment. There is an attractive garden to the front of the house. The home offers 24-hour care by a well trained and committed staff group, has been awarded the Investor in People Award and has won the Heart of England TEC prize for the best training of a small business. Building work is nearing completion to provide a new extension to the home, and a programme of refurbishment in the house is also taking place. Newland House DS0000062675.V273224.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and the second to take place in the inspection year. The inspector was given a warm welcome and all co-operation was given throughout the inspection by all the staff. A new wing to the home is nearing completion and the residents and staff are looking forward to the opening in the spring. The inspector spent time talking to the residents, staff and the registered manager to hear their views of life at Newland House. The Commission for Social Care Inspection also received comment cards from relatives/visitors and visiting professionals about Newland House. Individual care plans, and other records required by regulation, were examined. A tour of the premises took place, and the inspector had an enjoyable lunch taken with the residents in the dining room. What the service does well: What has improved since the last inspection? Newland House DS0000062675.V273224.R01.S.doc Version 5.0 Page 6 The separation of the building works for the safety of the residents. Weekly fire test are carried out and recorded. Changes to the management of the medication administration record when new medication is prescribed or the GP changes the dose of any medication. 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. Newland House DS0000062675.V273224.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 Newland House DS0000062675.V273224.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): None of these outcomes were assessed at this inspection. EVIDENCE: Newland House DS0000062675.V273224.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 All the residents have a care plan in which their assessed care needs are identified and the action required to meet them. The medication systems within the home are in good order and residents, where appropriate, are able to be responsible for their own medication. The residents are treated with dignity and respect. EVIDENCE: A sample of care plans was examined and, overall, were found to give an account of the residents’ assessed care needs and how those needs will be met. Monthly reviews are documented, and relevant risk assessments carried out. The nutritional assessment tool “MUST” is in the process of being implemented and all residents within the home will be included. Newland House DS0000062675.V273224.R01.S.doc Version 5.0 Page 10 One care plan examined showed that the resident was prone to falling and copies of completed incident/accident forms were seen within the care plan. Further discussion with the registered manager included information about a local Oxfordshire Falls Service. It is recommended that the registered manager should contact this service and seek advice on how best to manage people who fall frequently. All of the residents have access to a local GP, and if they require nursing care the district nursing service is readily available. There is access to dentist, chiropodist and opticians when required. The medication system was examined and found to be in good order. One of the residents is self-medicating and the medication requires being kept in the fridge. As there is no medication fridge available, this is kept in the kitchen. It is recommended that any medication kept in the food fridge should be kept in a lidded container within the fridge, and that consideration should be given to obtaining a separate medication fridge. The inspector observed staff assisting the residents’and it was clear that they understood the issues of privacy and dignity, such as knocking on doors and addressing the residents by their preferred term of address. Newland House DS0000062675.V273224.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15 Meals and mealtimes are considered by the residents to be enjoyable and tasty and they have a lot of choice. EVIDENCE: The inspector joined a group of residents for lunch that was served in the most attractive dining room. The meals served looked attractive and were served individually to suit the residents’ requirements. The desserts were served from a trolley and there was a choice of five different dishes to choose from or fresh fruit salad that all looked very appetising. At the evening meal there is always homemade soup at this time of the year, as well as the choice of other high tea dishes. The menus examined showed that a wholesome and nutritious diet is offered. The cook said that she is planning to make seasonal changes over the course of the year that will take into account fresh fruit and vegetables available. Residents told the inspector that the food was always lovely and that they did not have any particular favourites, as it was always good. Newland House DS0000062675.V273224.R01.S.doc Version 5.0 Page 12 The inspector spent some time with the cook who joined the staff relatively recently. It is commendable that soon after she was in post the cook took time to come into the home to meet with the residents individually to find out their individual likes and dislikes. The kitchen is part of the improvement plan that is being undertaken and the cook has been party to the design of the new kitchen. These improvements will not take place until the completion of the new wing and interim arrangements are being made to ensure that the extra number of residents anticipated will not be an issue as regards meals and mealtimes. This includes the provision of a mobile heated serving trolley. Newland House DS0000062675.V273224.