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Inspection on 17/02/06 for Newmans Care Homes (Pump Piece 41- 45)

Also see our care home review for Newmans Care Homes (Pump Piece 41- 45) for more information

This inspection was carried out on 17th February 2006.

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.

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

What the care home does well

Newman`s care home has given service users the opportunity to become part of the local community. It comprises of two family houses on a housing estate conveniently close to the centre of Leominster town. The accommodation is very homely and comfortable and is well furnished, decorated and maintained. The house was clean and tidy and has been personalised by the service users. There was a relaxed atmosphere in the home and service users and staff have an open and caring rapport. Service users said they are all happy living there and they clearly view it as their real home. One person on a regular respite stays was very settled and has become an accepted member of the household. Service users continued to lead full, active and interesting lives. Staff enabled them to be as independent as they want and can be and helped them to access work placements and other opportunities to develop their social and life skills. Good care planning helps to ensure staff know and understand service users` needs and preferences. Staff also make sure all their emotional, personal, and health care needs are met properly. Keyworkers are allocated to service users from the staff team which makes the support they receive even more personal. There is a stable staff team, which is good for consistency of care and also means that staff and service users know each other very well. All the staff are suitably qualified and experienced and had undertaken the relevant training so they have the skills and knowledge needed to meet service users` care needs and keep them safe better. The home is well run and it is clear the staff team are committed to the home and the service users and work well together.

What has improved since the last inspection?

The home did not need to take any action to address any shortfalls following previous inspections because it already provided a very good quality service. The service was (and continues) to meet all the National Minimum Standards. Whilst this is so it is positive that there continues to be development of the service, for the benefit of service users. This includes updating staff training and keeping up with currently accepted good care practices.

What the care home could do better:

There were very few aspects that needed improvement or any action taken to change them at this time. Although the sooner a new manager is appointed and their registration is approved the better to ensure the continued stability and efficient running of the home.

