Inspection on 14/03/07 for Newton House

This inspection was carried out on 14th March 2007.

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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Newton House 13/01/06

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 HOME MIXED CATEGORY MAJORITY ADULTS 18-65 Newton House South Newton Salisbury Wiltshire SP2 0QD Lead Inspector Karen Mandle Key Unannounced Inspection 14th March 2007 09:45 Newton House DS0000047637.V329228.R01.S.doc Version 5.2 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.V329228.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 and Care Homes for Adults 18 – 65*. 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.V329228.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Newton House Address South Newton Salisbury Wiltshire SP2 0QD 01722 742066 01722 744443 newtonhouse@glensidemanor.co.uk 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) 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.V329228.R01.S.doc Version 5.2 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 13th January 2006 Date of last inspection Brief Description of the Service: Glenside Manor - Newton House is a 15 bedded registered nursing home for older people with dementia, or general nursing needs 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 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 Krystyna Romain. The home is one of six on the same campus. The six registered homes are owned by Glenside Manor Health Care Services Ltd. The nominated responsible person is Mr Andrew Norman. Glenside Manor is situated in the village of South Newton, on the A36, five miles north west of the city of Salisbury. Newton House DS0000047637.V329228.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection took place 14th March 2007. The inspection commenced at 9.45am and was completed at 4pm. At the commencement of the inspection, Sarah Weston the deputy manager assisted the inspector with a tour of the home and later during the morning the manager Mrs Krys Romain was available to assist the inspector. Both the manager and deputy were helpful and open to the inspection process. The inspector was able to freely visit with service users, and observe and speak with staff. Due to the very complex needs of the service users, gaining the views and opinions of the service users was not possible. A number of records were seen such as care plans, medication records and some health and safety records. The requirement and good recommendations made from the previous inspection had all been met. Three requirements and one good practice recommendation were made following this inspection. The judgments contained in this report have been made from evidence gathered during the inspection, which included a visit to the service. What the service does well: What has improved since the last inspection? The communal room has had double-glazing windows installed to ensure that the room maintains a comfortable temperature during the winter. New carpet and be installed on the ground floor. The bathroom upstairs is now more manageable when using a hoist. The night staffing levels have been increased in line with the care needs of the service users. Employment procedures are now robust and protect the service users. Newton House DS0000047637.V329228.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Newton House DS0000047637.V329228.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Individual Needs and Choices Lifestyle Personal and Healthcare Support Concerns, Complaints and Protection Environment Staffing Conduct of Management of the Home Scoring of Outcomes Statutory Requirements Identified During the Inspection Adults 18 – 65 (Standards 1–5) (Standards 6-10) (Standards 11–17) (Standards 18-21) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37-43) Older People (Standards 1–5) (Standards 7, 14, 33 & 37) (Standards 10, 12, 13 & 15) (Standards 8-11) (Standards 16-18 & 35) (Standards 19-26) (Standards 27-30 & 36) (Standards 31-34, 37 & 38) Newton House DS0000047637.V329228.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 (Adults 18 – 65) and Standards 1 – 5 (Older People) are: 1. 2. 3. Prospective service users have the information they need to make an informed choice about where to live. (OP NMS 1) Prospective users’ individual aspirations and needs are assessed. No service user moves into the home without having been assured that these will be met. (OP NMS 3) Prospective service users’ know that the home that they choose will meet their needs and aspirations. Service Users and their representatives know that the home they enter will meet their needs. (OP NMS 4) Prospective service users’ have an opportunity to visit and “test drive” the home. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. (OP NMS 5) Each service user has an individual written contract or statement of terms and conditions with the home. Each service user has a written contract/statement of terms and conditions with the home. (OP NMS 2) 4. 5. The Commission considers Standard 2 (Adults 18-65) and Standards 3 and 6 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. An admission procedure is in place and all prospective service users are fully assessed by the manager prior to admission. The home is not registered to provide intermediate care. EVIDENCE: All prospective service users are assessed by the registered manager, Mrs Krys Romain, prior to admission to Newton House to ensure that through the assessment process the home is able to meet the nursing needs of both, the long term high dependency service users and the older people. Two-pre admission assessments were seen, one high dependency and one older person with dementia. Both assessments were detailed providing information relating to all current health care needs and social background. Where possible further Newton House DS0000047637.V329228.R01.S.doc Version 5.2 Page 9 information will be obtained from families, care managers and other health care professionals to support the assessments. The assessments are kept on the service users file and used towards implementing a care plan. Due to the care needs of the high dependency service users, a second person will assist with the assessment. The home is not registered to provide intermediate care therefore Standard 6 is not applicable. Newton House DS0000047637.V329228.