Inspection on 13/12/05 for Newnham Green

This inspection was carried out on 13th December 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Newnham Green 20/07/06

Newnham Green 18/05/05

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Newnham Green 67 Newnham Green Gorleston on Sea Gt Yarmouth Norfolk NR31 7JS Lead Inspector Linda Wells Unannounced Inspection 14:30 13 December 2005 th Newnham Green DS0000062045.V254614.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Newnham Green DS0000062045.V254614.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Newnham Green DS0000062045.V254614.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Newnham Green Address 67 Newnham Green Gorleston on Sea Gt Yarmouth Norfolk NR31 7JS 01493 651787 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) Mr Colin Graham Hallam Janet Hallam Mr Colin Graham Hallam Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Newnham Green DS0000062045.V254614.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: 67 Newnham Green is a semi-detached house situated in a residential housing estate in the coastal town of Gorleston. It is registered as a residential care home that provides accommodation and care for up to six people with a learning disability. Residents have the use of accommodation and facilities on both the ground and first floor of the home and there is no assisted passage to the first floor. The home has four single and one shared bedroom, all containing a washbasin and there is commual use of a shower room with toilet and a bathroom on the first floor, a toilet on the ground floor, lounge, dining area and kitchen. The home has a well kept garden to the rear of the property, road side parking at the front and is close to a row of local shops and a pub. There is local public transport available to the larger sea-side towns of Great Yarmouth and Lowestoft. Newnham Green DS0000062045.V254614.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection undertaken on the 13th December 2005 over four hours and was carried out as part of a routine inspection plan. On the day of inspection six residents were living at the home and were seen to be sitting in the lounge watching television or taking part in their interests, walking around the home and having a main meal. Conversation was limited for five of the residents and staff members were seen to talk openly with all residents in a warm, respectful manner that promoted choice. The inspection took the form of a tour of the premises, individual discussion with one resident, three staff members, the assistant manager and the manager, observation of five residents individually and in a group, examination of care plans, records, certificates and compliance of requirements and recommendations from the last inspection. What the service does well: What has improved since the last inspection? What they could do better: The requirements and recommendations from the last inspection have been nearly all complied with but there is still more to do to completely ensure that residents are fully protected, consulted and the environment well maintained in all areas. The following six requirements were made to further improve the experience of living and working at the home for residents and staff. Newnham Green DS0000062045.V254614.R01.S.doc Version 5.0 Page 6 • • • • • • The arrangements at death for residents must be recorded in the plans of care to demonstrate that the wishes of residents are known. The continued redecoration and re carpeting of further parts of the home is required to make the home attractive in all areas. Replacement of the damaged bath is required and redecoration of the bathroom needed to ensure that the health and safety of residents is fully protected. Repeated requirement. The target of 50 of staff on duty that have completed NVQ2 must be met to ensure the needs of residents are met. Repeated requirement. The manager must undertake the care component of the NVQ4 Registered Managers award to ensure that he completes the training. The quality assurance system produced must be further developed to include the views of residents, relatives, visitors, staff members and health care professionals to ensure feedback and the opinions of everyone is sought on the standard of care and facilities provided in the home. 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. Newnham Green DS0000062045.V254614.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Newnham Green DS0000062045.V254614.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5 The written information available about the home is complete and enables residents and staff to make a decision on whether the home will meet the needs of anyone wishing to live there. EVIDENCE: The homes Statement of Purpose, Service User Guide and Terms and Conditions contract were seen and found to contain relevant information. The manager said that prior to admission as much information as possible was collected from a prospective resident, their family and other professionals. He said residents, their family or friends sometimes visited the home, that he often visited residents in their own environment and that residents were admitted on a one-month trial basis. No resident had been admitted to the home and the records held showed that an assessment was completed prior to admission to the home to ensure that the needs of residents were identified as being able to be met by the home, that the views of residents, their family members and other professionals were sought and that residents and their relatives, friends or advocates visited the home prior to admission. Newnham Green DS0000062045.V254614.