CARE HOME ADULTS 18-65 Newmans Care Homes (Pump Piece 43/45) 43/45 Pump Piece Leominster Herefordshire HR6 8HR Lead Inspector Christina Lavelle Unannounced Inspection 17th February 2006 02:30 Newmans Care Homes (Pump Piece 43/45) DS0000024726.V285530.R01.S.doc Version 5.1 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 Newmans Care Homes (Pump Piece 43/45) DS0000024726.V285530.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Newmans Care Homes (Pump Piece 43/45) DS0000024726.V285530.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Newmans Care Homes (Pump Piece 43/45) Address 43/45 Pump Piece Leominster Herefordshire HR6 8HR 01568 612304 01568 612304 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) Dr Leslie Howard Newman Mrs Veronica Elizabeth Newman Mrs Rita Anning Care Home 5 Category(ies) of Learning disability (5), Learning disability over registration, with number 65 years of age (5) of places Newmans Care Homes (Pump Piece 43/45) DS0000024726.V285530.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. One place in the home must provide short-term respite care only. When a vacancy occurs in the shared bedroom in house number 45, the provider must contact the Registration Authority for a review of the home’s conditions of registration. Service users accommodated on a permanent basis will be expected to have a bedroom that meets with the size specified in the National Minimum Standards. 19th October 2005 Date of last inspection Brief Description of the Service: Newman’s care home is registered to provide accommodation with personal care for up to five adults (men and women) who may be over sixty-five years of age. Service users must require care due to learning disabilities. The stated aims of the home are to provide a comfortable, secure and homely environment, which helps service users to maintain and when possible increase their independence. Four service users had lived at the home for over twenty years and there is a place for one other service user for planned respite care. The home is situated in a quiet residential cul-de-sac that is less than a mile from the centre of Leominster, which is a market town. The shops, facilities and service users’ day services can therefore all be accessed easily. The home also has its own vehicle to provide transport further afield. The property consists of two houses joined together; one is a mid terrace and the other an end of terrace. There are pleasant, reasonably sized and private gardens to the rear of the premises. Each house has two first floor bedrooms for long-term service users and there is another bedroom used to provide respite care in house no. 43. There is an office upstairs in no. 45 and this house also has a stair lift. Each house has a lounge, dining room or dining area, a kitchen, bathroom and separate toilet for everyone to use. Newmans Care Homes (Pump Piece 43/45) DS0000024726.V285530.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine, statutory inspection carried out in three hours on a Friday afternoon in winter. The visit was arranged at short notice so the provider and manager could be available. It was considered their input would be helpful as the manager was soon to leave the home. Also so the proposal for 41 Pump Piece (another house adjoined to the home) to be registered as a separate small home could be discussed, as it is run and staffed by the existing home. For more detailed information about the service and facilities provided by the home you are advised to also read the report of the last, fuller inspection that was undertaken on the 19th October 2006. As part of the assessment process used in this inspection time was also spent with some service users to obtain their views of the home and their experience of living there. In addition a sample of records relating to the service users and their care, to staffing and which show how the home and service users are kept safe, were checked. What the service does well: Newman’s care home has given service users the opportunity to become part of the local community. It comprises of two family houses on a housing estate conveniently close to the centre of Leominster town. The accommodation is very homely and comfortable and is well furnished, decorated and maintained. The house was clean and tidy and has been personalised by the service users. There was a relaxed atmosphere in the home and service users and staff have an open and caring rapport. Service users said they are all happy living there and they clearly view it as their real home. One person on a regular respite stays was very settled and has become an accepted member of the household. Service users continued to lead full, active and interesting lives. Staff enabled them to be as independent as they want and can be and helped them to access work placements and other opportunities to develop their social and life skills. Good care planning helps to ensure staff know and understand service users’ needs and preferences. Staff also make sure all their emotional, personal, and health care needs are met properly. Keyworkers are allocated to service users from the staff team which makes the support they receive even more personal. There is a stable staff team, which is good for consistency of care and also means that staff and service users know each other very well. All the staff are suitably qualified and experienced and had undertaken the relevant training so they have the skills and knowledge needed to meet service users’ care needs and keep them safe better. The home is well run and it is clear the staff team are committed to the home and the service users and work well together. Newmans Care Homes (Pump Piece 43/45) DS0000024726.V285530.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? 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. Newmans Care Homes (Pump Piece 43/45) DS0000024726.V285530.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Newmans Care Homes (Pump Piece 43/45) DS0000024726.V285530.