Inspection on 11/05/05 for Newlands

This inspection was carried out on 11th May 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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Newlands 13/03/07

Newlands 03/10/05

Newlands 04/10/04

Newlands 13/08/04

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

CARE HOME ADULTS 18-65 Newlands South Newton Salisbury Wiltshire SP2 0QD Lead Inspector Steve Cousins Unannounced 11th May 2005 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Newlands D51 D01 s47634 Newlands v225239 110505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Newlands Address South Newton Salisbury Wiltshire SP2 0QD 01722 742066 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) Glenside Manor Health Services Ltd Mrs Margaret Hiscock Care Home 9 Category(ies) of MD Mental Disorder 18 Years - 64 Years - 9 registration, with number of places Newlands D51 D01 s47634 Newlands v225239 110505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th October 2004 Brief Description of the Service: Newlands is a 9-bedded rehabilitation unit for younger persons with acquired brain injury. It is not service users permanent home. The home is a domestic type dwelling, with bedrooms on the ground and first floor. A range of different recreational and therapeutic space is provided on the ground floor. Mrs Margaret Hiscock is the registered manager of the home; she leads a team of support staff. Occupational therapy, physiotherapy, psychology and other clinical staff provide support to rehabilitation programmes. Newlands is part of a group of homes on one campus owned by Glenside Manor Health Care Services Ltd. Mr Denis Barry is the nominated responsible individual. He is supported by a senior management team. One catering and laundry department supplies all the homes on site. A maintenance team also works across the site. The group of homes is situated in the village of South Newton, on the A36, five miles north west of the city of Salisbury. A mainline train station is in Salisbury, the A 36 is on a bus route and ample car parking space is available on site. Newlands D51 D01 s47634 Newlands v225239 110505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place between 9.30am and 2.45pm. There were 7 service users in the home. The findings from this inspection are based on a tour of the premises, speaking to service users, the manager and staff, and inspecting a number of records, including care plans. The inspector then met with the registered manager to report the findings of the inspection. What the service does well: What has improved since the last inspection? What they could do better: The complaints procedure needs to be slightly amended and it would be better if all complaints were recorded in the complaints log rather than service users care documents. There is also a need to clarify the procedure for reporting any alleged abuse of service users in order to ensure that the local vulnerable adults unit are informed in the first instance. Newlands D51 D01 s47634 Newlands v225239 110505 Stage 4.doc Version 1.30 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. Newlands D51 D01 s47634 Newlands v225239 110505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Newlands D51 D01 s47634 Newlands v225239 110505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 and 4. The service users aspirations and needs are thoroughly assessed and they have the opportunity to visit the home. The suitability of the home to meet their needs is regularly reassessed after admission. EVIDENCE: Care plans contained evidence that comprehensive assessments are undertaken of service users needs and that they are fully involved in the process. Assessments include risk management, physical and mental health needs, social and spiritual needs and treatment and rehabilitation programmes. Assessments involve the multidisciplinary team (MDT), which includes physiotherapists, occupational therapists and clinical psychologist. Some service users are transferred directly from other units at Glenside. This means that they are easily able to visit Newlands and ensures that staff are fully aware of their needs prior to admission. The manager discusses whether the placement will be suitable with the service user and the MDT. Those service users who are transferred from hospitals or other homes are fully assessed prior to admission and have the opportunity to visit. A prospective service user had visited prior to the inspection and his wife was due to visit on the afternoon of the inspection. The ongoing assessment system ensures that the suitability of the placement is constantly reviewed. Newlands D51 D01 s47634 Newlands v225239 110505 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. 