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Inspection on 26/05/09 for Newlands Nursing & Residential Home

Also see our care home review for Newlands Nursing & Residential Home for more information

This inspection was carried out on 26th May 2009.

CQC found this care home to be providing an Adequate service.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What has improved since the last inspection?

The care plans now contained information about wound dressings such as when they had been done and who had performed the task. This now allowed for a permanent record. The project manager had introduced a simple system for keeping a record of when reviews were due and when they had taken place. All new care plans or care plans that were amended after a review had to approved before being put into the care plan. There was more staff available at a meal time which was better for the residents especially those people who needed help with eating their meal. The bathrooms which had tiles missing from the walls had been either replaced or other wall covering installed instead. Staff training had improved; with many more staff completing training in moving and handling, infection control, safe handling of medicines, fire safety, fire drills, food hygiene and safeguarding of adults. Staff said; `A good comprehensive training programme is offered;` all said that they received training which was relevant to their role and kept them up to date with knew ways of working.` Staff had signed up to take National Vocational Qualifications which should improve the percentage of staff with a qualification substantially when they have completed their training. A new management team had been seconded to Newlands Care Centre. The two project managers had implemented a number of initiatives to improve theNewlands Nursing & Residential HomeDS0000041583.V375608.R01.S.doc Version 5.2 Page 8care and choices of the residents. More choices were now available at meal times, one of the activity organisers was now working weekends, was also working with people in their rooms on a one to one basis, menus were displayed on dining room doors for everyone to see, the nurse stations were less clinical and were now part of the home, dining/room lounge on the ground floor re-arranged with extra seating for relatives and residents. The clinical project manager had improved the recording, storage and administration of medication in order to protect the residents. Training and competency of the staff who gave out the medication was being monitored by the clinical project manager. Formal one to one supervision between the staff and the senior managers had not taken place on a regular basis. The project manager was aware of this and had plans ready to implement a programme to make sure that everyone had regular meetings. The manager was to use the company`s supervision format.

What the care home could do better:

No requirements or recommendations have been made at this inspection. We feel that the new management team that have been seconded to Newlands Care Centre are fully aware of what the home needs to do improve. We feel that they will continue to build on the improvements that they have already made.

Key inspection report CARE HOMES FOR OLDER PEOPLE Newlands Nursing & Residential Home 122 Heaton Moor Road Heaton Moor Stockport Cheshire SK4 4JY Lead Inspector Jackie Kelly Key Unannounced Inspection 26th May 2009 09:30 DS0000041583.V375608.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Newlands Nursing & Residential Home DS0000041583.V375608.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Newlands Nursing & Residential Home DS0000041583.V375608.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Newlands Nursing & Residential Home Address 122 Heaton Moor Road Heaton Moor Stockport Cheshire SK4 4JY 0161 432 2236 0161 282 3333 newlands@schealthcare.co.uk www.southerncrosshealthcare.co.uk Southern Cross Home Properties Limited 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) Care Home 72 Category(ies) of Old age, not falling within any other category registration, with number (72) of places Newlands Nursing & Residential Home DS0000041583.V375608.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home with nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 72 Date of last inspection 19th January 2009 Brief Description of the Service: Newlands Care Centre is owned by Southern Cross plc and provides care and accommodation for 72 people over the age of 45 years with physical disabilities and old age. The home is purpose built over four floors. At the time of this inspection only three floors were being used. The ground floor and the first floor accommodate people who require nursing care and the second floor was for people who required assistance with personal care only. Each floor had its own lounge, dining area and communal bathroom and toilets. All the rooms have their own en-suite facilities. The home is situated in the Heaton Moor area of Stockport, which is approximately thirty minutes from Stockport town centre. Local amenities such as shops, pubs and GP surgeries, together with bus and train services are available. A copy of the home’s last inspection report, service user guide, statement of purpose and newsletter were available from the main entrance area of the home. The current weekly fees range from £503.00 to £739.80. Further details regarding fees are available from the manager. Newlands Nursing & Residential Home DS0000041583.V375608.