Inspection on 03/08/05 for Newton Court Nursing Home

This inspection was carried out on 3rd August 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

Newton Court Nursing Home 21/08/07

Newton Court Nursing Home 01/08/06

Newton Court Nursing Home 06/02/06

Newton Court Nursing Home 05/01/05

Newton Court Nursing Home 12/08/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE NEWTON COURT NURSING HOME St Anns Road Middlewich Cheshire CW10 9BJ Lead Inspector June Shimmin Announced 3 August 2005 09:00 rd 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 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 F51 F01 S18729 Newton Court V223284 090605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Newton Court Nursing Home Address St Anns Road Middlewich Cheshire CW10 8BJ 01606 835294 01606 835295 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Ashbourne (KW) Limited Jan O`Hanlon Care Home 60 Category(ies) of OP Old Age (60) registration, with number PD Physical Disability (3) of places NEWTON COURT NURSING HOME F51 F01 S18729 Newton Court V223284 090605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 This home is registered for a maximum of 60 service users to include: * * within the maximum 60 beds, registered for the category of OP, 24 can be used to provide for personal care within the maximum of 60 beds, 3 service users aged 55 to 65 years, in the category physical disability (PD), requiring nursing or personal care may be accommodated 2 The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection Date of last inspection 5th January 2005 Brief Description of the Service: Newton Court is a modern purpose built care home located about two miles from Middlewich town centre. It can provide nursing or personal care. Newton Court is a two storey building and residents are accommodated on both floors. Access between floors is via a shaft passenger lift or one of the staircases. Residents` accommomdation consists of 60 single bedrooms, 24 on the ground floor and 36 on the first floor, all with en suite facilities. All bedroom doors are fitted with locks that can be overridden by staff in an emergency. Communal living areas include a large lounge and separate dining room on the ground floor and and a combined lounge/dining room on the first floor, plus a smaller quiet room on each floor. There are adequate numbers of separate toilets and a variety of bathrooms available. Aids to facilitate independence are installed throughout the home, including bath hoists, grab rails and an emergency call system. There is easy access for wheelchairs via the main entrance and to all parts of the home. Externally, Newton Court is surrounded by lawns with a walkway around the home. There are adequate car parking facilities. NEWTON COURT NURSING HOME F51 F01 S18729 Newton Court V223284 090605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 7 and a quarter hours. A tour of the premises took place and conversations were held with 16 residents, the manager, a health professional, 3 visitors and eight staff members. Six care records were inspected as well as records relating to medication, recruitment, fire safety and maintenance. Written comments were received from 8 residents, 12 relatives and 4 social care professionals. What the service does well: What has improved since the last inspection? Residents on both units have a care plan. Recruitment procedures are thorough. The fire alarms are tested and recorded every week. The needs of residents are reviewed on a regular basis. Local GP practices have been contacted to make sure that “homely remedies” are reviewed at least once a year. The activity coordinator has started the process of identifying the individual social and leisure care needs of residents. NEWTON COURT NURSING HOME F51 F01 S18729 Newton Court V223284 090605 Stage 4.doc Version 1.30 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. NEWTON COURT NURSING HOME F51 F01 S18729 Newton Court V223284 090605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection NEWTON COURT NURSING HOME F51 F01 S18729 Newton Court V223284 090605 Stage 4.doc Version 1.30 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 standard(s) 1 and 3 The home provides information about the facilities and services available. Residents are assessed prior to moving into the home to ensure that their needs can be met. EVIDENCE: Newton Court has various information leaflets displayed in the reception area. Information about the services and facilities together with the home`s aims and objectives is contained within a “statement of purpose” which is also displayed in the reception area. Newton Court provides a monthly newsletter and the new manager introduced herself in the June 2005 issue. The manager or the deputy matron carry out assessments of new residents before they move into the home. This is to ensure that Newton Court can meet their needs. The content of an assessment of a resident recently admitted to Newton Court was satisfactory. Written assessments may also be provided by nurses or social workers who have been involved with caring for the resident. If the needs of residents