Inspection on 27/06/07 for Newlands Care Home

This inspection was carried out on 27th June 2007.

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 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

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Newlands Care Home Newlands Park Workington Cumbria CA14 3NE Lead Inspector Marian Whittam Unannounced Inspection 27th June 2007 10:00 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 Newlands Care Home DS0000069261.V338225.R01.S.doc Version 5.2 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. Newlands Care Home DS0000069261.V338225.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Newlands Care Home Address Newlands Park Workington Cumbria CA14 3NE 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) 01900 872257 01900 607429 Barchester Healthcare Homes Ltd Post Vacant Care Home 35 Category(ies) of Dementia (3), Dementia - over 65 years of age registration, with number (12), Old age, not falling within any other of places category (23), Physical disability (1) Newlands Care Home DS0000069261.V338225.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The Service should at all times employ a suitably qualified and experienced manager who is registered with the CSCI. The home is registered for a maximum of 35 service users to include: up to 23 service users in the category of OP (Older people over the age of 65 years of age) up to 12 service users in the category of DE(E) (Dementia over 65 years of age) may be accommodated within the designated unit. 1 named service user in the category of DE(E) (Dementia over 65 years of age) may be accommodated within the overall number of registered places. 3 named service users in the category DE (Dementia under 65 years of age) may be accommodated within the overall number of registered DE(E) places. 1 named service user in the category of PD (Physical Disabilities under 65 years of age) may be accommodated within the overall number of Registered places. Date of last inspection Brief Description of the Service: Newlands Care Centre is a purpose built care home and provides nursing and personal care for people over the age of 65, some of whom have dementia, and offers to provide long term, short term and respite care. The home is in a quiet residential area and has easy access to the town of Workington and its amenities. Newlands Care Centre is wholly owned by Barchester Healthcare Homes Ltd. The home is a modern single storey building that is light and spacious and has wide corridors and ample communal space for people. The home is divided into two units with separate staff for each. One unit, Lonsdale, offers nursing care to 12 people who have dementia care needs and nursing care is provided for frail elderly residents on the other unit. There is a secure garden area for the people on Lonsdale unit to enjoy and use. Many bedrooms also have pleasant views out over the gardens and grounds at the front and side of the home and these are accessible to people on the nursing unit. There is adequate car parking for visitors and staff at the front of the home. Information is made available to people living in the home or considering Newlands Care Home DS0000069261.V338225.R01.S.doc Version 5.2 Page 5 coming to live there in the combined statement of purpose and resident’s guide that forms the welcome pack to the home and is given to all people coming to live there or to their relatives. The fees charged range from £625.00 to £700.00 and do not include the cost of personal magazines and newspapers, hairdressing, private chiropody treatment and the cost of any private travel arrangements. Newlands Care Home DS0000069261.V338225.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced site visit that forms part of a key inspection took place in slightly over five and a half hours. Before this site visit information was gathered on the service from the providers, from people living in the home and relatives using questionnaires. Concerns raised by residents, relatives and other stakeholders have been included in planning the inspection. The inspector arrived at 09.50 and following a discussion with the deputy manager a tour of the premises was made. Time in the morning was spent looking around the home observing routines and interaction, talking with residents in the lounges and in their own bedrooms, speaking to the nursing and care staff and cleaning staff, observing any activities in progress and looking at care plans. Policies and procedures, systems for recording complaints, financial records and personnel and training records were looked at in the afternoon as well as other records required by regulation. This is the first inspection of the home since it came under new ownership. What the service does well: Newland’s is a purpose built nursing home specialising in care for the elderly frail and residents with varying degrees of dementia. The building is very welcoming, it is well maintained and has pleasant communal areas for residents and visitors to use. The home provides a safe, warm and homely environment where residents feel relaxed and comfortable. Residents spoken to like living in the home and spoke highly of the staff and the care and support they receive from them. One person said staff were “very kind” and that they were “very pleased” with their bedroom and it was cleaned every day. The bedrooms are clean and well furnished and have en suite facilities. Staff training is being given a high priority and the people living there benefit from a trained, and experienced staff team who, together with the manager and other members of the senior team, deliver a good general standard of care. There are robust recruitment procedures for staff and the thoroughness of pre employment checks helps to safeguard the welfare of people living there. This is also supported by and effective quality monitoring system. The care plans in use are detailed and focused on the individual. The social assessment used is also very informative and useful to help staff in relating to residents as individuals and for the further development of activities around what individuals want. Dietary needs of residents are well catered for with a balanced and varied selection of good quality food and home cooked meals. People living there say that the food is good and that there is always a choice. Newlands Care Home DS0000069261.V338225.