Inspection on 24/07/07 for Newton House

This inspection was carried out on 24th July 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Newton House 148 Barrowby Road Grantham Lincolnshire NG31 8AF Lead Inspector Sue Hayward Key Unannounced Inspection 24th July 2007 09:50 X10029.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 DS0000069216.V348181.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 DS0000069216.V348181.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Newton House Address 148 Barrowby Road Grantham Lincolnshire NG31 8AF 01476 578072 01476 575507 newtonhouse@barchester.com 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) Barchester Healthcare Homes Ltd Mrs Lesley Hart Care Home 126 Category(ies) of Dementia - over 65 years of age (60), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (60), Old age, not falling within any other category (64), Physical disability (2) Newton House DS0000069216.V348181.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 38 beds for old age, not falling within any other category (OP) and 1 bed for a named person under 65 years (PD) in the Watergate Unit 32 beds for older people with dementia and mental disorders DE(E) and MD(E) in the Castlegate Unit 26 beds for old age not falling within any other category and 1 bed for a named person under 65 years (PD) in the Somerby Unit 28 beds for older people with dementia and mental disorders DE(E) and MD(E) in the Brownlow Unit New Service Date of last inspection Brief Description of the Service: Newton House is a large purpose built single storey care home. It is one of a number of homes owned and managed by Barchester Health Care Limited, which provides care services throughout England. The service provides nursing and personal care for up to 126 people. Newton House is situated a short distance away from the town centre of Grantham in Lincolnshire, which has various services and facilities such as shops, newsagents hairdressers and pubs. It is situated in its own grounds and there are car parking spaces at the front of the home. The home has an open layout to allow residents freedom of movement and easy access. It is divided into 4 separate units each caring for residents who have different types of needs. People living in Castlegate and Watergate are accommodated in mainly single rooms most having en-suite toilet and washbasins. There are a few twin rooms should anyone wish to share. Watergate has recently had an extension added and now provides eight rooms for single occupancy all with en-suite shower and toilet facilities, a clinical room and a training room. People who live in Somerby and Brownlow units are all accommodated in single rooms with en-suite toilet and washbasins. Each unit is self-contained with lounge and dining space and an enclosed garden area. There is a named manager responsible for each unit. There is also a clinical manager. The fees confirmed by the manager during the visit ranged from £395 to £800 per week. Additional fees are charged for hairdressing chiropody toiletries personal newspapers and magazines. Inspection reports are available in the home. Newton House DS0000069216.V348181.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit to the home was carried out by one inspector and formed part of a main inspection, which lasted seven hours. Whilst it is a new service previous information was taken into account as there had been no changes to the immediate management arrangements of the service. Information that the Commission for Social Care Inspection (CSCI) holds about the service such as the history and records of any incidents notified to the CSCI was taken into consideration. Prior to the visit, “Have your say about” questionnaires were received from twenty-one residents. all had been completed with the support of either relatives or staff. In addition the manager had forwarded an annual quality assurance self-assessment form prior to the visit . This gave important information about the service, which was also used in the planning of the inspection and the compilation of this report. The visit included following the care of five residents with a range of needs through checking records that are held about them, talking to them and to three staff members on duty. In addition three sets of relatives who were visiting were spoken to and short periods of observation were spent at various times of staff carrying out their duties. The visit focussed on key standards, which have the potential to affect residents’ health and welfare. The manager was present throughout the visit and discussion was held about general outcomes of the inspection at the end of the visit. What the service does well: The home is clean, comfortably furnished and well equipped to meet residents’ needs. People are able to make their rooms more homely with their own personal belongings if they wish. Records are well maintained and organised and contain sufficient information, about the needs and wishes of residents to ensure that they receive the care they need. There is a training programme in place to ensure staff have the knowledge and skills to provide appropriate care to meet residents needs. Visitors are made welcome and kept well informed. Newton House DS0000069216.V348181.R01.S.doc Version 5.2 Page 6 This is a well-managed service, which has systems in place to check on the overall quality of the care and accommodation provided to ensure good standards. Comments such as “I am very happy with the nursing care I’m given”, “staff are very good”, “I’ve been quite ill just recently and I have been given very good care”, “welcoming atmosphere”, “Newton House is a very nice place. It’s a modern building, lovely gardens” and “I think you would have to go a long way to beat it” gives an indication of peoples satisfaction with the care and accommodation provided. What has improved since the last inspection? What they could do better: No matters were raised at the time of this inspection that indicated standards in the home were not being met, however residents would benefit from further improvements in some areas. The manager demonstrated she is aware of areas that do need developing and improving in the home. For instance, residents made varied comments about how well they felt the social and recreational activities provided met their wishes. Training is already planned for staff about person centred care. Some areas of the home need redecoration and refurbishment but again this is in hand. Newton House DS0000069216.V348181.R01.S.doc Version 5.2 Page 7 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 DS0000069216.V348181.