Inspection on 21/10/09 for Newton Lodge

This inspection was carried out on 21st October 2009.

CQC found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Newton Lodge 06/11/08

Newton Lodge 31/10/07

Newton Lodge 28/06/07

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 17/02/2010.

Key inspection report Care homes for older people Name: Address: Newton Lodge 139 Berrow Road Burnham-on-Sea Somerset TA8 2PN     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Jane Poole     Date: 2 3 1 0 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 25 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Newton Lodge 139 Berrow Road Burnham-on-Sea Somerset TA8 2PN 01278787321 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: C & K Homes Limited care home 12 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 12. The registered person may provide the following category of service only: Care Home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (Code OP) Date of last inspection Brief description of the care home Newton Lodge is registered with the Care Quality Commission to provide care for up to 12 people over the age of 65. The house itself is extremely homely; all areas are well decorated and furnished to provide a comfortable environment. Accommodation is set over two floors and there is a stair lift between. All bedrooms are currently used for single occupancy. The home is owned by C & K Homes and the registered manager is Diane Taylor-House. 0 6 1 1 2 0 0 8 0 Over 65 12 Care Homes for Older People Page 4 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. The focus of this inspection visit was to inspect relevant key standards under the Commissions Inspecting for Better Lives 2 framework. This focuses on outcomes for people and measures the quality of the service under four general headings. These are:- excellent, good, adequate and poor. This inspection was carried out over two days as the manager was not at the home on the first day and therefore some records required were not available. At the time of this inspection there were 3 people living at the home. As part of this inspection We, The Commission were able to meet with everyone living Care Homes for Older People Page 5 of 25 at the home, observe care practices, talk with the staff member on duty, tour the building and view records. Prior to the inspection the manager completed an Annual Quality Assurance Assessment (AQAA) and some of the information provided has been used in this report. Care Homes for Older People Page 6 of 25 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Older People Page 7 of 25 following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has an admissions procedure in place. Intermediate care is not provided. Evidence: No new people have moved to the home since the last inspection. The AQAA states that prior to admitting anyone the home provide a comprehensive package of information and carry out a thorough assessment of the persons needs. Care Homes for Older People Page 10 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans give clear information to ensure that people are supported in their chosen manner. Privacy and dignity is respected. Medication practices need to be improved to ensure that they are safe and promote good practice. Evidence: At the time of this inspection the manager was in the process of up dating the care plans so only one was available for inspection. The care plan seen was extremely comprehensive and gave information about personal preferences as well as needs. The care plan was well written and gave clear guidelines for staff to ensure that the person received support in their chosen manner. It covered areas such as personal care, communication, mobility, eating and drinking, activities and interests and psychological and behavioural needs. Care Homes for Older People Page 11 of 25 Evidence: A requirement of the last inspection was to ensure that people living at the home had night time care plans and personal risk assessments. These have been completed. There is evidence that physical health is monitored and people have access to professionals outside the home including GPs, chiropodists, dentists and opticians. People spoken with said that staff assisted them to attend appointments. Care plans do not clearly record when people have been seen by medical professionals or the outcome of any appointments. One person had requested a change of doctor and the home respected their decision and supported them to make this change. People are able to spend time in communal areas or in the privacy of their personal rooms. Staff were observed knocking on doors before entering and it was noted that people received their post unopened. A flashing light has been installed for one person, who is hard of hearing, to alert them to the fact that someone is at the door. To further promote privacy and dignity the home is in the process of installing additional en-suite facilities. The home uses a Monitored Dosage System for medication and all staff have received basic training in this area from the dispensing pharmacist. Since the last inspection the home has purchased new metal cabinets for drugs, these are in a locked office but are not secured to the wall and could easily been removed. The care plan seen gave clear details of when as required medication should be administered. Medication Administration Records were viewed these showed that medication is checked and signed in when it enters the home and is signed for when administered or refused. It was noted that one medication had been delivered to the home at the wrong dosage and had not been administered. Although contact had been made with the pharmacist this medication had not been replaced and therefore the person had not received it for almost a month. One medication was prescribed as a variable dose ie take one or two and staff had not recorded how many tablets had been administered therefore making it difficult to monitor its effectiveness. Hand written entries on the administration records had not been signed and witnessed in line with good practice guidelines. Care Homes for Older People Page 12 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Activities are arranged in line with peoples interests and hobbies. Visitors are welcome at any time. Evidence: People living at the home are able to make choices about their day to day routines. There are no set times to get up or go to bed and people are able to choose how they spend their time. Due to the small number of people living at the home, currently only 3, there is no set activities programme. The care plan seen gave details about the persons interests and hobbies and staff stated that they try to provide activities on an individual basis in line with peoples interests. There is usually only one member of staff on duty but additional staffing is made available to support people to go out. One person said that staff take them shopping regularly, another person goes out to watch football each week. People asked were happy with the level of activity provided. Care Homes for Older People Page 13 of 25 Evidence: People stated that they were able to have visitors at any time and were able to use the home phone to keep in touch with friends and family. The AQAA states that visitors are able to have meals in the home if they wish. The main meal of the day is at lunch time and is cooked by care staff, there is a lighter meal at tea time and snacks available during the evening. Each week a menu is drawn up taking account of the likes and dislikes of the people living at the home. People asked said that they were able to ask for something different if they did not want what was on the menu. People said that the food was pretty good and alright. Everyone said that they received plenty to eat and were always able to have hot and cold drinks. Care Homes for Older People Page 14 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home are comfortable