Inspection on 01/09/05 for Newton Lodge

This inspection was carried out on 1st September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Newton Lodge 29/11/07

Newton Lodge 19/09/06

Newton Lodge 01/02/06

Newton Lodge 09/03/05

Newton Lodge 11/11/04

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Coopers Mill Ltd

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Pemdale

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

CARE HOME ADULTS 18-65 Newton Lodge 50 Olive Road New Costessey Norwich NR5 0AS Lead Inspector Dot Binns Announced 1 September 2005 9.30am 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 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 Lodge I55 S27627 Newton Lodge V242062 010905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Newton Lodge Address 50 Olive Road New Costessey Norwich NR5 0AS 01603 740282 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Care Management Group Limited Position vacant Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Newton Lodge I55 S27627 Newton Lodge V242062 010905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Three (3) people with Learning Disability may be accommodated. Date of last inspection 9 March 2005 Brief Description of the Service: Newton Lodge is a care home providing personal care and accommodation for up to 3 younger adults with a learning disability. The service users may also have a physical disability.Care Management Group Limited whose registered office is located in London owns Newton Lodge.Newton Lodge is located in a residential area of New Costessey and close to the city of Norwich. Local amenities, shops and pubs are also close by.The home consists of an adapted bungalow. All bedrooms offer single occupation and one is below 10 square metres. None of the bedrooms have en-suite facilities. There is ample communal space.There are access issues regarding the garden. On-road parking is available. Newton Lodge I55 S27627 Newton Lodge V242062 010905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine announced inspection lasting 7 hours. Time was spent discussing the requirements of the last inspection with the manager and what had been happening in the Home. Policies and records were examined and a tour of the building was made. Staff on duty were also seen in private. The service users were not able to speak to the inspector because of their disabilities but they were observed for some of the time as they moved around. What the service does well: What has improved since the last inspection? A new manager has been installed who is bringing enthusiasm and determination to the role. She is yet to be registered. One of the bedrooms was seen to have a fire risk because of access through the kitchen. This has now been attended to with a new corridor created making the room far safer. Medication systems and records have improved though still need to be monitored. Newton Lodge I55 S27627 Newton Lodge V242062 010905 Stage 4.doc Version 1.40 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Newton Lodge I55 S27627 Newton Lodge V242062 010905 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Newton Lodge I55 S27627 Newton Lodge V242062 010905 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 The service users needs are properly assessed ensuring that the service users will be properly looked after. EVIDENCE: Full assessments of each service user were on the care records showing the needs and abilities of the service users and what family, hobbies and routines they had. Other professionals were involved in the assessment of need, helping the Home to ensure they had all the information to assist the service users when they moved into the Home. A personal profile was also documented about each person. A care plan was formed on the basis of this information setting out for staff the tasks and assistance each service user needed. Newton Lodge I55 S27627 Newton Lodge V242062 010905 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7 and 9 Care plans are documented reflecting the needs and goals of the service users. This helps the staff to ensure they assist the service users correctly. Service users are assisted to make as many decisions about their lives as possible. However the way finances are handled by the Home is not acceptable nor accountable. Service users are supported to take risks as part of an independent lifestyle but usually need a lot of staff help. These assessments are documented correctly. Newton Lodge I55 S27627 Newton Lodge V242062 010905 Stage 4.doc Version 1.40 Page 10 EVIDENCE: Each service user had a care plan setting out the assistance they needed and the goals to be achieved. It covered a wide range of situations including their health and mobility, personal care, behaviour, recreation and communication. The plan was generated from the assessment document. Staff wrote detailed daily reports showing how they monitored the health and mood of the service user and what activities they did. Any restrictions on choice or activity were noted and the reasons why. Both of the service users accommodated on the day of the inspection need some support to make decisions and rely a lot on staff helping them with information and opportunities. However staff were able to discuss how the service users decided on their own routines and were able to indicate the sort of activity they enjoyed. Wherever possible, staff said they would help the service users make their own decisions and they came to know what they liked and disliked. One staff was seen helping a service user make a choice, explaining very patiently to her what the options were and being guided by the service user’s responses. Both service users need help with managing their own money and the records were examined to see how this was done. A record is kept of the money given to the Home and how this is spent. Receipts were kept and the cash when checked against the records was correct. However there was no financial profile showing where the money was from and what the Home had taken in fees. It was not possible to cross reference money being paid into the bank. Both records were the same. The Home must be more transparent on finances belonging to service users and is currently not meeting the regulation. In addition one of the service user’s money was being placed in a bank account belonging to the company owning the Home. It was not possible to verify whether the service user was receiving the interest on this account and it is expected practice for all service users to have their own accounts. Risk assessments were in the records covering all those areas where safety might be an issue, eg, choking, self medication, going out. Full instructions were in place for staff. Newton Lodge I55 S27627 Newton Lodge