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: There are effective monitoring systems in place and the information provided by the manager about the homes systems and evidence seen during the visit indicate that the new manager has a clear focus on what needs to improve and has put these forward. The most significant area that needs improving to make sure individual needs are always met is within better contingency planning for staff shortfalls. On Lonsdale unit there have been occasions when the one to one support outlined in the care plan has not been available. Consideration should be given to better contingency planning to make sure agreed levels of support are followed and care is not compromised when staff levels unexpectedly fall. Although care plans focus upon the individual it is not always evident in what ways people living there are being involved in creating and developing them. Consideration should be given to making it clear how people living there are being actively involved in creating and developing their care plans to support Newlands Care Home DS0000069261.V338225.R01.S.doc Version 5.2 Page 8 their independence. Recreational activities people take part in should also be recorded and if people found them valuable or beneficial and note any specific issues that need more attention and support. Although overall medication handling is satisfactory it is strongly recommended for safe practice that when a medication record has been handwritten by staff, and not checked by a GP, it should be checked by a second person and referenced back to the original prescription. This will minimise the potential for errors affecting residents when charts are rewritten by staff. Similarly a record should be kept on the medication chart of pulse rates where they are done before a medicine is given making monitoring this easier. Although the home is well maintained it was evident that the storage of equipment, particularly hoists, could be a problem. Consideration should be given to improving storage facilities so the corridors and communal areas are kept free from equipment that is not in use. In this way people will not have to share their space with equipment or be at risk of having their access to exits impeded. 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. The summary of this inspection report can be made available in other formats on request. Newlands Care Home DS0000069261.V338225.R01.S.doc Version 5.2 Page 9 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 Newlands Care Home DS0000069261.V338225.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 1,2,3 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is an effective assessment and admission procedure and relevant and detailed information about the home is provided to help people make an informed decision about coming to live there. EVIDENCE: Individual care plans are in place for all the people living in the home and comprehensive initial assessment have been completed before and on admission to help make sure that the home can meet individual needs and to identify personal preferences. These assessments form the basis of the care plan on admission that is developed further when people come in. The registered manager or senior nursing staff assess all new residents prior to their admission and this assessment is used as a basis for the plan of care. Newlands Care Home DS0000069261.V338225.R01.S.doc Version 5.2 Page 11 Where appropriate care management plans are obtained from social services before admission. People considering coming to live in the home are given the opportunity to visit the home and look at the rooms available, if they are unable to do this their relatives are welcome to visit. Following admission there is a four week trial period to make sure the home suits them and is meeting their needs. People living there have been given terms and conditions of residency and they or their relatives/advocates sign to agree these terms. Information is available about the home for prospective residents and their families in the statement of purpose and service users guide provided to all residents in their rooms. This does however need some minor updating to management arrangements to make sure that the information on the services provided is up to date. Otherwise the information is clear and in sufficient detail to identify as to the range of general and specialist services on offer to meet individual needs and sets out the organisational philosophy. In this way people thinking about using this service can make a fully informed choice about whether or not the home is suitable for them. Consideration should be given to providing information in different formats, such as large print and audio to meet particular needs although the deputy manager confirmed that if asked for this would be provided. The home does provide some information in pictorial formats on Lonsdale unit such as information on the Mental Capacity Act. Newlands Care Home DS0000069261.V338225.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care planning system, medication records and individual assessments provide staff with the information they need to meet people’s health and personal care needs. EVIDENCE: All residents have a clear and easily followed individual plan of care, based on the initial assessment. Each plan sets out the health, personal and social care needs of the residents and this information ensures staff are aware of the level of care necessary to meet these needs. Care plans show that they have been reviewed at least monthly and any identified changes are incorporated into them. It is evident from examining the plans that any changes in the care needs are noted promptly in between the reviews and have been updated to make sure the plan reflects the current situation. This was particularly evident for some people around their wound care, psychological needs and changes in Newlands Care Home DS0000069261.V338225.R01.S.doc Version 5.2 Page 13 personal care needs. There are good clinical and nursing strategies in place for handling conditions and behaviours this was evident for one person needing more individualised support and supervision. Additional staff training has been put in place on dealing with aggression in response to changing needs of one person living there. This indicates a proactive and individualised approach to providing care and support for residents and families. This individualised approach to nursing care could be further developed by making it clear within their personal plans how people living there or their representatives are being actively involved in developing and changing their own plans. This could give staff greater insight into peoples personal perspectives on how they themselves want to be supported and