CARE HOMES FOR OLDER PEOPLE
Newland House 304-308 Norton Road Stockton-on-Tees TS20 2PU Lead Inspector
Joanna D White Unannounced Inspection 27th January 2006 10:37a 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 DS0000000015.V278967.R01.S.doc Version 5.1 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 DS0000000015.V278967.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Newland House Address 304-308 Norton Road Stockton-on-Tees TS20 2PU 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) 01642 535702 01642 535702 Mr John Robinson Mrs Pearl Robinson Ms Angela Burgon Care Home 30 Category(ies) of Dementia - over 65 years of age (12), Old age, registration, with number not falling within any other category (18) of places Newland House DS0000000015.V278967.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. The number of persons shall not exceed 18 elderly frail people and 12 elderly mentally infirm people One named individual who is under the age category is allowed to reside in the home. 1st August 2005 Date of last inspection Brief Description of the Service: Newland House Care Home provides residential care for 30 older people. The home comprises two units, one with 12 places for older people with dementia, the second with 18 places for frail older people. The property comprises three terraced houses combined internally into one establishment. Single storey extensions have been added to the rear of the home over the years since it was originally registered. The two units operate separately, but not independently, and access between the units is by keypad locked internal doors. The home is situated in an urban area on a main road into Stockton, with access to frequent public transport to the local town and amenities. There are gardens and seating areas to the front and rear of the property. Newland House DS0000000015.V278967.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over five and three quarter hours. The inspector looked around the building and the grounds of the home as well as inspecting a number of the home’s records. Four residents, two members of staff, one visitor, and the proprietor, and the registered manager were spoken to on the day of the inspection. During the inspection the environment was observed to be clean, and tidy and there was a relaxed homely and welcoming atmosphere. The garden areas were tidy, and the pavements were free from algae. What the service does well:
Many of the staff have worked at the home for many years and have a good knowledge of the Residents they care for. A visitor who spoke to the Inspector said she always felt welcome when she visited the home. Her mother was always clean, and well dressed. The food was wholesome and met her mother’s needs. Some staff had been looking after her mother since her admission. She was always consulted about her mother’s care and had never had to make a complaint. A resident on the day of the inspection told the Inspector she was very comfortable and enjoyed living in the home. She said she could have a laugh with the staff that were always there to help her when needed. She said she had no complaints about her care or the food. Another resident told the inspector she had been well looked after since she had been admitted to the home. A further resident spoke to the Inspector and said she had liked her lunch. The inspector spoke to a resident who told her she was going to the lounge to listen to the singing. On the day of the inspection, the Inspector saw a group of the residents smiling and singing songs with their visitors and the staff. The staff that were spoken to by the inspector both said they enjoyed working at the home. On the day of the inspection the food was observed to be wholesome and nutritious and properly prepared. Newland House DS0000000015.V278967.R01.S.doc Version 5.1 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. Newland House DS0000000015.V278967.R01.S.doc Version 5.1 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 DS0000000015.V278967.R01.S.doc Version 5.1 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): 6 Standard 6 was not inspected on this occasion. The home does not provide intermediate care. EVIDENCE: Newland House DS0000000015.V278967.R01.S.doc Version 5.1 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 10 The resident’s health, personal and social care needs are set out in an individual plan of care The arrangements for health and personal care ensure that resident’s privacy and dignity are respected at all times. EVIDENCE: The Inspector audited a sample of Care Plans and the homes training records including staff files. Whilst it was evident the residents Care plans set out their health, personal and social care needs no clear explanation was recorded when neither the resident or the residents representative were unable to sign their Care Plan. Samples of resident’s files were audited. Risk assessment documentation needs to be monitored, reviewed, updated, and signed on a monthly basis. Staff that spoke to the Inspector confirmed they called the residents by their preferred name which was recorded in the Care Plan.
Newland House DS0000000015.V278967.R01.S.doc Version 5.1 Page 10 The visitor who spoke to the Inspector said they were able to speak to their relative in privacy. The registered manager and the proprietor who spoke to the inspector on the day of the inspection confirmed screens were available to ensure where residents shared a room that their privacy was not compromised when personal care was being given or at any other time. The Induction provided for staff was audited. Staff, are instructed on how to treat residents with respect at all times which is also included in the NVQ Level 2. One of the residents who spoke to the Inspector said they could spend private time in their room. Staff confirmed when they visited a resident’s room they always knocked on the door and waited for permission before they entered. Newland House DS0000000015.V278967.R01.S.doc Version 5.1 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): 14.15 The registered person conducts the home so as to maximise the resident’s capacity to exercise personal autonomy and choice. The residents receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. EVIDENCE: The registered manager and the Proprietor told the Inspector the personal possessions of residents were agreed before their admission to the home. All residents and their friends had been informed how to contact external agencies e.g. an advocate who would act in their interests if this were identified to be appropriate. One of the residents who spoke to the inspector said she had brought belongings from home to furnish her room. During the inspection the Inspector saw rugs belonging to some of the residents on their bedroom floors. Photographs, ornaments, bedside lights televisions, radios and their own chairs were also present. The Inspector audited the Homes access to personal records procedure.