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6-10 (Adults 18-65) and Standards 7, 14, 33 & 37 (Older People) are: 6. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. The Service Users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users make decisions about their lives with assistance as needed. Service Users are helped to exercise choice and control over their lives. (OP NMS 14) Service users are consulted on, and participate in, all aspects of life at the home. The home is run in the best interests of service users. (OP NMS 33) Service users are supported to take risks as part of an independent lifestyle. The service users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users know that the information about them is handled appropriately and that their confidences are kept. Service Users rights and best interests are safeguarded by the home’s record keeping, policies and procedures. (OP NMS 37) 7. 8. 9. 10. The Commission considers Standards 6, 7 and 9 (Adults 18-65) and Standards 7, 14 and 33 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each service user is provided with a comprehensive care plan, however the review process is not always detailed. Due to the very complex needs of the service users, decision-making is limited, as is an independent lifestyle. EVIDENCE: Each service users is provided with a comprehensive care plan. The inspector reviewed four care plans; two care plans of older service users, one of which had recently been admitted. The care plan showed in detail the care needs of Newton House DS0000047637.V329228.R01.S.doc Version 5.2 Page 11 the service user and clearly directed staff on how to meet the care needs. The second care plan was detailed, however had not fully addressed the use of a safety belt, which was used to ensure the service user did not fall whilst out of bed. The care records of the high dependency service users were the same comprehensive format providing clear instructions on how to meet all nursing needs. Evidence was seen of care records being reviewed monthly or when needs changed. However the review process to one care plan provided limited information of any changes to the service users care needs. All appropriate risk assessments were in place such as, tissue viability, manual handling and nutritional assessments, again these were reviewed monthly. At the time of the inspection the home was providing care for 6 elderly service users the majority of which had some degree of dementia and care to 8 high dependency younger service users. Due to these very complex needs it would not be possible for the high dependency service users to make any decisions about their lives and the older service users could make very limited decisions. However two older people spent much of the day in the communal lounge where staff were observed trying to support these service users to make even small decisions, such as where they would like to sit and choice of food. The service users are provided with a range of risk assessments relating to daily life in the home but due to the complex needs an independent approach to risk would again be very limited and impossible for the majority of service users. Newton House DS0000047637.V329228.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 (Adults 18-65) and Standards 10, 12, 13 & 15 (Older People) are: 11. Service users have opportunities for personal development. 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. (OP NMS 12) Service users are able to take part in age, peer and culturally appropriate activities. 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. (OP NMS 12) Service users are part of the local community. Service users maintain contact with family/ friends/ representatives and the local community as they wish. (OP NMS 13) Service users engage in appropriate leisure activities. 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. (OP NMS 12) Service users have appropriate personal, family and sexual relationships and maintain contact with family/friends/representatives and the local community as they wish. (OP NMS 13) Service users’ rights are respected and responsibilities recognised in their daily lives. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users are offered a (wholesome appealing balanced) healthy diet and enjoy their meals and mealtimes. Service users receive a wholesome appeaing balanced diet in pleasing surroundings at times convenient to them. (OP NMS 15) 12. 13. 14. 15. 16. 17. The Commission considers Standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 10, 12, 13 and 15 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 10, 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Newton House DS0000047637.V329228.R01.S.doc Version 5.2 Page 13 Activities are provided to suite the needs of the service users. Service users are treated with respect and their dignity maintained. Service users are fully supported to maintain links with family and friends and to engage in the service users’ care. The dietary needs of the service users are very well monitored. Service users are provided with a healthy and balanced diet. EVIDENCE: Whilst touring the home and visiting with service users, it was evident that all personal and nursing care is provided in the privacy of the service users’ bedroom or bathroom, ensuring that their dignity is respected. Staff were observed knocking on bedroom doors before entering and more importantly identifying themselves to the service user and verbally informing the service user as to what they were doing. The home is currently without an activities person, however care staff and the occupational therapists are providing