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Inspection on 21/08/07 for Newton Court Nursing Home

Also see our care home review for Newton Court Nursing Home for more information

This inspection was carried out on 21st August 2007.

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 but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

People interested in going to live at Newton Court are provided with information about the home, and have a full assessment to determine whether the home will meet their needs. The health and personal care needs of residents are identified in their care plans and are met to a good standard by the home`s staff with support from visiting healthcare professionals as needed. A comment card received from a relative read: They are very dedicated to looking after my mother who needs their help at all times. My mother can`t speak and has difficulty making the staff understand but they always manage to cope and find out what she needs. A comment from another relative was: I cannot fault any aspects of the care given to my mother at Newton Court. Newton Court has been taking part in the BUPA `end of life care` project facilitated by the Primary Care Trust to ensure that people`s wishes are respected as they approach the end of their life. The `preferred place of care` documentation was seen in the care plans and the deputy manager said that the next step would be to introduce the Liverpool Care Pathway to plan and document the care given to residents during their last days. Newton Court has a complaints procedure and a record is kept of any written and verbal complaints and their outcome. The complaints procedure is included in the service user guide and is also displayed in reception, together with complaints forms.Newton Court provides a comfortable and pleasant living environment for residents. There are private gardens with sitting areas and these are attractive and well kept. The home is well maintained and provides a range of communal areas. All bedrooms and communal are adequately furnished and carpeted, and nicely decorated. Some residents have brought their own belongings into their rooms. All bedrooms have an en-suite toilet. There is a range of different assisted bathing and showering facilities. Equipment, including mobile hoists and nursing beds, is provided to meet the needs of residents with disabilities. All parts of the home were spotlessly clean and there were no unpleasant smells. Enough qualified and experienced staff are provided to meet the needs of the residents, with 70% of care staff having a national vocational qualification in care. Good recruitment practices are followed when recruiting new staff. An annual customer satisfaction survey is carried out by BUPA to enable residents and their relatives to express their views.

What has improved since the last inspection?

A new activities organiser has been appointed since the last inspection to provide more social stimulation for residents. The variety of menus has been improved at the request of residents. The range of facilities has been improved by developing a wheel-in shower room on the first floor. All staff attend regular fire drills so they know what to do to protect residents in case of fire.

What the care home could do better:

On both floors there were some missed signatures on the medicine administration record sheets. If a medicine is not given then a reason must be documented. Staff should be vigilant in noticing and reporting missed signatures on medicine administration record sheets so that the manager can find out whether residents are not receiving their medicines as prescribed or whether staff are forgetting to sign the sheet. More frequent medicine audits may be needed to address this issue, which is an outstanding requirement from the last two inspections.A record must be kept of all medicines kept in the home and this means that any medicines that are carried forward from one month to the next should be counted, and the quantity recorded on the new medicine administration record sheet.