their individuality and independence promoted. This could compliment the good work already being done on life stories and individual preferences. Referrals are being made for timely medical assessment and to specialist services including dieticians and speech and language therapy for one resident. Inspection of the medicines storage and records showed a system that is being monitored to protect resident’s interests. Policies and procedures are readily available for staff handling medication to access and read. Medication records examined were satisfactory and these together with the medicines held are subject to audit on a regular basis. The management has implemented a daily check of controlled drugs following the investigation of two incidents in order to reduce the risk of error or mishandling and so safeguard residents. Some further good practice actions should also be given consideration to further minimise any risk to residents. In line with the guidance from The Royal Pharmaceutical Society when a medication record has been handwritten and not checked by a GP it is strongly recommended that these be checked by a second person and referenced back to the original prescription. This will minimise the potential for error when charts are re- written by staff. Also when a medication is given requiring the checking of pulse rates the rate should be recorded on the chart for easy monitoring. Observations during the visit indicate that staff treated the residents with care and consideration and handled difficult situations with patience and understanding. One resident said, “ they are sensitive to my needs “ and “ I don’t think I could be looked after better, the staff are very kind”. Newlands Care Home DS0000069261.V338225.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home are able to make lifestyle choices, follow their own interests if they want and maintain social and family contacts. EVIDENCE: The home encourages relatives and friends to visit and residents say there are no restrictions on when people can visit them. People living there are supported to go into the community or to the local shops if they wish and the home has a minibus that can be used for visits and trips out. There are links with the local ‘Stroke Club’ that people can also attend if they wish to. Care plans show a good level of information about people’s preferred social and religious activities and useful personal profiles indicating life histories, important events and interests. This is valuable information that can be used in promoting a person centred focus on opportunities for recreation particularly for those who have difficulty communicating their thoughts and feelings. However this needs to be incorporated more actively into people’s individual social and recreational needs. The home is in the process of implementing its Newlands Care Home DS0000069261.V338225.R01.S.doc Version 5.2 Page 15 own ‘Memory Lane’ training programme under the direction of the organisations Clinical Development Nurse to develop recreational opportunities that are meaningful for people. Information provided by the management and the planning approach being taken by staff and management indicates a lot of effort is going into devising and implementing an activity programme that reflects what people living there want and expect to improve this aspect of life in the home. One person told how they used their motorised wheelchair to go out in the local area and this made them feel “normal”. More than one person said how much they enjoyed spending time in the gardens. Improvements are also planned by the management for improving the gardens to provide a safe sensory garden for use by people living Lonsdale unit. Residents can also take part in different religious services at the home if they wish to or be visited by their own clergy and priests. There is access to advocacy services through ‘Care Aware’ to help and support people and this is displayed in the foyer. An activity plan for the week is displayed and there are two organisers covering the two units on each unit providing activities through the week which people may chose to attend. Residents confirm that some activities take place, one especially liked the quizzes and “having my hair done”. Activities scheduled include bingo, reminiscence groups, exercise sessions, music sessions and entertainment and quizzes. There is a hairdresser that visits the home every two weeks, aromatherapy is available and the home has just recruited a beautician to work 7 hours a week for use by residents. However records in care plans about what social and recreational people were taking part in and if they had found them valuable or beneficial and any specific issues that needed more attention are not being consistently kept. This kind of individual evaluation could add to useful work being done on person centred care. This avoids a ‘blanket’ approach to recreational opportunities. The management is aware of the need to increase recreational opportunities and is taking steps to address this. The home offers a choice of food at each meal and the menus are displayed on each unit. People may choose to take their meals with others in the pleasant dining room or in their own rooms if they prefer. The presentation of the meals is good and people living there and relatives have commented on the good standard of catering and food. Resident’s confirm that food and menus are raised and discussed at resident’s meeting, one said that the food is “very good” and that the menu is “varied”. Newlands Care Home DS0000069261.V338225.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and relatives are able to express their concerns through an effective and accessible complaints procedure and protection is promoted by an efficient adult protection policy and practices. EVIDENCE: The home has a clear complaints procedure that is displayed within the home and in the statement of purpose/service user guide and in the terms and conditions of residency given to all people living in the home. The system in use logs complaints raised for investigation records the actions taken and by whom and the feedback given to the complainant. There was evidence of an investigation being underway in regard to a complaint raised by a relative and what actions were currently being taken to resolve and prevent a reoccurrence. Copies of correspondence and details of investigation are kept on file. There have been 6 complaints received in the last 12 months and all of these have all been responded to within the 28 day timescale stated in the procedures. Records