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Outcomes Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) Newton House DS0000069216.V348181.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 3 (Older People) and 2 (Adults 18 –65) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good systems in place to introduce and assess residents, which ensures their care needs are identified and can be met prior to admission. Information about the home is readily available. EVIDENCE: The care records of two people recently admitted to the service were checked along with records of three other people with a range of needs. Newton House DS0000069216.V348181.R01.S.doc Version 5.2 Page 10 Records were well maintained and demonstrated that an assessment had been carried out, which included obtaining a range of information about residents communication, mobility, personal hygiene, pain, nutritional, social, spiritual, cultural and needs associated with gender/sexuality and relationships. From this information care plans had been developed indicating the help and support residents needed. Since the last inspection the statement of purpose, a document, which gives information about the home has been updated to reflect that Barchester Healthcare Homes Limited owns the home. Barchester have recently implemented a web page, which is to be individualised for each service to provide up to date information. Relatives confirmed they had been given information about the changes of ownership. The certificate of registration and other information about the service is on display in the home for anyone to check. Discussion with a person who had recently been admitted to the home indicated that both he and his wife had had the opportunity to visit and ask any questions before making the decision to stay. He said they had been made to feel very welcome. It was also said that discussions had included information about the financial aspects of residential care and the terms and conditions. The majority of surveys completed indicated that people who use the service had received sufficient information about the service. For example, “the brochure and staff were very helpful at time of admittance”. Discussion with the manager confirmed that a trained member of staff would endeavour to visit any prospective resident in their home surroundings or hospital to ensure that the service could meet their needs prior to admission. There was discussion with the manager as to whether there is a policy in place about emergency admissions. The manager said that where possible the majority of admissions are planned but agreed to check to ensure that there was a procedure in place for any people who needed to be admitted urgently. Newton House DS0000069216.V348181.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) 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, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are the key standards. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7 - 10 (Older People) and 6, 9, 16, 18, 19 and 20 (Adults 18 –65) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are well organised and reflect the individual needs of residents and how to meet them to ensure their health and welfare as well as taking into account their personal preferences. Medication is managed in a satisfactory way, which promotes the safety of residents. EVIDENCE: Newton House DS0000069216.V348181.R01.S.doc Version 5.2 Page 12 Care records were well organised and maintained. Discussion with relatives confirmed that they were kept well informed about their relatives care and felt there was good communication between themselves and staff. Care records checked included information such as assessments, care plans (in all but one instance of a resident who had only been at the home for two days), risk assessments and activities records. Whilst there was one person who had not yet had a care plan completed discussion with him indicated that staff were aware of his care needs. He said, “Staff must communicate well because I do not have to keep telling them that I drink black tea. They know how I like it”. A range of equipment was in place to enable residents’ differing needs to be met for example, pressure mattresses, manual handling equipment and wheelchairs. Care plans contained information reflecting residents spiritual and cultural wishes and the implications of these when providing care. For example, whether people wished to practice their religion or not or whether they needed any particular dietary requirements. Care plans included dates demonstrating they were reviewed regularly and contained signatures to denote residents if able or their relative’s involvement with their development. Records also included information, which demonstrated that health care was well monitored through visits and referrals to other professionals such as doctors and physiotherapists. Two relatives commented that the care given was of a good standard. Residents spoken to made positive comments about the care provided and said their privacy, dignity and independence was respected. Staff were seen to be polite and courteous and dealt with residents needs sensitively for example when helping them to