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 8, 10 Residents are consulted and the information held in the individual plans of care ensures that the personal and health care needs of residents are identified and met. EVIDENCE: Residents were seen to be well looked after and examination of four care plans revealed that they contained personal health and social care information, daily report, medial conditions, assessments, assistance, communication, memory, choice, orientation, motivation, sleep patterns, diet, weight, care needs, risk assessments, activities, religious choice and a photograph of the resident. The manager said that he was in the process of producing person centred plans for each of the residents and records demonstrated that residents were consulted on their daily activities, given choice, supported to take risks, were protected and that their confidentiality was maintained by the individual and safe storage of their information. Newnham Green DS0000062045.V254614.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 15, 16, 17 Social activities and meals are both well planned, creative and provide daily variation and interest for the people living in the home. EVIDENCE: Residents are stimulated by the program of daily activities and records were seen to demonstrate that residents attend a local day care centre, take part in leisure activities and outings such as going to the pub, shopping, for walks and to the beach, attend local community events such as the theatre and are taken on holiday by staff. The assistant manager said that residents were encouraged to keep in contact with their families who were invited to visit the home and to any parties held at the home such as Halloween and the Christmas party due to be held. Photographs were seen around the home and in resident’s bedrooms to support this. The three staff spoken to said that residents were supported to take part in appropriate activities by staff accompanying residents to health care appointments and by arranging activities and leisure pursuits that were determined by the interests and personal development plan of each resident. The resident spoken to gave examples of outings he had been on with other Newnham Green DS0000062045.V254614.R01.S.doc Version 5.0 Page 11 residents and staff and how staff at the home informed him of his progress and goals and encouraged him to maintain his interests such as going on a coach holiday. The staff members spoken to also gave examples of how they work with residents to support them in their personal development and behavioural management by working with other professionals, encouraging each resident to be independent and to make choices whilst ensuring that the rights of each resident were promoted and protected. The main meal and menus were seen and were balanced and varied. Records showed that residents were given a choice, an alternative offered and that staff member had completed food hygiene training. Newnham Green DS0000062045.V254614.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 21 Personal support is given to residents in the way they prefer, their needs are met but they were not fully consulted and records were incomplete. EVIDENCE: Residents were assisted with decision-making and the three staff spoken to said that they assisted the five residents with limited communication skills by understanding their response to questions and preferred manner of communication, using simple sign language, pictures, observation and as recorded. The resident spoken to said that he received personal and emotional support from staff members who were always willing to listen to him and demonstrated that he knew who to tell if “he was unhappy”. The plans of care seen did not contain the arrangements at death for each resident and a requirement was made that this information be held for each resident to demonstrate that they were consulted and their wishes known. Newnham Green DS0000062045.V254614.R01.S.doc Version 5.0 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): 22, 23 The home has an active procedure on the protection of vulnerable adults that protects residents and supports the investigation of any cause for concern. EVIDENCE: No complaints have been received by the home and the resident spoken to said that if he was unhappy he would tell his key worker or the manager and he agreed that he would be listened to and the appropriate action taken to resolve the problem to the satisfaction of all concerned. Residents are protected from abuse, neglect and self-harm by the objectives, policies and procedures of the home and staff have undertaken training in Adult Abuse to help them recognise, prevent and deal with any potential abuse. Newnham Green DS0000062045.V254614.R01.S.doc Version 5.0 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, 25, 27, 28, 29, 30 The standard of the environment within this home has improved and is mainly good providing residents with an attractive, safe and homely place to live, however some areas require attention. EVIDENCE: Residents live in a home that is decorated and maintained to a reasonable standard and improvements have been made to protect the health and safety of residents by the guarding of the radiators and the boxing-in of the central heating boiler however, a requirement was repeated that the bath, which was damaged, must be replaced and two further requirements were repeated that redecoration and the replacement of carpets in the home continues. The home was clean, tidy, odour free and is comfortable but is showing some signs of wear in some areas and although