Inspection on 16/08/05 for Newlands House Cheshire Home

This inspection was carried out on 16th August 2005.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Newlands House Cheshire Home 12/11/08

Newlands House Cheshire Home 28/11/06

Newlands House Cheshire Home 24/01/06

Newlands House Cheshire Home 08/02/05

Newlands House Cheshire Home 05/08/04

Newlands House Cheshire Home 10/03/04

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

CARE HOME ADULTS 18-65 Newlands House Cheshire Home Main Street Netherseal Swadlincote DE12 8DA Lead Inspector Claire Williams Unannounced Inspection 16 August 2005 at 9:15 am th 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 House Cheshire Home C52 C02 S2158 Newlands V243571 160805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Newlands House Cheshire Home Address Main Street, Netherseal, Swadlincote, Derbyshire, DE12 8DA 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) 01283 761202 01283 762888 Leonard Cheshire Ann Linda Stanley Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (32) of places Newlands House Cheshire Home C52 C02 S2158 Newlands V243571 160805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. 32 places for PD aged 18 years and over. 2. Provides 10 Nursing Places. Date of last inspection 8/2/05 Brief Description of the Service: Newlands House is a purpose built home offering 24-hour personal care and nursing for adults of either sex with a physical disability between the ages of 18 and 65 years. The accommodation comprises of 32 single bedrooms. The design, layout and size of the home allow Service Users good access and freedom of movement. The Home has a hydrotherapy pool, physiotherapy and occupational therapy areas. The Home is situated in the village of Netherseal and has some nice views from its grounds. It is close to local amenities. The Responsible Person is a national charitable organisation. Newlands House Cheshire Home C52 C02 S2158 Newlands V243571 160805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and started at 9.30pm and lasted 7 hours. The Inspector spent time examining care records, and associated documents, speaking with the 10 service users and 2 relatives, and observing service users and staff interactions. A partial tour of the building was undertaken. The inspector spoke with the Registered Manager who was on duty. The inspector used “case tracking methodology” which involves the examination of records/documents, discussion with (the individual service users, staff and where appropriate relatives) and evidence in relation to individual service users to determine how the National Minimum Standards work for them in practice. Three service users were case tracked during this inspection visit. Following discussions with individuals living in the home the inspector was informed that for the purpose of the report they would like to be called ‘residents’. What the service does well: What has improved since the last inspection? The Registered Manager has developed a pre-admission assessment, which gathers all of the required information about a residents needs. The Registered Manager then confirms in writing as to whether the home can meet individual support needs based on the assessment undertaken. Newlands House Cheshire Home C52 C02 S2158 Newlands V243571 160805 Stage 4.doc Version 1.40 Page 6 Potential staff members are now asked to confirm in writing the reasons for any gaps in their employment. This ensures that the staff team are appropriately checked in order to safeguard the resident’s welfare. Residents have all of the required assessments completed, to ensure that their physical needs are met, and monitored regularly. The home has appropriate procedures in place to safeguard residents from abuse. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Newlands House Cheshire Home C52 C02 S2158 Newlands V243571 160805 Stage 4.doc Version 1.40 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 House Cheshire Home C52 C02 S2158 Newlands V243571 160805 Stage 4.doc Version 1.40 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) 1, 2 ,3, 5 Information and opportunities are provided to enable residents to make an informed choice about moving into the home. Assessments are undertaken to ensure individual needs and aspirations are met. EVIDENCE: Residents are provided with a copy of the Statement of Purpose and service user guide, which enables them to have the information they require to make an informed choice about where to live, and to be informed about the facilities available at this home. Each resident has an individual support plan, which includes the cost for each element of support required, this links in with the terms and conditions of residency which is issued to all residents. The Registered Manager has developed the pre-admission assessment, which now includes all of the required areas apart from information concerning the compatibility of the individual with other residents living in the home. The Registered Manager now formally writes to all individuals in relation to the outcome of the assessment undertaken, and whether the home can meet their support needs. Newlands House Cheshire Home C52 C02 S2158 Newlands V243571 160805 Stage 4.doc Version 1.40 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, 7, 8, and 9 Care files reflect individual aspirations and needs, and details how these should be supported. Service users are consulted about their lives and about the running of the home. EVIDENCE: The inspector examined three residents’ files. The inspector found it difficult to locate up dated and current information, as the files contained a lot of old information, and the documentation was not filed in sections or date order. The files did contain support plans; the topics covered within these plans were varied but included aspects of personal and healthcare needs, specific to individuals. Each resident has a document entitled ‘My Personal daily needs’, which is written from the resident’s perspective and details the individual preferences and support required in personal care tasks. Within the files there was support plans and information in relation to physiotherapy support and therapeutic programmes, which are completed by trained staff members. Information and support plans in