Inspection on 06/02/06 for Newton Court Nursing Home

This inspection was carried out on 6th February 2006.

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 03/08/05

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 Ann`s Road Middlewich Cheshire CW10 9BJ Lead Inspector June Shimmin Unannounced Inspection 6th February 2006 09:00 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.V272441.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Newton Court Nursing Home DS0000018729.V272441.R01.S.doc Version 5.0 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 Ashbourne (KW) Limited Vacant 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.V272441.R01.S.doc Version 5.0 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 The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection 3rd August 2005 2. Date of last inspection 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 passenger lift or one of the staircases. Residents` accommodation 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 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 bathing facilities. Aids to 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 DS0000018729.V272441.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two inspectors carried out this unannounced inspection over six hours. A tour of the building took place and the inspectors spoke to 6 residents, one relative, the manager and 8 staff. Four care records were examined together with medication, fire safety, maintenance and accident records. What the service does well: What has improved since the last inspection? Staffing levels have increased to take into account the need for cover during holidays and sickness. Bedroom doors are not wedged open. A risk assessment has been provided for the storage of large items in corridors. Staff have undergone medication training. Newton Court Nursing Home DS0000018729.V272441.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Newton Court Nursing Home DS0000018729.V272441.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Newton Court Nursing Home DS0000018729.V272441.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 3 Residents funded by social services may not be fully aware of the terms and conditions of their accommodation at Newton Court. EVIDENCE: Contracts between Newton Court and residents who are privately funded are provided and signed by the resident or their representative. However, there is no contract available between the resident and Newton Court for residents who are funded by social services. This means that residents or their representative may be unaware of their rights and those of the home regarding their accommodation at Newton Court. The manager indicated that these contracts would be provided within a month. Other information about Newton Court is included within the information leaflet (service user guide). The manager or deputy matron assesses the care needs of residents before they are admitted to Newton Court to ensure that the home can meet their needs. An assessment of care needs is documented on admission. Little information was recorded on two assessments about their previous or current interests and social care needs. Nurses and social workers who have known the resident may also supply further information about their care needs. Newton Court Nursing Home DS0000018729.V272441.R01.S.doc Version 5.0 Page 9 Newton Court does not routinely offer intermediate care. However, respite care is offered on a short-term basis and if a bed is available. Newton Court Nursing Home DS0000018729.V272441.R01.S.doc Version 5.0 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 the following standard(s): 7,8,9 and 11 Residents have a care plan which describes their care needs and which is kept under review. Newton Court contacts health professionals when necessary to meet additional care needs. Medication is generally well managed but some residents are not receiving prescribed medication. EVIDENCE: Four care plans were looked at. These had identified most care needs and areas of risk relating to the care of the residents. The care plans and risk assessments had been drawn up within two days of admission. However, there was no risk assessment for the use of bedrails on two care plans. In one case a resident had been found on the floor although bedrails had been in use. The care plan had not been reviewed to reflect this and to indicate what actions would be taken to prevent further accidents. There was no risk assessment for a resident with a history of frequent falls. Other health professionals such as a dietician and speech and language therapist had visited Newton Court to assess residents. A care plan for the management of pressure sores was reviewed during the inspection. There was no care plan or reference to the wishes of a resident about terminal care. This resident was very ill. Newton Court Nursing Home DS0000018729.V272441.R01.S.doc Version 5.0 Page 11 Medications were quite well managed. Photographs of residents were provided to help identification. Records were kept of medication received and a list provided of the specimen signatures and initials of nurses. Controlled drugs were well managed. Several gaps were noted on medication administration records. A reason must be documented if a medicine is not given. One medicine had been out of stock on nine occasions but no action had been taken by care staff to address this. Newton Court Nursing Home DS0000018729.V272441.R01.S.doc Version 5.0 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 the following standard(s): 13,14 and 15 Visitors are made to feel welcome at Newton Court. Residents have choice in their daily lives. The temperature of some food is not hot enough when given to residents. EVIDENCE: 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 resident`s own bedroom. Relatives may also have a meal with a family member if they wish. Residents at Newton Court 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. Newton Court displays the menu of the day on the door of both dining rooms. Menus are rotated on a four weekly basis. The main meal is served at lunch and there is choice at all meals. Special diets are provided including puree diets, the components of which are served separately. On the nursing floor there were many residents who required assistance to eat. An extra member of staff was available to help feed residents. However, it was noted that at least three pureed meals were left on unheated trays while care staff were feeding other residents. Newton Court Nursing Home DS0000018729.V272441.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Some verbal complaints are not recorded which may result in residents feeling that their concerns are not adequately addressed. Residents at Newton Court are protected from possible abuse through staff training and appropriate policies and procedures. EVIDENCE: Newton Court has a complaints procedure and a record of written complaints and their outcomes is made. During discussion with residents it appeared that verbal complaints are not always recorded. This could mean that residents do not think their complaints are taken seriously and that the resident remains unhappy. Newton Court has policies and procedures in place relating to the protection of vulnerable adults. The majority of staff have undertaken recent training in this subject. Newton Court Nursing Home DS0000018729.V272441.