CARE HOMES FOR OLDER PEOPLE Newton Court Nursing Home St Ann`s Road Middlewich Cheshire CW10 9BJ Lead Inspector Wendy Smith Unannounced Inspection 21st August 2007 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 Newton Court Nursing Home DS0000018729.V342872.R01.S.doc Version 5.2 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. Newton Court Nursing Home DS0000018729.V342872.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Newton Court Nursing Home Address St Ann`s Road Middlewich Cheshire CW10 9BJ 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) 01606 835294 01606 835295 BUPA Care Homes (AKW) Ltd Care Home 60 Category(ies) of Old age, not falling within any other category registration, with number (60), Physical disability (3) of places Newton Court Nursing Home DS0000018729.V342872.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 60 service users to include: * Up to 60 service users in the category OP (old age not falling within any other category) * Within the 60, 3 service users in the PD (physical disability) category Date of last inspection 1st August 2006 Brief Description of the Service: Newton Court is a modern purpose built care home located close to Middlewich town centre. The ground floor accommodates up to 24 older people who require personal care, and the first floor accommodates up to 36 older people requiring nursing care. The home is part of the BUPA group. The current weekly fees range from £472.50 to £627.73 per week. Further details regarding fees are available from the manager. Newton Court Nursing Home DS0000018729.V342872.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit took place on 21st August 2007 and took five and a quarter hours. The home had 49 residents, all over 65 years of age, of whom 22 were receiving personal care and 27 nursing care. A tour of the building, including all communal areas and some bedrooms, was completed. A sample of records was looked at and time was spent in conversation with residents, the deputy manager, staff and a visitor. Some of the information contained in this report is taken from the Annual Quality Assurance Assessment that was completed by the manager at the request of the Commission for Social Care Inspection. Prior to the visit, comment cards were provided for a number of residents, visitors, social workers and GPs to give their views of the home. What the service does well: People interested in going to live at Newton Court are provided with information about the home, and have a full assessment to determine whether the home will meet their needs. The health and personal care needs of residents are identified in their care plans and are met to a good standard by the home’s staff with support from visiting healthcare professionals as needed. A comment card received from a relative read: They are very dedicated to looking after my mother who needs their help at all times. My mother can’t speak and has difficulty making the staff understand but they always manage to cope and find out what she needs. A comment from another relative was: I cannot fault any aspects of the care given to my mother at Newton Court. Newton Court has been taking part in the BUPA ‘end of life care’ project facilitated by the Primary Care Trust to ensure that people’s wishes are respected as they approach the end of their life. The ‘preferred place of care’ documentation was seen in the care plans and the deputy manager said that the next step would be to introduce the Liverpool Care Pathway to plan and document the care given to residents during their last days. Newton Court has a complaints procedure and a record is kept of any written and verbal complaints and their outcome. The complaints procedure is included in the service user guide and is also displayed in reception, together with complaints forms. Newton Court Nursing Home DS0000018729.V342872.R01.S.doc Version 5.2 Page 6 Newton Court provides a comfortable and pleasant living environment for residents. There are private gardens with sitting areas and these are attractive and well kept. The home is well maintained and provides a range of communal areas. All bedrooms and communal are adequately furnished and carpeted, and nicely decorated. Some residents have brought their own belongings into their rooms. All bedrooms have an en-suite toilet. There is a range of different assisted bathing and showering facilities. Equipment, including mobile hoists and nursing beds, is provided to meet the needs of residents with disabilities. All parts of the home were spotlessly clean and there were no unpleasant smells. Enough qualified and experienced staff are provided to meet the needs of the residents, with 70 of care staff having a national vocational qualification in care. Good recruitment practices are followed when recruiting new staff. An annual customer satisfaction survey is carried out by BUPA to enable residents and their relatives to express their views. What has improved since the last inspection? What they could do better: On both floors there were some missed signatures on the medicine administration record sheets. If a medicine is not given then a reason must be documented. Staff should be vigilant in noticing and reporting missed signatures on medicine administration record sheets so that the manager can find out whether residents are not receiving their medicines as prescribed or whether staff are forgetting to sign the sheet. More frequent medicine audits may be needed to address this issue, which is an outstanding requirement from the last two inspections. Newton Court Nursing Home DS0000018729.V342872.R01.S.doc Version 5.2 Page 7 A record must be kept of all medicines kept in the home and this means that any medicines that are carried forward from one month to the next should be counted, and the quantity recorded on the new medicine administration record sheet. 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. The summary of this inspection report can be made available in other formats on request. Newton Court Nursing Home DS0000018729.V342872.R01.S.doc Version 5.2 Page 8 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 Newton Court Nursing Home DS0000018729.V342872.