relation to individual’s culture and faith was not included in the files examined. Each resident had daily logs, which provided detailed information about the daily lives and activities of the people living in the home. Some documentation was not dated so the inspector was unable to ascertain when the documents Newlands House Cheshire Home C52 C02 S2158 Newlands V243571 160805 Stage 4.doc Version 1.40 Page 10 were implemented. Each file contained risk assessments in relation to Moving and Handling and behavioural assessments. The risk assessments indicated key areas of concern and ways in which staff could minimise or eliminate any problems arising from these risks. There was evidence in all three files to confirm that the documentation has been reviewed every 6 months. Some of the documentation just had a date recorded, and no explanation about why it remains the same or requires amendments. Residents informed the inspector that they are actively encouraged to be independent in their lives, and that the staff team do consult them on all aspects of their care, and about issues concerning the running of the home. However the inspector was informed by some residents about a change to the domestic support available in the home (see Environment standards). The residents confirmed that they had not been consulted about this change, which was implemented by the organisation. Newlands House Cheshire Home C52 C02 S2158 Newlands V243571 160805 Stage 4.doc Version 1.40 Page 11 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, 12, 13, 14 and 16 Residents have access to varied opportunities, and life experiences in order to develop independent living skills. Opportunities were tailored to individual interests and abilities. EVIDENCE: Within this home there are activity workshops, which are utilised by some daycare residents, and the residents living at the home. Facilities available include; a computer room, which has hi-tech equipment to enable individuals with profound physical disabilities to use; an arts and crafts area, gardening workshop, and the hydrotherapy pool. All of these facilities enable residents to have the opportunity for personal development and access to age appropriate activities. Discussions with residents highlighted the value placed on the availability of these facilities, and all residents stated that this is one of the reasons why they ‘choose this home’ and what makes the home ‘good’. All residents that access the hydrotherapy pool, stated how relaxing it was and how it helped them with exercising all parts of their body. Some of the ‘skills and interests’ plans in the files were out of date. The activities co-ordinator informed the inspector that she has recently consulted Newlands House Cheshire Home C52 C02 S2158 Newlands V243571 160805 Stage 4.doc Version 1.40 Page 12 all service users on what activities they would like to access. This documentation was being held by the activity co-ordinator for information to enable her to organise appropriate activities. An information board was on display listing the planned weekly activities for that week. Residents stated that it was their individual choice to participate in these activities or not, and stated how they liked this flexibility. Residents have access to various leisure activities available in the community, which include visits to the shops, and local facilities, parks, theatres etc. Residents can also access sailing and horse riding but these have to be paid for. Service users confirmed that the daily routines of the home are flexible and promote their independence, choice, and freedom of movement, in accordance with their individual support needs. Service users confirmed that contact with their family and friends are encouraged by the staff team, and the records confirmed this. Newlands House Cheshire Home C52 C02 S2158 Newlands V243571 160805 Stage 4.doc Version 1.40 Page 13 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) 18, and 19 Residents are supported in accordance with their individual needs and preferences in all aspects of their personal care needs. Improvements are required in the completion of monitoring forms to ensure residents healthcare needs are met. EVIDENCE: Residents confirmed that the staff team supported them in their personal care tasks in a manner, which is in accordance with their individual preferences. The examination of records and discussions held with residents confirmed that residents physical and emotional health needs were being met at the home. However the inspector observed a staff member support a resident with their continence needs and left the bathroom door open resulting in their privacy and dignity not being maintained. Residents are supported to attend health care appointments by the staff team, and information about specific medical conditions was available in resident’s files. However the information concerning the outcome of healthcare visits was recorded in daily logs and in separate books, and had not been transferred to individual files. Residents are weighed on a regular basis and this information is recorded in a communal book for all residents. This information had not been transferred to individual files. Residents now have tissue viability and nutritional monitoring assessments completed. However these and other monitoring tools had not been reviewed Newlands House Cheshire Home C52 C02 S2158 Newlands V243571 160805 Stage 4.doc Version 1.40 Page 14 as recommended on the documentation in individual files. Some of these forms were outdated. Regular checks are undertaken on all equipment used by the residents and records maintained. Newlands House Cheshire Home C52 C02 S2158 Newlands V243571 160805 Stage 4.doc Version 1.40 Page 15 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) These standards were not checked during this inspection. EVIDENCE: Newlands House Cheshire Home C52 C02 S2158 Newlands V243571 160805 Stage 4.doc Version 1.40 Page 16 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, 26, 27, 28, 29, 30, The home is equipped, furnished and maintained to a satisfactory standard and offers spacious facilities for service users to enjoy. EVIDENCE: This home offers a spacious environment for residents to move freely around in. All residents that are accommodated within