change, the manager takes action to have their needs reassessed. This process may involve talking to doctors, nurses and social workers. NEWTON COURT NURSING HOME F51 F01 S18729 Newton Court V223284 090605 Stage 4.doc Version 1.30 Page 9 Verbal feedback from a visiting health professional was positive about Newton Court. Written comments made by four social care professionals was also supportive of the home. One professional commented that changes in a resident`s health were not always communicated. NEWTON COURT NURSING HOME F51 F01 S18729 Newton Court V223284 090605 Stage 4.doc Version 1.30 Page 10 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 standard(s) 7,8,9 and 10 All residents have a care plan that shows how their individual care needs will be met. The care home staff ensure that contact is made with other health professionals to visit the home regarding any additional health care needs of residents. One aspect of the management of medication is not safe. The privacy of residents is respected. EVIDENCE: Six care plans were read, three of residents accommodated on the nursing care unit and three of residents receiving personal care. The care plans on the nursing unit had identified and addressed all risks and care needs. However, a plan and risk assessment was not provided for a resident with diabetes. The deputy matron supplied this later that day. The plans had been reviewed on a monthly basis. Five residents had pressure sores but in four cases these had been acquired elsewhere. Appropriate action was being taken by care staff to heal the pressure sores. It was noted that on the nursing unit a number of residents were being nursed in bed for most of the day. Care plans should demonstrate what actions are being taken to prevent social isolation. One visitor made a comment about a relative staying in bed for most of the day and would have preferred the relative to get up for part of the day. NEWTON COURT NURSING HOME F51 F01 S18729 Newton Court V223284 090605 Stage 4.doc Version 1.30 Page 11 The care plans on the unit providing personal care were generally of a satisfactory standard. Some minor issues needed to be looked at. The assessment and details of one resident had not been updated for six years. Care plans had not always been reviewed on a monthly basis. The daily records of one resident stated that the resident was self caring but the assessment stated otherwise. Out of date information needed to be archived. There was no evidence of the involvement of residents in the review of their care plans. The care plans on both units indicated that advice had been sought from a number of health care professionals. The management of medication on the nursing unit was satisfactory. On the unit providing personal care there was a discrepancy in a number of cases between the number of tablets given and the number of tablets in stock. In once instance there was too much stock and in two cases too little stock. Residents said that staff treated them well and that they were well cared for. The following comments were made by residents, “the staff are lovely” and “very happy.” Residents said that staff knocked on their door before entering and that their privacy was respected. It was noted that large blue plastic aprons were being used at breakfast to protect the clothing of residents on the nursing unit. These do not protect the dignity of residents and an alternative form of protection for clothing should be sought. NEWTON COURT NURSING HOME F51 F01 S18729 Newton Court V223284 090605 Stage 4.doc Version 1.30 Page 12 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 standard(s) 12, 13, 14 and 15 Routines are flexible at Newton Court to suit residents` individual preferences and a range of activities are provided. Visitors are made to feel welcome. The standard of food is good. EVIDENCE: Newton Court employs an activity organiser who works five days. The monthly newsletter includes a timetable of activities and an activity update. This is displayed in the reception. Activities take place in groups and on a one to one basis. Group activities include bingo, board games, newspaper discussions and seated exercise. A recent trip had been organised on three consecutive days to Stapeley Water Gardens and one resident said it had been a very enjoyable day out. More able residents are able to visit the weekly market. A party had been held to celebrate VE day. One to one activities include manicures, jigsaws and chats. Holy communion is given every two weeks. The activity organiser has started the process of documenting the former and current social and leisure interests of individual residents. Occasional entertainers visit. The next project organised by the activity organiser is that of “planting tables” so that wheelchair dependent residents can take part in gardening. Most of the written comments about activities at Newton Court were positive. NEWTON COURT NURSING HOME F51 F01 S18729 Newton Court V223284 090605 Stage 4.doc Version 1.30 Page 13 Visitors said that they were made to feel welcome and that they could visit at any reasonable time of day. Residents could see their