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This was a key unannounced inspection, which included a site visit to the home. Before the inspection we asked the manager of the home to complete a form called an Annual Quality Assurance Assessment, AQAA, to tell us what they felt they did well, and what they needed to do better. We felt that time had been given to filling in the form and the information provided was satisfactory. On the day of the inspection, 26th May 2009, seven hours were spent on the premises. During this time discussions took place with the two project managers, operations manager and operations director. We spoke with three relatives, two members of the staff team and a small number of residents. Observations were also made of staff carrying out their duties. We were accompanied on this visit by an expert by experience who looked around the home, talked to residents and staff and had a meal with the residents. The expert by experience was pleased with what they saw and heard from both staff and residents. Their views and opinions have been taken into account when writing this report and making this judgement. We sent survey forms to a small sample of residents and care workers, asking for their views on the care they received. Seven surveys were returned from care workers and four from residents; all the four resident surveys were completed by relatives. The resident surveys said ‘always, usually or sometimes’ that the home provide the care they needed; they also said that ‘always, usually, sometimes’ that staff were available when they needed them. To the question do you receive the medical support you need; three replied ‘always’ with one person not answering the question. There were very few direct comments which were mostly about there not always being enough staff to meet their needs all the time. The staff surveys did have more direct comments such as: ‘I think we do everything well apart from staffing levels. This is the main problem;’ ‘caring attitude, genuine concern. Loyalty to the residents and family;’ ‘When the floors are fully staffed everything is fine.’ Five said usually, one said sometimes, and one said never that there were enough staff to meet the needs of the people who used the service. During the previous inspection of September 2008 we had concerns about the way in which medication was being recorded, stored and administered and we Newlands Nursing & Residential Home DS0000041583.V375608.R01.S.doc Version 5.2 Page 6 asked our pharmacist inspector to visit the home. The pharmacist visited again at the inspection of January 2009 in order to check that the requirements we made had been implemented. We felt that there had been little improvement and we issued an immediate requirement notice at the end of the inspection to ensure that all residents had enough medicines in the home to ensure their treatment could be continuous. The pharmacist inspector made a Random Inspection visit on the 2nd April 2009. We found that the clinical project manager who had been brought in by the company to manage the medication had complied with the requirements. We also found that there was still room for improvement particularly on the two nursing care floors. However the clinical project manager was aware of what was needed and was putting in place systems and procedures to improve practice. We discussed with the clinical project manager progress made regarding medication since this visit and were satisfied that people were receiving the medication they should. Amongst the documents we looked at during this visit of the 26th May were the care plans for two of the residents, complaints file, training record, personnel file of the last person to be employed and supervision records.. There had been a small number of complaints recorded all of which had been dealt with quickly and efficiently. We had been copied into two complaints from relatives which had been sent to the managers of the company to investigate. The project manager said that the investigations had been completed and the complainants written to. At the time of writing this report there had been no further correspondence. No safeguarding referrals or investigations had taken place since the last inspection of September 2008. The report was written on behalf of the Care Quality Commission therefore throughout the report the terms ‘we’ and ‘us’ are used. The report collectively refers to the people who use the service as residents; this is their preferred form of address. What the service does well: There was a thorough admissions procedure which made sure that people were able to make choices about living in the home. Meetings for relatives to attend and ask any questions they felt necessary were organised frequently. There were two activity organisers, one full time and one part time. The people who used the service also had access to a mini-bus once every eight Newlands Nursing & Residential Home DS0000041583.V375608.R01.S.doc Version 5.2 Page 7 weeks when they were able to go out for a drive. This activity was available for the spring and summer months only. Each day the people who used the service were asked to choose what they would like to eat from a menu prepared by the cook. Before new staff were employed they went through a recruitment and selection process which was designed to protect the people who live at Newlands. All the staff who completed a survey form said that all the necessary employment checks had been carried out; two comments received were ‘I was not offered any work until my CRB (Criminal Record Bureau) and references were received back to my manager;’ ‘Yes all staff can only start once their refs and CRB had been checked.’ The home was reasonably furnished, odour free and generally clean and tidy. The home was spacious with wide corridors, wide doorways to allow easy access for people who may be wheelchair mobile. What has improved since the last inspection? The care plans now contained information about wound dressings such as when they had been done and who had performed the task. This now allowed for a permanent record. The project manager had introduced a simple system for keeping a record of when reviews were due and when they had taken place. All new care plans or care plans that were amended after a review had to approved before being put into the care plan. There was more staff available at a meal time which was better for the residents especially those people who needed help with eating their meal. The bathrooms which had tiles missing from the walls had been either replaced or other wall covering installed instead. Staff training had improved; with many more staff completing training in moving and handling, infection control, safe handling of medicines, fire safety, fire drills, food hygiene and safeguarding of adults. Staff said; ‘A good comprehensive training programme is offered;’ all said that they received training which was relevant to their role and kept them up to date with knew ways of working.’ Staff had signed up to take National Vocational Qualifications which should improve the percentage of staff with a qualification substantially when they have completed their training. A new management team had been seconded to Newlands Care Centre. The two project managers had implemented a number of initiatives to improve the Newlands Nursing & Residential Home DS0000041583.V375608.R01.S.doc Version 5.2 Page 8 care and choices of the residents. More choices were now available at meal times, one of the activity organisers was now working weekends, was also working with people in their rooms on a one to one basis, menus were displayed on dining room doors for everyone to see, the nurse stations were less clinical and were now part of the home, dining/room lounge on the ground floor re-arranged with extra seating for relatives and residents. The clinical project manager had improved the recording, storage and administration of medication in order to protect the residents. Training and competency of the staff who gave out the medication was being monitored by the clinical project manager. Formal one to one supervision between the staff and the senior managers had not taken place on a regular basis. The project manager was aware of this and had plans ready to implement a programme to make sure that everyone had regular meetings. The manager was to use the company’s supervision format. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Newlands Nursing & Residential Home DS0000041583.V375608.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 Nursing & Residential Home DS0000041583.V375608.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 36 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their needs assessed before they move into Newlands Care Centre so they know their needs can be met. EVIDENCE: No one had been admitted to the home since the previous inspection of January 2009. However the project manager said that a thorough assessment process would be carried out as it had for previous admissions using the company’s documentation. Newlands Nursing & Residential Home DS0000041583.V375608.R01.S.doc Version 5.2 Page 11 The procedure required assessment documents from the local authority or primary care trust being sent to the home before a decision was made to visit the person being referred. After considering this information and if thought suitable a visit took place to the person’s home or to the hospital. These visits had in the past been undertaken by the previous manager and the project manager will carry on with these initially. However the project manager plans to introduce the unit managers to carrying out the home visits and assessments. This would give them a greater understanding of the prospective persons needs and if they would fit into the current group of residents. If the person wished to be considered for a place and it was thought appropriate people were given the opportunity to visit the home for a few hours and have a meal. All of these processes ensured that the person could make a choice about the home and that their needs could be met by the staff team. Standard 6 did not apply, as the home did not have any intermediate care beds. Newlands Nursing & Residential Home DS0000041583.V375608.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 and 10 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Administration and recording of medication continues to improve to make sure that people receive the medication they are prescribed. People receive the care and support that they need in a respectful and dignified manner. EVIDENCE: Care plans were in place, which used the company’s documentation and were organised in sections such as daily living, risk assessments, dependency levels, moving and handling, nutrition, urinary continence, bowel elimination and falls risk assessments. The two care plans we looked at during this visit contained all the necessary information regarding the persons care needs such as when wound dressings had been changed, GP visits, District Nurse visits etc. All care plans had to go to the manager to be approved before they were put into the care file. Newlands Nursing & Residential Home DS0000041583.V375608.R01.S.doc Version 5.2 Page 13 Fluid charts where necessary were being completed to make sure that the person was receiving sufficient drinks. Pressure sores were monitored and the tissue viability nurse was involved for complex wounds. The system for recording when wound dressings were due for changing and when the dressing had been changed was introduced by the project manager. It was now a requirement that the information was to be recorded in the care plan so that there was a permanent record for people to check if necessary. At the previous inspection there had been concerns about the way in which medication was ordered from the pharmacist, how the medication was kept, how it was recorded and administered and staff training. Soon after the inspection the company brought into the home a clinical project manager to take