this home use wheelchairs as an aid to their mobility. Discussions with residents confirmed that although the home is spacious, due to its large size it does not reflect a homely environment, although attempts have been made to make it as homely as possible. The inspector and the Registered Manager discussed the National Minimum Standard which states that the home should be organised into clusters of up to ten service users, each with its own staff group by 2007. The inspector was invited to look at resident’s bedrooms by the individual residents. The bedrooms was personalised to reflect the interests of that individual. Residents stated that they “ liked their bedrooms” as they are spacious, and have specialist equipment installed to aid resident’s independence. Each room is fitted with a ceiling-tracking hoist to assist with transfers and each resident had aids, which were appropriate to their needs. Newlands House Cheshire Home C52 C02 S2158 Newlands V243571 160805 Stage 4.doc Version 1.40 Page 17 The toilets and bathrooms areas are accessible to wheelchair users and have appropriate aids installed. These areas would benefit from redecoration as they are showing signs of wear and tear. All areas of the home were clean at the time of the inspection and there was no odour apparent in any areas. As mentioned previously residents informed the inspector that higher managers from the organisation have implemented a new cleaning schedule, without any consultation with the residents. In their opinion the hygiene standards and the cleaning of the home has begun to deteriorate. Comments were also made about resident’s wheelchairs not being cleaned especially after meals, when wheelchairs can become soiled with food. Newlands House Cheshire Home C52 C02 S2158 Newlands V243571 160805 Stage 4.doc Version 1.40 Page 18 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) 32 and 33 The deployment and numbers of staff appeared satisfactory to meet the needs of the current service user group. EVIDENCE: A copy of the duty rota for week ending 21/8/05 was provided. The staffing levels provided are based on the individual costing for each individual and did include some one to one support for residents. The staffing levels were appropriate to meet the needs of the residents. Although the staff files was not examined on this occasion the Registered Manager confirmed that the application form is now sent out with an extra sheet requesting a written explanation of any gaps in employment. The inspector and the Registered Manager discussed the status of the staff team in relation to achieving National Vocational Qualification (NVQ). The inspector was informed that currently there are 29 staff members who have completed and 3 staff members are working towards an NVQ level 2 or above, 6 staff members will be enrolling on the course in Sept. This means the home has already achieved the target of having at least 50 of its staff team qualified or undertaking training by December 2005. Newlands House Cheshire Home C52 C02 S2158 Newlands V243571 160805 Stage 4.doc Version 1.40 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 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) These standards were not checked during this inspection. EVIDENCE: Newlands House Cheshire Home C52 C02 S2158 Newlands V243571 160805 Stage 4.doc Version 1.40 Page 20 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 3 3 x 3 Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 2 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 x 3 x Standard No 31 32 33 34 35 36 Score x 3 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Newlands House Cheshire Home Score 2 2 x x Standard No 37 38 39 40 41 42 43 Score x x x x x x x C52 C02 S2158 Newlands V243571 160805 Stage 4.doc Version 1.40 Page 21 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 6 Regulation 15 (1) Requirement The Registered Persons must ensure that all residents have a support plan that reflects their cultural and faith needs, and the support required to meet these needs. The Registered Person must ensure that all documentation is reviewed regularly, and that the reasons why the plan remains the same or requires amending is recorded. The Registered Person must ensure that all residents are supported in their personal care needs in a manner that maintains their privacy and dignity. The Registered Person must ensure that healthcare monitoring forms are completed and reviewed as required. The Registered Person must ensure that information concerning access to healthcare professionals, and information about residents weight is recorded in residents files. The Registered Person must consider the redecoration of the toilet and bathrooms areas of Timescale for action 31st November 2005 2. 6 15 2 (b) 31st November 2005 3. 18 12 (4) (a) 31st November 2005 4. 19 Schedule 3 Schedule 3 31ST November 2005 31st November 2005 5. 19 6. 27 23 (2) (b) 31st January 2006 Page 22 Newlands House Cheshire Home C52 C02 S2158 Newlands V243571 160805 Stage 4.doc Version 1.40 the home. 7. 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 1 Good Practice Recommendations The Registered Person should ensure that the preadmission assessemnt includes a reference to the compatability of the individual with other residents already living in the home. The Registered Person should ensure that residents files are organised to enable easy access to up to date information and relevant documentation. The Registered Person should consult all residents concerning the running of the home and any changes to the services provided in the home. The Responsible Person are reminded that by 2007 the Home should be organised into clusters of up to ten Service Users, each with its own staff group. The Registered Person should ensure that the staff team assist residents to clean their wheelchairs, and any aids that they may use. 2. 3. 4. 5. 6 8 and 30 24 29 Newlands House Cheshire Home C52 C02 S2158 Newlands V243571 160805 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection South Point Cardinal Square Nottingham Road Derby, DE1 3QT 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 House Cheshire Home C52 C02 S2158 Newlands V243571 160805 Stage 4.doc Version 1.40 Page 24 - 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!