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 The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7and 9 Individual plans reflect service users assessed needs and goals. Service users are able to make decisions about their lives and are supported in achieving independence as far as is possible. EVIDENCE: Individual plans were very comprehensive, based on assessment and regularly reviewed. Service users sign agreement to their plans and are aware of the purpose of rehabilitation programmes in meeting their personal needs and goals. Conversations with service users and entries in their notes indicate that they are able to make decisions about their lives, and were supported by staff in achieving things. Where this may include a degree of risk, this is fully assessed and appropriate support and guidance is offered. It is acknowledged that full independence is sometimes limited by the degree of brain injury suffered. A service user wished to move on from the home and was supported in doing so. Another had started delivering mail to the other units; she was initially being accompanied but was now doing this independently. Newlands D51 D01 s47634 Newlands v225239 110505 Stage 4.doc Version 1.30 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,14,15 and 17. There are opportunities for personal development and independence is promoted. Leisure, social, nutritional and relationship needs are met. EVIDENCE: Rehabilitation programmes are in place, which aim to support service users to develop an independent lifestyle and encourage personal development. Service users are fully supported by a range of professionals to achieve this. Service users time is structured to resemble a working week; therefore leisure time is usually during the evening or at weekends. Group activities are held and the home has an activities room. Computer, television and audio equipment is available and service users are supported to pursue interests both in and out of the home. Service users reported contact with friends and relatives and some had formed friendships within the home. There were complimentary remarks regarding meals. The main kitchen provides lunch and a choice is available. Some service users prepare their own evening meals as part of their rehabilitation programmes. There is a separate dining area and staff provide support if required. Newlands D51 D01 s47634 Newlands v225239 110505 Stage 4.doc Version 1.30 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 20 Service users physical and emotional health care needs are being met. The arrangements regarding medication ensure the service users safety, and promote independence where appropriate EVIDENCE: Care plans indicated that health care needs were assessed and reviewed, and any changes were dealt with promptly and appropriately. Referrals were made to GP’s and other health care professionals and outcomes were recorded. Service users confirmed that they had access to GP’s and other services as required. A GP visits the home each Friday and there a GP is available on the Glenside campus throughout the week. Evidence in care plans, along with the staff and service users comments, suggested that emotional needs were being addressed. There was access to a clinical psychologist and staff displayed a good awareness of the service users emotional needs. No service users were currently self-administering medication within the home. Two did have the responsibility of approaching staff to request medications when they were due, in order to work towards self-administration. The arrangements for storage, recording and administration of medicines were satisfactory. Team leaders received appropriate training and since the last inspection, a policy had been developed regarding the emergency administration of rectal diazepam, which had been agreed by the community nursing service. Newlands D51 D01 s47634 Newlands v225239 110505 Stage 4.doc Version 1.30 Page 12 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 Service users complaints are listened to and action is taken to resolve them. As far as possible, service users are protected from possible abuse although staff need to be aware of local protocols. EVIDENCE: The complaints procedure was on view in the home. This needed to be amended to state that complaints can be referred to CSCI at any time, not just if the complainant was dissatisfied with the homes investigation. There were two complaints recorded in the complaint log since the last inspection. Both were minor and had been resolved promptly. Details in a care plan indicated that a service user had made a complaint. This had been investigated to a satisfactory conclusion and the service user happy with the outcome, however as the sequence of events leading to the conclusion had been documented in several separate sections of the plan, it is recommended that the complaints log be used for this purpose. No complaints have been received by CSCI. Small amounts of money are held on behalf of service users in a safe. Regular audits are undertaken to ensure probity. Two ‘accounts’ were checked and found satisfactory. Two staff members and the manager displayed an awareness of procedures regarding the reporting of suspected abuse and had received training. There needs to be further clarification to staff and managers regarding the local guidelines issued by Wiltshire Social Services (WSS), which suggest that any suspected abuse is reported to either social WSS or the Vulnerable Adults Unit (VAU), before any in-house investigation commences and any staff are interviewed. Staff also need to be aware that they can contact either WSS or VAU independently if they need to. There have been no reports of suspected abuse