Inspection on 03/10/05 for Newlands

This inspection was carried out on 3rd October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Newlands 13/03/07

Newlands 11/05/05

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 Announced Inspection 3rd October 2005 09:00 Newlands DS0000047634.V255253.R01.S.doc Version 5.0 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 Newlands DS0000047634.V255253.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 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. Newlands DS0000047634.V255253.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Newlands Address South Newton Salisbury Wiltshire SP2 0QD 01722 742066 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) newlands@glensidemanor.co.uk Glenside Manor Healthcare Services Ltd Mrs Margaret Hiscock Care Home 9 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (9) of places Newlands DS0000047634.V255253.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11/05/05 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 Andrew Norman 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 DS0000047634.V255253.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place on the 3rd October 2005 between 9.00am and 1.00pm. There were eight 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. Inspection of staff recruitment and training records took place on the 5th October 2005 and Mary Collier, pharmacy inspector, also visited the home on this date to assess the arrangements regarding medications. The inspector met with Mrs Hiscock, the registered manager and Mr Norman, the responsible individual, to report the findings of the inspection. What the service does well: What has improved since the last inspection? What they could do better: There were very few complaints about the home apart from some people feeling that the meals could be improved. Recruitment procedures need to be more robust as not all of the required documents relating to staff were in place. Newlands DS0000047634.V255253.R01.S.doc Version 5.0 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Newlands DS0000047634.V255253.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Newlands DS0000047634.V255253.R01.S.doc Version 5.0 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 the following standard(s): 1, 2 and 4 Service users have the information and opportunity to make an informed choice about the home and their needs are thoroughly assessed before admission. EVIDENCE: Copies of the service users guide and the statement of purpose are available in the front hallway of the home and in each service users bedroom. A new service user who was due to be admitted on the day of the inspection had previously visited the home and there was evidence of pre admission visits in other service users plans. Some service users are transferred directly from other units at Glenside. This means that they are easily able to visit Newland’s and enables staff to be fully aware of their needs prior to admission. Care plans contained evidence that comprehensive pre admission 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. Newlands DS0000047634.V255253.R01.S.doc Version 5.0 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 the following standard(s): 6, 7 and 10. Individual plans reflect service users assessed needs and goals and they are able to make decisions about their lives. Confidentiality is respected. 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. The main aim of the unit is to try and enable service users to develop some degree of independence within their capabilities and Mrs Hiscock described how they are encouraged and supported to make decisions about their life. Programmes to facilitate this are in place utilising qualified therapy staff. Limitations were only in place where service users are unaware of a risk to their health and safety. One service user is delivering the internal mail around Glenside and another delivers papers around the local village. Staff receive training regarding client confidentiality as part of their induction. All personal documentation is kept in an office, which is locked when not in use. Newlands DS0000047634.V255253.R01.S.doc Version 5.0 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 the following standard(s): 12, 13, 14 and 17. Service users are able to take part in appropriate social and therapeutic activities. Nutritional needs are met, but not all are happy with the meals provided. EVIDENCE: A mixture of therapeutic and social activity is available and service users are given the option to participate. Some service users are working on producing a regular newsletter. A ’social club’ has been set up on Thursdays in Grovely House and service users have the opportunity to meet others from the Glenside campus. Monthly residents meetings are held and recorded. Service users were planning to attend a ‘Quiz Night’ in a nearby pub. A ‘newspaper’ group was held during the inspection whereby service users are encouraged to discuss current affairs. A minibus is available and regular trips to Salisbury are arranged. One service user attends church with their family and another has visits for Holy Communion. Six service users comment cards were received that indicated an overall satisfaction with the home although three responded ‘sometimes’ to the question, do you like the food? The main kitchen provides lunch and a choice is Newlands DS0000047634.V255253.R01.S.doc Version 5.0 Page 11 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 DS0000047634.V255253.R01.S.doc Version 5.0 Page 12 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 the following standard(s): 18, 19 and 20. Service users receive appropriate support and their physical and emotional needs are met. The systems for the handling of medication are good and arrangements are such that service users’ individual needs are met. EVIDENCE: The current service users are able to look after their own personal hygiene needs but some require prompts and supervision to achieve this. Service users spoken to, allied to the comment cards received, indicate that they are happy with the support provided by staff. One service user was hoping to return home and support workers from the community were attending Newlands in order to ensure that they would be able to meet his needs on discharge. Care plans indicated that health care needs were assessed and reviewed, and any changes were dealt with promptly. Referrals were made to health care professionals and outcomes were recorded. A GP visits the home each Friday and cover is available throughout the week. A GP visit is arranged during the first week of admission. Emotional needs are addressed and a psychologist is available. A phlebotomist has now been employed and there are now four speech and language therapists at Glenside to compliment the existing therapy services. Newlands DS0000047634.V255253.R01.S.doc Version 5.0 Page 13 The home has a comprehensive medication policy and up to date homely remedies list. All records are appropriately kept and medication stored securely. The same medication disposal system is used as that required for homes with nursing. Carers receive training in medication handling and specific training relevant to the drugs used in the home. It is recommended that two trained nurses should witness the disposal of controlled drugs in the DOOP system. Newlands DS0000047634.V255253.R01.S.doc Version 5.0 Page 14 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 the following 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 