Inspection on 26/09/05 for Newnton House

This inspection was carried out on 26th September 2005.

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

The inspector 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

Newnton House 05/02/07

Newnton House 11/01/06

Newnton House 25/01/05

Newnton House 14/10/04

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

CARE HOME ADULTS 18-65 Newnton House 4 Newnton Close Stamford Hill Hackney London N4 2RQ Lead Inspector Kristen Judd Unannounced Inspection 26th September 2005 10:25 Newnton House DS0000010277.V259652.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 Newnton House DS0000010277.V259652.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. Newnton House DS0000010277.V259652.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Newnton House Address 4 Newnton Close Stamford Hill Hackney London N4 2RQ 020 7690 5182 020 7690 5182 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) Mrs Dymphna Caulfield Mr & Mrs Despo & Jim Gopalla Mrs Despo Gopalla Care Home 7 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (7) of places Newnton House DS0000010277.V259652.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th January 2005 Brief Description of the Service: Newnton House is a residential care home offering accommodation, support and guidance to a maximum of seven service users who have mental health support needs. Most service users are ex-offenders and have been referred to the home via the Home Office and mental health specialists. Many have previously been detained under Mental Health legislation. The home is located in a residential area of Manor House within the London Borough of Hackney. Bus and train links are good and the home is close to local shops and amenities. The home’s premises are a spacious two-storey building, which is very well maintained both internally and externally. Service users have access to a garden in the rear of the house. There is private parking in the front driveway. Newnton House DS0000010277.V259652.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced which started at 10.25 am. This inspection followed up the requirements made at the unannounced visit held on 25th January 2005. The inspector spoke with several service users and staff during the inspection. A tour of the environment was undertaken and samples of the homes records were examined. There were six service users placed at the time of inspection. There have been 5 requirements made following this inspection. Verbal feedback was given to the current registered manager at the end of the inspection. The inspector wishes to thank the staff and service users for facilitating this unannounced inspection and actively contributing to the regulatory process. A feedback card was left for completion. What the service does well: 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. Newnton House DS0000010277.V259652.R01.S.doc Version 5.0 Page 6 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 Newnton House DS0000010277.V259652.R01.S.doc Version 5.0 Page 7 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 The inspector believes that the home is able to meet service users needs in line with the homes Statement of Purpose. EVIDENCE: The homes statement of purpose has been updated as previously required. The statement of purpose clearly reflects the aims of the home and how those aims will be met. Individual records are kept for each of the residents. Records for the most recent admission were viewed; evidence was seen to show that the service users are only admitted only when a full assessment has been undertaken. The records reflected that the service users had several day visits to the home, followed by an overnight stay, which included joining residents for a meal. Through the tracking of care it was evident that the service users care plans were being developed from the pre admission assessments. There was evidence to demonstrate that the home is meeting the assessed needs of the current service users accommodated in the home. Additionally there were relevant assessments conducted by health professionals clearly indicating the service users needs. Newnton House DS0000010277.V259652.R01.S.doc Version 5.0 Page 8 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): 6,7& 8 The inspector believes that staff are aware of service users support needs and that that service users are proactively involved in the care planning process. EVIDENCE: Service user plans examined contained information about the service users daily routines, any personal care issues and aspects of daily living. The inspector reviewed the individual files for three current service users. Care plans include service users views, key worker views, in addition to agreed objectives and actions. The most recent service user who was admitted to the home had a care plan developed this was viewed at the time of inspection. The plan covered issues such as physical and mental health, medication, independence and risk taking. Evaluations were recorded, and they are clearly discussed with the individual service users. Daily recording indicated that staff closely liaise with health professionals when appropriate. Monthly summaries are completed by key workers, which provide an overview of the service users current situation. Newnton House DS0000010277.V259652.R01.S.doc Version 5.0 Page 9 There was evidence to suggest that service users are involved in the day-today running of the home, participation in activities of daily living and involvement in choice of daily activities. Service users undertake all their own daily living such as maintaining their personal space, laundry shopping and cooking. Service users are given £20.00 per week to purchase their own shopping in addition to their own monies. Service users plan their own meals, some cook for each other on occasions. Service users are able to go out freely. This was observed during the inspection. Service user meetings are held weekly, minutes reflected that numerous issues of interest/concern to service users are discussed. One issue discussed was with regard to cooking arrangements for one service user. Due to cultural reasons the service user likes to cooks alone this was discussed and other residents agreed a set time for the service user to have sole use of the kitchen. Through observations made during the inspection the inspector was satisfied that service users are given every opportunity to make their own decisions on a daily basis. Newnton House DS0000010277.V259652.