V242062 010905 Stage 4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,16 and 17 Service users are not able to work but where possible are in sheltered workshops. Service users participate in the local community and use the local facilities. Service users are offered a range of leisure activities and are offered plenty of stimulation by the Home. Within the limits of their abilities, service users’ rights are protected and staff work hard to make sure their views are listened to and respected. The menus are varied and nutritious and service users enjoy them. Newton Lodge I55 S27627 Newton Lodge V242062 010905 Stage 4.doc Version 1.40 Page 12 EVIDENCE: Service users are not able to be employed but one service user does attend the Adult Training Centre four days a week. The care records showed plenty of outings in the community with shopping, pub visits, and walks out a regular feature of service users’ lives. Transport is provided by the Home and staff said they considered taking the service users out very much part of their work. The rota at weekends and in the evenings showed sufficient staff on duty to allow this to happen as well as during the day. Each service user has an activities programme and the service user who has no outside work placement has a programme of daily activities. As well as the trips to community resources, records showed visits to seaside resorts, Snetterton market, Thetford forest and to friends in other homes. Picnics, visits to Norwich Cathedral and Horsford woods were also mentioned. Overall the Home offered plenty of opportunities for the service users to go out and staff gave this a high priority. Staff were able to give examples where the service users kept to their own routines, for example going to bed. Sometimes one slept late. Service users are not able to go out alone or have their own key but within the limits of their communication, can show that they want to be alone in their room or that they would like to go out. Staff have to help them in the bath but try to give as much privacy as possible. Staff were seen to be interacting well with the service users and had a good understanding of their needs. The Home has a residents charter emphasising the rights of the residents. The menus were seen and appeared to be varied and nutritious. The manager said there were no special diets but that some food supplements were used to prevent one service user losing weight. Newton Lodge I55 S27627 Newton Lodge V242062 010905 Stage 4.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 20 Service users’ health care needs are monitored well and they have good access to medical professionals in the community. Medication is appropriately secured and administered (except for one small error) ensuring service users are protected by the Home’s procedures. EVIDENCE: The records showed plenty of evidence that service users health was monitored. There was evidence of the district nurse visiting and appointments with the GP. The dentist, chiropodist and occupational therapist were also part of the service. On a daily basis staff recorded how well a service user ate or slept and whether they had sustained scratches or had stomach upsets. Behaviour and mood was also noted. Service users are not able to administer their medication themselves and staff take care of this. The medication cupboard was safely locked and the records of administration were in place and correctly completed except for the habit of writing “F” in the box when a tablet was not required. A recommendation has been made about this. Newton Lodge I55 S27627 Newton Lodge V242062 010905 Stage 4.doc Version 1.40 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 A complaints procedure is in place and the philosophy of the Home ensures that service user will be listened to. Service users are protected from abuse by policies and training for staff. EVIDENCE: The complaints procedure was seen in the service users guide in a pictorial form. However service users may still not be able to understand it. However reviews of care and committed staff enable service users to be listened to and their views understood. The Home has procedures for the protection of vulnerable adults from abuse and both staff confirmed they had received training on abuse and would know what to do if it was suspected. Newton Lodge I55 S27627 Newton Lodge V242062 010905 Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,26,27,28 and 30 The home is comfortable, homely and safe except for the garden which should be ramped to make it more accessible for the service users. Bedrooms are comfortable and made personal to the service users. The bathroom of the house is adapted with a hoist to make it suitable for the service users but a thermostat on the bath is required to make it safer. The sitting room is comfortable but could do with a coat of paint. Newton Lodge I55 S27627 Newton Lodge V242062 010905 Stage 4.doc Version 1.40 Page 16 EVIDENCE: The Home is a residential bungalow with three bedrooms and is homely and comfortable. Recent alterations to the building have been carried out on the advice of the fire officer to make one of the bedrooms safer. The fire officer is still to make his final visit before a new service user will be accommodated. The Home is equipped with facilities to ensure the service users can be looked after properly except for the garden which is tiered and therefore inaccessible to the service users. A requirement has been made about this. Bedrooms though on the small size are comfortable and made suitable for the service users. For example one service user can hurt easily and her bedroom has foam supports to allow more comfort. One person has a special bed. There are no armchairs in the bedrooms as service users would be unable to support themselves and only sit with staff in the sitting room. Carpets and furnishing are satisfactory. The bedrooms have been made individual with personal possessions. There is one bathroom in the house with a hoist chair in the bath. All service users need help in the bath and could not use a shower. There is no thermostat on the bath to control water temperature and this should be attended to. There is one living room with a through dining area. The paintwork is a bit shabby but the furniture is satisfactory. The radiators do not have covers and give no protection to service users against burns should they fall against them. These need to be attended to. There is a television in the sitting room and service users can also listen to their music in here. The Home was clean with no offensive odours. The laundry is done on the premises and there are facilities for laundry to be washed at appropriate temperatures. Newton Lodge I55 S27627 Newton Lodge V242062 010905 Stage 