control of the whole area of medication. The pharmacist inspector visited the home in early April and found that a lot of work had been done which was backed up with evidence. The medication records on the residential care floor were the best with the two other floors still showing some errors and still some room for improvement. All staff who administered medication had now received supervision/training on medication management, theoretical and practical competency assessments. In addition the medication policy had been re-issued. Staff meetings had taken place which addressed the importance of medication management. Competency note books had been filled in and checked by the clinical project manager. We had received no complaints from any of the people we had contact with about their privacy and dignity not being respected. Everyone had a single room, wore their own clothes and looked clean, tidy and comfortable. Newlands Nursing & Residential Home DS0000041583.V375608.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 and 15 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with activities and a choice of food at meal times. EVIDENCE: There were two activity organisers who planned the events and all the people who used the service were asked if they wanted to participate. The hours of the second activity organiser had been changed to work weekends and to work purely on a one to one basis with the people who were in their bedrooms. Activities included newspaper readings, exercise class, one to one and small group activities. Trips out in the mini-bus took place during the summer months. Newlands Nursing & Residential Home DS0000041583.V375608.R01.S.doc Version 5.2 Page 15 Relatives were encouraged to visit and the three relatives we spoke with visited every day. People could receive their visitors in their rooms if they so wished however the project manager had re-arranged and introduced some new seating in the lounge/dinning room on the ground floor. The two relatives we spoke with were pleased with this as they said they could now sit with their relative and talk without having to go to her room or sit in the main lounge every time. Everyone managed their own finances, sometimes with the assistance of relatives or friends. The project manager said that more choice and variety had been introduced into the menus. Brightly coloured notices on the doors leading into the dining rooms informed people of the menu. This enabled relatives as well as service users to see the choices and what was available. There were nutritional charts in each of the dining rooms for everyone to see. Mid morning coffee and snacks were also displayed on menus. The two relatives we saw had noticed an improvement the meals and in the choices available and on the staffing levels. This was much better for the people who needed to be fed as they were not having to wait for long periods between courses whilst others were given their meal. Newlands Nursing & Residential Home DS0000041583.V375608.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home and their relatives are able to complain and action is taken to respond to their concerns. EVIDENCE: There was a complaints procedure which everyone had access to. All complaints were recorded in a complaints file, which we were able to look at. The last two complaints that were recorded had been dealt with appropriately and quickly. The project manager said that she was hoping to improve on the response rate to complaints so that people would know that their complaints and concerns were taken seriously and would be dealt with as soon as practicable. All the people who completed a survey form said that they knew who to complain to. We had received two complaints both of whom had received a reply from senior managers of the company. At the time of writing this report there had been no further correspondence from the complainants. Newlands Nursing & Residential Home DS0000041583.V375608.R01.S.doc Version 5.2 Page 17 There had been no safeguarding investigations since the last inspection of September 2008. All the staff had received a Criminal Records Bureau disclosure check before they started work. The training statistics that was given to us by the project manager showed that eighty-four percent of the staff team had received training on the protection of vulnerable adults Newlands Nursing & Residential Home DS0000041583.V375608.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People lived in a suitably adapted, clean, comfortable and pleasant home. EVIDENCE: The location of the home of the home in the Heaton Moor area of Stockport was good and within easy reach of many facilities, such as doctors, dentist, restaurants, pubs, banks and churches. The home was purpose built some 14 years ago and some areas, particularly the en-suite bathrooms, needed new floor covering as it was worn and looked grubby from the years of constant use. This was discussed with the project manager who said that it was being looked into. Newlands Nursing & Residential Home DS0000041583.V375608.R01.S.doc Version 5.2 Page 19 Other parts of the home were satisfactorily decorated, clean and odour free, providing a pleasant environment for the people to live in. Many of the bedrooms had been personalised and looked very comfortable. A number of the bedrooms were extremely spacious. The laundry area was situated on the lower ground floor and a laundress was employed. There was a coloured bag system in place for soiled linen. There were policies and procedures in place for the control of infection. There was a small garden to the left hand side of the building which had a lawn surrounded by trees and shrubs. The wooden garden benches were not particularly clean and could prevent people from sitting out there in the warmer weather. The project manager was told about this during the inspection; she said she would look into it. Newlands Nursing & Residential Home DS0000041583.V375608.