Inspection on 28/06/07 for Newton Lodge

This inspection was carried out on 28th June 2007.

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 Lodge 21/10/09

Newton Lodge 06/11/08

Newton Lodge 31/10/07

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

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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 Lodge 139 Berrow Road Burnham-on-Sea Somerset TA8 2PN Lead Inspector Jane Poole Unannounced Inspection 28th June 2007 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 Lodge DS0000069330.V337285.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 Lodge DS0000069330.V337285.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Newton Lodge Address 139 Berrow Road Burnham-on-Sea Somerset TA8 2PN 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) 01278 787321 C & K Homes Limited Mrs Sandra Diane Taylor-House Care Home 12 Category(ies) of Old age, not falling within any other category registration, with number (12) of places Newton Lodge DS0000069330.V337285.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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) The maximum number of service users who can be accommodated is 12. First key inspection since change in ownership. 2. Date of last inspection Brief Description of the Service: Newton Lodge is registered with the Commission for Social Care Inspection to provide care for up to 12 people over the age of 65. C & K Homes took over the home in March 2007 and the registered manager is Diane Taylor-House. The house itself is extremely homely; all areas are well decorated and furnished to provide a comfortable environment. Service user accommodation is set over two floors and there is a stair lift between. All service users currently have single rooms. Fees at the home range from £351.00 to £399.00 Newton Lodge DS0000069330.V337285.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the first key inspection since C&K homes purchased Newton Lodge in March 2007. A random inspection was carried out on 19th April 2007. An Annual Quality Assurance Assessment was sent to the home on the 24th April 2007 but was not completed and returned to the Commission for Social Care Inspection before this inspection. Three completed questionnaires were received from service users and two from visitors/relatives prior to this inspection. At the time of this inspection there were six service users living at the home and the inspector was able to talk with all six. The inspector was given access to all areas of the home, was able to talk with staff and view records. The manager was available throughout the inspection. What the service does well: What has improved since the last inspection? This is the first key inspection since C & K Homes registered the home with the CSCI. Newton Lodge DS0000069330.V337285.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Newton Lodge DS0000069330.V337285.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Newton Lodge DS0000069330.V337285.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is (excellent, good, adequate or poor). This judgement has been made using available evidence including a visit to this service. No new service users have moved into Newton Lodge since C & K Homes registered the home, therefore no standards in this section have been assessed on this occasion. EVIDENCE: Newton Lodge DS0000069330.V337285.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans do not give clear guidelines for staff and there in no evidence that they have been agreed with service users. EVIDENCE: All service users have a care plan which sets out their preferred daily routines. The inspector viewed two care plans in detail. The care plans are very basic and give limited guidance for staff. Although some service users are able to fully express their needs and wishes on a daily basis others are not and there needs to be full care plans to ensure that staff are able to provide consistent care. Two service users expressed their concerns to the inspector that they were now expected to empty and clean their commodes each morning. This was Newton Lodge DS0000069330.V337285.R01.S.doc Version 5.2 Page 10 written in care plans but there was no evidence that it had been agreed with the service user. Service users were unhappy about performing this task. All service users are registered with local GPs and other healthcare professionals appropriate to their needs. One person stated that they were visited regularly by a district nurse. All appointments with healthcare professionals are recorded in personal files and staff write daily records in respect of all service users. One care plan seen had a moving and handling assessment but this was not dated and therefore the inspector was unable to ascertain whether this was up to date. Both care plans seen contained evidence that service users were being weighed on a monthly basis. Two of the three service users who completed questionnaires answered ALWAYS to the questions ‘Do you receive the care and support you need?’ and ‘Do you receive the medical support you need?’ (The other person answered usually.) The inspector was able to meet with all six service users currently living at the home, all felt that their privacy was respected by staff but as stated above some had concerns about tasks that were expected of them. The home uses a Monitored Dosage System for medication and there is adequate storage. The key to the medication cupboard was being kept in an unlocked office drawer at the time of this inspection. Medication Administration Records (MARs) were viewed by the inspector and found to be reasonably maintained and completed. Some minor errors were discussed with the manager during the inspection. Newton Lodge DS0000069330.V337285.