Inspection on 09/11/06 for Newton House EPH

This inspection was carried out on 9th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 EPH 21/08/07

Newton House EPH 08/01/06

Newton House EPH 19/07/05

Newton House EPH 27/01/05

Newton House EPH 15/06/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Newton House EPH Earlstone Crescent Cadbury Heath South Glos BS30 8AA Lead Inspector Grace Agu Key Unannounced Inspection 9th November 2006 09:30 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 EPH DS0000035424.V313796.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. 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 EPH DS0000035424.V313796.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Newton House EPH Address Earlstone Crescent Cadbury Heath South Glos BS30 8AA 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) 01454 866281 01454 866282 South Gloucestershire Council Mrs Lynne Elizabeth Smith Care Home 37 Category(ies) of Old age, not falling within any other category registration, with number (37) of places Newton House EPH DS0000035424.V313796.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Mrs Smith to complete NVQ (National Vocational Qualification) training at Level 4 In Care & Management by 2005 May accommodate 37 people aged 65 years and over requiring personal care. The bathroom is not to be used until the work has been fully completed and the CSCI notified of its completion. 8th January 2006 Date of last inspection Brief Description of the Service: Newton House is a purpose built home that is operated by South Gloucestershire Council and is registered to provide personal care and accommodation for up to 37 Service users aged 65 or over. The home is located in Cadbury Heath on the outskirts of Bristol. There are shops, community facilities and local bus routes nearby. Accommodation is provided on two levels and residents have the choice of stairs or passenger lift to the first floor. All rooms are single occupancy. Two rooms are designated for service users to receive respite care. Each room has a wash hand basin. One room has an en-suite bathroom. Communal/shared spaces comprise of three main lounges, a visitors lounge, smoking room, large dining room, activities rooms, visitors lounge, and hairdressing room. The grounds and gardens are well maintained and are fully accessible to service users. All exits have ramps and handrails. Fees range from £490 per week. Newton House EPH DS0000035424.V313796.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place over nine hours to review the requirements made at the last inspection and also to review the care practice to ensure that it is in line with the legislation and that best practice is followed at the home. At the last inspection three requirements were made. It was pleasing to note that the home had made considerable effort to ensure that the all of the requirements had been met. Action was taken in relation to one of the medication discrepancies noted on the day of inspection before the inspection was completed. The inspection also followed up Regulation 37 Notifications sent to the Commission for Social Care Inspection by the home in relation to incidents of attempted break-in. The incidences were reported to the police and action had been taken by the provider to prevent further occurrence. A concern raised by a relative about an individual’s care and subsequent complaint to the providers was also reviewed. Full details of the above can be found in the body of the report. A tour of the building was undertaken and a number of records were reviewed. Nine residents, four staff members and one relative were spoken with during the inspection. What the service does well: Generally the home was found clean, warm and free from unpleasant odour. Staff were noted working as a team and interacting with residents in a positive, dignified and sensitive manner, residents were found to be relaxed and looked well cared for in there homely environment. Newton House EPH DS0000035424.V313796.R01.S.doc Version 5.2 Page 6 A Statement of Purpose that has the information on the ranges of needs that the home intended to meet, the admission criteria and information about dealing with complaints was in place at the home. The home has a Service Users’ Guide with information about the home; aims and objectives, management and staff to enable the prospective service user to make an informed choice of moving into the home. The home has a statement of terms and conditions to include, occupancy, period of notice and fees to be paid. There is a satisfactory care planning system that is person centred and specifies how identified needs were being met. The care plans were regularly reviewed. . Good and nutritious meals are provided for service users in a relaxed atmosphere and not hurried, resident who are not able to feed themselves are fed in a sensitive and dignified manner. Relevant training courses are provided for staff to enable them to meet the needs of the service users. Aids and equipment are provided to assist staff with meeting the needs of the service users. The home has an effective communication system that enables staff and supporting services to deal with the challenging needs of residents within and outside the home. What has improved since the last inspection? What they could do better: To ensure that care needs of identified residents are met it would be better to Newton House EPH DS0000035424.V313796.R01.S.doc Version 5.2 Page 7 Provide appropriate care plans for identified needs and to