activities. Service users are also able to join in other social groups taking place across the campus. Activities provided are, church services, social groups, listening to music, watching TV. Again due to the high dependency of the service users, participation in-group activities would not be possible. However it was observed that service users needing to spend much of their day in bed had radios playing with appropriate music to their age group. Service users are supported to maintain links with family and friends. The home considers family support to the service users as an important part of their care and therefore fully encouraged families to engage in the care of the service users. Only one visit was took place during the course of the inspection.Family and friends can visit the home at any reasonable time, which was evidenced through the visitors signing in book. All the high dependency service users are fed though a gastric feeding tube with all appropriate systems in place to support this method of feeding. The older people were able to manage a normal diet, which may be soft diet or a purred. Two service users were observed having lunch in the communal room, both being assisted by care staff. The menus across the campus have recently been changed with a good improvement. The nutritional needs of all the service users are closely monitored through dieticians, nutritional risk assessments, and monthly weights. A 24hour fluid record is maintained of all service users fed via gastric feeding. Newton House DS0000047637.V329228.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 – 21 (Adults 18-65) and Standards 8 – 11 (Older People) are: 18. 19. 20. Service users receive personal support in the way they prefer and require. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users’ physical and emotional health needs are met. Service users’ health care needs are fully met. (OP NMS 8) Service users retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicines. Service users, where appropriate, are responsible for their own medication and are protected by the home’s policies and procedures for dealing with medicines. (OP NMS 9) The ageing, illness and death of a service user are handled with respect and as the individual would wish. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. (OP NMS 11) 21. The Commission considers Standards 18, 19 and 20 (Adults 18-65) and Standards 8, 9 and 10 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 8, 9,19 and 20 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The nursing and personal care provided is of a very good standard. The health care needs of service users are closely monitored and prompt action taken when health care needs change. The medication procedure was safe. EVIDENCE: The nursing team, work hard to provide a good standard of nursing and personal care, this was evident through the well presented appearance of the service users and the attention to detail in the nursing care provided is excellent. Through observation it was evident that the carers and qualified nurses work closely as a team to achieve this level of care. Evidence seen in Newton House DS0000047637.V329228.R01.S.doc Version 5.2 Page 15 the care records showed, that the health care needs of the service users being closely monitored and prompt and appropriate action taken when health care needs change. All service users are registered with a local GP who visits the home weekly or more if requested. Evidence was seen of other health care professionals being contacted when care needs changed, such as the tissue viability nurse and swallowing specialist. An older service user who was able to communicate said, “They are very good at looking after you here”. Two student nurses were on placement at the home and both commented that they were enjoying the experience and learning new skills. The medication procedure was safe. The medications were stored correctly, as were the controlled medicines. The controlled medication registered was correct. The disposal of medications was in line with current legislation. The medication records were complete and up to date. Service users at this level of care could not self medicate. Newton House DS0000047637.V329228.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22-23 (Adults 18-65) and Standards 16-18 & 35 (Older People) are: 22. 23. Service users feel their views are listened to and acted on. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted on. (OP NMS 16) Service users’ are protected from abuse, neglect and self-harm. Service users legal rights are protected. (OP NMS 17) Also Service users are protected from abuse. (OP NMS 18) Also Service users financial interests are safeguarded. (OP NMS 35) The Commission considers Standards 22-23 (Adults 18-65) and Standards 16-18 and 35 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18, 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A complaints policy and procedure is in place and available to service users and families. There are polices and procedures in place to protect service users and the staff receive training in abuse awareness. EVIDENCE: A complaints policy and procedure are in place. The complaints procedure is displayed in the entrance of the home. A record of complaints is maintained along with the outcome of the complaints and what action (if required) was taken. Through discussion with the manager, it was evident she had an open approach to complaints and would involved the senior management if necessary. Glenside provides annual training in abuse awareness and vulnerable adults to all levels of staff and is part of the induction programme. Mrs Romain had a good understanding how to make a referral if any allegation of abuse was Newton House DS0000047637.V329228.R01.S.doc Version 5.2 Page 17 reported to her. Two members of staff were receiving training on the day of the inspection. The employment procedure for the Glenside homes is robust and protects the service users as much as possible. Newton House DS0000047637.V329228.