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People interested in going to live at Newton Court are provided with information about the home, and have a full assessment so they know their needs can be met at the home. EVIDENCE: The home has a satisfactory statement of purpose and service user guide which provide detailed information about the services offered. These have been kept up to date to include details of the current management arrangements. Newton Court Nursing Home DS0000018729.V342872.R01.S.doc Version 5.2 Page 10 When an enquiry is received from a person interested in coming to live at the home, or having a short stay there, the manager or the deputy manager goes out to assess their needs. The new BUPA care documentation, introduced earlier in 2007, includes a comprehensive assessment form that is completed before admission, straight after admission and after the first six months. These completed forms were seen in the residents’ care folders. Newton Court does not provide intermediate care but people can come for short stay if a room is available. Newton Court Nursing Home DS0000018729.V342872.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9, 10 and 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care needs of residents are identified in their care plans so they can be met to a good standard by the home’s staff with support from visiting healthcare professionals. EVIDENCE: Residents living on the ground floor receive personal care from care assistants and senior care assistants; if they need any nursing care, this is provided by district nurses. Residents on the first floor receive nursing care from registered nurses employed at the home. At the time of the visit, most of the residents on the first floor had a high level of care needs. Each resident has a care folder that contains a full assessment of their needs and care plans for how their needs should be met. Earlier in 2007 BUPA introduced a new style of documentation and this has been implemented to a good standard at Newton Court. Newton Court Nursing Home DS0000018729.V342872.R01.S.doc Version 5.2 Page 12 Four care folders were looked at on the first floor. The first two had been completed to an excellent standard. One referred to a gentleman who is very frail. The assessment of his needs was very thorough and a record of discussion with his close relatives had been recorded each month. He has significant tissue damage due to pressure and general ill health, and the care of pressure ulcers was well documented. Advice had been provided by the tissue viability nurse specialist. He had been provided with a profiling bed and alternating pressure mattress. He was visited every weekly by his GP. The regular recording of his weight showed a considerable weight loss due to difficulty with eating and drinking and a dietician had provided support with this problem. There was a care plan for pain management and a full medication review had been carried out by his by GP in August 2007. A ‘Preferred Place of Care’ document detailed the decision not to admit this gentleman to hospital but to keep him as comfortable as possible at Newton Court. The second care plan provided detailed information for staff about the care of a resident with communication difficulties. The resident’s daughter had made the following comment on a Commission for Social Care Inspection comments form: My mother can’t speak and has difficulty making the staff understand but they always manage to cope and find out what she needs. Both of these care plans had been written in a very person-centred and sensitive manner and detailed the involvement of the residents’ families in their care. In the third care plan looked at, all of the documents had been completed to a satisfactory standard except that there was no record of any communication with resident’s relatives. The deputy manager said that the resident has a daughter who visits regularly so she could not understand why this had been missed out. The care plan showed that this resident had frequent visits from her GP, usually due to medication difficulties. The fourth care plan was looked at because one of the nurses said that this resident had a small pressure sore. It was recorded that the resident had a small area of broken skin on her sacrum earlier in the year, but that this had healed. None of the nurses had made a record that the skin had broken down again. A relative spoken with on first floor said that her mother is over one hundred years old and has lived at the home for eight years. The daughter has been very satisfied with care given to her mother and clearly had a good relationship with the staff. She visits nearly every day and said that the staff are excellent, including the younger members of staff. On the ground floor the same care documentation is used. Two care plans were looked at and both had been well completed. One of the residents was having a significant number of falls, fortunately without any serious injury. Newton Court Nursing Home DS0000018729.V342872.R01.S.doc Version 5.2 Page 13 Accident forms had been completed and a falls risk assessment was kept up to date. His GP had been consulted about the cause of the falls. Staff were observed to treat residents courteously and residents said that staff treated them with respect and maintained their privacy and dignity. Newton Court has been taking part in the BUPA ‘end of life care’ project facilitated by the Primary Care Trust. The ‘preferred place of care’ documentation was seen in the care plans and the deputy manager said that the next step would be to introduce the Liverpool care pathway to plan and document the care given to residents during their last days. BUPA provides policies and procedures for the management of residents’ medicines. Four senior care staff on days, and two on nights, have completed medication training and so are able to administer the medicines for the residents on the ground floor. Medicines on the first floor are administered by registered nurses. There is a medicine storage room on each floor of the home, providing good storage facilities. Some controlled drugs are in use for residents receiving nursing care. Storage and recording of controlled drugs was satisfactory. On both floors there were