Newland House DS0000000015.V278967.R01.S.doc Version 5.1 Page 12 On the day of the inspection the residents had fish/fish fingers peas mashed potatoes /chips for lunch and rice pudding for desert. The food was well presented and looked appetising. The three dining areas were comfortable and homely. Staff were observed to be available should any of the residents require help or support. One resident who spoke to the inspector said she had enjoyed her lunch The kitchen was clean and well organised. The proprietor said fresh meat was purchased on a daily basis from the local butcher. There were fresh fruit and vegetables in the kitchen. Newland House DS0000000015.V278967.R01.S.doc Version 5.1 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 Written procedures are in place, which promote the welfare of the residents. EVIDENCE: The Adult Protection and Prevention of Abuse Policies and Procedures were audited and contained information about the No Secrets Protecting Vulnerable Adults Tees wide Inter agency Policy Procedures and Practice Guidance. The homes whistle blowing policy was audited There was evidence in the training files that the staff had received training in abuse and the protection of vulnerable adults. The staff that spoke to the Inspector confirmed they had received training and were aware of what action to take should they become aware of any form of abuse towards the Residents. The visitor who spoke to the Inspector stated that she could go home after visiting her Aunt and be confident that she would be well looked after. Newland House DS0000000015.V278967.R01.S.doc Version 5.1 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 26 The residents live in a safe and well-maintained environment. The registered manager and the proprietor take a pride in making sure the home remains clean, pleasant and free from odours. EVIDENCE: The Proprietor confirmed there is a rolling programme of refurbishment, decoration and maintenance to keep the home looking good. Two new cookers are to be purchased during the next four to six weeks. An en-suite door is to be replaced. New carpets have been laid in three lounges, some of the bedrooms and the upstairs and downstairs passages. The corridors have all been decorated. New light shades have been fitted in the passages and the corridors. A cleaning rota ensures the residents rooms and the homes environment are odour free. The Inspector saw clean and ironed bed linen on the day of the inspection, which contributed towards a homely and comfortable environment.
Newland House DS0000000015.V278967.R01.S.doc Version 5.1 Page 15 The relative who spoke to the inspector on the day of the inspection said the home was always clean. Newland House DS0000000015.V278967.R01.S.doc Version 5.1 Page 16 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 30 Staff are being trained to NVQ level 2 which should ensure they could meet the residents needs. The skill mix of staff that are trained, and competent to undertake their jobs meets the residents’ needs. There is a comprehensive and ongoing programme of training for staff. EVIDENCE: It was recorded in the Pre-Inspection Questionnaire that 80 of staff had been successful in obtaining their NVQ Level 2. There are 19 members of staff who currently hold a first aid certificate. A staff member who spoke to the Inspector confirmed she had received training in food hygiene, fire prevention, manual handling, dental hygiene, first aid and COSHH Examples of training provided for staff revealed that staff had received training in first aid, health and safety, COSHH, Infection Control, Moving and Handling, Food and Hygiene, Risk assessment, No secrets, Oral health promotion, NVQ 2 and 3 and NVQ4 in social care. The plan for future training was audited.
Newland House DS0000000015.V278967.R01.S.doc Version 5.1 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): 35 38 The financial interests of residents are promoted by the homes policies and procedures. The manager ensures as far as reasonably practicable the health safety and welfare of residents and staff EVIDENCE: The homes policies and procedures, which promote the financial interests of the residents, were audited. The registered Manager and the Proprietor confirmed there were two residents who control their own money. Written records of all transactions were made although the Inspector observed the resident had not signed the financial records at the same time as the designated member of staff. Secure facilities were provided for the safe – keeping of money on behalf of the resident. The inspector was informed on the day of the inspection there were no possessions handed over for safe keeping by any of the residents.
Newland House DS0000000015.V278967.R01.S.doc Version 5.1 Page 18 The Homes Health and Safety Policies and Procedures were audited. The registered Manager and the Proprietor agreed to update their procedures in respect of ‘cot sides’. The pre inspection questionnaire included information about staff that had undertaken training in health and safety, COSHH, Infection Control, Moving and Handling, and Food and Hygiene, Risk Assessment, and Fire Safety. The records for future planned training were also audited. Samples of staff records were audited and confirmed Mandatory training in Health and Safety had been completed in November 2005. The Homes Maintenance Records were examined. Newland House DS0000000015.V278967.R01.S.doc Version 5.1 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 2 8 X 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 2 X X 3 Newland House DS0000000015.V278967.R01.S.doc Version 5.1 Page 20 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 Care Plans must be agreed and signed by the resident whenever capable and /or their representative (if any) The registered manager must ensure all Residents risk assessments are monitored reviewed updated and signed on a monthly basis. The registered Manager must update the procedures in respect of ‘cot sides’. Timescale for action 30/03/06 2. OP7 13 31/03/06 3. OP38 13 28/02/06 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 OP23 OP35 Good Practice Recommendations Residents, who are wheelchair users, should be offered a bedroom at least 12 sq m. The Registered Manager should ensure the entries in the resident’s financial records, are signed and dated, by the
DS0000000015.V278967.R01.S.doc Version 5.1 Page 21 Newland House resident, at the same time as the entry of the designated member of staff Newland House DS0000000015.V278967.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Tees Valley Area Office Advance St. Marks Court Teesdale Stockton-on-Tees TS17 6QX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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