Inspection on 13/01/06 for Newton House

This inspection was carried out on 13th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 House 14/03/07

Newton House 03/10/05

Newton House 02/03/05

Newton House 04/10/04

Similar services:

Hunters Care Centre

Manor Lodge

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

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

CARE HOMES FOR OLDER PEOPLE Newton House South Newton Salisbury Wiltshire SP2 0QD Lead Inspector Karen Mandle Unannounced Inspection 13th January 2006 9.50am 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 House DS0000047637.V275521.R01.S.doc Version 5.1 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 House DS0000047637.V275521.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Newton House Address South Newton Salisbury Wiltshire SP2 0QD 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) 01722 742066 01722 744443 newtonhouse@glensidemanor.co.uk Glenside Manor Healthcare Services Ltd Mrs Krystyna Henrietta Maria Romain Care Home 15 Category(ies) of Old age, not falling within any other category registration, with number (15), Physical disability (8), Terminally ill (2), of places Terminally ill over 65 years of age (2) Newton House DS0000047637.V275521.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The maximum number of service users who may be accommodated at any one time is 15 No more than 8 service users under the age of 65 years with a physical disability may be accommodated at any one time No more than 2 service users over the age of 18 years with a terminal illness may be accommodated at any one time The staffing levels set out in the Notice of Decision dated 24 July 2003 must be met at all times 3rd October 2005 Date of last inspection Brief Description of the Service: Glenside Manor - Newton House is a 15 bedded registered nursing home for older people and younger adults with acquired brain injury. The younger adults with acquired brain injury are people who have suffered a profound head injury who now require long term nursing care. The older people have general nursing care needs. The home is an older building, which has been extended. Newton House is domestic and homely with bedrooms that vary in size and shape. Communal rooms are provided which again are domestic and homely. The registered manager for Newton House is Mrs Krys Roman. The home is one of six on the same campus. The six registered homes are owned by Glenside Manor Health Care Services Ltd. Glenside Manor is situated in the village of South Newton, on the A36, five miles west of the city of Salisbury. Newton House DS0000047637.V275521.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection commenced at 9.50am and was completed at 2.15pm. The inspector toured the building visiting with many of the service users accompanied by the Registered Manager Mrs Romain. Due to the high complex needs of many of the service users the inspector was only able to communicate with two service users to gain their views and opinions of the service provided by the home. Both service users were very positive regarding the care they received and the service provided. Three care plans were reviewed, and staffing rotas seen. What the service does well: What has improved since the last inspection? Maintaining a comfortable temperature in the large communal room situated at the rear of the building was identified at the previous inspection. However at the time of the inspection secondary double-glazing was being installed to all the windows in the communal room, which should rectify the heating and temperature problem. The bathroom on the first floor had been refurbished ensuring that staff were able to use a lifting hoist more appropriately in the bathroom. Newton House DS0000047637.V275521.R01.S.doc Version 5.1 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 House DS0000047637.V275521.R01.S.doc Version 5.1 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 House DS0000047637.V275521.R01.S.doc Version 5.1 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): A clear admission procedure is in place and all needs are fully assessed prior to admission to Newton House. EVIDENCE: A service user who had recently been transferred from another registered home on the Glenside campus to Newton House had been fully pre assessed by the Registered Manager. The Registered Manager informed the inspector that both Managers had also reviewed the service users’ care plan together, which was transferred with the service user ensuring the care plan was up to date and supported all current health care needs. The family were also involved with the transfer. The inspector visited the service user who appeared settled at Newton House. Newton House DS0000047637.V275521.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 and 10 The health care needs of the service users are monitored and appropriate action taken when health care needs change. The care plans fully address all aspects of care.The care team support the privacy and dignity of the service users. EVIDENCE: Each service user is provided with a comprehensive care plan. The inspector reviewed 3 care plans 2 of which were the care plans’ of service users with high dependency care needs. The care plans provided information relating to long-term care needs and current care needs. A multidisciplinary team approach is taken when the care plans are compiled and implemented. Wound documentation was of a good standard providing clear evaluation of the wound healing process. Pressure area risk assessments were in place, however one risk assessment had not been fully completed therefore did not fully support the service users’ pressure area care needs. Eight of the fifteen service users have complex nursing needs however the home continues to fully support health care needs. Care charts are in place based on the individual needs of the service user providing evidence of the care staff closely monitoring service users especially those who are unable to Newton House DS0000047637.V275521.R01.S.doc Version 5.1 Page 10 communicate. The GP visits the home weekly or more if required. The care records provided evidence of the GP visits taking place. Service users at Newton House are not only supported by the care team but also the physiotherapy team who were seen visiting whilst the inspector toured the home. Two service users were able to communicate with the inspector both of which were complimentary of the care provided. Service users are well equipped with medical equipment they required to meet their care needs. All care is provided in the privacy of the service users’ bedroom or bathroom. Good interaction was heard between the staff and service users. Newton House DS0000047637.V275521.