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 (Adults 18-65) and Standards 19-26 (Older People) are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users live in a safe, well-maintained environment (OP NMS 19) Also Service users live in safe, comfortable surroundings. (OP NMS 25) Service users’ bedrooms suit their needs and lifestyles. Service users own rooms suit their needs. (OP NMS 23) Service users’ bedrooms promote their independence. Service users live in safe, comfortable bedrooms with their own possessions around them. (OP NMS 24) Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Service users have sufficient and suitable lavatories and washing facilities. (OP NMS 21) Shared spaces complement and supplement service users’ individual rooms. Service users have access to safe and comfortable indoor and outdoor communal facilities. (OP NMS 20) Service users have the specialist equipment they require to maximise their independence. Service users have the specialist equipment they require to maximise their independence. (OP NMS 22) The home is clean and hygienic. The home is clean, pleasant and hygienic. (OP NMS 26) The Commission considers Standards 24 and 30 (Adults 18-65) and Standards 19 and 26 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24, 26 and 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Newton House provides a homely and well-equipped home for service users to live in. The home is well maintained and clean offering a good standard of accommodation. EVIDENCE: Newton House DS0000047637.V329228.R01.S.doc Version 5.2 Page 19 Newton House is an older building with a newer extension, which was purpose, built for the high dependency service users. Bedrooms are provided on the 1st floor for the older service users and the ground floor rooms are for the high dependency. A large, well-furnished communal room is located on the ground floor. The home benefits from a large well-maintained garden, which several bedrooms have patio doors leading to. The home is well maintained and homely. The ground floor corridors had recently been re-carpeted. The inspector was able to visit al the bedrooms. The bedrooms provided for the high dependency service users all have an en-suite facility. The bedrooms are spacious enough for the equipment required to meet the needs of the service users. The bedrooms had been decorated to suite the age group of the service users and personalised with small personal items, photographs of family and friends. The bedrooms on the 1st floor are not purpose built but provide a homely environment and again personalised. The area around the sink in room 5 needed to be repaired. Service users are provided with a range of equipment to meet their complex physical needs such as, specialised wheelchairs, hoists, and profile beds. A weighing scale suitable for wheelchairs users is provided across the campus, for use by all the homes. Discussions with the maintenance department also indicated that while industrial carpet cleaners were available, there were not enough for each registration. Joint equipment across the campus needs to be reviewed, as while it is appreciated that sharing equipment between units may be necessary, such sharing may also involve a range of health and safety risk and spread of infection. These need to be fully considered. The home was clean though out with no apparent odours and infection control measures in place. Newton House DS0000047637.V329228.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 (Adults 18-65) and Standards 27 – 30 & 36 (Older People) are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users are supported by competent and qualified staff. Service users are in safe hands at all times. (OP NMS 28) Service users are supported by an effective staff team. Service users needs are met by the numbers and skill mix of staff. (OP NMS 27) Service users are supported and protected by the home’s recruitment policy and practices. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users’ individual and joint needs are met by appropriately trained staff. Staff are trained and competent to do their jobs. (OP NMS 30) Service users benefit from well supported and supervised staff. Staff are appropriately supervised. (OP NMS 36) The Commission considers Standards 32, 34 and 35 (Adults 18-65) and Standards 27, 28, 29 and 30 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30, 32, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users are fully supported by the number and skills of the staff. The systems for recruitment are robust and protect the service users. Service users needs are met by the training provided to staff. Staff are fully supported and supervised in their roles. EVIDENCE: The staffing levels at Newton House operate in line with a condition of registration. The night staffing levels have been recently increased from one Newton House DS0000047637.V329228.R01.S.doc Version 5.2 Page 21 qualified nurse and two carers to two nurses and one carer due to the care needs of the high dependency service users and the amount of medications required. The rotas provided evidence that the staffing levels required were maintained. The Glenside Group has a training department, which is managed by a qualified trainer. All staff, at all levels, undergo a standard induction programme when they take up their posts. This includes all relevant areas such as manual handling, health and safety, fire safety and infection control. Newly employed staff are issued with a standard induction booklet, which they and their/mentor sign, once they had been fully inducted into each area. The Glenside Group supports NVQ2 or above. Staff who work in the brain injury service receive additional training in the area, to enable them to fully support service users and be aware of the range of service user needs and therapies involved. All staff undergo resuscitation training. Additional training to meet service user needs also is provided in a range of areas, for example prevention