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Routines in the home are flexible to enable service users to choose how they spend their day. Service users were generally happy with the meals but complained of limited variety. EVIDENCE: There are no strict routines in the home and service users are free to decide when they get up, when they go to bed and how they spend their day. One person uses the local bus service to go to church and to visit friends. Another goes out to a local social club. Everyone spoken to stated that they were able to have visitors whenever they wish and many enjoy trips out with family members. Newton Lodge DS0000069330.V337285.R01.S.doc Version 5.2 Page 12 The manager is keen to encourage service users to maintain their independence but as previously mentioned some service users are now being asked to undertake tasks which they are not happy to do. There are currently no organised activities but service users stated that they were quite happy to amuse themselves. On the day of the inspection some service users were chatting and knitting whilst others were doing the crossword in the daily paper. The manager stated that the home is trying to encourage people to go out more and use local facilities. All service users manage their own financial affairs, some with assistance from family members. The inspector viewed some personal rooms and noted that people are able to personalise them with their own possessions. Service users were generally happy with the food in the home although many stated that there is no longer the variety of meals that there once was. People said that they get told what is for lunch each morning and can request an alternative if it is not to their liking. On the day of the inspection the inspector noted that one person had a different meal. At tea-time there is a set meal but again service users are able to choose an alternative if they wish. When C & K homes first took over Newton Lodge concerns were expressed to the Commission for Social Care Inspection about the amount of food in the home. This situation has now been rectified and cupboards and fridges were seen to be well stocked with good quality products. The menu is created on a weekly basis and is not displayed for service users. The weeks menu seen shown that the home use fresh, in season, fruit and vegetables. Newton Lodge DS0000069330.V337285.R01.S.doc Version 5.2 Page 13 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 & 18. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Poor recruitment practices place service users at risk. EVIDENCE: There is a complaints procedure on display in the main entrance but no complaints have been received by the home. Three staff members and two relatives have contacted the Commission for Social Care Inspection to express concerns since the home was registered. Two of the three service users who completed questionnaires prior to the inspection answered YES to the question ‘Do you know how to make a complaint?’ On person wrote on their questionnaire that they would like to speak with the management to ‘discuss welfare issues.’ On the day of the inspection two service users asked, stated that they would be comfortable to speak with a member of staff if they were unhappy about any aspect of their care. Two people who raised concerns stated that they were Newton Lodge DS0000069330.V337285.R01.S.doc Version 5.2 Page 14 more comfortable to discuss issues with the inspector than the manager although there were some staff who they felt able to talk with. The manager stated that they are planning to use policies and procedures developed by another home owned by the same company. These policies and procedures are not yet available in the home and therefore the inspector was unable to view those in respect of recognising and reporting abuse or whistle blowing. The inspector viewed the recruitment files of three newly appointed members of staff. None had been checked against the Protection Of Vulnerable Adults (POVA) register before commencing work at the home. Two had references dated after the start date and one person who started on the day of this inspection had no checks or references in place. There was no evidence that verbal references had been sought and one person did not have a reference from their previous employer. (An immediate requirement was issued during the inspection.) Newton Lodge DS0000069330.V337285.R01.S.doc Version 5.2 Page 15 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): 20, 24, 19, & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Newton Lodge provides a comfortable homely environment for service users. EVIDENCE: Newton Lodge is an older style house, which has been extended over the years to provide 11 bedrooms for service users set over two floors. A stair lift gives access to the first floor. All areas of the home are fitted with a fire detection and call bell system. Newton Lodge DS0000069330.V337285.R01.S.doc Version 5.2 Page 16 The inspector viewed a selection of bedrooms and noted that service users had been able to personalise them with their own small items of furniture and personal effects. This gives rooms a homely, individual feel. One person who was planning to move rooms had been able to choose the colour scheme for their new bedroom. All communal areas are located on the ground floor, there is a large lounge/diner and a small conservatory. All fixtures and fittings are domestic in style. There is a small laundry area which meets the needs of the current service user group. The new owners have begun to re carpet and redecorate some areas of the home. All areas seen by the inspector were reasonably clean and odour free. 2 service users who completed questionnaires answered ALWAYS and one person answered USUALLY to the question ‘Is the home fresh and clean?’ Newton Lodge DS0000069330.V337285.R01.S.doc Version 5.2 Page 17 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, 29 & 30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Recruitment practices are poor and place service users at risk. There is no induction or training programme in place. EVIDENCE: Many staff who had worked with the previous owner of the home have now left and new staff are being recruited. The shift pattern in the home has been changed and there are two staff on duty between the hours of 8am and 10pm, overnight there is one waking member of staff and one sleep in. The manager is currently working shifts in the home but is hoping to be supernumerary once more staff are employed. The inspector viewed the recruitment files of three newly appointed members of staff. None had been checked against the Protection Of Vulnerable Adults (POVA) register before commencing work at the home. Two had references dated after the start date and one person who started on the day of this inspection had no checks or references in place. There was no evidence that Newton Lodge DS0000069330.V337285.R01.S.doc Version 5.2 Page 18 verbal references had been sought and one person did not have a reference from their previous employer. (An immediate requirement was issued during the inspection.) There has been no staff meeting or training in the home since it was registered to C & K Homes. Staff spoken to were unsure of their roles and responsibilities and new staff were not undertaking an induction programme. There is no duty rota displayed in the home and service users stated that they did not know who would be working with them until they arrived at the home. One person was particularly concerned about this, as they liked to know who would be assisting them with intimate personal care. Newton Lodge DS0000069330.V337285.R01.S.doc Version 5.2 Page 19 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, 32, 33, 35 & 38. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. There is a lack of direction in the home. Service users and staff have not had opportunities to discuss their concerns or share opinions with the management. EVIDENCE: The registered manager of the home is Diane Taylor-House. She has many years experience of working in care but limited experience of working with older people. She holds a Registered Managers Award (NVQ level 4) Newton Lodge DS0000069330.V337285.R01.S.doc Version 5.2 Page 20 The manager has not completed and returned the Annual Quality Assurance Assessment sent out by the Commission for Social Care Inspection 2 months prior to this inspection. Since the home was registered to C & K Homes there has been no staff or service user meeting in the home to explain changes that may occur. Some service users spoken to were genuinely concerned about the future of the home and stated that they would value the opportunity to discuss this further with the manager. One person also commented on this in their questionnaire. Staff were unclear about their roles and responsibilities and there appears to be a lack of leadership and direction in the home. There is currently no system in place to enable service users, staff or other interested parties to affect the management of the home. Quality assurance systems have not yet been put in place. The home does not act as a financial appointee or power of attorney for any service user living at the home. A fire log is maintained this shows that alarms are tested on a weekly basis and emergency lighting monthly. New staff have been instructed in the fire procedure for the home, but as previously mentioned there are no records of induction training. The last moving and handling training was in July 2006 therefore no staff appointed since this date have received training. All accidents are recorded and show that appropriate action is taken. Records pertaining to the gas and electrical installation were seen at registration in March this year. There are up to date certificates of registration and insurance displayed in the home. Newton Lodge DS0000069330.V337285.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 1 3 3 X X X 3 X 3 STAFFING Standard No Score 27 2 28 X 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 1 1 x 3 x x 2 Newton Lodge DS0000069330.V337285.R01.S.doc Version 5.2 Page 22 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 OP32 Regulation 10 (1) 12(1) Requirement The registered person must ensure that there is clear leadership in the home. (previous timescale of 15/05/07 not met.) The registered person must ensure that communication in the home promotes good personal and professional relationships between the management, staff and service users. (previous timescale of 15/05/07 not met.) Care plans must give clear guidelines for staff and be agreed with service users. The registered manager must ensure that service users are not asked to carry out tasks that they are not comfortable to perform. There must be a thorough recruitment process in place. No staff must work at the home before appropriate checks and references have been obtained. (Immediate requirement issued) DS0000069330.V337285.R01.S.doc Timescale for action 30/07/07 2 OP32 12(5)a 15/07/07 3 4 OP7 OP10 OP14 15 (1) 12(3)(4) 15/08/07 28/06/07 5 OP18 OP29 19 (1) 30/06/07 Newton Lodge Version 5.2 Page 23 6 OP30 12(1) 18(1) 24 (1)(2) 7 OP31 8 OP32 12(2)(3) 21 (2) 9 OP33 24(1) The registered manager must ensure that there is an induction and ongoing training programme for all staff. The registered manager must complete the Annual Quality Assurance Assessment and return it to CSCI. The registered manager must ensure that there are opportunities for staff and service users to express their views and concerns. The registered manager must ensure that there are quality assurance systems in place that involve consultation with service users and their representatives. 15/07/07 30/07/07 15/07/07 30/08/07 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 Refer to Standard OP9 Good Practice Recommendations The key to the drugs cabinet should be kept secure. Newton Lodge DS0000069330.V337285.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Taunton Local Office Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Lodge DS0000069330.V337285.R01.S.doc Version 5.2 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. 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