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14 and 15 Where possible, due to high complex needs service users are supported by the home with choice over their own lives. The dietary needs of all service users are monitored by the home. EVIDENCE: Due to the high dependency of the service users, choice and control over their own lives is very limited. However music was heard in several rooms, which the inspector was informed was the music the individual service user enjoyed. Only 7 service users are able to have a normal diet the other 8 service users are fed via a PEG system. The inspector did not observe the lunch-time meal but did assess how the monitoring of PEG feeds takes place, most of which are during the night but are assessed on the service users needs. Clear written dietary guidance was in place for each service user with a PEG and weights were monitored monthly. The two service users able to communicate when asked were both satisfied with the food provided. The food is provided by the main kitchen on campus and transported to the individual homes. Newton House has a small kitchen for the preparation of meals. The main kitchen provides a person to assist the home with serving and washing up following each meal ensuring that care staff are not removed from the service users. Newton House DS0000047637.V275521.R01.S.doc Version 5.1 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 A clear complaints policy and procedure is in place and available to service users and visitors. The staff had been fully informed of the local vulnerable adults procedure. EVIDENCE: A complaints policy and procedure is in place, a copy of which is displayed in the front entrance hall of the home for service user and visitors information. The Registered Manager projects an open approach to complaints. The home has not received any formal complaints. The CSCI have not received any formal complaints regarding the service provided at Newton House. An “Abuse awareness” policy is in place supported by a “Whistle Blowing” policy. It was noted that staff were attending protection of vulnerable adults training in January, which is conducted annually as mandatory training. Newton House DS0000047637.V275521.R01.S.doc Version 5.1 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 24 and 26. Newton House is well maintained and provides a homely environment for service users to live in. The bedrooms are single which are personalised and homely. A large communal room is provided for service users. The home was clean and infection control measures in place. EVIDENCE: Newton House is an older building, which had been extended. The building provides a homely environment for service users to live in. The communal lounge is a large well-furnished room, which on the day of the inspection was having secondary double-glazing applied to all windows. It was identified at the previous inspection that the room was cold during the winter months and difficult to maintain a comfortable temperature. The home is well maintained. The inspector was able to visit all the bedrooms, which were very personalised and homely. The bedrooms provided for the high dependency service users had an en-suite facility. Newton House DS0000047637.V275521.R01.S.doc Version 5.1 Page 14 The bathroom on the first floor has recently been refurbished to ensure that sufficient space is provided for the use of a lifting hoist in the bathroom for service users living upstairs. A good size assisted bathroom is located on the ground floor. The home is clean through out, however a domestic person is not provided to cover cleaning duties at weekends or during holiday periods. Due to the high complex needs of the service user group and the risk of cross infection, the need to maintain the standard of hygiene through out the home at all times is high. This was a requirement set at the previous inspection. However the manager did ensure that infection control practices are well maintained within the home. Newton House DS0000047637.V275521.R01.S.doc Version 5.1 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 28 The increase in staffing levels ensures that all care needs of the service users are met. However the recruitment of staff under the age of 18 providing assistance with personal care is not appropriate. EVIDENCE: At least one qualified nurse is on duty at all times, during the morning shift when nursing care needs are higher two qualified nurses are on duty who are supported by a team of four carers. Due to the increasing high care needs, the home has increased the daily care staff hours by 6 hours from 10am to 4pm ensuring that all care needs of the service users can be met. Whilst the inspector was observing records of supervision it became evident that the home was employing a person under the age of eighteen who was assisting with personal care and was counted on the staff rotas as a member of the team. This was discussed with the Operational Manager and the persons’ job description reviewed. The Operations Manager provided the inspector with a solution to the employment issue without compromising the number of staff available to support the service users and will be completing an investigation as to why this occurred and provide the CSCI with a copy of the investigation. Increased domestic staff remains a requirement. Newton House DS0000047637.V275521.R01.S.doc Version 5.1 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 36 and 38 Mrs Romain confirmed that regular supervision sessions for all staff takes place. The home is well maintained and health and safety issues addressed. EVIDENCE: Mrs Krys Romain the Registered Manager informed the inspector that staff supervision records were kept in the Glenside human resources department, apart from one employee. Mrs Romain confirmed that all staff had been provided with regular supervision. Mrs Romain has now delegated senior staff to assist with the supervision sessions. Newton House DS0000047637.V275521.R01.S.doc Version 5.1 Page 17 Fire records indicated that all appropriate fire checks were taking place and that staff had been provided with fire training. Accidents are recorded and audited by the central office with the Manager being informed of any patterns of accidents forming. The hoists are regularly serviced ensuring the safety of service users. The home is well maintained and health and safety issues addressed. Newton House DS0000047637.V275521.R01.S.doc Version 5.1 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 X 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 3 X X 3 X 3 STAFFING Standard No Score 27 2 28 2 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X 3 X 3 Newton House DS0000047637.V275521.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard OP7 OP27 Regulation 15 18 Timescale for action The registered person will ensure 10/02/06 that the pressure area risk assessments are fully completed. The registered persons must 01/11/05 increase the number of domestic staff to ensure cleaning duties are maintained during holiday periods and weekends. This requirement remains outstanding. 3. OP29 19 The registered person is required to ensure that all staff had undertaken a Criminal Record Bureau check. This was not assessed on this occasion, as all records are stored in the human resource department. 4. OP29 19 The registered person is required to ensure that two written references, including, where applicable, a reference to the last person’s employment, be obtained for all new staff. 03/10/05 03/10/05 Requirement Newton House DS0000047637.V275521.R01.S.doc Version 5.1 Page 20 This requirement was not assessed on this occasion as all records are stored in the human resource department 5 OP28 19 The Registered person will ensure that any person under the age of 18 years employed in the home will not provide or assist with personal care. The registered person is required to ensure that details of any criminal offences of which a staff member has been convicted are recorded. This requirement was not assessed on this occasion as employment records are stored in the human resource department. 13/01/06 6. OP29 19 03/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP9 Good Practice Recommendations The registered person should consider revising the morning medication round between the night shift and the day shift. The registered person should adjust the medication fridge so that it falls between the temperature range of 2-8c. 2. OP9 Newton House DS0000047637.V275521.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB 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 House DS0000047637.V275521.R01.S.doc Version 5.1 Page 22 - 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. 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