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): 11,12,13,14,15,16&17. The inspector observed and was satisfied that staff provide service users with support to make choices and provide them the opportunity to lead independent lives. EVIDENCE: The ethos of the home is to promote all the service users to be independent and to maintain and develop their social and daily living skills. The inspector was informed that individual key work sessions offered opportunities for emotional support to be offered. Through interview with the registered manager and observation of records, the inspector was satisfied that service users’ are involved in the day to day running of the care home. Newnton House DS0000010277.V259652.R01.S.doc Version 5.0 Page 11 The inspector spoke with several service users during the inspection. Service users stated that they had good opportunities to develop a range of skills. As previously stated service user independence was promoted in a number of ways including service user’s being encouraged to complete all their own daily living tasks such as laundry, shopping and preparation of meals, management of their own finances and in some cases, self medicating. Service users are encouraged to involve themselves in meaningful activities. One service user attends a day service three times weekly and does cooking for which he receives a nominal pay. The service user is being supported to undertake National Vocational Qualification (NVQ) training in catering. Other service users have undertaken an NVQ in horticulture and attend college three times a week. One service user is on a language and computer course. Additional activities include service users for example attending day centres, the mosque, the local gym or friends in the community. One service user maintains the gardens of the home, maintaining the lawns and at times grows tomatoes for the house. Service users who spoke with the inspector confirmed that they were free to visit whomever they wished and could have visitors to the home. Staff spoken to during the inspection were well aware of the level of contact between individual service users, their family and friends. Service users are encouraged to maintain positive social networks and decide for themselves their level of involvement with family members. Evidence on service users files indicated that family members are invited to attend key meetings at the home. As previously stated service users are given money each week for shopping and are responsible for the planning and budgeting of their meals. On the day of the inspection, the inspector observed one of the service users preparing their own lunch in the kitchen area. The freezer is divided into individual service user compartments and separate cooking utensils are available to service users who require this due to religious observances. Periodically, service users share a meal out or a take away meal together. Newnton House DS0000010277.V259652.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): 19&20 It is the inspector’s view that service users are well supported by staff to ensure that physical and emotional needs are met. EVIDENCE: The home does not accept referrals for service users who are physically disabled or who require personal care. Service users require prompting only with regards to personal care. The inspector was satisfied that the registered manager and staff are fully aware of service users’ needs and makes appropriate referrals when required. All service users files contained documented medical appointments to GPs, dentist, the local hospital and specialist clinics. The home is managed in a very flexible manner, service users are free to wake and retire to bed when they chose, and are able to access the community freely, accompanied by staff if they so wished. Service users are expected to inform staff if they are staying out after 11.00pm at night. Newnton House DS0000010277.V259652.R01.S.doc Version 5.0 Page 13 Service users are very independent and are able choose their own clothes. The inspector felt, through speaking to both staff and the service users that the staff treat service users with respect. The ethos of the home and through observation during the inspection the inspector was satisfied that the service users are supported to maintain their personal identity and choice. Information was seen during the inspection in regard to service users having access to medical appointments. One service user who has a diabetic was being monitored, as they were not eating appropriately. Staff were recording relevant information and were in touch with relevant health professionals. One the day of the inspection staff were observed supporting a service user to attend hospital appropriately. Staff were fully aware of service users medical needs and monitor compliance for service users who self medicate. Service users medication is provided in doset boxes. The home appropriately stores medication in a locked medication cabinet. Other medicines in need of refrigeration are kept in a small locked refrigerator in a locked cupboard on the first floor of the home. The inspector completed three spot checks on medication all of which were deemed correct at the time of inspection. Medication records were correct. Newnton House DS0000010277.V259652.R01.S.doc Version 5.0 Page 14 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): It is the inspector’s view that complaints are acted upon promptly to ensure satisfactory outcomes. EVIDENCE: The complaints procedure has been updated to indicate clear timescales and the correct information with regards to contacting the Commission for Social Care Inspection. The manager investigates complaints and concerns that service users, relatives or others may have. There have been two recorded complaints, which were with regard to one particular service users behaviour in the house. This had been appropriately dealt with and outcomes were recorded. Service users spoken to indicated that they would speak to staff or the manager if they had any concerns or complaints. The home has Adult Protection procedures in place. Discussions with staff evidenced a good understanding and awareness of Adult Protection issues. Staff had recently received Vulnerable Adult training. However concern was raised, as there was a new staff member on the premises who did not have the relevant statutory checks in place prior to commencement of work. This is being reported on under standard 34. Service users manage their own finances unless they request assistance. Records seen regards for two service users, which was correct at the time of inspection. Newnton House DS0000010277.V259652.R01.S.doc Version 5.0 Page 15 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): 24,25,26,27,28 &30 It is the inspector’s view that the home is suitable for its purposes however there are some minor issues regarding the standard of the environment that need to be addressed. EVIDENCE: The home is situated in a quiet residential area of Stamford Hill area of Hackney and is within easy access of transport links and the local community. The home is within walking distance of some local amenities; there is a garden area and a driveway for a few cars. A tour of the premises was conducted. The office is situated on the ground floor. There is no separate visitors room available. At the time of this inspection there were six service users placed, the home has adequate private and communal areas. The inspector was satisfied that the premises are suitable for