Inspection on 03/10/05 for Newton House

This inspection was carried out on 3rd October 2005.

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 13/01/06

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 Announced Inspection 3rd October 2005 13:45 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.V263064.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Newton House DS0000047637.V263064.R01.S.doc Version 5.0 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.V263064.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. No more than 8 service users under the age of 65 years with a physical disability 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 The maximum number of service users who may be accommodated at any one time is 15 No more than 2 service users over the age of 18 years with a terminal illness may be accommodated at any one time 2nd March 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.V263064.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The announced inspection commenced at 1.45pm the 3rd October. The inspector returned the morning of the 4th October to complete the inspection. The inspector toured the building with the registered manager and met with many service users. Care plans were reviewed. Medications were reviewed by the pharmacy inspector Mary Collier. What the service does well: What has improved since the last inspection? What they could do better: A solution will have to be found to ensure that the lounge area is maintained at an appropriate temperature to ensure that service users can use the lounge area all year round. The bathroom upstairs will need to be up graded to meet the needs of the service users. Recruitment procedures will need to be more robust. Newton House DS0000047637.V263064.R01.S.doc Version 5.0 Page 6 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.V263064.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Newton House DS0000047637.V263064.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 5 A clear admission procedure is in place and all needs are fully assessed during the pre admission assessment. Service users where possible visit the home prior to admission. EVIDENCE: All service users are fully assessed by the registered manager prior to admission to Newton House. Due to the complex nursing needs of the service users the Operations Manager for Glenside will assist with the pre admission assessment ensuring that the home is able to meet the nursing and social needs of the service user. The assessment is detailed providing information of all current health care needs and social needs. A record of the assessment is kept on the service users’ file. Service users are encouraged and invited to visit the home prior to admission, to meet with staff and other service users and view the accommodation provided. However due to the complex nursing needs pre admission visits do not always take place. Newton House DS0000047637.V263064.R01.S.doc Version 5.0 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, 9 and 10 Health care needs of service users are closely monitored and appropriate action taken when health care needs change. The care plans fully address all aspects of care and are of a good standard. The care team support the privacy and dignity of the service users. EVIDENCE: Each service user is provided with a comprehensive care plan. The care plans are detailed and address current and long-term health care needs. Monthly reviews take place or when the care needs of the service user change. All appropriate risk assessments are in place and regularly reviewed. The service users’ or representative sign in agreement to the care plan. Health care needs are closely monitored with appropriate action taken when needs change. Many of the service users have complex nursing needs however the care provided is individualised and of a good standard. Care monitoring charts are used for those service users with little or no communication skills. The charts were up to date throughout the inspection and provided detailed information. Service Users who were able to communicate were complimentary Newton House DS0000047637.V263064.R01.S.doc Version 5.0 Page 10 of the care they received. All service users are registered with a GP who visits weekly or more if required. The home has a comprehensive medication policy and up to date homely remedies list. All records are appropriately kept and medication stored securely. A disposal system for medication is in place, in line with current legislation. Nurses receive additional training for the PEG feeding and the concurrent medication regimes. The medication fridge temperature is regularly monitored, however it has recently been below the recommended 2-8c range. Currently all morning medications are administered by the night nursing staff between 7am and 8am. The registered manager should consider the day nursing staff administering the morning medication or to split the task between the two shifts. Due to the complex needs of the service users the drug administration round is complicated and this would reduce the responsibility of one nurse completing the medication round, therefore providing safer practice. Through observation of the care team it was evident that all service users were treated with respect and dignity. All care was provided behind closed doors and the appearance of service users was individualised and appropriate to age. Newton House DS0000047637.V263064.R01.S.doc Version 5.0 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): 12 and 13 Service Users are supported by the home to retain links with family and friends. The activities provided meet the social needs of the service users. EVIDENCE: Service users can receive friends and families at any time in the privacy of their own room or in a communal area. The visitors signing in book provided evidence of this taking place. Due to the complex needs and reduced communication with the service user with acquired brain injury the home very much keeps the family involved with any changing needs, health or social. An activities programme is provided however the registered manager is hoping this will also improve in the near future and is currently evaluating the activities provided. All activities are clearly documented. Newton House DS0000047637.V263064.R01.S.doc Version 5.0 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 There is a clear complaints policy and procedure in place. Recruitment procedures need to improve to protect service users from possible