Inspection on 26/03/09 for Newstead Lodge Nursing Home

This inspection was carried out on 26th March 2009.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Newstead Lodge Nursing Home 27/02/08

Newstead Lodge Nursing Home 05/02/07

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Newstead Lodge Nursing Home Warwick Road Southam Leamington Spa Warwickshire CV47 0HW     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Patricia Flanaghan     Date: 2 6 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Newstead Lodge Nursing Home Warwick Road Southam Leamington Spa Warwickshire CV47 0HW 01926813694 01926814068 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Genesis Homes (Essex) Ltd Name of registered manager (if applicable) Ms Sandra Mguquka Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Newstead Lodge is a care home providing nursing care for older people over the age of 65 years. The home is registered for 26 people. The home is located on the outskirts of the small market town of Southam, set back off the main road, about three quarters of a mile from the town centre. There is ample parking to the front of the home. Accommodation is provided over two floors and can be accessed either by using the stairs or by a passenger lift. There are two shared rooms and sixteen single rooms. One of the rooms is only accessible by stairs and would not be suitable for a wheelchair user or a person with impaired mobility Care Homes for Older People Page 4 of 28 0 Over 65 26 care home 26 Brief description of the care home The service user guide stated that the fee levels range from £477 to £500 per week. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means that that people who use this service experience good quality outcomes. One inspector carried out this unannounced inspection over one day between 08:30am and 3:00pm. The last key inspection visit to Newstead Lodge Nursing Home was on 27th February 2008. Before the inspection, we looked at all the information we have about this service, such as information about concerns, complaints or allegations, incidents and previous Care Homes for Older People Page 6 of 28 inspection reports. We do this to see how well the service has performed in the past and how it has improved. We looked at the Annual Quality Assurance Audit (AQAA) which the manager completed and returned to us before our visit. This is the managers review of the service and gives us information about how the service has progressed in the last 12 months. We sent out random surveys to ten people who live at the home and five staff in order to gain peoples views about the service. Four people and three staff completed and returned surveys to us. Their comments are included in this report. We used a range of methods to gather evidence about how well the service meets the needs of people who use it. We talked to people who use the service and observed their interaction with staff. We looked at the environment and facilities provided and checked records such as care plans and risk assessments. We also looked at staff duty rotas, training and recruitment records. We talked to the manager, a nurse and two care staff. Three people using the service were identified for case tracking. This is a way of inspecting that helps us to look at services from the point of view of some of the people who use them. We track peoples care to see whether the service meets their individual needs. We chatted informally with about ten of the people living in the home and one visitor. Our assessment of the quality of the service is based on all this information, plus our own observations during our visit. What the care home does well: What has improved since the last inspection? The manager has taken steps to address all of the requirements from the last inspection. This demonstrates her commitment to ensuring people live in a safe and well run home. People continue to benefit from the ongoing refurbishment plan which is providing a clean and comfortable place for them to live in and enjoy. Duty rotas clearly record the hours care staff spend undertaking non- caring duties such as laundry and cleaning. The AQAA tells us that the home employs a full time cook and have provided extra staff to do laundry and cleaning. A picture menu has been introduced which is shown to all people when making their choice of food. It is also displayed on the notice board for people to see the meal of the day. A personal folder has been developed for each person which contains a copy of the service users guide, contract, complaints procedure and contact details of advocacy services. The manager ensures that people do not start working in the home until satisfactory pre employment checks have been undertaken. This ensures people living at the home Care Homes for Older People Page 8 of 28 are protected by robust employment procedures. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have sufficient information about the home to enable them to make an informed decision about whether they would like to live there. Pre admission assessments ensure that people know their needs can be met prior to moving in. Evidence: We looked at the information given to people before they move to Newstead Lodge. Everyone is given a copy of the statement of purpose and user guide, which is also available in the hallway of the home along with our most recent inspection report. We spoke with a person who told us they had enough information about the home before they moved in. They had not visited beforehand, but said their family had looked around the home and that they had an opportunity to change their minds once they had been there a while. We looked at the assessment that had been completed for a person who had recently Care Homes for Older People Page 11 of 28 Evidence: moved to Newstead Lodge. The assessment were comprehensive and included all the information required in order for the home to assess if it could meet peoples physical and mental health needs and how many carers are needed for support. We saw that notes are made of the persons social interests, hobbies, religious and cultural needs. Before the person is admitted a draft care plan is developed which outlines the care and support to be provided for that person. Newstead Lodge does not provide intermediate care. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home can be confident their needs will be recognised and met and they will be treated with respect at all times. Evidence: The case files of three people identified for case tracking were examined. We saw that each person had care plans and risk assessments that detailed the care they needed. Care plans are kept under regular review and changes to care are recorded. Care plans were personalised, for example we saw information for staff on how to encourage a persons mobility by assisting him to walk a few steps each day and to stand for a few minutes morning and evening in order to exercise his knees. The care plans we looked at were very detailed and individual to the person concerned. They provided confirmation that people are involved in planning and reviewing their care. We saw very good evidence that people admitted with complex problems improve during their stay at the home. The nursing outcomes described in Care Homes for Older People Page 13 of 28 Evidence: the care plans are linked to current nursing research and staff are provided with clinical training so they keep up to date and practice evidence based nursing. Risk assessment had been reviewed and completed in all care plans examined. These include risks related to pressure areas, falls, mobility and nutrition. The home makes sure that risk assessments and kept under review. This will mean that any person considered to be at risk will be known to staff and a risk management plan drawn up. Entries in each persons health records and comments by people living in the home confirmed that they are supported in getting access to relevant health care professionals when needed. This includes access to GP, Chiropodist, Community Psychiatric Nurse and Optician. This should mean that people receive specialist advice about their healthcare needs. Written daily reports in care files provided information on peoples day-to-day life in the home and provides details on their health and well being. We examined systems for the management of medication. There are good systems in place for ensuring people receive their prescribed medication safely and regular audits are carried out by the community pharmacist to confirm staff are working to the homes polices and procedures. The facility for storing controlled drugs was satisfactory and complies with legislation. The contents of the controlled drug cabinet were audited against the controlled drug register and the quantities were correct. Medication Administration Record sheets maintained an accurate record of medicines administered to people. We observed a very high level of personal care and attention to clothing, nail and hair care, that enabled people to maintain their dignity and individual identity. People spending time in bed because of their frailty, all looked comfortable and well supported with drinks and call bells to hand, if applicable. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Opportunities to participate in varied activities has improved ensuring people living at the home are involved in daytime activities of their own choice and according to their interests and capabilities. Meals are well balanced and nutritious. Evidence: People who were able to mobilise independently were observed to access all parts of the care home as they chose. Observations made and discussion with people living at the home showed that they have the opportunity to make choices in their daily lives, such as when to get up and go to bed, what to eat, whether to join in activities or not and where to spend their time. A planned programme of activities such as arts and crafts, board games and quizzes takes place daily. A copy of the programme is available in the home. Outside entertainers, such as singers, regularly perform in the home. Armchair aerobics and mobility exercises take place fortnightly. Reminiscence therapy is Care Homes for Older People Page 15 of 28 Evidence: undertaken monthly. On the day of the inspection visit we saw people participate in a quiz in the morning and some had hand massages in the afternoon. The case files of people case tracked contained some details of their hobbies, interests and past working life. Several people living in the home spend much of their day in bed because of their care needs. The service could improve the opportunities for these people to engage in meaningful and stimulating activity to enhance the quality of their lives. A record of group and individual activities is maintained in the home. The home has an open visiting policy and people can see their visitors in the privacy of their own rooms should they choose to do this. This means that people can maintain the relationships that are important to them. Relatives and friends were seen to visit during the day of inspection. People told us that visitors are made welcome and the visitors record demonstrated that people can visit when they want to. Visitors told us, I am always made welcome. I visit every day and I am greeted by name. Religious visits were arranged to the home at fortnightly or monthly intervals. There was information displayed showing involvement with the local church. This ensures that people can continue to follow their religious needs if they choose to. A hairdresser visits weekly so that people can have their hair styled in a way that they prefer. Small pieces of furniture, pictures, ornaments and photos belonging to the occupants were seen in bedrooms showing that residents were able to bring personal possessions with them when they came to live in the home. There is a four-week menu in place and this offers two hot choices at lunchtime and a choice of soup and sandwiches or hot snack in the evening. On the day of our visit, people had a choice of cooked gammon or chicken pie with creamed potatoes, cauliflower and carrots. The meal was served from a heated trolley brought up from the kitchen. Meals were delivered to people who chose to eat in their room. People made positive comments about the food provided in the home. Comments received during the visit and from people who completed surveys include, I always have plenty of choice. Meals are cooked on the premises and my relative always has a choice. Care Homes for Older People Page 16 of 28 Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home can be confident that their concerns will be listened to and acted upon. There are systems in place to respond to suspicion or allegations of abuse to make sure people living in the home are protected from the risk of harm. Evidence: The home has a formal complaints policy which is accessible to people living in the home and their families. People are encouraged to raise their concerns with the manager or senior staff on duty. People told us that they would initially raise concerns with their relatives or representatives who would speak to the manager on their behalf, but they said they felt they could go to the manager or any member of staff and they would be listened to. People and relatives spoken with said that they were aware of how to complain and whom to complain to. Comments made include, I have never had to make a complaint, but this wouldnt be a problem if the need arose as the staff are very approachable. Evidence was available that the manager makes a timely and objective response to concerns made directly to the home. A