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 Every effort is made to protect the residents from any form of abuse. EVIDENCE: A copy of the Oxfordshire Multi-Agency Protection of Vulnerable Adults Group guidelines are used as part of the induction training for all staff, and for those staff involved in NVQ 2 and 3. The registered manager said that all new staff go through the criminal records bureau and protection of vulnerable adults first check as part of the recruitment process. The registered manager was unaware of the latest directive that all new staff must not commence duties until the application for criminal records bureau check has been processed and a protection of vulnerable adults first check has been obtained. It is a requirement that all staff must have applied for a criminal records bureau check, and a protection of vulnerable adults first check been made before they commence duties. Newland House DS0000062675.V273224.R01.S.doc Version 5.0 Page 14 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): 19,25,26 The residents live in a comfortable, warm and clean environment. A system of regularly checking the temperature of the water from the hot water outlets needs to be put in place. EVIDENCE: As mentioned earlier there is major building work going on in the home, and the inspector found all areas of the home to be clean, and all necessary arrangements to protect the residents from any disruption or harm had been put in place. The inspector carried out random checks of the hot water outlets, and a wash hand basin in one of the bathrooms exceeded 48°C. There was no record of any regular checks having been made and an immediate requirement was made that the temperature of the hot water outlet must be controlled to around 43°C, and a record of monthly checks on all hot water outlets must be kept. Newland House DS0000062675.V273224.R01.S.doc Version 5.0 Page 15 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, 30 The staffing levels and skill mix are appropriate to meet the care needs of the residents. All the staff are trained and competent to do their jobs. The home’s recruitment policy and practices are in good order. EVIDENCE: The inspector examined the current staff rota, and the sample sent with the Commission for Social Care Inspection pre-inspection questionnaire that the registered manager had completed prior to this inspection. These showed that the correct numbers and skill mix of staff are on duty at all times. The registered manager is committed to the training and development of staff and all of the staff are either qualified to a minimum of NVQ Level 2 in Care, or registered on a programme to attain this. One member of staff has completed Levels 2,3 and 4 and is progressing to obtain the Managers’ award. There are 2 NVQ assessors. A sample of staff files was examined and showed that the correct policies and procedures are in place regarding recruitment. Newland House DS0000062675.V273224.R01.S.doc Version 5.0 Page 16 All new staff receive induction training that meets the National Training Organisation training targets. An ongoing training plan is being developed that will include all training provided including the mandatory fire safety, moving and handling and food hygiene. Newland House DS0000062675.V273224.R01.S.doc Version 5.0 Page 17 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): 33, 38 The home is run in the best interest of the residents. Quality systems need to be further developed. The health, safety and welfare of residents is considered to be a priority by the registered manager and all necessary systems are in place to support this. EVIDENCE: There is no quality assurance system in place at the present time, or an annual development plan. The registered manager operates an “open door” management style and has very good communication skills. Families and visitors are always able to access the staff at any time to talk through any issues. Newland House DS0000062675.V273224.R01.S.doc Version 5.0 Page 18 The Commission for Social Care Inspection relatives’/visitors’ comment cards received prior to this inspection gave positive comments regarding the excellent communication systems in place. Letters of commendation received are always shared with all the staff. The training record showed that all staff receive mandatory training in fire safety, moving and handling, first aid, food hygiene and infection control. All records required by regulation were made available to the inspector and found to be up to date and complete. Newland House DS0000062675.V273224.R01.S.doc Version 5.0 Page 19 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 X X X N/A 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 X 13 X 14 X 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 2 3 X X X X X 2 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 X X 2 X X X X 3 Newland House DS0000062675.V273224.R01.S.doc Version 5.0 Page 20 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. Standard OP18 Regulation 19(4)(b) Requirement It is a requirement that all staff must have applied for a criminal records bureau check, and a protection of vulnerable adults first check been made before they commence duties. Timescale for action 15/12/05 2. OP25 13(4)(c) It is an immediate requirement that the temperature of the hot water outlets must be controlled to around 43°C, and a record of monthly checks on all hot water outlets must be kept. 15/12/05 Newland House DS0000062675.V273224.R01.S.doc Version 5.0 Page 21 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 OP8 Good Practice Recommendations It is recommended that the registered manager should contact the falls service and seek advice on how best to manage people who fall frequently. It is recommended that any medication kept in the food fridge should be kept in a lidded container within the fridge, and that consideration should be given to obtaining a separate medication fridge. 2. OP9 Newland House DS0000062675.V273224.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South Cowley Oxford OX4 2SU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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