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20, 21, 22, 25 and 26 Newton Court is well maintained. Two of the three ground floor bathrooms cannot be used, limiting the number of useable bathing facilities. The home is well ventilated and has satisfactory heating systems. The environment is kept clean and tidy. EVIDENCE: Newton Court provides a comfortable and pleasant living environment for its residents. The home is well maintained. Externally there are private gardens with sitting areas and these are also well kept. There is a range of communal living areas although there appears to be little usage of the smaller, quiet lounges. All bedrooms have thermostatically controlled heating which can be individually adjusted. Newton Court provides adequate ventilation. The laundry is clean and tidy, as are all parts of the premises. Two of the three ground floor bathrooms cannot be used as they do not provide suitable equipment for residents requiring assistance to bathe. One of these bathrooms is being used to store various items. The manager said that a new shower room is to be provided but could not indicate the timescale for this. Newton Court Nursing Home DS0000018729.V272441.R01.S.doc Version 5.0 Page 15 Newton Court provides a range of other equipment suitable for the needs of residents with a disability. A risk assessment for the storage of large items such as mobile hoists has been provided. Newton Court Nursing Home DS0000018729.V272441.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 30 Newton Court is adequately staffed. There is low dependency on agency staff. Staff receive appropriate training for their role. EVIDENCE: The manager said that Newton Court is overstaffed by up to ten percent to compensate for holidays and sickness. On the day of inspection the manager said that there were two first level nurses (RGN) and ten carers on duty in the morning, two RGN`s and eight carers during the afternoon and one RGN and seven carers at night. The deputy matron was also on duty in a supernumerary capacity. This also helps to reduce agency usage and means that residents receive continuity of care. Staff described Newton Court as a friendly place to work and said that they felt supported by the manager and BUPA. Staff turnover is low. Staff were undertaking medication training which was expected to be completed by March 2006. The manager said that training in the management of dementia was also planned. It was suggested that training in Parkinson`s disease would also be beneficial. Newton Court Nursing Home DS0000018729.V272441.R01.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35, 36 and 38 Newton Court has a satisfactory mechanism for the management of residents` monies. The process of supervision needs to be more consistent. The CSCI is not kept informed of all notifiable events. Residents may be put at risk because staff have not taken part in a recent fire drill. EVIDENCE: Financial records were looked at. These demonstrated that the management of residents` monies was accurate, safe and well managed. The interests of residents are protected. There was a copy of the audited accounts. The process of formal supervision has started. This should be increased to six times a year to ensure that care staff receive an appropriate level of supervision. Newton Court Nursing Home DS0000018729.V272441.R01.S.doc Version 5.0 Page 18 Accident records were looked at. In some instances the tear off slip indicating that follow up action has been taken was not initialled or dated by the manager or deputy matron. The manager had not informed the CSCI of an incident where a resident had fallen out of bed when bedrails were in place. Fire records were examined. These indicated that staff had undergone refresher training in fire safety in the last year. Records showed that fire equipment was tested and well maintained. However, there were no records of staff having taken part in a recent fire drill. Several staff said they could not remember having participated in a recent fire drill. An immediate requirement was made in relation to fire drills. Newton Court Nursing Home DS0000018729.V272441.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 2 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 X 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 X 3 2 2 X X 3 3 STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 2 X 2 Newton Court Nursing Home DS0000018729.V272441.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 13 Requirement Risk assessments must be provided for the use of bedrails. These must include the actions to be taken by staff to protect residents and must be kept under review. Risk assessments must be provided for residents who are at risk of falling and the actions to be taken to reduce the number of falls. Medication administration records must be fully completed and reasons recorded for nonadministration of medication. Staff must take prompt action if medication is out of stock. (Previous timescale of 23/09/05 not met) All meals must be kept warm until they are ready to be served. All complaints, including verbal complaints, must be recorded together with the outcomes and actions to be taken as a result of the complaint. Timescale for action 14/03/06 2. OP7 13 06/04/06 3. OP9 13 14/03/06 4. OP9 13 14/03/06 5. 6. OP15 OP16 16 22 14/03/06 06/04/06 Newton Court Nursing Home DS0000018729.V272441.R01.S.doc Version 5.0 Page 21 7. OP22 23 8. OP38 37 9. OP38 23 All bathrooms must be fit for purpose. The registered person must inform the CSCI in writing if any bathrooms are to be used permanently for storage. The registered person must inform the CSCI in writing of any event which adversely affects the well-being or safety of any service user. All staff must take part in an unannounced fire drill at least twice a year. 06/05/06 06/04/06 06/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. 6. Refer to Standard OP2 OP3 OP11 OP18 OP21 OP36 Good Practice Recommendations All residents should be provided with a statement of terms and conditions from Newton Court on admission. The interests and social care needs of residents should be documented on admission. Where possible, the wishes of residents or their next of kin, in relation to terminal care, should be documented. All remaining staff should undertake training in adult protection policies and procedures. The registered person should ensure that there is at least one assisted bath to 8 service users. Care staff should receive formal supervision six times a year. Newton Court Nursing Home DS0000018729.V272441.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich 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. 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