of pressure damage and diabetic care. Home managers are responsible for ensuring that their receive mandatory training. The Glenside Group has a central human resources (personal) department, which handles all applications for employment. Much improvement has been made since the previous inspection in a range of areas relating to employment of staff. All staff have a criminal records check and are checked against the vulnerable adults list. If a positive result is identified, their suitability for their role is assessed and a risk assessment performed. All prospective staff completes an application form and health status questionnaire. At least two suitable references are now always obtained prior to employment. All staff are interviewed, using an interview assessment tool. These were fully completed on an individual basis. A clear system for staff to receive regular supervision is in place. All staff spoken with confirmed that they had received supervision at least every six weeks and an annual appraisal. Records relating to supervision and appraisal were seen on staff files. Supervisions and appraisals were individual in tone and issues relating to training and development were consistently included. Records also showed supervisions were performed when it was considered that a member of staff needed additional support in a particular area. Supervision and appraisal records cross-reference to training records, so that it was clear that where a member of staff has requested, or was assessed as needing training in a particular area, arrangements had been made for the person to attend training in a timely manner. Newton House DS0000047637.V329228.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 (Adults 18-65) and Standards 31-34, 37 & 38 (Older People) are: 37. Service users benefit from a well run home. 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. (OP NMS 31) Service users benefit from the ethos, leadership and management approach of the home. Service users benefit from the ethos, leadership and management approach of the home. (OP NMS 32) Service users are confident their views underpin all self-monitoring, review and development by the home. The home is run in the best interests of service users. (OP NMS 33) Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping, policies and procedures. (OP NMS 37) Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping policies and procedures. (OP NMS 37) The health, safety and welfare of service users are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (OP NMS 38) Service users benefit from competent and accountable management of the service. Service users are safeguarded by the accounting and financial procedures of the home. (OP NMS 34) 38. 39. 40. 41. 42. 43. The Commission considers Standards 37, 39 and 42 (Adults 18-65) and Standards 31, 33, 35 and 38 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 37, 38, 39 and 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Newton house is very well managed by Mrs Romain. Quality audits systems are in place. The health safety of service users is protected. Newton House DS0000047637.V329228.R01.S.doc Version 5.2 Page 23 EVIDENCE: Mrs Krystyna Romain is a qualified general nurse who has much experience of nursing and caring for younger adults with a brain injury requiring long term care. Mrs Romain also has experience with older people suffering from dementia. Mrs Romain provides good leadership to the home and clinical supervision to the staff ensuring that attention to detail in all aspects of the service users care is carried out. Quality assurance systems are in place with audits from senior management regularly taking place. Surveys are carried out to gain the views of the families, as service users would not be able to participate. The Glenside Group has systems to ensure that staff are trained as required in a range of health and safety. A recent fire safety audit had taken place across the services on site. At present night staff are trained in fire safety twice a year. The home is advised that, as fire officers consider the risk to service users at night, when there are fewer staff, to be higher, that all staff who work nights need to be trained in fire safety four times a year. A review of maintenance records and discussions with the maintenance manager showed that other areas relating to health and safety, such as lifts, hoists and boilers servicing, fire safety checks and water temperatures testing takes place at the regularity advised. Newton House DS0000047637.V329228.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. 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 X 2 3 3 3 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 3 28 3 29 3 30 2 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT Standard No Score 37 4 38 X 39 3 40 X 41 X 42 3 43 x 3 3 X 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Newton House Score 4 4 3 x DS0000047637.V329228.R01.S.doc Version 5.2 Page 25 NO 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 YA6 Regulation 15 Requirement Timescale for action 30/05/07 2 YA6 15 3 YA30 23 The registered person must ensure that reviews of care plans are more detailed and document accordingly. The registered person must 30/05/07 clearly address in the care records any use of safety belts and a care plan in place to support the use. A policy and procedure on 30/06/07 equipment shared across the site must be put in place to ensure that adequate equipment is provided. This must conform to health and safety and infection control guidelines. 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 House DS0000047637.V329228.R01.S.doc Version 5.2 Page 26 1. YA25 The area around the sink in bedroom 5 should be refurbished. Newton House DS0000047637.V329228.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB 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 House DS0000047637.V329228.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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