the stated purpose, and it is accessible to service users. The inspector was informed that an application had been submitted to both the Commission for Social Care Inspection and the planning department for an extension, which will provide two further en-suite bedrooms, extend the kitchen, provide a smokers room and a covered area to the laundry. Newnton House DS0000010277.V259652.R01.S.doc Version 5.0 Page 16 Staff and service users share the cleaning within the care home. There is a separate laundry facility, which was clean and tidy. However the lint catcher needed cleaning for the dyer. The garden is well maintained by the manager. The premises were found to be generally clean, homely, comfortable, appropriately heated, lit and ventilated although however attention should be made to dusting of lampshades. Decoration and furnishings reflected the style and ambience of a domestic home. However the lounge area was looking very ‘tired,’ due to service users smoking, the inspector was informed that there would be a decoration programme following the extension works. All of the individual rooms seen had been personalised and were comfortable. A number of areas require attention: The downstairs shower room needs some attention to peeling paint and seals. A suitable window covering to be provided for the downstairs shower room for privacy. Attention must be taken to the dusting of high areas such as lampshades. A lampshade must be provided in the first floor toilet. The tumble dryer must be cleaned from lint regularly. Newnton House DS0000010277.V259652.R01.S.doc Version 5.0 Page 17 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 &34 It is the inspectors view that the home has an experienced and effective staff team who work well together to provide an excellent level of care to service users. EVIDENCE: The inspector was satisfied through discussions and observations made during the inspection that that the registered manager and staff are aware of their own roles and responsibilities. Rotas indicated that staffing levels are satisfactory and there are sufficient staff on duty to meet the needs of the service users. There are two members of staff on duty throughout the waking day and one waking night. There is an on call rota for management staff. Staff were observed to interacting with service users in a relaxed and respectful manner, and there was evidence that good relationships have been built up with service users. One service user had an appointment to attend to due to medical issues staff dealt with the situation well providing much support in a difficult situation. The inspector viewed staff files one of which was the most recent employee. The inspector raised severe concern as the staff member had commenced work Newnton House DS0000010277.V259652.R01.S.doc Version 5.0 Page 18 without references being taken up, no Criminal Bureau check in place, no Protection of Vulnerable Adults check in place and no proof of identification. On discussion with the registered manager the inspector was informed that arrangements had been made for the paper work to be done on the day of inspection as the manager had been off. The inspector stressed that this is unacceptable practise. The staff member was asked to leave the premises until relevant checks were in place. Minutes for staff meetings were seen they are held regularly. Minutes are clear and records were seen for June 05,July05 and Aug 05. The content of the meeting was good; items that were discussed were as follows: Client issues Staff issues Christmas Day to day issues Newnton House DS0000010277.V259652.R01.S.doc Version 5.0 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 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): 38,41&42 The inspector believes that the home is run by a registered manager who is competent to run the care home in line with its stated purpose. EVIDENCE: Through interviewing the current registered manager, the inspector was satisfied that the home is managed in an open and positive way. All the staff and service users were friendly, open and appeared comfortable within the care home. Staff stated that they had been well supported by management. The home’s records are well kept, recording is clear and all records are formatted well. The individual service plans are good and contain relavant information. The monthly unannounced monitoring visits have been untaken since the previous inspection, reports were available for inspection. House and staff meetings are being held and copies of the minutes were available. Evidence showed relevant issues were discussed and service users take an active role in the discussions. Newnton House DS0000010277.V259652.R01.S.doc Version 5.0 Page 20 However the inspector noted an incident involving a service user and a staff member in June 05 was not reported to the Commission under regulation 37. The inspector acknowledges that staff dealt with the incident appropriately at the time. The service users’ finances and petty were seen which were being recorded accurately and were deemed correct. Relevant documentation was in place regarding the health and safety requirements certificates were seen. However there were inconsistencies in the date for the portable appliance test. The manager must clarify whether this is valid. Newnton House DS0000010277.V259652.R01.S.doc Version 5.0 Page 21 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 3CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 x Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 x x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 2 3 N/A 2 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score x x 3 1 x x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Newnton House Score N/A 3 3 x Standard No 37 38 39 40 41 42 43 Score x 3 x x 2 2 x DS0000010277.V259652.R01.S.doc Version 5.0 Page 22 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 YA27 Regulation 23.2 Requirement The registered manager must ensure that the minor issues indicated in the report are addressed. The registered manager must ensure that the lint is removed regularly from the dryer so not to be a fire hazard. The registered manager must not employ any person to work in the care home unless of the statutory checks are complete as stated in Schedule 2. The registered manager must ensure that notifable incidents are reported to the Commission for Social Care Inspection without delay. The registered manager must forward confirmation of the valid portable appliance testing certificate. Timescale for action 31/12/05 2 YA30 16.2 30/11/05 3 YA23YA34 19.1 30/11/05 4 YA41 37 30/11/05 5 YA42 23.2 30/11/05 Newnton House DS0000010277.V259652.R01.S.doc Version 5.0 Page 23 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 Newnton House DS0000010277.V259652.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection East London Area Office Gredley House 1-11 Broadway Stratford London E15 4BQ 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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