indicate that the complaints procedure is being followed and the organisation is responding to complaints that are brought to them. Day to day issues that people raise can be dealt with by nursing staff on the units if brought to their attention or passed to the manager if they cannot resolve it. Newlands Care Home DS0000069261.V338225.R01.S.doc Version 5.2 Page 17 Adult protection procedures are in place and local multi agency guidance available to staff and information on whistle blowing. There are procedures regarding Protection of Vulnerable Adults (POVA) processes and on referral to the POVA register. Training is given on adult protection and preventing abuse and a training session was taking place on the day of the visit. Staff spoken with were clear about what they would do if they suspected abuse and which were the appropriate agencies to contact. Survey responses and comments from people in the home indicate that they are aware of how to make a complaint. One person said to the inspector “ I have never needed to make a complaint but I would go to the head one and she would sort it out”. Training has recently been given to staff on handling and responding to aggression and unpredictable behaviour so that they are better prepared to deal with this especially on the Lonsdale unit. Staff spoken with said that they felt able to raise any concerns they had generally. There are regular staff meeting and residents and relatives meetings and these allow people to express their views and any concerns they feel. Newlands Care Home DS0000069261.V338225.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 19, 20, 21,22, 23, 24, 25 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enables the people living there to live in a safe, well-maintained, clean and comfortable environment that allows them both freedom and privacy. EVIDENCE: The home has dedicated cleaning staff to maintain a clean and hygienic environment and there were 2 working in the home during the visit. Resident’s spoken with said their rooms were cleaned each day. There were no lingering malodours noted on either of the units and all areas visited were clean and hygienic. Staff have been given training on infection control and were observed to be following infection control procedures. Gloves and protective aprons were Newlands Care Home DS0000069261.V338225.R01.S.doc Version 5.2 Page 19 available on each unit and being used by staff. Records show that infection control is an area of practice subject to audit. There is sufficient communal space in lounges and dining rooms for people to relax, see visitors or join in an activity and the main lounge has recently been redecorated. The entrance and foyer is bright and welcoming and the nursing station is sited so staff are accessible to anyone entering the home. There is a separate hairdressing room and a small kitchen on the elderly frail unit for relatives and staff to make drinks or snacks. The home has its own laundry for the resident’s clothes and bedding and the home has a full time maintenance person who checks equipment, systems and water temperatures. Staff have their own changing rooms and staff areas for breaks. All bedrooms are single rooms and have their own en suite facilities and there are separate toilets close by and bathrooms with assisted bathing aids. Bedrooms are well furnished and the soft furnishings coordinated and many people have brought in their own possession to make their room more personal and homely. Bathrooms, toilets and showers are all sufficiently large enough to allow wheelchair access and for the use of equipment There are suitable adaptations in the home, ramps for wheelchair users and moving and handling equipment in place to make people comfortable and promote their independence. Call bells are in resident’s bedrooms, toilets, bathrooms and communal areas. Adjustable nursing beds are used following assessment. There is a variety of moving and handling equipment used in the home and these hoists and wheelchairs were seen stored in bathrooms and in the corridors, one leading to a fire exit. Consideration should be given to providing separate storage areas that keep the body of the home free from equipment not being used and that does not impede access to exits for people. Newlands Care Home DS0000069261.V338225.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 27, 28, 29 and 30Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The numbers and skill mix of care staff on the duty rota are sufficient to meet the personal and health care needs of people living in the home. EVIDENCE: There is one Registered General Nurse (RGN) and three care assistants on the Elderly frail unit for the morning and afternoon shifts and one RGN or Registered Mental Nurse (RNM) and two care assistants on the EMI unit. At night this changes to one registered nurse and one care assistant on each unit. This provides a level of staffing in keeping with the nursing needs of current residents on the elderly frail unit. People spoken with and survey comments indicate that there are staff available to give them a good level of care and attention. On Lonsdale unit care management plans indicate that an additional member of staff is needed during the day to provide one to one support for a resident to help maintain their safety and personal care in line with clear management strategies for their needs This additional carer allows the remaining staff to maintain an appropriate level of care and supervision for the rest of the people living there so there is no negative impact on their care. Rotas, reviews and staff spoken with confirm that there have been occasions when this one to one Newlands Care Home DS0000069261.V338225.R01.S.doc Version 5.2 Page 21 support has not been available. This may have a negative impact on the care and support available to the other people living on Lonsdale. If the manager offers to provide services to people with dementia according to their assessed needs as stated in the Statement of Purpose then it should be done consistently according to the care strategies. Consideration should be given to better contingency planning to make sure agreed levels of support are followed and care is not compromised when staff levels unexpectedly fall. Management planning indicates sickness monitoring for staff is being addressed to bring absence levels down so this problem has been noted. There is a good skill mix of nursing and care staff and there are, currently 50 of the care staff trained to National Vocational Qualification (NVQ) level 2 or above with more doing this