redecoration of the lounge and three bedrooms and replacement of one bedroom carpet has taken place the overall look of the home would be made more attractive if further redecoration of the home, such as the hall and bathroom were carried out. The manager said that he planned to completely redecorate and refurbish the bathroom and would redecorate and re carpet the hall once the bathroom is finished. Residents do not require adapted equipment to maximise their independence because all are mobile. Newnham Green DS0000062045.V254614.R01.S.doc Version 5.0 Page 15 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): 31, 32, 33, 35 Staff are competent and the procedure for the recruitment and supervision of staff provides safeguards to offer protection for the people living at the home. EVIDENCE: The three staff members spoken to felt supported by the senior carer, assistant manager and manager, handover, staff meetings and supervision and were aware of their role and responsibilities. Records showed that residents were protected and that all staff recruitment checks were carried out and CRB, proof of identity, references and personal details were held on each member of staff. Since the home has been under new ownership increased training opportunities have been available to staff to ensure that all staff are trained, competent, updated and fully equipped to meet the needs of residents living in the home. Staff changes have occurred and the three staff members spoken to who had been in post for four to six months gave examples of completing basic induction and foundation, adult abuse, food hygiene, moving and handling, challenging behaviour, infection control and in one case NVQ3 training. The manager said that one staff member was in the process of doing NVQ level 2 training and two were waiting to commence NVQ level 2. This part of this standard will be met once 50 of staff has completed NVQ2 training. Newnham Green DS0000062045.V254614.R01.S.doc Version 5.0 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 40, 42, 43 The manager is supported by the assistant manager, in providing leadership, guidance and direction to staff to ensure that residents receive a good standard of care and support. EVIDENCE: Residents are protected by the management and administration procedures carried out in the home and the proprietor has past experience of running and managing a small residential care home for people with learning disabilities. He has completed the management part of the NVQ 4 Registered Managers award and is in the process of commencing the care component of the NVQ4 Registered Manager award. A requirement was repeated and will be met upon completion of the award. Policies and procedures have been produced on all aspects of the home and service provided and the records held promote and protect the rights and best interests of each service user. Newnham Green DS0000062045.V254614.R01.S.doc Version 5.0 Page 17 A Quality Assurance system is in the process of being produced that the manager said would be carried out with residents. A requirement was made that the Quality Assurance system be further developed and include the feedback and views of residents, relatives, visitors, other professionals and staff members on the standard of care, service, facilities and lifestyle provided for residents and that an action plan of improvements be produced from the information gathered. To ensure that the health and safety of residents is protected the servicing and testing of all equipment had been carried out, relevant and timely certificates were held and records were stored securely. The manager successfully monitored identified financial budgets for the home and said that there was no reason to doubt that the financial security of the home was not sound. Newnham Green DS0000062045.V254614.R01.S.doc Version 5.0 Page 18 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 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X 3 X 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 X 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 X 13 X 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 2 3 X 3 x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Newnham Green Score 3 3 X 2 Standard No 37 38 39 40 41 42 43 Score 2 X 2 3 X 3 3 DS0000062045.V254614.R01.S.doc Version 5.0 Page 19 YES 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 YA21 Regulation 12.2 Requirement The registered person must ensure that the arrangements at death are recorded for each service user and their wishes known. The registered person must ensure that the damaged bath is replaced. (Previous timescale of 31st July 2005 not met) The registered person must ensure that the hall and stair way is redecorated and re carpeted (Previous timescale of 31st July 2005 not met) The registered person must ensure that 50 of staff on duty are or have completed NVQ 2 training. (Previous timescale of 31st December 2005 will not be met) The registered person must ensure that he fully completes the NVQ4 Registered Manager award. The registered person must ensure that he further develops the quality assurance system produced to include feedback from everyone. Timescale for action 31/03/06 2. YA24 13.4 30/06/06 3. YA24 23.2.d 30/06/06 4. YA32 18.1.c 31/03/06 5. YA37 9.2.b.i 30/06/06 6. YA39 24.1.2 31/07/06 Newnham Green DS0000062045.V254614.R01.S.doc Version 5.0 Page 20 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 Newnham Green DS0000062045.V254614.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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. 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