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People received care and support from staff who have the skills but not always the qualifications to support them correctly. EVIDENCE: The managers we talked with on the day of the visit all felt that there were enough trained and experience staff to care for the forty-four people who were living at Newlands. The staff who we received surveys from also agreed apart from when there was sickness and holidays. These comments were given to the project manager who said that there had been problems with sickness but this was being dealt with. Disciplinary action and back to work interviews were being implemented and the project manager felt that it was working as the sickness levels had reduced. A very small number of staff had National Vocational Qualifications (NVQ). However on the 8th May eight people signed up to NVQ training. Another signing up date was scheduled for the 8th June. The training is being coordinated by NVQ UK and the trainer is going to run two groups. Newlands Nursing & Residential Home DS0000041583.V375608.R01.S.doc Version 5.2 Page 21 There had been one new member of staff employed since the previous inspection of January 2009. All documents were in place such as application form, references and Criminal Record Bureau check. All new staff had an induction book which was kept on the unit they worked on. Training was taking place on the day of our visit on Nutrition and Health and Safety. The trainer employed by Southern cross was presenting the training course. Other training in core skills was ongoing such as infection control, challenging behaviour, moving and handling and food hygiene. all the staff who completed a survey form said that they received training that was relevant to their role. Newlands Nursing & Residential Home DS0000041583.V375608.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has an experience management team who are making sure that the staff are working for the best interests of the people who use the service. EVIDENCE: The registered manager in day-to-day control of the home had recently resigned from her post at Newlands. Two project managers one being specifically responsible for the clinical care had taken control of the home and both were present on the day we visited. Both of the managers were experienced and had the relevant qualifications to Newlands Nursing & Residential Home DS0000041583.V375608.R01.S.doc Version 5.2 Page 23 manage a care home. We also saw both the operations manager and the operations director. The company had in place quality assurance systems such as regular visits by senior managers, resident meetings and service user and staff questionnaires. All these methods were aimed at seeking the views and opinions of the people who lived at Newlands. The project manager had done some ‘dining room experience’ questionnaires. Six that had been completed were shown to us during our visit. The overall responses were positive. Results of questionnaires are put together with other information from other homes and published in the company’s annual report. The residents and/or their relatives or friends were responsible for their own finances. Sometimes, money was left with the staff by relatives to pay for hairdressing, newspapers or other daily items, for which a record was kept. A company regional auditor checked these records, as he did all financial records to do with the running of the home. Formal supervision when a member of staff had time on a one to one basis with a manager to discuss their work and training needs had not taken place on a regular basis. The project manager was aware of this and had plans to train the unit managers to enable them to implement supervision with the staff on their floor. This type of formal supervision gives everyone the opportunity to discuss any problems they may have and any training needs in private on a regular basis. The project manager hoped that all the unit managers would have been seen by the end of May. There had been concerns at the previous inspections that the health and safety of the people who used the service was being put at risk due to poor management and poor administration of medication. We were very pleased to see that these concerns had been taken very seriously by the company and that a clinical project manager had been brought to the home in early February as soon as they had received our report. A second project manager had now been seconded to the home due to the resignation of the homes registered manager. We felt that both of the project managers were aware of the problems and had shown that poor practice would result in disciplinary action being taken. We also felt that they recognised there was still room for improvement but were pleased with the progress they have made in the short time they have been there. We also felt that they were aware of safe working practices and would ensure that the care workers and people who used the service would be kept safe and protected. Newlands Nursing & Residential Home DS0000041583.V375608.R01.S.doc Version 5.2 Page 24 Newlands Nursing & Residential Home DS0000041583.V375608.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X x 3 x x 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 2 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 2 Newlands Nursing & Residential Home DS0000041583.V375608.R01.S.doc Version 5.2 Page 26 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. Refer to Standard Good Practice Recommendations Newlands Nursing & Residential Home DS0000041583.V375608.R01.S.doc Version 5.2 Page 27 Care Quality Commission North West Regional Office Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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