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These Standards are not assessed, as there had not been any new service users admitted to the home for a while, and then only to receive respite care. However it was previously confirmed that appropriate information documents are provided by the home for current and prospective service users including a statement of purpose, service users guide and placement agreement (contract) Newmans Care Homes (Pump Piece 43/45) DS0000024726.V285530.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6&9 A good “person centred” care planning and risk assessment system is operated which ensures that staff know service users’ needs, wishes and goals and how to meet them well, and also any possible risks to their safety are minimised. EVIDENCE: These Standards are not fully assessed. However, it was confirmed in previous inspections that each service user has a care plan detailing all their care needs and the action staff should take to meet them. One person’s care records were looked at during this inspection and their plan covered relevant areas of need. Care planning is appropriately “person-centred” so service users’ wishes and goals in life are sought and they are involved in planning their care. Relevant risk assessments had been carried out to minimise any risks to the individuals’ safety whilst allowing them to take appropriate risks to promote independence. Service users are all allocated a keyworker from the staff team who take a lead role in planning and reviewing their care needs and record any changes weekly. This helps the support given them be more personal and means staff know and understand service users better. Plans were reviewed at least six monthly and a formal review meeting annually involving relevant other people. Newmans Care Homes (Pump Piece 43/45) DS0000024726.V285530.R01.S.doc Version 5.1 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 16 & 17 Service users are enabled by staff to lead full, active and interesting lives and are well integrated within the wider community. They are also encouraged to make choices and decisions and to develop their social and life skills. Staff ensure service users receive a suitable and healthy diet. EVIDENCE: The manager and service users confirmed they continued to take part in a wide range of activities in the local community in line with their individual interests. Activities pursued include weekday work-related placements, such as recycling and gardening projects. To occupy their leisure time some service users like to visit pubs, watch football; attend a drama group and go horse riding. Those who wish go out to various social clubs for people with learning disabilities, as well as being involved with mainstream organisations, such as the Church. Service users are expected to be actively involved in running the household and daily tasks are allocated to them. They also choose their daily routines. Service users meetings are held regularly (which are minuted) when they are Newmans Care Homes (Pump Piece 43/45) DS0000024726.V285530.R01.S.doc Version 5.1 Page 11 consulted and make decisions about the home and plan for such as holidays and social events, choose menus etc. Records of food provided in the home were being appropriately maintained. They showed service users receive a varied range of nutritious and wholesome meals. Service users are also involved in meals preparation and cooking and confirmed they are able to choose to eat what they like, although staff always try to encourage healthy options. There was evidence that advice is sought whenever needed from a Dietician. Newmans Care Homes (Pump Piece 43/45) DS0000024726.V285530.R01.S.doc Version 5.1 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Appropriate arrangements are in place to ensure the personal, emotional, and health care needs of service users are met properly, and that medicines are managed safely in the home. EVIDENCE: It was re-affirmed that service users are given any guidance and support they need from staff to maintain good personal care and hygiene. A checklist is kept of personal care received and service users were seen to be appropriately dressed and well presented, in accordance with their age and preferred style. Service users’ care records include information about their medical history and keyworkers make monthly reports on their health. Their daily reports also cover issues relating to behaviour and emotional health. Treatment records are kept showing that annual and other regular heath related check ups are arranged and the input from relevant health care specialists is sought. For instance one service user had an assessment recently of their nutrition and continence to help staff know how to best manage these aspects of their care. The home provides policies and procedures relating to medicines in care homes generally and to this home. There is suitable storage and all records related to the handling and administration of medicines were being kept appropriately. All staff have undertaken accredited safe handling of medicines training. Newmans Care Homes (Pump Piece 43/45) DS0000024726.V285530.R01.S.doc Version 5.1 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These Standards are not fully assessed. However it was previously confirmed the home provides a written complaints procedure, which is also available in a suitable format for the service users. The home provides policies & procedures regarding the protection of vulnerable adults, including possible indicators of abuse and whistle blowing. There was also a copy of the Herefordshire multi-agency procedures for the Protection of Vulnerable Adults. It is good it was planned to arrange a training session for staff on these local procedures, taken by the Adult Protection co-ordinator. This will ensure they are clear about their responsibility to report and how and whom to refer any suspicion or incidence of abuse or neglect of service users. There had not been any complaints or vulnerable adults concerns raised with the home or the Commission since the last inspection. Newmans Care Homes (Pump Piece 43/45) DS0000024726.V285530.