Inspection on 07/11/05 for Newstead House Nursing Home

This inspection was carried out on 7th November 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 but made no statutory requirements on the home.

Other inspections for this house

Newstead House Nursing Home 05/10/06

Newstead House Nursing Home 15/08/05

Newstead House Nursing Home 14/02/05

Newstead House Nursing Home 29/09/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Newstead House Nursing Home 43 Venns Lane Hereford Herefordshire HR1 1DT Lead Inspector C Presley Unannounced Inspection 07th November 2005 10:00 X10015.doc Version 1.40 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 Nursing Home DS0000027685.V258376.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 Older People. 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 Nursing Home DS0000027685.V258376.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Newstead House Nursing Home Address 43 Venns Lane Hereford Herefordshire HR1 1DT 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) 01432 263131 01432 275903 Somerset Redstone Trust Miss Catherine Horrigan Care Home 47 Category(ies) of Old age, not falling within any other category registration, with number (47), Physical disability (5), Physical disability of places over 65 years of age (35), Terminally ill (33) Newstead House Nursing Home DS0000027685.V258376.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Conditions of Registration 1. Younger adults will only be accommodated in the nursing unit and will only be admitted if they require palliative care and the placement is not considered to be long term. 2. Service users admitted under the category of terminal illness must be accommodated in the nursing unit. 3. Service users admitted under the category of physical disability (over 65) must be accommodated in the nursing unit or on the ground floor of the residential unit. 4. Service users will only be admitted into the first and second floors of the residential unit if they are able to descend the stairs in the event of a fire evacuation. When a service user looses this ability the Fire Risk Assessment must be reviewed and the Fire Safety Officer and the Commission informed about any interim arrangements, while the appropriateness of the placement is reviewed. Date of last inspection 15th August 2005 Brief Description of the Service: Newstead House is a Victorian property with a modern two-storey adjacent wing built in 1988. It is situated north of Hereford City approximately one mile from the town centre. It is owned and managed by Somerset Redstone Trust. In the original building the home offers accommodation for a maximum of 14 residents requiring support with personal care. The adjacent two-storey wing offers accommodation for a maximum of 33 residents requiring nursing care. The service is able to offer care for adults of both sexes who have a physical disability, are terminally ill or are frail due to old age. Newstead House Nursing Home DS0000027685.V258376.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place during the morning time was spent with the registered manager and her deputy, a number of residents and staff were spoken to during the course of the morning. This inspection focused on requirements from the previous inspection visit and inspecting the standards not inspected last time. What the service does well: What has improved since the last inspection? The registered manager and her deputy continue to address the shortfalls highlighted at the last inspection; this has been made difficult by the continuing major building work ongoing in the home. During this period the registered manager and her staff have ensured residents care has not been compromised and they have been kept safe and warm. Newstead House Nursing Home DS0000027685.V258376.R01.S.doc Version 5.0 Page 6 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 Nursing Home DS0000027685.V258376.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Newstead House Nursing Home DS0000027685.V258376.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of the standards in this section of the report were inspected at this visit, for further information refer to previous report. EVIDENCE: Newstead House Nursing Home DS0000027685.V258376.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9 Residents who were self medicating were not doing so within a risk framework. EVIDENCE: Medication policies and procedures were inspected on both units. There were two residents who were self medicating they were doing so without an up to date risk assessment and any audit procedure to ensure they complied with their medication regime. Medication to be given as and when had set times in the medication chart. Medication procedures for the disposal of medication complied with new legislation regarding disposal of medication including controlled drugs. Residents self-medicating had lockable storage space in their bedrooms. Medication records seen did not have any signature gaps, this was commendable. A fluid chart seen during the inspection had not been updated for several hours the previous day, this lack of documentation for frail residents is unacceptable. Newstead House Nursing Home DS0000027685.V258376.R01.S.doc Version 5.0 Page 10 The registered manager said care plan documentation had been reviewed and updated following the last inspection visit; requirements related to this were not inspected at this visit. The registered manager said she invites resident’s families to have input into care plans; to date residents and relatives have not taken up this offer; discussion around documenting this took place. Newstead House Nursing Home DS0000027685.V258376.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14 & 15 Residents are enabled to live as full a life as possible within their physical and mental disabilities. EVIDENCE: The home has an open visiting policy and visitors were seen coming and going during the inspection. The home has a Holy Communion service once a month and children from the local primary school visit at Christmas to sing carols. Residents in the nursing unit are frail; those in the social care unit are more active and able to leave the building, for organised trips out. Lunch on the day of inspection was appetising and residents were offered choices for all meals. The kitchen was inspected and was clean; records for the previous day were requested. It was noted these had not been filled in completely. Newstead House Nursing Home DS0000027685.V258376.R01.S.doc Version 5.0 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of the standards in this section of the report were inspected at this visit, for further information refer to previous report. EVIDENCE: There have been no complaints to the home or the Commission for Social Care