recruitment practice needs to improve. EVIDENCE: The complaints procedure was on view in the home. No complaints had been received by CSCI and the complaints log indicated that no serious complaints had been received by the home. The one informal complaint logged had been dealt with promptly. A policy regarding protection of vulnerable adults is available and the manager and staff have experience in, and awareness of, procedures regarding abuse. Staff also receive mandatory training in abuse awareness. Small amounts of money are held on behalf of service users in a safe. Regular audits are undertaken to ensure probity. Three ‘accounts’ were checked and found satisfactory. Recruitment procedures need to be more robust with regard to obtaining CRB checks and references. Findings are detailed in the ‘Staffing’ section of this report and there are three statutory requirements relating to this. Newlands DS0000047634.V255253.R01.S.doc Version 5.0 Page 15 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 the following standard(s): 24, 25, 27, 28 and 30 Newlands provides a safe, homely environment, which meets the service users needs and lifestyle. The home is clean and hygienic. EVIDENCE: The home 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 lockable 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 are 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. Any clinical waste is disposed of appropriately. Newlands DS0000047634.V255253.R01.S.doc Version 5.0 Page 16 The main laundry is provided in a separate two-storey building on site. The laundry staff provide a service to all the units at Glenside; infection control measures were in place and all equipment was working. Two staff were on duty the day of the inspection and they confirmed that they were generally able to cope with the workload during the week, however at weekends staff sickness levels had caused some concern. The management team were aware of this issue. The current layout of the laundry over two floors necessitates staff carrying laundry upstairs to be ironed and stored. Mr Norman reported that there were plans to redesign and extend the laundry to incorporate all services on the ground floor and to provide an extra washing machine. Newlands DS0000047634.V255253.R01.S.doc Version 5.0 Page 17 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, and 35 The home has an effective well trained staff team, with sufficient numbers and complimentary skills to support service users assessed needs at all times. In some instances, recruitment procedures do not fully protected service users. EVIDENCE: Many service users at Newland’s have complex needs and can be challenging. 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 nine service users. The manager felt that staffing levels were appropriate as did two service users spoken to. New staff are recruited via the Glenside human resources department and the registered managers do not always have the opportunity to undertake interviews, although they do meet candidates to show them around the individual units. Recruitment procedure appears non discriminatory. A selection of staff recruitment records for all of the Glenside units was reviewed. In the main appropriate documentation was in place, however in one instance a CRB check had not been obtained for a staff member who had been employed for almost two years and in two other cases, references from previous employers, one of whom had been a care provider, had not been obtained. Should a person with a criminal record be employed, full details of any convictions Newlands DS0000047634.V255253.R01.S.doc Version 5.0 Page 18 should be on file. It is also desirable that written evidence of a risk assessment process, indicating their suitability for employment, be available. Records indicated that staff had received induction, foundation and mandatory training. Further training in relevant subjects such as dementia care and cognitive rehabilitation therapy is also provided. NVQ training is provided and the training manager stated that on ‘most units’ had up to 50 of staff with an NVQ. Newlands DS0000047634.V255253.R01.S.doc Version 5.0 Page 19 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 40 and 42 The registered manager is qualified, competent and experienced to run the home, and receives appropriate support to do so. Comprehensive quality monitoring is undertaken and policies and procedures aim to safeguard service users rights and best interests. Health and safety arrangements are satisfactory. EVIDENCE: Margaret Hiscock, the homes registered manager, has 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. 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. Newlands DS0000047634.V255253.R01.S.doc Version 5.0 Page 20 Effective quality monitoring systems are in place, elements of which involve seeking service users views. The management team undertakes regular audits of the service and action plans are developed to address findings. Comprehensive policies and procedures are in place, all of which had been reviewed in September 2005, authorised by the business management team and signed by the registered manager. 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. Accidents are recorded and action taken if appropriate. Staff are trained in first aid and a first aid kit is available. Fire safety arrangements were satisfactory. Arrangements for maintenance of services and equipment were not reviewed during this inspection. Newlands DS0000047634.V255253.R01.S.doc Version 5.0 Page 21 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 3 4 X 3 X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 4 3 X X 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 X 3 3 X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 3 2 3 X CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Newlands Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 X 4 3 X 3 X DS0000047634.V255253.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? No 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 YA34 Regulation Requirement Timescale for action 03/10/05 2 YA34 3 YA34 19(1,a,b,i)Sc2(7a,b) The registered person is required to ensure that all staff have undertaken a Criminal Record Bureau check. 19(4,c) The registered person is 03/10/05 Sch 2(3) required to ensure that two written references, including, where applicable, a reference to the person’s last period of employment, be obtained for all new staff. 19(1,a,b,i) The registered person is 03/10/05 Sch2(a,b) required to ensure that details of any criminal offences of which a staff member has been convicted are recorded. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Newlands DS0000047634.V255253.R01.S.doc Version 5.0 Page 23 1 2 3 4 YA17 YA20 YA34 YA34 It is recommended that service users be consulted about the meals provided. It is recommended that two trained nurses should witness the disposal of controlled drugs in the DOOP system. It is recommended that registered managers be involved in interviewing potential staff members. It is recommended that when staff with a criminal record are employed, a risk assessment process that indicates their suitability for employment is undertaken, and written evidence of this process be available. Newlands DS0000047634.V255253.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham 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 DS0000047634.V255253.R01.S.doc Version 5.0 Page 25 - 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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