some missed signatures on the medicine administration record sheets. If a medicine is not given then a reason must be documented. On the ground floor, one resident was prescribed an eye ointment to be given at night. This had been missed on five nights at the beginning of the month with no explanation. Staff should be vigilant in noticing and reporting missed signatures on medicine administration record sheets so that the manager can find out whether residents are not receiving their medicines as prescribed or whether staff are forgetting to sign the sheet. More frequent medicine audits may be needed to address this issue, which is an outstanding requirement from the last two inspections and therefore has not yet been fully addressed by the management team. On the first floor there were significant quantities of analgesics in the store cupboard. This is due to residents’ being prescribed analgesics ‘as required’ so they do not use all of the tablets prescribed within the month. A record must be kept of all medicines that are in the home and this means that any medicines that are carried forward from one month to the next should be counted, and the quantity recorded on the new medicine administration record sheet. Newton Court Nursing Home DS0000018729.V342872.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to exercise choices in daily living and social activities are provided regularly so that residents can follow their chosen lifestyle in the home. EVIDENCE: Residents are given choice in their daily lives. This includes choice about staying in their own room, joining in activities and where they take their meals. Care plans record personal choices about the person’s preferred time of getting up and going to bed. Friends and relatives can visit Newton Court at any reasonable time. They are able to see residents in one of the communal areas or the person’s own bedroom. An activities organiser is employed for 30 hours a week and has been in post for five months. As well as group activities, she spends individual social time with residents, takes people out locally, and does personal shopping for some. Some residents on the ground floor like to sit in the reception area where they can see visitors coming and going. Residents in their bedrooms were watching TV and reading newspapers. A number have their own phone in their bedroom. Newton Court Nursing Home DS0000018729.V342872.R01.S.doc Version 5.2 Page 15 A comment received from resident was that there are activities arranged but: I don’t take part from my own choice. The staff ask me but I like being in my room. There is a large dining room on each floor. Only three residents had lunch in the first floor dining room, and one in the adjoining lounge. The carers said that others were either too frail or preferred to stay in their room. The food is brought to the dining rooms in large heated trolleys and meals are served out by the care staff. A carer was sitting assisting a resident with her meal and was chatting with her. All the residents spoken with said the food was very good and they had plenty of choice. Snacks are available 24 hours a day. Newton Court Nursing Home DS0000018729.V342872.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are procedures in place so that the people who live at the home and their relatives can be confident that their complaints will be addressed and that they are protected from abuse. EVIDENCE: Newton Court has a complaints procedure and a record is kept of any written and verbal complaints and their outcome. The complaints procedure is included in the service user guide and is also displayed in the reception area, together with complaints forms. A monthly return of any complaints and compliments is sent to the regional manager and quality manager. No complaints had been recorded since November 2006. A relative spoken with said that has never had to make a complaint as she can discuss any issues with the staff, but she would have no hesitation in going to manager if she did have a complaint. There are also policies and procedures in place for the protection of vulnerable adults and reporting any suspected abuse. All staff except the most recently recruited have undertaken training in this subject. Newton Court Nursing Home DS0000018729.V342872.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 and 26 Quality in this outcome area is excellent. using available evidence including This judgement has been made a visit to this service. The home is clean and well maintained with an excellent standard of accommodation so that residents live in very comfortable and safe surroundings. EVIDENCE: Newton Court provides a comfortable and pleasant living environment for residents. There are private gardens with sitting areas and these are attractive and well kept. The home is well maintained and provides a range of communal areas. All bedrooms and communal areas are adequately furnished and carpeted and nicely decorated. Some residents have brought their own belongings into their rooms. All bedrooms have an en-suite toilet. There is a range of different assisted bathing and showering facilities, including a new wheel-in shower on the first floor. Hot water temperatures are checked on a regular basis. Newton Court Nursing Home DS0000018729.V342872.R01.S.doc Version 5.2 Page 18 Equipment, including mobile hoists and nursing beds, is provided to meet the needs of residents with disabilities. All parts of the home were spotlessly clean and there were no unpleasant smells. The laundry and kitchen were clean and tidy. Newton Court Nursing Home DS0000018729.V342872.