provide adequate protection, risk assessment must be undertaken following falls to identified residents. At this inspection evidence from residents’ comments on the day, feedback from the survey and observation showed that insufficient activities are provided at the home. The Manager must address this concern to enable the residents to remain stimulated whilst living in a care home and eliminate the feeling of boredom A resident would be better cared for if care plan is drawn up for specific need and the resident’s dietary needs will be adequately met if the individual is referred to an appropriate professional. It would be better if resident are provided with a choice of meals and specifically at lunch time to enable them to chose what they would like to eat. All medication administered must be signed for, all medication not administered must be properly recorded to prevent drug errors and to protect the residents. Further more all hand written medication must be signed and dated. Residents will be better protected if the label on the controlled drug packet form the supplying pharmacy corresponds with the Medication Administration Record Sheet (MARS). Whilst reviewing the medication, it was noted that the Controlled drugs were being recorded in loose leafs of paper. It was recommended that this practice be reviewed to record the Controlled drugs in a bound book to ensure that vital information is not missed out. 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 Newton House EPH DS0000035424.V313796.R01.S.doc Version 5.2 Page 8 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Newton House EPH DS0000035424.V313796.R01.S.doc Version 5.2 Page 9 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 EPH DS0000035424.V313796.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents and their families receive information about the home The home ensures that residents are assessed before admission to and are assured that ensure that their needs will be met. Terms and Conditions of their stay are also provided. EVIDENCE: Newton House EPH DS0000035424.V313796.R01.S.doc Version 5.2 Page 11 The home’s Statement of Purpose and Service Users Guide have been recently reviewed to include the name of the new manager and other relevant information as required by the regulations. These documents are readily available to prospective residents and their representatives when they visit or make enquiries to enable them to make an informed choice about moving to the Home. Discussion with two residents evidenced that they were assessed before admission to the home to ensure that the home is able to meet their needs. One resident confirmed that their relative visited the home before they were admitted. The individual is aware of one -month trial period to enable them to make a decision to stay at the home permanently. The acting home manager stated that terms and conditions of their stay are usually issued after one -month trial and the resident or their relatives confirm permanent stay. Staff spoken with demonstrated understanding of the needs of the resident. Newton House EPH DS0000035424.V313796.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents’ needs are assessed; Doctors and other health professionals are involved in their care, however the home fails to protect the residents through lack of risk assessments following frequent falls and unsatisfactory drug administration practices. EVIDENCE: Three care files were reviewed following high numbers of falls at the home. All the care files seen contained detailed assessment of needs and care plans were in place to support staff in meeting those needs. However it was noted that there were no detailed risk assessments following frequent fall in two of the care files reviewed. Newton House EPH DS0000035424.V313796.R01.S.doc Version 5.2 Page 13 It was also noted that another resident with poor nutrition and identified weight loss who was seen by the General Practitioner (GP) had no care plan on how the need was being met. Whilst there was evidence that the weight was being monitored, and there was evidence that the individual was still loosing weight, and it was recognised that the person had swallowing problems, there was no evidence of referral to the other appropriate health professionals(dietician and speech and language therapist) for further management. The individuals relative contacted the Commission, to raise concern about the person and stated that they were aware and concerned about the weight loss and had raised concerns with the management of the home. The council is currently looking into this as apart of complaint. The other care plans were relevant to the assessed needs and were backed up with a range of assessments. The daily report seen on those care files were detailed and contained information of care provided. There was no evidence that the care plans were developed with the residents and or the representatives to ensure that the needs are adequately met. The inspector was concerned about the numbers of recorded accidents to residents over a period of three months before the inspection. The incidences were discussed with the manager who stated and there was evidence that two of the residents had been discharged to a more appropriate setting. It was note that one resident had no risk assessment following six falls between 04/04/06 and 18/04/06. At a discussion, the acting manager stated that the Falls Advisor had visited to talk to staff about falls prevention and how to reassess residents following falls. The acting