Inspection since the last inspection visit. Newstead House Nursing Home DS0000027685.V258376.R01.S.doc Version 5.0 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 & 26 A number of environmental risks, risk the health and safety of the residents in the home. EVIDENCE: The home has ongoing major building work in progress; this includes a new call bell and fire bell system, which is due to be commissioned this week. A number of areas in the home required refurbishment following the building work including re-decoration and new carpets. Concerns following a tour of the premises were based on unacceptable risk to residents these included unlocked cupboards containing hot water pipes, a number of exposed hot water pipes, a free standing heater which had not been risk assessed. A number of fire doors were wedged open by means of a stool and in one case a pack of toilet rolls. There were no lamp shades in toilets. There was an unlocked full-length window on the first floor with no window restrictors (the room was unoccupied and was locked following the request of the inspector). Newstead House Nursing Home DS0000027685.V258376.R01.S.doc Version 5.0 Page 14 Laundry and bathing facilities were appropriate bathrooms felt very clinical. Some bedrooms on the nursing wing appeared small if the resident required hoisting. Infection control policies were adhered to and in the past the home had had access to the infection control nurse and her expertise. Bedrooms were personalised, not all bedrooms had lockable storage space. The registered manager said residents were risk assessed for a key to their bedroom these records were not seen. Communal areas in some areas of the home would benefit from refurbishment following the building work and a number of carpets required cleaning or replacing. Residents who were in bed or in rooms were listening to appropriate television and radio programmes and looked comfortable. Newstead House Nursing Home DS0000027685.V258376.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 30 Staff have a full induction and ongoing training programme in place, which ensures they have the knowledge to care for residents. EVIDENCE: There is an induction programme and all staff attend training in moving and handling before moving any residents. A training matrix in place evidenced staff received continual updates in mandatory training. The home employs thirty-five care staff of these twenty have an NVQ qualification and two staff are currently training. The foundation programme is based on TOPPS and underpins NVQ training, the home was implementing a new pack for new staff which looked comprehensive. New staff had the benefit of a senior member of the care staff team to mentor them during this period. Newstead House Nursing Home DS0000027685.V258376.R01.S.doc Version 5.0 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The registered manager is experienced and runs the home in a manner, which ensure residents are kept safe and secure. EVIDENCE: The registered manager has the necessary experience to run the home well. There is a committed staff team and the home uses agency staff to cover holidays and sickness. Staff receive regular supervision from other members of the team. Resident’s monies are kept safe and records are audited weekly. The home has a quality assurance programme in place this requires further development into a yearly report which should be made available to residents and prospective residents. Newstead House Nursing Home DS0000027685.V258376.R01.S.doc Version 5.0 Page 17 Health and safety issues were raised with the registered manager and have become requirements of this report. The home has a legionella risk assessment in place and recent changes in the supply of water have now decreased the risk of legionella. Newstead House Nursing Home DS0000027685.V258376.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 Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 X 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x 2 3 2 3 3 2 2 3 STAFFING Standard No Score 27 X 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 3 x x 3 Newstead House Nursing Home DS0000027685.V258376.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? yes 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 OP9 Regulation 13 (2) Requirement Residents who are self medicating must have an up to date risk assessment in place which ensures they are safe to self-medicate Medication that is written up ‘to be given as necessary or PRN’ must not be marked to be given at set times on the medication charts There must be an audit system in place for residents who self medicate to ensure compliance Fluid balance charts must be kept up to date and reasons why fluids are not taken written on the chart. Health and safety records related to food must be filled in daily Window restrictors must be fitted to windows; windows not fitted with restrictors must be kept locked. Hot water pipes must be boxed in, in the meantime they must be risk assessed All sinks that residents have access to must be checked to make sure they are fitted with a DS0000027685.V258376.R01.S.doc Timescale for action 07/11/05 2 OP9 13 (2) 07/11/05 3 4 OP9 OP7 13(2) 17 07/11/05 07/11/05 5 6 OP15 OP19 13 13 07/11/05 07/11/05 7 8 OP25 OP21 13 13 07/11/05 30/11/05 Newstead House Nursing Home Version 5.0 Page 20 9 10 11 12 OP19 OP21 OP19 OP19 13 13 13 13 13 14 OP19 OP19 13 23 15 16 OP19 OP24 19 12,13 working thermostatic control valve The free standing heater must be risk assessed Toilets in the social care wing must be fitted with lampshades Boiler rooms must be kept locked at all times A lock must be fitted to the door leading down to the laundry. Requirement outstanding from last inspection Named clinical items must not be used for other residents Fire doors must not be wedged open by means of any item that does not conform with fire safety Requirement outstanding from last inspection The stained sink in the bedroom identified during the inspection must be replaced Residents must be provided with lockable storage space for medication, money and valuables and a key, which he or she can retain (unless the reasons for not doing so are explained in the care plan). 07/11/05 30/11/05 07/11/05 07/11/05 07/11/05 07/11/05 31/12/05 31/12/05 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 OP27 Good Practice Recommendations It is recommended the employment of one domestic during the day is monitored to ensure the home is kept thoroughly clean at all times Newstead House Nursing Home DS0000027685.V258376.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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 Nursing Home DS0000027685.V258376.R01.S.doc Version 5.0 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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