have their meals. Observations also indicated that residents with higher dependency needs were given opportunities to be as independent as possible for example a resident was asked whether she wanted to help lay the tables. There are satisfactory policies and procedures in place relating to the safe keeping and storage of medication. Nursing staff give out the majority of medication using a pre-packed system, which has been prepared by the local pharmacist. This is a recognised method, which helps to ensure the safety of residents. The staff member checked the medication sheet prior to dispensing medications and signed a record after it had been taken. It was also noticed that a staff member dealt sensitively with a resident who was reluctant to take Newton House DS0000069216.V348181.R01.S.doc Version 5.2 Page 13 their medication. The storage arrangements seen on this unit were also satisfactory. There are weekly checks made on the medication systems in place for each unit. In addition there is an agreement with a local pharmacist who visits and provides a report on medication systems in place and how they can be improved. The last visit was carried out on 07/06/07. Some recommendations were made in relation to recording quantities and signing records immediately after they have been taken which was seen to happen during the visit. Newton House DS0000069216.V348181.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. 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 have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with assistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12 - 15 (Older People) and 12,13,15,and 17 (Adults 18 –65) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are a range of social and recreational opportunities available for residents to participate in but it is recognised this needs to be developed further to ensure a more fuller person centred approach. Residents’ independence is promoted and they are supported to have choice in their daily lives. The meals provided are well balanced and take into account residents personal preferences and special dietary requirements to ensure their welfare. Newton House DS0000069216.V348181.R01.S.doc Version 5.2 Page 15 Visitors are made welcome and are able to be involved in the care of their relative. EVIDENCE: There are four specific staff employed for ninety-seven hours per week whose role is to provide social, leisure, and recreational activities for residents. Residents and relatives made a range of comments as to how well they felt the service was meeting their needs in this respect. For example, a resident said “there is not a lot for me to do” another “staff are too busy I think to spend much time with me”. Other comments made indicated residents were satisfied with what was provided. Discussion with the manager and information provided prior to the visit confirmed that this is an area that has already been identified as needing development in order to provide a more individual and person centred approach to providing activities. The manager agreed to address ways in which social activities could be improved for residents who had made less satisfactory comments. Notices are on display informing residents of any planned entertainment or activities. That said it was observed during the visit that one person was involved in the preparation of some vegetables, others in a game of dominoes and one was seen having their nails painted. A relative commented that “there is always something going on” and said they knew that a “strawberry tea” and a “memory walk” is planned in the local town. There are links with other organisations in the community such as the Alzheimer’s society. Craft and board games were seen around the home and there is mobile sensory unit. Staff confirmed religious services are held. Menus seen showed that there is a well-balanced and nutritious diet provided. There is a choice of meals available at breakfast, lunch and tea and drinks available at various periods throughout the day and on request. The manager agreed to remind residents that should they wish for an early morning cup of tea this could also be provided. There is a kitchenette area in one unit where drinks can be made and the manager confirmed that it is planned to alter another area within the home to provide a kitchen for residents to use. Since the last visit to the home the home has improved and obtained a five star rating for the quality of the meals it provides from the environmental health services. The lunchtime meal was well presented and staff were noted to be sitting with and providing sensitive support for residents who needed help. Comments from residents indicated they had a choice of daily routines, for example one person said he could get up and go to bed when he liked and had been given a choice of where he would like to eat his meals. Visitors said they were always made welcome and felt involved in the care of their relative. Newton House DS0000069216.V348181.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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 feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18 (Older People) and 22 and 23 (Adults 18 –65) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are satisfactory systems in place to raise concerns and as far as possible protect residents from abuse. EVIDENCE: There is a satisfactory complaints procedure in place. This is included in the information given to residents and can be provided in an audio version or read out to residents who may have for example, difficulties with their eyesight. Out of the surveys that were returned all except one confirmed that they knew who to speak to if they were unhappy and all except two knew how to make a complaint. Comments included, “No occasion to complain but assume a line of command through senior nurse” and “we have residents meetings every six months I