manager also stated that residents are encouraged to use the call bells to summon assistance in order to minimise falls. In regard to how residents perceive their care at the home, one resident stated, “ I like it here, staff are wonderful and friendly they look after us well. We have a cup of tea at 7am and I have a wash and dress myself. Some days I get up early some days I don’t, it depends on how I feel”. Another resident states, “staff are very good, I get up at 6am and when I feel like. I wash and dress and make my bed. I only ring the bed when it is necessary because I am an independent person and staff respect that” At a discussion with a resident met in the room, the resident stated, “staff are very kind, I am registered blind and staff help me”. However, the concerns raised by the individual in relation to needing more assistance with meeting the individual’s personal care needs were discussed with the manager and Newton House EPH DS0000035424.V313796.R01.S.doc Version 5.2 Page 14 another senior staff member. The Acting manager would meet with the individual to review the care plan in relation to personal care needs. One resident stated staff “respect me and always make sure that the door is closed when I am bathing or using the toilet”. Staff were noted knocking on the doors before going in to the residents rooms to assist them with personal care. Residents are empowered to make choices about their personal care through the key working system however one resident states “my key worker is lovely but only part time, there is nobody when the person is on holiday” The care files viewed had evidence of visits from the health professionals to include General Practitioners (GP) Chiropodists, Opticians and Dentists. The procedure for the administration, storage and disposal of medication was reviewed and was noted to be unsatisfactory. It was disappointing to note whilst reviewing medication that dosage on the medicine box of an individual’s Controlled Drug was different from the printed copy of the Medication Administration Record Sheet from the supplying pharmacist The Acting Manager stated that the doctor had recently reviewed the resident’s medication, however the new dose had not been changed. This practice puts the resident at risk of drug error. It was agreed that that the home contact the supplying pharmacy to reflect the changes in order to protect the resident. Furthermore, whilst it was noted that the Controlled drug had a correct balance and was administered by two staff members, it was recorded in loose leafs of papers. The Acting Manager stated that the home would record the Controlled drugs in the bound book to prevent the risk of loosing information if the loose leafs were lost or destroyed It was also noted that a resident’s hand written medication was not signed or dated. Furthermore, whilst the balance of a night medication for an individual was correct, it was not recorded as given on 6 November. Notification received by the Commission in relation to drug error to a resident on 24/08/06 was reviewed. The deputy manager provided evidence of the measures put in place to prevent reoccurrence. Response including action to be taken to remedy the discrepancies noted was received at the Commission For Social Care Inspection within the time-scale agreed. Newton House EPH DS0000035424.V313796.R01.S.doc Version 5.2 Page 15 One Staff member spoken with was aware of measures to be taken if a resident became terminally ill and in the event of death. The staff also demonstrated awareness of the importance of ensuring that information about residents is kept confidential. Newton House EPH DS0000035424.V313796.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are enabled to maintain links with their families. Whilst residents are provided nutritious meals, it lacked choice at lunch times. Meaningful activities for the residents must improve. EVIDENCE: On the day of inspection residents were noted relaxing in the lounge and enjoying the company of each other, some residents were noted sitting in their bedrooms other residents were also observed accessing different areas of the home without restriction. At a discussion with some of the residents met in the lounge, both stated that they are happy at the home; they get up when they wanted to and retire to bed when they wanted to and that staff treated them with respect. Newton House EPH DS0000035424.V313796.R01.S.doc Version 5.2 Page 17 The Acting manager stated that there are no planned activities however carers are rotered to do activities with the residents. Activities noted in the book include, 27/04/06 five residents went on trip to Cotswold Wild Life Park; 3/05/06 Coffee morning for all residents; 30/9/06 reminiscence evening; 3/10/06 Pass the parcel. The manager stated that the planned activities for the residents this autumn include a trip to look at the Christmas light, Christmas party and carol singers and entertainers. Review of the care files evidenced that the home operates a key working system and the key workers encourage residents to participate in activities provided and ensure that these are recorded in a section of the care file. One resident spoken with stated, “I like knitting to send abroad to disadvantaged children I am quite content another resident stated I went out on a trip and it was very enjoyable. However, the general feeling of the residents on the day was different. A sample of the residents’ opinion regarding activities was that the home provided them with little or no meaningful