visitors in a communal room or their bedroom. Residents have choice in their daily lives. They are not forced to join in activities if they do not wish to and are able to get up and go to bed when they decide. One resident goes for a walk to the local shops after breakfast and enjoys “a tipple in the evening.” Newton Court provides menus which rotate on a four weekly cycle. The main meal of the day is served at lunch. On the day of inspection this was chicken or quiche with a choice of dessert. The tea menu was haddock and mashed potato or sandwiches. Special diets were catered for. Alternatives to the main meal were omelette or a selection of cold meats with chips. Mealtimes were as follows: Breakfast between 9 and 10am Lunch between 12 30 and 1 30pm Evening meal 5pm Supper from 8pm onwards. NEWTON COURT NURSING HOME F51 F01 S18729 Newton Court V223284 090605 Stage 4.doc Version 1.30 Page 14 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 standard(s) 16, 17 and 18 Complaints made about Newton Court are investigated and action taken to put right any concerns. Policies, procedures and staff training are in place to protect residents from abuse. EVIDENCE: The pre inspection questionnaire (PIQ) indicated that Newton Court had received three complaints in the last year. One complaint was upheld and two partially upheld. Residents and visitors spoken to were aware of what to do if they needed to complain. The complaints procedure was displayed in the reception and is detailed within the service user guide (the information booklet given to new residents/relatives). The MP for Congleton was visiting Newton Court during August 2005 to discuss local issues with the home`s residents and staff. Residents are able to vote if they wish to do so. Staff spoken with were aware of the action to take in the case of alleged abuse. The care home has appropriate policies and procedures in place. The topic of adult protection forms part of the induction process for new staff. NEWTON COURT NURSING HOME F51 F01 S18729 Newton Court V223284 090605 Stage 4.doc Version 1.30 Page 15 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 standard(s) 19, 20, 21, 22, 24 and 26 The owner has taken adequate steps to ensure that residents live in a well maintained environment. Newton Court maintains high standards of cleanliness. Storage space is lacking. Hoists stored in corridors present a health and safety hazard to staff and residents. EVIDENCE: The PIQ did not indicate what improvements or refurbishment had been made to the environment since the last inspection. However, it was noted that the standard of the décor and furnishings was good. A number of rooms were viewed and these had been personalised by residents. Residents said that they were satisfied with the standard of décor of their rooms. Newton Court was found to be clean, tidy and hygienic during a tour of the building. Various aids and adaptations at the home assist residents with varying degrees of disability. NEWTON COURT NURSING HOME F51 F01 S18729 Newton Court V223284 090605 Stage 4.doc Version 1.30 Page 16 During a tour of the building no major issues were noted in relation to maintenance. Although corridors are quite wide it was noted that two hoists were being stored adjacent to rooms 40 and 41. The issue of storage space was raised at the last inspection but a review of storage space has not been carried out by the owners. There were no risk assessments for equipment stored in corridors. The gardens and seating areas are accessible to residents. The manager said that new planting of flowers will take place in the near future. NEWTON COURT NURSING HOME F51 F01 S18729 Newton Court V223284 090605 Stage 4.doc Version 1.30 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28, 29 and 30 Staffing levels at Newton Court are satisfactory. Recruitment procedures are thorough. Staff are well regarded by residents and relatives. Staff are supported to undertake training relevant to their role. EVIDENCE: Staffing levels at Newton Court were as follows: 8am – 2pm 2pm – 8pm night duty – 2 registered nurses and 8 care assistants – 2 registered nurses and 6 care assistants – one registered nurse and 5 care assistants There has been a slight increase in staffing levels on days and decrease in staffing levels on nights since the last inspection. Rotas indicate that there is a continuing dependency on agency staff but that most staff working at any time are permanent staff. Residents and visitors were complimentary about staff and made comments such as “warmth and friendliness when I walked through the door,” “staff very, very good.” Staff also commented that they were happy working at Newton Court. The PIQ indicated that 62 of staff have achieved NVQ level 2 or above. Newton Court is to be commended for this. The recruitment records of two new members of staff were complete and all necessary checks had been carried out. NEWTON COURT NURSING HOME F51 F01 S18729 Newton Court V223284 090605 Stage 4.doc Version 1.30 Page 18 A new member of staff said that he had been given a full induction and had been supernumerary for three shifts. Staff at Newton Court