think”. Residents and relatives spoken to made generally positive comments about staff that were observed to be kind and courteous. All persons spoken to on the day knew who was in charge and said they would feel comfortable to raise Newton House DS0000069216.V348181.R01.S.doc Version 5.2 Page 17 any matters. A relative said “you see the manager regularly”. A student nurse who had been working in the home over the past eleven weeks made comments, which confirmed that she was aware of what to do and how to respond if anyone wished to raise any concerns. Safeguarding adults training is included as part of the staff training programme. Information provided prior to the visit also confirmed that there were policies and procedures in place to follow in order to safeguard residents such as bullying, staff code of conduct, dealing with violence and aggression, disclosure of abuse and bad practice, physical restraint, safeguarding adults and the prevention of abuse, recruitment and employment and the management of residents money, valuables and financial affairs. A random sample of staff records checked demonstrated that there is a satisfactory staff recruitment procedure, which helps to protect residents. The manager confirmed no money was being held in safe keeping on behalf of residents and it is not the policy of the home to do so. Records are in place which detail any concerns or complaints raised. The commission has not received any complaints directly since the last visit of 13/09/06. Records held about complaints that had been received by the home showed that since the last inspection three matters had been raised. These had been appropriately recorded and demonstrated the actions taken to address and resolve them. One matter has not yet concluded. Residents’ comments indicated that they felt safe at the home. Newton House DS0000069216.V348181.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 and 26 (Older People) and 24 and 30 (Adults 18 –65) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean and hygienic and provides residents with a comfortable, homely and safe environment. EVIDENCE: Newton House DS0000069216.V348181.R01.S.doc Version 5.2 Page 19 Four bedrooms of people whose care was being followed were checked on this occasion from different units as well as some of the lounges and dining areas, the laundry, some bathrooms and toilets and the garden. All areas of the home were clean, tidy and generally well maintained. One unit is showing signs of wear and tear in relation to the carpet and furnishings however the manager is aware of this and it is programmed to replace and renew this area. The manager said that some colour schemes of the furnishings had not been the best choice although furniture is regularly steam cleaned. She also said that the service had been successful in obtaining a grant. It was intended that this would be spent on improving some areas of the home such as those already mentioned. No unpleasant odours were noticed on the day of the visit. A range of equipment was seen around the home and bedrooms were furnished and equipped to meet resident’s individual needs, such as pressure mattresses to promote good skin care. Residents were satisfied with the comfort and cleanliness their rooms provided. Most have en-suite facilities and residents said they were able to have keys to their rooms if they wished. Residents said they had been able to bring with some of their own personal effects to make their rooms more homely. Since the last visit an extension has been completed offering a further eight bedrooms with an en-suite toilet and shower. There are well-maintained gardens and patio areas with seating areas for residents to use. The kitchen premises were not seen on this occasion however the most recent Environmental Health report of the kitchen inspection was viewed. It described the service as “excellent premises” and “ well run”. There is a large laundry equipped with industrial machines. There have been no changes to staffing arrangements with separate laundry, catering, housekeeping and maintenance staff employed. A housekeeper on duty at the time of the visit was noticed to store cleaning materials securely. Residents made generally satisfactory comments about the laundry arrangements. A staff member was noted to respond promptly to a resident’s request to locate and return some missing laundry. Information provided prior to the visit confirmed that there are policies and procedures in place for staff to follow to promote good hygiene practices and stocks of disposable gloves were seen to ensure good hygiene practices. Newton House DS0000069216.V348181.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 28, 29 and 30 (Older People) and Standards 32, 34 and 35 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27 - 30 (Older People) and 32, 34 and 35 (Adults 18 –65) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are satisfactory staffing arrangements in place to meet the needs of residents and staff are trained to ensure they have the knowledge and skills to provide the appropriate care for residents. Residents are as far as possible protected by a thorough staff recruitment process. EVIDENCE: Comments about the care received were positive. For example, two relatives spoken to made comments indicating that they felt their relatives “received good care” from staff. A resident also said that staff responded promptly Newton House DS0000069216.V348181.R01.S.doc Version 5.2 Page 21 when he needed help and felt they were always about when needed. Other comments were that whilst there were sufficient staff to meet their needs they would like staff to have more time to be able to spend with them socially. Residents all looked well cared. There are qualified nursing staff on duty at all times and comments and rotas checked demonstrated that each unit has six to seven care staff. Catering, laundry, housekeeping, maintenance, activities, administration