activities. One resident stated, “ We did keep-fit on Tuesdays and some one came from outside for entertainment but not anymore. We used to have craft but not anymore. It used to be a good atmosphere here, but things have changed. Why can’t we have what we have before, is it the management or that carers have no time”? Another resident stated “No activities, during the day”. Compilation of the evidence from the residents survey in relation to activities showed that four of four surveys received stated the there are no activities in the home. One anonymous comment card received before the inspection states: “I have been a visitor at Newton House for so many years. I can see how things have changed especially in the last two years. The décor and the furniture have improved but the lack of staff is the main issue. The residents have no activities, there used to be Bingo, exercises, coffee mornings etc. now all they do is to go to the dinning room for meals. Apart from relatives visiting or perhaps taking them our occasionally there is no stimulation”. It was also disappointing to note that on the day residents were noted sitting in the lounges and some in their rooms with little or no activities to stimulate them. This was discussed with the manager at feedback and a requirement was made for the home to develop a more structured activities programme after Newton House EPH DS0000035424.V313796.R01.S.doc Version 5.2 Page 18 consultation with the residents to ensure that the feeling of boredom expressed by the residents is eliminated. The visitors’ book showed that the relatives and representatives regularly visit the residents. Residents spoken with stated that they had regular visitors. One resident stated, “My daughter comes from time to time. I have a telephone in my room so we can talk whenever we like.” Two residents met in the lounge stated, “ Our families come to see us”. One relative met on the day stated that they visit the home every other day and that they are made welcome. The lunch on the day looked nutritious and balanced and the residents spoken with stated that they enjoyed their meal. However the menu displayed on the wall in the dining and kitchen area had no choice of meal for lunch. The home is required to provide varied meals for the residents and ensure they are encouraged to make their preferences in the menu It was noted that a different meal was provided to a resident with swallowing problem, this indicates that the home ensures that residents are nutritionally assessed to ensure that their needs are met. There was also vegetarian meal to meet a resident’s need. The kitchen was found clean and staff have attended basic food hygiene to ensure that the residents are adequately protected. A risk assessment was in place to protect staff, residents and visitors. Fridge and freezer temperatures were recorded. Newton House EPH DS0000035424.V313796.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17,18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are enabled to complain and are confident that their complaint will be listened to. Practices at the Home ensure protection of resident from harm and abuse EVIDENCE: The Home has appropriate and robust procedures in place for management of complaints. The complaints procedure was noted displayed in the hallway at the entrance. This document contains information about the Commission for Social Care Inspection to enable individuals to contact the Commission if they were not satisfied with the outcome of their complaint to the organisation. This inspection was also undertaken in relation to a phone call received from a concerned relative about his/her mother’s care. The complaint was being investigated by the council who would inform the Commission for Social Care Inspection of the outcome of the investigation. The complainant was contacted on the phone and the individual confirmed that they are satisfied with the way the complaint was handled and that significant changes had occurred following the meeting with the management. Newton House EPH DS0000035424.V313796.R01.S.doc Version 5.2 Page 20 The acting manager stated that the Council is awaiting response from the complainant following the outcome of the complaint. Other recorded complaints were satisfactorily investigated and the outcome was fully recorded. Residents spoken with and responses noted on the comment cards evidenced that residents are aware who to complain to. One resident stated, “I know where to go if I have any reason to complain my daughter would take it further if I don’t get any joy from my complaint to the council”. The acting manager stated that new residents/ families are given a welcome pack with information about the home including the complaints procedure One resident stated that they are aware of their rights and were enabled to vote using the postal voting system. Staff are aware of the Whistle Blowing policy and would report any bad practices to the Manager without fear of reprisal. There is evidence of staff training in relation to Protection of Vulnerable Adults from Abuse. There is a copy of the South Gloucestershire Council policy on The Protection of Vulnerable Adults from Abuse at the Home to ensure that the Home is aware of the protocol to be followed if incidences of abuse occur. Newton House EPH DS0000035424.V313796.