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Enough qualified and experienced staff are provided to ensure that the needs of the residents are met. EVIDENCE: Residents living on the ground floor receive personal care from care assistants and senior care assistants. Residents on the first floor receive nursing care from registered nurses employed by the home. The ground floor has three or four staff on duty in a morning, two or three in an afternoon and evening, and two at night. The number of staff depends on occupancy and on the needs of residents. On the first floor there are two nurses and four or five care staff in a morning, two nurses and three or four care staff in the afternoon and evening, and one nurse with two or three carers at night. Staff usually work on same unit but will cover both as needed. There are six staff whose first language is not English, but the manager considered that their communication is good. There are no staff vacancies at present and there had been no recent use of agency staff. All care staff are offered the opportunity to train for a national vocational qualification in care and 70 have achieved this qualification. Newton Court Nursing Home DS0000018729.V342872.R01.S.doc Version 5.2 Page 20 Recruitment records were looked at for the last three staff to be employed at the home. All had completed an application form which gave details of their previous employment. A gap in one person’s employment history had been investigated. All three had good references and Criminal Records Bureau disclosures had been applied for. All had completed fire safety training, moving and handling training, and had attended at least one fire drill. There was evidence that the new staff were working through a programme of induction which lasts for 13 weeks. On-going training was provided for the other staff and all of the catering staff and 94 of the care staff had completed food hygiene training. Staff can go to other BUPA care homes for training courses such as First Aid. The deputy manager and another senior nurse are qualified to provide moving and handling training. Members of staff also attend the nursing homes partnership training. Following their induction, staff are able to commence BUPA’s ‘personal best’ training about customer care. Some staff at Newton Court have completed this and over half are currently on the programme. All of the staff spoken with during the visit were polite, friendly and helpful, and were knowledgeable about the needs of the residents. Newton Court Nursing Home DS0000018729.V342872.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35, 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed to ensure that company policies and procedures are implemented to promote the health, safety and well-being of residents. EVIDENCE: A new manager was registered with the Commission for Social Care Inspection in May 2007, however the manager has been asked to manage another BUPA care home from 2nd July 2007 and has not yet returned to Newton Court. The home has a competent and experienced deputy manager who has been able to keep the home running well and receives regular support from the Regional Manager. Newton Court Nursing Home DS0000018729.V342872.R01.S.doc Version 5.2 Page 22 The Commission for Social Care Inspection Annual Quality Assurance Assessment had been completed well, although most of the ‘What the home could do better’ sections had been left blank. Monthly returns of any complaints and of any residents having pressure sores are sent to the head office. Good accident records are kept and reported quarterly to head office. Regular meetings are held for residents and relatives. There is a monthly heads of department meeting and a quarterly health and safety meeting. There had been no recent staff meetings, but they were planned for September. Visits required by regulation 26 of the Care Homes Regulations are carried out monthly by the regional manager. An annual customer satisfaction survey is carried out by BUPA. In the 2006 survey some relatives said that they would like to be more involved in the care of their relative, and there were some complaints about the variety of menus which has been addressed by head cook. The 2007 survey forms will be sent out in September. BUPA has achieved Investors in People accreditation. All staff have one to one supervision with their head of department every eight weeks which includes all aspects of practice and training and development needs. The home employs a full-time administrator to deal with the day to day finances of the home. The administrator said that she does not deal with the financial affairs of any residents. One resident has a solicitor who looks after their interests and the others all have a family member to assist them. Residents are able to deposit personal spending money into a post office account and the administrator can access this for them when required. It is mostly used to pay for hairdressing and chiropody. Individual records are kept electronically and a print out can be made for residents or their relatives. Receipts are kept for any purchases made on behalf of residents. Information provided by the manager showed that all equipment was checked and serviced on a regular basis. The fire log book showed that fire systems were checked and serviced at the required intervals and that staff had undergone refresher training in fire safety in the last year. The maintenance person coordinates fire drills and there were notices on a board identifying dates for staff to attend. There is a fire risk assessment for the building. Newton Court Nursing Home DS0000018729.V342872.R01.S.doc Version 5.2 Page 23 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 3 X 3 Newton Court Nursing Home DS0000018729.V342872.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes Newton Court Nursing Home DS0000018729.V342872.R01.S.doc Version 5.2 Page 25 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) Timescale for action In order to show that people 27/08/07 always receive their prescribed medicines, the medication administration records must be fully completed. If the medicine is not given, then the reason for this must be recorded. (This is an outstanding requirement from 14/03/06 and 31/08/06). The home is responsible for the 27/08/07 safety of all medicines kept on the premises, therefore there must be a record of all medicines that are in the home. This must include the quantity of any items that are carried over from one month to the next. Requirement 2 OP9 13(2) 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 Newton Court Nursing Home DS0000018729.V342872.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Newton Court Nursing Home DS0000018729.V342872.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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