Inspection on 26/01/06 for Newstead House

This inspection was carried out on 26th January 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 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 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Newstead House 10/11/06

Newstead House 05/10/05

Newstead House 15/03/05

Newstead House 22/04/04

Similar services:

Ashlong House

Norbury Crescent (30)

Henry Nihill House

Birchwood

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

The Infirmary

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

CARE HOME ADULTS 18-65 Newstead House Trooper Drive Harold Hill Romford Essex RM3 9DE Lead Inspector Mrs Denyse Lillington Unannounced Inspection 26th January 2006 10:00 Newstead House DS0000027866.V280113.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 Newstead House DS0000027866.V280113.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. Newstead House DS0000027866.V280113.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Newstead House Address Trooper Drive Harold Hill Romford Essex RM3 9DE 01708 381363 01708 381 347 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) Servite Houses Mr Michael Davies Care Home 34 Category(ies) of Learning disability (28), Old age, not falling registration, with number within any other category (1), Physical disability of places (2) Newstead House DS0000027866.V280113.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th October 2005 Brief Description of the Service: Newstead House is a large purpose build home owned by Servite Houses which is a not for profit organisation. The home was originally predominately caring for older people however during the past few years this has changed to adults with learning disabilities. The building is large but attention to furnishings has made the interior a less institutional and more homely environment. Having been built with older people in mind it is fully wheelchair accessible. From discussion with staff, service users and management it would appear that the service has experienced major changes during the past five years with the focus now being much more geared to younger adults and a more user led model of care. Newstead House DS0000027866.V280113.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A tour of the home was undertaken, where a number of the Service Users were seen and communicated with. A number of documents were seen and seven members of staff were spoken to. The Manager and Deputy Manager were present during the inspection. There were 11 requirements made at the last inspection. Of these, 8 had been met at this inspection and the other 3 had been part met. There have been 10 requirements made in this report and 3 requirements repeated from the last inspection. The inspector was impressed with how hard the home had worked to address the requirements from the last report and the dedication and commitment of the staff team including the managers. What the service does well: What has improved since the last inspection? Newstead House DS0000027866.V280113.R01.S.doc Version 5.1 Page 6 The staff had worked hard to address the requirements since the last inspection. An administrator had been employed to sort out the paperwork at the home including the staff files, which was underway at the time of this inspection. The care plans for Service Users were being completed by the Service Users with the support of staff where needed and this was understandably taking longer than if staff were completing this task. The medication room had been identified, to store medication at the correct temperature and Service users were busy preparing this room at the time of this inspection. Carpets had been replaced since the last inspection. A misunderstanding regarding the safety and risk assessment of one Service User between the Commission and the home had been addressed by the home and the Commission had formally apologised to the home. 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. Newstead House DS0000027866.V280113.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 Newstead House DS0000027866.V280113.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): 2 and 4 Service Users are given the opportunity to visit and to “test drive” the home. EVIDENCE: At the last inspection files looked at during the inspection, did not show any evidence that an assessment was done prior to the admission to the home. At the time of this inspection, the policy and procedure manual included a new comprehensive assessment package that will be used for all new admissions and futures placements. There have not been any admissions since the last inspection, however there were 3 vacancies at the time of inspection. There was one perspective service user who was in the process of visiting the home, spending time looking around, staying for tea with the other service users and involving their family with the intention of moving to the home. The Deputy Manager said that all prospective Service Users come to dinner, tea and have over night stays. This is over a period of time giving the home and the Service User the opportunity to establish if it is suitable. Newstead House DS0000027866.V280113.