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,2122,23,24,25,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents enjoy a clean, hygiene and pleasant atmosphere; the home provides them with safe and well-maintained environment. EVIDENCE: The Home is purpose built and provides good accommodation for the residents. The residents were found to be relaxed in their homely environment. There have been no changes in the services and facilities provided at the home since the previous inspection. Newton House EPH DS0000035424.V313796.R01.S.doc Version 5.2 Page 22 The location and layout of the home is suitable for its intended purpose. The home is a large detached building with accommodation set over two levels with lift access to the first floor, The inspector did a tour of the home and viewed lounge and dining areas, bathroom, toilets and three bedrooms. The home is well maintained. The tour of the premises also found that all communal areas of the home were clean, tidy and odour free. The home has an array of comfortable spaces for shared use, residents were seen relaxing and making use of these areas. All bedrooms viewed, were personalised and colour co-ordinated. Each bedroom had small items such as pictures, photographs and other personal items to remind them of past memories. Toilets and bathrooms have hand and grab rails and manual handling equipment to assist with the mobility of service users. The communal areas were noted well furnished and attractively decorated and meet the needs of the current residents. Residents spoken with stated that they liked their rooms. One resident stated that she/he felt safe at the home. The laundry was noted to be clean with good flooring and ventilation. The washing machines have sluicing programme to ensure that a good infection control is maintained. The Home has Control of Substances Hazardous to Health Policy. The maintenance book was up to date. The work to be done is clearly written in the maintenance book, and the contractors come in and do the repairs. Date completed and any relevant comment in relation outstanding jobs is also documented. Newton House EPH DS0000035424.V313796.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are provided with sufficient numbers of staff to meet their needs, adequate training is also provided to staff to protect the residents. EVIDENCE: On the day of the inspection there were thirty-one residents at the Home. Evidence from the staff rota and discussion with the Acting manager showed that the home has a sufficient staffing level to meet the needs of the residents. In addition to the care staff, the Home also employs, an administrator, domestic and laundry staff and a handy man. Residents spoken with stated that staff attended to them promptly when they rang the bell and provided time for them to talk. However a cross section of the residents’ staff and one comment card received from a relative would prefer a higher staffing level. Newton House EPH DS0000035424.V313796.R01.S.doc Version 5.2 Page 24 The Home operates a key working system to enhance the resident/staff relationship. Staff training records showed that the home invests in the training of its staff to ensure that staff are aware of their roles and responsibilities and that a high standard of care is maintained. Records of training attended include on manual handling, fire updates, dementia awareness and other relevant courses. Evidence also showed that four care staff have achieved National Vocational Qualification (NVQ) at level 2. The inspector was unable to view staff files due to unavailability of the cabinet keys. However the Acting manager stated that appropriate recruitment procedure was followed, before the most recent staff member was employed. Last inspection report evidenced that recruitment procedure was satisfactory. The Acting manager stated that application forms, references and Criminal Record Bureau disclosures are stored at the Head Office. Records also showed that new staff have received in- dept induction training prior to attending to residents’ personal care independently. Newton House EPH DS0000035424.V313796.R01.S.doc Version 5.2 Page 25 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, 37,38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is well managed; however must be protected through appropriate risk assessments. EVIDENCE: Ms Lynne Smith is the registered manager of Newton House, however, currently acting manager at Alexandra Way another home owned by South Gloucestershire Council following the departure of the previous manager. Newton House EPH DS0000035424.V313796.R01.S.doc Version 5.2 Page 26 The council has not informed the Commission that Ms smith will not be returning to Newton House. On the day of inspection, there was evidence of a friendly and interactive atmosphere in the home. Residents looked well cared for and staff were noted interacting with the residents in informal dignified and respectful manner. The Acting manager and two senior staff members met on the day showed satisfactory leadership qualities and assisted professionally with the smooth running of the home and the inspection process. Staff spoken with stated that they work as a team and that the Acting manager and the senior management team enable them to provide quality care and to support the residents. Another staff stated that the absence of the registered manager has brought instability to the home however, the acting manager is good and that he is approachable and would listen to any concern raised. Residents spoken with made positive comments about the Acting manager. One resident states ”Martin is good, he always comes round to talk to us”. A group of residents met in the lounge stated, “Martin is