record of complaints received by the home is maintained along with the action taken by the manager regarding each issue raised. Care Homes for Older People Page 18 of 28 Evidence: As noted at the last inspection visit, most of the concerns and complaints recorded had been raised verbally. This demonstrates that the home listens to what people have to say so they can be certain their concerns are listened to and acted upon. The home has an adult protection policy to give staff direction in how to respond to suspicion, allegations or incidences of abuse. Training records examined show that all staff have had training in recognising signs and symptoms of abuse. Staff also confirmed that they had attended training related to the protection of vulnerable adults. Two members of staff were able to explain the action they would take if they saw abuse. It was evident through discussions with the manager that she is aware of local Social Services and Police procedures and her responsibilities for responding to allegations of abuse. Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well maintained and provides a pleasant place for people who use this service to live. There are systems in place to prevent the spread of infection. Evidence: The home comprises of an original house with a more recent ground floor extension. Some of the accommodation and facilities in the home were seen while visiting and talking to people, their families and staff. People who live at the home were observed making use of all the communal spaces. Several bedrooms, including the people involved in case tracking, were viewed. Rooms were comfortable, cosy and well decorated with en suite facilities. Most of the rooms visited showed that they were attractive and homely. People said that being able to bring in small items of furniture and other furnishings such as pictures and cushions helped to make their bedrooms comfortable. We asked if the rooms and furniture were comfortable. A person told us Im very comfortable here, I have a lovely room. Equipment is available to assist residents and staff in the delivery of personal care, which includes assisted baths, moving and handling equipment including hoists. Pressure relieving equipment such as cushions and various types of mattress are Care Homes for Older People Page 20 of 28 Evidence: available for people who have an identified need for them. There are systems in place to prevent the spread of infection. Staff have access to gloves and aprons, there is also liquid soap and paper towels for hand washing purposes in all toilets and bathrooms. The home was clean and fresh on the day of the visit. A relative told us, the home is spotlessly clean, I couldnt fault it at all. There is never a bad smell. Care Homes for Older People Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by staff who have been recruited safely, trained appropriately and have the knowledge and skills to meet peoples needs. Evidence: The home has enough staff on duty to meet the needs of people living there. Staffing levels are responsive to peoples needs. On the day of the inspection visit there were 19 people living in the home. The manager told us the usual staff complement is one registered nurse supported by three care staff until 6pm and one registered nurse and two care staff until 8pm. There is one registered nurse and one carer on duty from 8pm to 8am. We looked at staff records which show that staff are supported with National Vocational Qualification training and are only recruited after the appropriate safety checks. We observed staff working in the communal areas of the home and we saw they were competent to carry out their jobs in a caring and supportive manner. Evidence was available to confirm that newly recruited staff follow an induction programme. A staff training matrix provided evidence that mandatory training such as moving and handling, fire safety, infection control, food hygiene, first aid and abuse awareness is available for staff. We also saw that some staff had attended specialist Care Homes for Older People Page 22 of 28 Evidence: training in Parkinsons disease, pressure ulcer prevention and supporting people with challenging behaviour. People told us, The staff are delightful and offer help and support to all residents as far as they are able. The staff are marvellous, very patient and kind. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Newstead Lodge is managed by an experienced and competent person to ensure the service is run in the best interests of people living in the home. Evidence: The manager has worked at the home for over twelve months and is registered with us. She is a Registered General Nurse and is experienced in the care of older people. Staff, people living in the home and visitors said the manager was approachable. One person commented, the manager is friendly and always ready to help. Records seen indicated that systems are in place to obtain the views of the residents, relatives and other stakeholders about the service. The provider conducts regular quality assurance audits. A copy of a quality assurance survey from December 2008 and February 2009 was seen, the results are available in the homes service user guide and on the notice boards throughout the home for people to examine. Regular meetings are held with relative, residents and staff, and minutes of the meetings were Care Homes for Older People Page 24 of 28 Evidence: seen. Reports were seen for regulation 26 visits made by the provider to monitor the care and service they provide and ensure that the home is being run in the best interests of people who live there. The systems in place for keeping peoples money safe remain unchanged since our last visit. People are supported to manage their own money where possible. Where the home is responsible for peoples money it works to a safe system and maintains clear records. The home has effective systems for maintaining equipment and services to the home to promote the safety of people in the home. The home confirmed in the AQAA forwarded to us that health and safety checks had been completed. The homes records for fire safety were seen and were up to date. A fire evacuation drill had been undertaken in January 2009 and records showed a satisfactory response by staff to the drill. Hot water checks are done weekly, however where high temperatures had been recorded, there was no record to demonstrate the action, if any, the home had taken to reduce the scald risk to the person. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 12 Opportunities for people to engage in meaningful and stimulating activity should be reviewed to ensure it is accessible to all people, whatever their needs or abilities. This should enhance the quality of life for people living in the home. Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!