relating to this service. Newlands D51 D01 s47634 Newlands v225239 110505 Stage 4.doc Version 1.30 Page 13 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,28 and 30 Newlands is a safe, homely environment, which meets the service users needs and lifestyle. The home is clean and hygienic. EVIDENCE: Newlands is a spacious domestic style dwelling, which has two sitting rooms, a dining room, kitchen and activity area. Furniture was of an acceptable standard, as was the decoration. There are adequate bathroom and toilet facilities. The home is suitable for wheelchair users. There is a large accessible garden to the rear of the home. Service users rooms are lockable and some show evidence of individualisation, however this is somewhat limited as Newland’s is not intended as a permanent residence and some service users are not from the local area. All bedrooms are single. The home was clean and odour free and where able, service users were responsible for cleaning their own rooms, with staff assistance if required. A washing machine is provided for personal items and there is a sluice facility, and staff hand washing facilities. There is a central laundry at Glenside. A tour of the home indicated that it was free from hazards to safety. To enhance service users safety, there is controlled access to the home and the entrance and area to the front of the building are CCTV monitored. Newlands D51 D01 s47634 Newlands v225239 110505 Stage 4.doc Version 1.30 Page 14 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33. The home has an effective staff team, with sufficient numbers and complimentary skills to support service users assessed needs at all times. EVIDENCE: The manager, her deputy and two support assistants were on duty at the time of the inspection. The duty rota indicated that there was usually a minimum three staff on duty during the day, in addition to the manager, and two at night. The home accommodates up to eight service users. Staff and the manager felt that levels were appropriate and more stable than in the past. Staff have to undertake some domestic tasks, but those spoken to felt that this did not impinge on their primary role. Occupational therapy, physiotherapy and clinical psychology staff are also available on the Glenside site and this enables rehabilitation programmes to be more effective. Service users were happy with the numbers of staff available and felt their needs were met. A service user felt he was supported to make progress towards independence. Service users were made aware of when there may not be a staff member of the same sex as them on duty, and alternative arrangements can made by utilising other staff at Glenside if necessary. Newlands D51 D01 s47634 Newlands v225239 110505 Stage 4.doc Version 1.30 Page 15 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37 The registered manager is qualified, competent and experienced to run the home, and receives appropriate support. EVIDENCE: Margaret Hiscock, the homes registered manager, has recently completed the Registered Managers award. She is a registered nurse who has many years experience in brain injury services and has managed other care homes. Conversation with Mrs Hiscock indicated that she was fully aware of her role and responsibilities. Mrs Hiscock is supported by a deputy, and line managed by the Glenside Operations Manager, who has almost daily contact with the home. Weekly meetings are held with the Operations Manager and the other registered managers at Glenside. The management team regularly monitors standards of service. Service users were aware who the manager was and were complimentary about her. Staff felt the manager was very approachable and ‘a good manager’. Newlands D51 D01 s47634 Newlands v225239 110505 Stage 4.doc Version 1.30 Page 16 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x 3 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x x 3 x 3 Standard No 11 12 13 14 15 16 17 3 x x 3 3 x 3 Standard No 31 32 33 34 35 36 Score x x 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Newlands Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 x x x x x x D51 D01 s47634 Newlands v225239 110505 Stage 4.doc Version 1.30 Page 17 No 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 YA22 Regulation 22(7,a,b) Requirement The registered person is required to ensure that the complaints procedure states that complaints can be referred to the CSCI at any time. Timescale for action 11.5.05 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 YA22 YA23 Good Practice Recommendations It is recommended that all complaints be recorded in the complaints log book It is recommended that staff and the manager receive clarification of the role of Social Services and the Vulnerable Adults Unit, with regard to the reporting of supected abuse. Newlands D51 D01 s47634 Newlands v225239 110505 Stage 4.doc Version 1.30 Page 18 Commission for Social Care Inspection Suite C, Avonbridge House Bath Road Chippenham Wiltshire SN15 2BB 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 Newlands D51 D01 s47634 Newlands v225239 110505 Stage 4.doc Version 1.30 Page 19 - 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. 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