alright, nice and approachable”. Staff supervision record was reviewed. Evidence from the records viewed showed that staff has received supervision. Staff spoken with confirmed that they have received supervision and that they benefited from the exercise The fire log book was noted to be up to date. Staff have attended fire awareness training and regulare fire drills. Generic risk assessments of different areas of the home were noted in place. Other health and safety checks as well as the maintainace book were up to date. Regulation 37 received at the Commission in relation to attempted break-in and staff stoten car was reviewed. The above incidences were reported to the police. The acting manager stated that the following strategies have been put in place following the incidences. They included increased security in the evenings, from 5pm windows are closed and locked in consultation with the residents; all managers check that windows and doors are securely locked before going off duty; night staff have a comminicating devise on their person to alert each other if anything happens; all entrance doors are alarmed to alert staff of any intruders; Police patrol the area at random. Newton House EPH DS0000035424.V313796.R01.S.doc Version 5.2 Page 27 Accident book showed a high recorded number of accidents to four individuals between May and August 2006. One individual had three recorded falls . The individual had a care plan in relation to poor mobility, the other residents had one recorded fall each. There was no risk assessment noted in the files to minimise the accidents to these residents. The manager stated that the high number of accidents was due to increasing frailty of the residents and that the home enables the the residents to be as mobile as practically possible. The home would raise staff awareness in relation to accidents and would liase with the doctors and other relevant health professionals to find a balance between maintaing independence and providing care intervention. The home was visited by a falls advisor to support staff in developing appropriate risk assessments and strategies that would help to minimise falls to residents. It was agreed that there must be a risk assessment in place for the residents and that this must be regularly reviewed following the falls. A requirement was made to ensure that this happens in order to protect the residents At a discussion to assess how the home monitors the quality of its services, the inspector was informed that the Council has an independent assessor that gather information through questionnaires from residents, relatives health professionals and visitors about how they rate the services provided. The format had been changed and a new format is being expected. Feedback from last year’s survey was good. Other ways used to audit the service include the provider’s monthly visits, reviewing the Care plans monthly. Staff meetings and resident/ relative meetings provide a forum for discussion in relation to service improvement. Issues discussed include documentation, use of agency staff and sick leave. The management of the home meets after the general staff meeting to discuss the issues highlighted and to draw up an action plan on how to address them. The Acting manager stated that the home has excellent compliments from GPs, district nurses, relatives and volunteers. There is also low staff turnover a high occupancy level and there was always good feed back from the residents and relatives after a trial period. Other methods used to audit the quality of its services include care plan reviews, resident and staff meetings. Newton House EPH DS0000035424.V313796.R01.S.doc Version 5.2 Page 28 The home has policies and procedures to include recruitment and employment, supervision, restraint and Protection of Vulnerable Adults from Abuse. The residents’ money reviewed was satisfactory. The administrator explained that the money in the safe is checked every week and that receipts are obtained and are recorded for every item purchased. The amount recorded in the book corresponded with the amount found in the safe. Other residents’ information was noted securely locked away. Newton House EPH DS0000035424.V313796.R01.S.doc Version 5.2 Page 29 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 3 3 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 3 2 Newton House EPH DS0000035424.V313796.R01.S.doc Version 5.2 Page 30 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 Requirement Ensure that residents care/service delivery plans accurately reflect each residents needs and how they are to be met. Ensure that all handwritten medication are signed and dated. Furthermore the label on all medication boxes must correspond with the printed copy of the Medication Administration Record Sheet (MARS). Risk assessments must be undertaken following falls. Provide residents with meaningful activities after consultation. Provide residents with a choice of meals. Timescale for action 01/12/06 2 OP9 13 22/11/06 3 4 5 OP38 OP12 OP15 13 16 16 22/11/06 07/01/07 07/01/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Newton House EPH DS0000035424.V313796.R01.S.doc Version 5.2 Page 31 No. 1. Refer to Standard OP9 Good Practice Recommendations It is recommended that all Controlled drugs be recorded in a bound book Newton House EPH DS0000035424.V313796.R01.S.doc Version 5.2 Page 32 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 EPH DS0000035424.V313796.R01.S.doc Version 5.2 Page 33 - 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!