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): 6,7 and 9 The newly introduced care plan review forms enable service users to become involved in their assessment planning and changing needs. These are reflected in their individual plan. Service Users are consulted on and participate, in all aspects of life in the home. Service Users do take part in independent lifestyles. EVIDENCE: At the last inspection Care Plans looked at during the inspection did not have any indication that the Service User or significant others had been involved in the care planning. The Deputy Manager was able to produce new procedures and forms that would necessitate the involvement of Service Users. At the time of this inspection some of the care plans had been re-written by the service users with support from the staff where necessary. The aim of the home is that all service users will be supported to write their own care plans and work is already underway to achieve this aim. The deputy manager stated that the home were about 50 or more towards their achievement. Newstead House DS0000027866.V280113.R01.S.doc Version 5.1 Page 10 It was noted during the inspection that Service Users were coming and going from the home. The home does have an ethos of encouraging an independent lifestyle and participating in all aspects of the life in the home. It was discussed with the manager and deputy manager at the time of inspection, the need for a community and annual holiday risk assessment to take into consideration the various emergency situations that may occur, as a support for staff members. There has been a requirement made in this report for a community risk assessment. The manager explained that since the last inspection all services users had an individual risk assessment, which can be found on the service user file. During the tour of the building, Service Users were seen making themselves drinks, undertaking their own laundry and being part of the activities arranged. The home does need to make sure that there are risk assessments for Residents accessing the community and are supporting them where necessary. The home hold service user meetings on a regular basis and make it a special occasion such as a ‘Curry night’ or coffee morning so that service users are relaxed when they make suggestions about their decisions about their life. All service users take individual risks as assessed. Newstead House DS0000027866.V280113.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 Service Users have the opportunities for personal development, which is documented in their Care Plans. The Service Users are offered a healthy diet and enjoy their meals. EVIDENCE: The Service Users files looked at had a programme of daily activities in their Care Plan. It was observed during the inspection and during the tour of the home, the Service Users were taking part in both activities of daily living and social activities that were keenly supported. The Service User meetings minutes that were checked discussed the service users comments about the food provided, the Service Users preferences and any changes the Service Users would like. Meals seen being prepared were healthy and it was clear that all the Service users enjoyed them. The home offer options such as theme nights, Birthday parties and take away meals. Newstead House DS0000027866.V280113.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 Service Users physical and emotional health needs are being met. Some of the Service Users do self-medicate. The home had made errors in the recording of administration of medication. EVIDENCE: The Deputy Manager and the Senior Carer both said that some of the Service Users do self-medicate. These Service Users had a lockable facility in their bedrooms to use for medication storage, as requested by the pharmacist inspector. The Deputy Manager said that they had recently had a thorough review and inspection of their medication and produced the inspection report and follow up report. Medication Administration sheets (Mar sheets) were checked at random and the inspector found that one MAR sheet had been incorrectly signed by the member of staff, so that it did not correspond correctly with the blister pack. The outstanding issue over the temperature of the storage of medication was being addressed. At the time of inspection, a room was being prepared for medication storage. The room meets all the requirements raised at the last inspection. Newstead House DS0000027866.V280113.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): 22,23 Service users views are listened to and acted on. There is some concern about the Service Users being protected from abuse, but are protected from neglect and self-harm. EVIDENCE: At the previous inspection there was a misunderstanding about a serious incident that had been reported to CSCI, but the paperwork was mislaid and it was thought that the incident had not been reported. That had since been sorted out. All serious incidents and occurrences are reported to CSCI as required and the managers stated that they always send information to CSCI, even if they are in doubt whether or not the incident is serious, just to make sure they are meeting the requirement. The inspector did find that an incident of one Service User hitting another service user causing a bruise was not reported to CSCI so this has been required in the report. Two incidents that occurred in December 2005 had been recorded in the complaints book but there was no evidence that it had been followed up and an incident report form was not completed. All the Service Users spoken to stated that they were happy and well cared for/supported by the staff. It was observed and through discussion with staff that no Service User is neglected or self-harms. The Service Users were observed to be treating the home as comfortably as people would in their own home, coming and going, relaxing, watching T.V, drinking coffee, chatting, moving around the home etc. Newstead House DS0000027866.V280113.R01.S.doc Version 5.1 Page 14 Staff talked to were clear that all the views and complaints by Service Users and staff would be listened to and acted upon. Newstead House DS0000027866.V280113.R01.S.doc Version 5.1 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 and 30 Service Users live in a homely and safe environment, some carpets had been replaced. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. Kitchens in the units looked tired and in need of replacement fronts and some area’s of paintwork were scuffed spoiling the ambience of the home. EVIDENCE: During the tour of the home it was noted that some of the carpets had been replaced since the last inspection. All bedrooms had en-suite facilities and in addition to these there were sufficient numbers of toilets to meet the needs of service users. Some of the paintwork in the communal area’s were scuffed and spoiled the appearance of the home. These areas need re-painting. Newstead House DS0000027866.V280113.R01.S.doc Version 5.1 Page 16 The communal bathrooms are due to be refurbished in the next financial year,(from 1st April 2006). The existing bathrooms were put in when the home was built and are now in need of replacement. Bedrooms were personalised. Newstead House DS0000027866.V280113.R01.S.doc Version 5.1 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): 32,34 and 35 Service Users are not protected by the home’s recruitment policy and practices, as there was no evidence of Criminal Record Bureau checks having been taken up on some staff files. This was being addressed by the home. Service Users individual and joint needs are met by appropriately trained staff. Service Users benefit from well supported and supervised staff. EVIDENCE: The Deputy Manager did say that no staff could commence work without adequate checks taking place. Not all staff files held at the home had evidence of the CRB checks ( or POVA First checks) at the time of the inspection. This was being addressed by the home. An administrator had been employed by the organisation and was in the process of obtaining the required information for the commission. CRB and other checks are held on file at head office and had not been cascaded down to the home for inspection. It was seen during the inspection of staff files that staff receive adequate supervision. When the inspector spoke with the staff team they felt that they should have more appropriate training such as training in epilepsy, violent/challenging behaviour, mental health training, understanding Downs Syndrome, bereavement and first aid training. Newstead House DS0000027866.V280113.R01.S.doc Version 5.1 Page 18 The staff said they had discussed training with the management team and the managers had tried unsuccessfully to obtain this training for them. The staff also felt that regular relief staff should also be offered training. Seven staff had completed their NVQ level 2 and approximately six staff needed to complete their NVQ level 2. Newstead House DS0000027866.V280113.R01.S.doc Version 5.1 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): 37and 42 The Service Users benefit from a well run home. The manager ensures safe working practices in the home for the safety and welfare of Service Users and staff but must obtain a regular fire safety check annually. EVIDENCE: At the time of inspection the annual fire safety check was due. The managers were asked to call in the fire safety officers to carry out the relevant checks and a requirement has been made in this report. The manager had all the required qualifications and experience to run the home. The manager and deputy manager were clear about the aims and objectives of the home and said they were supported by the board of trustee’s to meet their aims and objectives. The manager, deputy manager and staff had received training for mandatory training such as moving and handling, adult protection, food hygiene. Newstead House DS0000027866.V280113.R01.S.doc Version 5.1 Page 20 The home ensured compliance with COSHH regulations and had up to date certificates for gas and electricity and electrical checks for the lift. Newstead House DS0000027866.V280113.R01.S.doc Version 5.1 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 CHOICE OF HOME Standard No Score 1 x 2 3 3 x 4 3 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 2 STAFFING Standard No Score 31 x 32 3 33 x 34 2 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 2 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 x x x x 2 x Newstead House DS0000027866.V280113.R01.S.doc Version 5.1 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 YA9 Regulation 13 Requirement The service must provide community risk assessments for service users accessing the community individually and in groups and going on holiday. The medication record sheets must be signed correctly to correspond to the blister packs. Medication must be stored at the correct temperature. This is repeated from previous inspections, however it is acknowledged that the room identified for this purpose was almost complete. The home must ensure that when complaints have been investigated, the outcomes are actioned and that action is recorded and the relevant people involved are informed. All incidents under section 37 of the regulations occurring in the home must be recorded on the incident DS0000027866.V280113.R01.S.doc Timescale for action 26/04/06 2 YA20 13 26/01/06 3 YA20 13 26/02/06 4 YA22 22 26/02/06 5 YA23 37 26/01/06 Newstead House Version 5.1 Page 23 forms at the home. 6 YA23 37 The home must inform the commission of the occurrence of incidents under section 37 of the regulations. This is a repeat requirement. The home must have evidence of adequate checks, CRB’s for staff working at the home. This was being addressed at the time of inspection, but is a repeat requirement. The staff must receive adequate training to be competent and confident to carry out the tasks expected of them. The home must have the annual fire safety check. 26/01/06 7 YA34 18,19 26/04/06 8 YA34 18 26/08/06 9 YA42 13 01/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA30 Good Practice Recommendations The home must be well maintained and kept in a good state of repair, this includes bathrooms, kitchen units and areas of scuffed paintwork. Newstead House DS0000027866.V280113.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU 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 Newstead House DS0000027866.V280113.R01.S.doc Version 5.1 Page 25 - 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. 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