training. There is an ongoing staff training programme, some done on computer, with records of training completed and when updates are due. All mandatory training is up to date, including manual handling, food hygiene, infection control, fire training and First aid. Staff spoken with felt that they were given opportunities for training and development and for nursing staff to continue to develop professionally and keep up to date. Regular staff meetings take place that provides another opportunity to discuss relevant issues. There are clear recruitment and selection procedures overseen by the administrator and manager. Application forms are completed, references taken up and interviews arranged. Records show that new staff are appointed and begin work only after all the required legal checks have been completed and that they have a period of induction before working unsupervised. An example of good practice in recruitment was evident in the way residents are being involved in recruitment under the new manager. Two of the people living in the home were involved in interviews when the head of unit for Lonsdale was being recruited and asked questions from a resident’s perspective. One of these people told the inspector they had enjoyed being involved in this process. Newlands Care Home DS0000069261.V338225.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 31, 33, 35, 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management and administration of the home is open and there are quality monitoring systems in operation to promote and safeguard the best interests and welfare of people living there. EVIDENCE: The new manager Ms Alison Farran came into post in January this year and has undergone the process for registration as manager with the Commission for Social Care Inspection. (CSCI). As part of that registration process Ms Farran, a registered nurse demonstrated that she has the skills, experience and Newlands Care Home DS0000069261.V338225.R01.S.doc Version 5.2 Page 23 qualifications to manage the home and to ensure people living there receive a high standard of service. There is also a deputy manager in post who assists the registered manager especially in training and overseeing clinical areas in the home. There are clear lines of accountability for staff within the home and staff spoken to are clear about their roles. Staff spoken with felt that whilst the acting manager had done a good job they were glad to have someone permanent in post. There are quality monitoring systems in operation to protect resident’s interests and allow them a say in the way things are done in the home. One person told the inspector they always attended the resident’s meeting so they could have their say and confirmed that the management sought their opinions and they felt “listened to”. Quality audits are being carried out and the organisation has a ‘Compliance Officer ’who does audits in line with the national minimum standards. Records were seen of recent health and safety, medication and infection control audits and a nutrition and dining audit. These identified areas that the manager will target for improvement one was training for staff that are being acted upon. The management has already reviewed systems and identified areas that it needs to improve over the next 12 months and this includes carrying out satisfaction surveys as part of quality monitoring and developing the new business plan with residents and staff and making sure formal supervision goes ahead for staff. This indicates an understanding of the need for planning and a proactive approach to management issues and service development. A system for appraisals has also been introduced and these are currently being done for all staff. There are working practices in place to minimise the risk of accidents and the home has a comprehensive range of policies and procedures in place to promote and protect residents and staff. Equipment is maintained under annual service agreements and by the home’s own maintenance staff who attend to the regular testing of emergency equipment. Some staff were receiving fire training on the day of the visit. The home has a policy for the safe handling of residents money. The only money handled in the home is petty cash and small amounts of cash for the resident’s personal use, which are recorded, and receipts given. All other expenses are invoiced monthly and the home’s administrator demonstrated this system in operation. Newlands Care Home DS0000069261.V338225.R01.S.doc Version 5.2 Page 24 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 2 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 2 3 3 3 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 3 Newlands Care Home DS0000069261.V338225.R01.S.doc Version 5.2 Page 25 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. Standard Regulation Requirement Timescale for action 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 OP7 Good Practice Recommendations Consideration should be given to making it clear within personal plans how people living there are being actively involved in creating and developing their care plans and their personal perspectives on how they want to be supported and their independence maintained. When a medication record has been handwritten and not checked by a GP it is strongly recommended that these be checked by a second person and referenced back to the original prescription. This will minimise the potential for errors affecting residents when charts are re- written by staff. When a medication is given requiring the checking of pulse rates the rate should be recorded on the chart for easy monitoring should changes be needed. Records should be consistently kept in care plans about what social and recreational opportunities people are taking part in and if they have found them valuable or DS0000069261.V338225.R01.S.doc Version 5.2 Page 26 2. OP9 3. 4. OP9 OP12 Newlands Care Home 5. OP22 6. OP27 beneficial and any specific issues that need more attention to improve or adapt them are not being consistently kept. Consideration should be given to improving storage facilities to keep the home and communal areas free from equipment not in use and do not impede access to exits for people. Consideration should be given to better contingency planning to ensure staffing to meet clearly identified support needs and make sure no one’s care is compromised by any staff shortfalls. Newlands Care Home DS0000069261.V338225.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Care Home DS0000069261.V338225.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!