4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33,34 35 and 36 Recruitment processes have not been rigorous enough but a new manager is improving the process to ensure that service users are protected. Training needs to be more consistent and documented to show what the Home is offering to staff. More opportunities for outside courses should be offered. Staff are committed and enthusiastic about their work giving a good service to the users though more permanent staff should be recruited to bring consistency to the service. Newton Lodge I55 S27627 Newton Lodge V242062 010905 Stage 4.doc Version 1.40 Page 18 EVIDENCE: Staff recruitment files showed that whilst some checks were made and references were completed, application forms were not scrutinised as they could have been. Issues raised in references were not shown to have been discussed with the applicant in interview. In one file an up to date criminal record check was only obtained well after the applicant had started work. It is acknowledged that these discrepancies did not happen recently and the current manager is employing more rigorous standards. The Commission expects improvement in this area with any new recruits. There was evidence in the files, and staff confirmed, that induction training took place. Topics such as moving and handling and food hygiene were covered. However one file showed that the induction had been covered very quickly all in one day with no other evidence of instruction. The manager and staff confirmed they did receive instruction and shadowed an experienced member but this had not been documented. A more comprehensive induction system should be considered. In addition, there were no certificates of attendance on a moving and handling course in the staff files though the manager said they were up to date. Clearly better documentation is required. None of the staff in this Home have completed or are studying for their NVQ. The Home is failing the standard in this respect. Despite the lack of cohesion on the training side, staff seen were very committed to the service users and demonstrated a very good understanding of their needs and the philosophy of the Home. They could describe in detail what each service user needed and liked and how to assist them. They were enthusiastic about their work and wanted to offer the best service to the users. They thought communication was improving but thought more staff meetings would help them all. This has been recommended. In terms of staff cover, there are always two staff on duty to give support to service users who often need one to one attention. This cover was in place at the inspection and the rota showed this to be the norm. However the Home has had to use a number of agency staff on a regular basis in order to fill vacancies. Newton Lodge I55 S27627 Newton Lodge V242062 010905 Stage 4.doc Version 1.40 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 and 42 There are components for a quality assurance system in place which can give confidence that the views of service users will be taken into account. However some refinements to the system are recommended. Health and safety policies and procedures are in place to ensure that the Home is safe for both service users and staff. The exception to this is the water temperature of the bath is not controlled. Newton Lodge I55 S27627 Newton Lodge V242062 010905 Stage 4.doc Version 1.40 Page 20 EVIDENCE: A quality assurance system was seen to be in place with annual questionnaires for service users, relatives and visitors to the Home. A residents charter is in place. A detailed policy was seen on quality assurance though the standards by which quality will be judged could be clearer, for example, looking at the number of complaints, staff supervision etc. as well as analysing the views of the responses to the surveys. The health and safety of service users and staff are promoted by policies and procedures in the Home. The fire system is inspected regularly and a risk assessment for the building was seen. Staff receive fire training. Recent requirements by the fire officer have been put in place. Gas and electrical safety is tested and the accident record was in place. Staff sign a form to show they have understood the policies. There is no thermostat on the bath to control the temperature of the water and this could pose a risk. The Home has been asked to attend to this. Newton Lodge I55 S27627 Newton Lodge V242062 010905 Stage 4.doc Version 1.40 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 1 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x 3 3 x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 x 3 3 Standard No 31 32 33 34 35 36 Score x 2 2 2 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Newton Lodge Score x 3 2 x Standard No 37 38 39 40 41 42 43 Score x x 2 x x 2 x I55 S27627 Newton Lodge V242062 010905 Stage 4.doc Version 1.40 Page 22 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard 7 7 Regulation 17 schedule 4 17 schedule 4 23(2)(o) Requirement Timescale for action 31.10.05 3. 24 4. 42 13(4) A record must be maintained on any money deposited or held or spent on behalf of a service user. The service users should have 31.10.05 their own bank accounts and their money should not be placed in the account of the organisation. The external grounds of the 31.3.06 Home must be made suitable and safe for use by the service users and properly maintained. A thermostat should be installed 31.12.05 in the bath to protect the health and safety of the service users. 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. 3. 4. Refer to Standard 39 28 33 34 Good Practice Recommendations It is recommended that a uniform procedure is devised for when medication is not required to avoid confusion. It is recommended that the sitting room is redecorated. It is recommended that regular staff meetings are held to ensure staff have a voice. Recruitment procedures are being tightened by the new I55 S27627 Newton Lodge V242062 010905 Stage 4.doc Version 1.40 Page 23 Newton Lodge 5. 6. 35 39 manager but it is recommended that all files are checked and brought up to date. It is recommended that the induction training and shadowing is documented in a cohesive way to show all the elements in it. It is recommended that stardards are developed as part of the quality assurance system so that quality can be easily measured. Newton Lodge I55 S27627 Newton Lodge V242062 010905 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection 3rd Floor, Cavell House St Crispins Road Norwich NR3 1YF 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 Lodge I55 S27627 Newton Lodge V242062 010905 Stage 4.doc Version 1.40 Page 25 - 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. 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