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Newman’s care home provides accommodation which suitably meets service users’ needs and is very homely and comfortable. Appropriate arrangements are in place to ensure a good standard of repair, decor and furnishings, and also that safety and cleanliness is maintained. EVIDENCE: The home comprises of two ordinary houses built in the mid 50s, which are in a quiet cul-de-sac on a residential estate. It is conveniently located in walking distance of the shops, services and facilities of Leominster. Most service users are able to walk into town without staff support for social and leisure activities; to see their families and friends and to attend their weekday opportunities. The home is decorated, furnished, fitted and equipped to a good standard. It was also seen today to be clean and tidy and the environment presents as very homely and comfortable. Work to upgrade the accommodation is ongoing. It was previously confirmed there is sufficient and suitable communal space. Two current service users have chosen to share a bedroom and hence there is a condition that the Commission should be consulted if a shared place becomes vacant. This is because the National Minimum Standards state that service Newmans Care Homes (Pump Piece 43/45) DS0000024726.V285530.R01.S.doc Version 5.1 Page 15 users should have single bedrooms and if they do share should be offered the chance not to share when the other place in their bedroom becomes vacant. However if this happened at this home the other available bedrooms have less space than the minimum size specified in the Standards. The home has appropriate policies and procedures in place for staff relating to good hygiene and infection control. Staff are expected to use the disposable gloves and aprons, antic bacterial soap and paper towels the home provides. All staff had completed a substantive health & safety training course covering general health and safety matters in care homes, including infection control. . Newmans Care Homes (Pump Piece 43/45) DS0000024726.V285530.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 & 35 Service users’ needs are being fully met by a suitably staffed home and by an appropriately trained, experienced and stable staff team. EVIDENCE: These Standards are not fully assessed. However it was previously confirmed that staff are deployed at an appropriate level to cover the home and meet service users’ needs. They also work flexibly to facilitate their social activities. Service users’ needs had not changed, although staff were now also providing care for two people with learning disabilities who live in house no 41. This was being well managed as part of the home’s normal working routines, with most staff working additional hours. Two new staff were currently being recruited to cover these extra hours and also in view that the manager was leaving today. There is still a very stable staff team and no new staff had been appointed since the last inspection. However the home does require all their new staff to undertake an induction programme, which is accredited especially for staff who care for people with learning disabilities (which is as the Standards specify). Staff had completed all the mandatory health & safety training topics and attended training sessions relating to service users’ needs i.e. person centred planning, autism, epilepsy, and managing challenging behaviour. Most had achieved a certificate in Care Skills and had an NVQ care qualification. One staff member was about to complete LDAF and would then commence NVQ. Newmans Care Homes (Pump Piece 43/45) DS0000024726.V285530.R01.S.doc Version 5.1 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These Standards are not fully assessed. However it is evident the home is still managed effectively and there is an open and positive management approach. As already mentioned in this report the manager is leaving the home’s employ. The provider confirmed suitable arrangements are being put in place and the responsibility for the management task delegated to the deputy manager. The deputy is suitably qualified (she has an NVQ 4 in care and management) as well as many years experience of working at the home. It should therefore continue to run smoothly until a new manager is appointed and is registered by the Commission. Clearly the sooner this happens the better to ensure the continued stability and efficient running of the home. The home provides comprehensive health & safety policies and procedures. All relevant records that were checked (e.g. the fire log and PAT tests) indicated that due attention is paid to maintaining safety in the home to protect service users. There were also no safety hazards observed during the inspection. Newmans Care Homes (Pump Piece 43/45) DS0000024726.V285530.R01.S.doc Version 5.1 Page 18 A quality assurance and monitoring system was being operated by the home as required. This appropriately includes an evaluation and audits carried out of all relevant aspects of the service and facilities provided. The views of service users, their families and other stakeholders are also appropriately being sought through questionnaires, service users’ meetings and care reviews. It was discussed that quality assurance will play an increasingly important role in the regulation of care services. This process should also result in periodic reports showing plans to improve/develop the service; copies of which must be sent to the Commission and made available to all other interested parties. Newmans Care Homes (Pump Piece 43/45) DS0000024726.V285530.R01.S.doc Version 5.1 Page 19 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 Standard No Score 1 X 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 3 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 4 14 4 15 X 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X X X X X X X X Newmans Care Homes (Pump Piece 43/45) DS0000024726.V285530.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? N/A 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 Newmans Care Homes (Pump Piece 43/45) DS0000024726.V285530.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Hereford Office 178 Widemarsh St Hereford Herefordshire HR4 9HN 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 Newmans Care Homes (Pump Piece 43/45) DS0000024726.V285530.R01.S.doc Version 5.1 Page 22 - 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!