to raise concerns with the manager or a member of staff. The complaints procedure and whistle blowing policy should have up to date contact details for the Care Quality Commission to ensure that people can easily access this information. Evidence: The home has policies and procedures in respect of making a complaint, recognising and reporting abuse and whistle blowing. The complaints procedure does not have up to date contact details for the Care Quality Commission and the whistle blowing policy has contact details for the Public Disclosure at work office rather than the Commission. There have been no complaints since the last inspection but people asked said that they would be comfortable to speak to the manager or a member of staff if they had any concerns. Some staff have received training on the protection of vulnerable adults as part of their National Vocational Qualification and others have watched a video on the subject to ensure that they are familiar with signs and symptoms of abuse. Care Homes for Older People Page 15 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Newton lodge provides a comfortable home which will be enhanced by the major refurbishment that is taking place. Evidence: Newton Lodge is an older style building that has been extended to provide accommodation on two floors. There is a stair lift in place to give access to the first floor. All areas are fitted with a fire detection and call bell system. Communal areas are located on the ground floor and are accessible to people with all levels of mobility. There is a large lounge/diner and small conservatory, both are comfortably furnished and homely. There are pleasant gardens at the front of the house. Bedrooms are currently used for single occupancy and people are able to furnish them according to their tastes and needs. The washing machine and tumble drier have been moved out of the laundry and are now located in a very small room with limited storage and no hand washing facilities. Care Homes for Older People Page 16 of 25 Evidence: The present owners are in the process of complete refurbishment. Downstairs bedrooms are being fitted with en suite bathrooms and a new bathroom has been created on the ground floor. Patio doors have been installed in the lounge/diner and a new garden area is being created. The entrance hall has been re plastered and new lighting has been fitted. Although the AQAA states Bedrooms, main bathroom and hallway have all been refurbished to a very high standard, none of the works has yet been completed. At the time of the inspection all areas in use were reasonably clean and odour free. Care Homes for Older People Page 17 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is adequately staffed to meet the needs of the people currently living at the home. As there is usually only one member of staff in the home, details of on call rota and emergency contacts need to be easily accessible. Evidence: The home employs 6 care staff, 3 have a National Vocational Qualification (NVQ) in care at level 2 or above (Figures taken from AQAA.) Duty Rotas seen show that there is one member of staff on duty for most of the day. Additional staff are made available to support people to go out. Overnight there is one member of staff sleeping in. The recruitment file of the most recently appointed member of staff was seen and this gave evidence of a thorough recruitment process which minimises the risks of abuse to people living at the home. The file also demonstrated that an induction programme is undertaken by new staff. There is an ongoing training programme which ensures that everyone working at the home undertakes training in statutory health and safety matters and other courses Care Homes for Older People Page 18 of 25 Evidence: relevant to the needs of the people who live at the home. There are regular staff meetings where people are able to share information and ideas. Due to the small number of people living at the home there is usually only one member of staff on duty. Risk assessments have been carried out and a lone working policy is in place. The duty rota seen did not state who was on call each day and the lone working policy does not state who to contact in the event of an emergency. Although there is only a small number of people working at the home and informal arrangements are in place these on call and emergency arrangements need to be formalised and contact details for the person on call need to be easily accessible. Care Homes for Older People Page 19 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home has opportunities to express their views on the quality of the service that they receive. Equipment in the home is well maintained and regularly serviced. Evidence: The joint owner and registered manager of the home is Diane Taylor-House. She has completed the Registered Managers Award (NVQ level 4) and has experience of working in the care sector, although limited experience of working with older people. Before this inspection the manager completed an Annual Quality Assurance Assessment (AQAA) this gave details about the home and their plans for the future. The completed document gave evidence of a commitment to providing care that is individual to each person and looking at ways to continually improve the service and facilities offered. Care Homes for Older People Page 20 of 25 Evidence: The registered manager works at the home providing direct care as well as her management role. This enables her to monitor the quality of the service and informally seek the views of people who live at the home. There are also more formal quality assurance processes in place that are appropriate to the size of the home. There are regular meetings for people who live at the home and everyone has completed a satisfaction questionnaire within the last 12 months. Evidence was seen that staff receive regular formal supervision with the manager, which is an opportunity to express their views identify areas of training and support needed. The home does not act as a financial appointee or power of attorney for anyone at the home but does assist one person with personal finance. The persons money is securely stored and there are clear records of all transactions. At the time of the inspection money held correlated with records maintained. A fire log is maintained and this shows that the system is regularly serviced by outside contractors. Alarms and emergency lighting is tested regularly by the home. Equipment in the home is regularly tested to ensure its safety. Up to date certificates of insurance and registration are displayed in the home. Care Homes for Older People Page 21 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 (1 & 2) The register manager must ensure that staff have access to care plans at all times. To ensure that there is access to up to date information about peoples needs and wishes. 04/12/2009 2 9 13 (2) Where medication is 15/11/2009 prescribed at a variable dose the actual dose given must be recorded. To ensure that there is a clear audit trail and the effectiveness of medication can be monitored. 3 26 13 (3) Hand washing facilities must be made available in the laundry area. To promote good infection control measures. 31/12/2009 Care Homes for Older People Page 23 of 25 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 4 27 18 (1) [a] The on call and 30/11/2009 emergency contact arrangements must to be easily available to everyone. To ensure that everyone at the home is aware of who to contact in an emergency and can do so easily and quickly. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 9 Hand written entries on Medication Administration Records should be signed and witnessed to minimise the risk of errors. The complaints procedure and whistle blowing policy should contain up to date contact details for the Care Quality Commission. 2 16 Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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