abuse, however staff are fully informed of local vulnerable adults procedure. EVIDENCE: The company has a complaints policy and procedure in place, a copy of which was displayed in the front entrance of the home. The CSCI have not received any complaints for this service. A policy regarding protection of vulnerable adults is available and the manager and staff have experience in, and awareness of, procedures regarding abuse. The staff also receives mandatory training in abuse awareness. Recruitment procedures need to be more robust with regard to obtaining CRB check and references. Findings are detailed in the staffing section of this report and three statutory requirements are made relating to this. Newton House DS0000047637.V263064.R01.S.doc Version 5.0 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 provides a homely and comfortable environment for service users to live in which is well maintained. The home is clean and infection control measures are in place. An assisted bath does not fully meet the needs of the service users. EVIDENCE: Newton House is homely and generally well maintained throughout. The furnishings and decor are domestic. The large communal room to the rear of the home is light and comfortable, however maintaining a comfortable temperature during the winter period is an on going problem, which the registered manager is monitoring. The communal room leads to a very well kept garden with a patio, which is suitable for service users. Many of the bedrooms have views across the garden. All of the bedrooms were visited which were all very personalised and homely. The bedrooms vary in size and meet the needs of the service users. Newton House DS0000047637.V263064.R01.S.doc Version 5.0 Page 14 An assisted bathroom on the top floor is not appropriate to meeting the needs of the service user group, as transferring from hoist to the bath is very difficult due to the size of the bathroom and location of the bath. The home was clean throughout with no odours. However only one domestic cleaner is employed for the home, with no support at weekends or holiday periods. Cross infection measures and practices were of a good standard. Newton House DS0000047637.V263064.R01.S.doc Version 5.0 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 29 The staffing levels are appropriate to meeting the care needs of the service user. However the domestic cleaning arrangements do not ensure that the home remains clean and fresh at all times. In some instances, recruitment procedures do not fully protect service users. EVIDENCE: The staffing levels provided are appropriate to meeting the needs of the service users. During the morning when daily care needs are high, two trained nurse are available and four carers. This is reduced to two nurses and two carers during the afternoon period. The staffing rotas provided evidence that a trained nurse is on duty at all times ensuring that nursing needs of the service users are being met. More domestic help is needed. New staff are recruited via the Glenside human resources department and the registered manager do not always have the opportunity to undertake interviews, although they do meet the candidates to show them around the individual units. Recruitment procedures appear non discriminatory. A selection of staff recruitment records for all of the Glenside units was reviewed. In the main appropriate documentation was in place, however in one instance a CRB check had not been obtained for a staff member who had been employed for almost two years and in two other cases, references form previous employers, one of whom had been a care provider, had not been obtained. Should a person with a criminal record be employed, full details of any convictions Newton House DS0000047637.V263064.R01.S.doc Version 5.0 Page 16 should be on file. It is also desirable that written evidence of a risk assessment process, indicating their suitability for employment, be available. Newton House DS0000047637.V263064.R01.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 and 38 The home is well managed by the registered manager. Health and safety issues are fully addressed. EVIDENCE: Mrs Krys Romain the registered manager who has been a registered nurse for many years and has a good understanding and knowledge of the service users complex care needs that she is responsible for at Newton House. The home was organised and well managed during the inspection and service users were observed responding well to Krys Romain. Fire records indicated that all appropriate fire checks were being made and that staff were receiving training. All accidents are recorded and then audited by the central office. The hoists are serviced regularly ensuring the safety of Newton House DS0000047637.V263064.R01.S.doc Version 5.0 Page 18 service users and all electrical equipment is tested annually. The home is generally well maintained and health and safety issues addressed. Newton House DS0000047637.V263064.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 2 X X 3 X 3 STAFFING Standard No Score 27 2 28 X 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X X X 3 Newton House DS0000047637.V263064.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP19OP19 Regulation 23 Requirement The registered persons must monitor the temperature of the lounge area and find a solution to maintain the heat in the lounge to a comfortable temperature so service users are able to use the room all year round The registered persons must up grade the upstairs bathroom to ensure the bathroom meets the needs of the service users. The registered persons must increase the number of domestic staff to ensure cleaning duties are maintained during holiday periods and weekends. The registered person is required to ensure that all staff have undertaken a Criminal Record Bureau check. 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. The registered person is required to ensure that details of any DS0000047637.V263064.R01.S.doc Timescale for action 15/12/05 2 OP21 23 01/01/06 3 OP27 18 01/11/05 4 OP29 19 03/10/05 5 OP29 19 03/10/05 6 OP29 19 03/10/05 Newton House Version 5.0 Page 21 criminal offences of which a staff member has been convicted are recorded. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP9 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. Newton House DS0000047637.V263064.R01.S.doc Version 5.0 Page 22 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.V263064.R01.S.doc Version 5.0 Page 23 - 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!