and management staff are additional to care staffing levels. The manager said care staff are involved in some light housekeeping duties only when there is unplanned absence and sickness of housekeeping staff and there had been no change to the staffing arrangements since the last inspection. There are systems in place to monitor the needs of residents to ensure that there are sufficient staff on duty. Three staff members were spoken to on this occasion. One who is responsible for monitoring training. Records showed that there is a varied training programme in place covering a range of topics some of which staff have regular updates about. There is a training programme in place for any new staff. Some staff have achieved a nationally recognised vocational qualification in care. The training programme ensures staff have the knowledge and skills to provide care to residents and ensures equal opportunities and a system in place where more experienced staff provide advice and guidance to new staff. Staff were noticed to carry out their work in a sensitive and prompt manner, which respected residents individuality. Records of three staff who had been recently employed were checked on this occasion and demonstrated a satisfactory recruitment procedure had been followed which included checking identity, employment history as well as obtaining references and carrying out the necessary criminal records bureaus and protection of vulnerable adults checks to ensure residents are as far as possible protected by the recruitment procedure in place. Newton House DS0000069216.V348181.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. 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 a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s policies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 31, 33, 35 and 38 (Older People) and Standards 37, 39 and 42 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35 and 38 (Older People) and 37, 39 and 42 (Adults 18 –65) Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Newton House DS0000069216.V348181.R01.S.doc Version 5.2 Page 23 The service is being effectively managed which helps to ensure the health, safety and welfare of residents is promoted. There are good systems in place to ensure that residents and relatives have opportunities to put forward their views about the standard of the care and accommodation provided. EVIDENCE: Although there have been changes to the company ownership of the home there has been no changes to the management arrangements since the last inspection. The manager is a qualified nurse and has many years of experience of managing the service. She continues to participate in training and is currently working towards achieving an Open University degree in health and social care. Comments from residents and relatives confirmed that they knew who was in charge, saw the manager regularly and said she was approachable and would feel comfortable to raise any matter with her. There are various systems in place to monitor the quality of the service. This includes resident councils, which are held on a six monthly basis, staff meetings and friends of Newton House meetings. Records are kept to demonstrate the matters discussed at these meetings. There are also internal auditing systems in place such as weekly checks on medication and visits by company representatives at least monthly as well as customer satisfaction surveys, which are undertaken periodically. In addition the manager said that she does “daily walks around the units” when on duty which enables her to check on standards of care. Discussion indicated that she was aware of the areas, which need attention and to be developed was discussed the plans in place to address them. There are a range of policies and procedures and information in place, which are easily available for staff to refer to covering aspects such as residents’ personal care, health and safety matters and staff codes of conduct. Records are in place demonstrating that risks have been assessed relating both to individuals and the environment in order that action can be taken to minimise them. Residents’ comments indicated that they felt safe and well cared for. All but one survey, which had been returned, indicated that residents felt that staff always listened an acted on their comments. One comment made was “I think you would have to go a long way to beat Newton house”. Two relatives seen made comments indicating that they felt the home was well managed. Those records that are required to be kept by law are well organised and maintained. There are also records in place to demonstrate that there are good systems to ensure that health and safety matters are regularly checked. For example risk assessments checked showed that these were last reviewed Newton House DS0000069216.V348181.R01.S.doc Version 5.2 Page 24 and updated in May 2007 and records of fire alarm tests indicated these were checked regularly. Information provided prior to the visit indicated that equipment was checked and serviced regularly. A random sample of service certificate demonstrated that the gas central heating system was last serviced on 24/07/06 Newton House DS0000069216.V348181.R01.S.doc Version 5.2 Page 25 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 3 2 X 3 4 5 6 ENVIRONMENT Standard No Score 19 3 20 X 21 22 23 24 25 26 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No Score 31 4 32 X 33 4 34 X 35 3 36 3 37 X 38 3 Newton House DS0000069216.V348181.R01.S.doc Version 5.2 Page 26 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. Standard Regulation Requirement Timescale for action 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 DS0000069216.V348181.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 DS0000069216.V348181.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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!