are supported to undertake training relevant to their role as well as undertaking NVQ qualifications. Staff confirmed that they were encouraged to do additional training. The PIQ indicated that staff undertake mandatory and other specialist training. NEWTON COURT NURSING HOME F51 F01 S18729 Newton Court V223284 090605 Stage 4.doc Version 1.30 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33 and 38 Newton Court is a well managed home. Management act to ensure the wellbeing of residents. The wedging open of bedroom doors puts residents at risk if a fire breaks out. EVIDENCE: The home has a new manager who has previously managed another home within the BUPA group. The new manager has made herself known to residents and visitors and is well regarded by all. Staff and residents said that there had been a smooth transition from the former to the new manager and that the running of the home had not been adversely affected. The new manager is working towards the Registered Manager`s award and expects to complete this by November 2005. NEWTON COURT NURSING HOME F51 F01 S18729 Newton Court V223284 090605 Stage 4.doc Version 1.30 Page 20 The manager held a meeting with residents in July 2005 and minutes of this meeting were available. The meeting was well attended. The manager intends holding meetings every three months with no preset agenda. A representative of BUPA visits Newton Court every month to assess the quality of care services provided. The representative provides a copy of the written report to the manager and to CSCI. Newton Court operates a “personal best” programme to encourage staff to take pride in their work and to achieve high standards. The kitchen was clean and tidy. Cleaning schedules and equipment checks were in place and up to date. The temperature of hot food, fridges and freezers were checked and recorded as required by environmental health authorities. A letter from environmental health stated that the premises were rated as being “above normal standards.” The laundry was clean, tidy and well maintained. There were individual baskets for the laundry of residents. A staff member in the laundry was unfamiliar with how to use the eye wash in case of emergency. Accident records were looked at. There was no mobility care plan in place for a resident who had fallen and who had a history of further falls. The risk assessment relating to falls had not been reviewed. There was also no evaluation of the risk assessment of a second resident who had fallen frequently. The fire records were looked at and found to be up to date. The PIQ indicated that fire safety at the home had been maintained. However, during a tour of the building it was noted that a number of bedroom doors had been wedged open. This puts residents at risk in the event of an outbreak of fire. NEWTON COURT NURSING HOME F51 F01 S18729 Newton Court V223284 090605 Stage 4.doc Version 1.30 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 2 x 3 x 3 STAFFING Standard No Score 27 3 28 4 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 x 3 x x x x 2 NEWTON COURT NURSING HOME F51 F01 S18729 Newton Court V223284 090605 Stage 4.doc Version 1.30 Page 22 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 9 Regulation 13 Requirement The correct procedure for the administration of medication must be followed. Medication audits must be conducted to track the over or under stocking of several medications. Storage space must be suitable for the size of the home. Where equipment is stored in a main thoroughfare a risk assessment must be provided. Bedroom doors must not be wedged open at any time. (Previous timescale of 5/3/2005 not met) Timescale for action 23/09/200 5 2. 22 23 23/09/200 5 3. 38 23 03/09/200 5 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 7 Good Practice Recommendations A care plan and risk assessment should be provided for residents with diabetes. Assessments and care plans should be reviewed on a monthly basis. F51 F01 S18729 Newton Court V223284 090605 Stage 4.doc Version 1.30 Page 23 NEWTON COURT NURSING HOME 2. 3. 4. 10 30 38 Care plans should demonstrate what actions are being taken to prevent social isolation. Residents should be involved in the assessment, care planning and review process Risk assessments relating to falls should be reviewed every month or sooner if the falls are very frequent. Blue plastic aprons should not be used to protect clothing at mealtimes. More suitable protection, such as plastic backed serviettes should be used. Staff on the personal care unit should undergo refresher training in the management of medication. Staff should be shown how to use the eye wash. NEWTON COURT NURSING HOME F51 F01 S18729 Newton Court V223284 090605 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Unit D, Off Rudheath Way Gadbrook Park Northwich Cheshire, CW9 7LT 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 NEWTON COURT NURSING HOME F51 F01 S18729 Newton Court V223284 090605 Stage 4.doc Version 1.30 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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. 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