Inspection on 31/10/07 for Newton Lodge

This inspection was carried out on 31st October 2007.

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 21/10/09

Newton Lodge 06/11/08

Newton Lodge 28/06/07

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Poldhu

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Belma

Hunters Care Centre

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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 31st October 2007 10:00 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.V353319.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.V353319.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.V353319.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. 28th June 2007 2. Date of last key 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.V353319.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of this inspection visit was to inspect relevant key standards under the Commission’s ‘Inspecting for Better Lives 2’ framework. This focuses on outcomes for service users and measures the quality of the service under four general headings. These are: - excellent, good, adequate and poor. Since the last Key Inspection two random inspections have been carried out to monitor the quality of care at the home, some of the findings of random inspections have been incorporated into this report. At the time of this inspection there were 6 people living at Newton Lodge. The inspector was given unrestricted access to all areas of the home, was able to talk with staff and service users and observe care practices. The manager was not at the home and therefore some records were not available. What the service does well: What has improved since the last inspection? The last key inspection was carried out on the 28th June 2007, since this time there has been many improvements in the home. Communication has improved. There are now regular staff and service user meetings to ensure that everyone is kept up to date and to give people an opportunity to express their views and opinions. Newton Lodge DS0000069330.V353319.R01.S.doc Version 5.2 Page 6 Care plans are being up dated in full consultation with service users. This process is not yet complete meaning that currently there are two care plan systems in the home. New care plans seen were person centred and gave information about peoples likes and dislikes, not just their physical needs. All service users stated that the food had improved. The menu is now displayed and all service users asked said that they felt able to ask for an alternative if they did not like what was on the menu. An assistant manager has been employed who takes responsibility for the dayto-day running of the home in the absence of the manager. This gives much clearer leadership and direction for staff. There is now a formal induction programme for new staff. Risk assessments have been carried out in respect of free standing wardrobes and in occupied rooms these have been more robustly secured to minimise the risk of them toppling and causing injury. What they could do better: Only 33 of care staff have a National Vocational Qualification in care at level 2 or above. There are no records pertaining to ongoing training for staff including training in health and safety issues such as fire safety, moving and handling and food hygiene. The home must ensure that all members of staff receive training up dates to ensure that they are working in line with current best practice guidelines. The assistant manager stated that 4 members of staff have received training in the protection of vulnerable adults and this training needs to be completed by all staff. The home need to maintain a complaints log which gives details of any complaint made and the action taken to address it. The inspector viewed the Medication Administration Records and noted that hand written entries had not been signed and witnessed to minimise the risk of mistakes being made. Please contact the provider for advice of actions taken in response to this Newton Lodge DS0000069330.V353319.R01.S.doc Version 5.2 Page 7 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.V353319.R01.S.doc Version 5.2 Page 8 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.V353319.R01.S.doc Version 5.2 Page 9 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): 3 & 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users have their needs fully assessed before being offered a place at the home. Intermediate care is not provided. EVIDENCE: Since the last inspection one new service user has moved to the home. The inspector saw evidence that the home obtained a copy of the persons’ assessment and this has formed the basis of the care plan. The new service user was able to visit the home, with their representative, on more than one occasion before moving in on a permanent basis. Newton Lodge DS0000069330.V353319.R01.S.doc Version 5.2 Page 10 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 good. This judgement has been made using available evidence including a visit to this service. Service users privacy and dignity is respected. Care plans are drawn up in consultation with service users. EVIDENCE: Since the last inspection the home has begun to up date the care plans to make them more person centred. This means that at the current time there is more than one system working in the home. The inspector viewed two care plans and saw evidence that service users are being fully involved in the creation of the plans. The care plans give details of peoples likes and dislikes as well as their needs. It is planned that keyworkers and service users will meet on a regular basis to discuss and up-date the care plan. Some evidence of these meetings was seen. Newton Lodge DS0000069330.V353319.R01.S.doc Version 5.2 Page 11 All medical appointments are recorded in the care plans and these give evidence that service users have access to health care professionals such as GPs, district nurses and physiotherapists. Since the last inspection the home has changed their pharmacy supplier and are in the process of ensuring all staff are fully trained in the new system. One member of staff stated that they had already received training from the assistant manager. The inspector viewed the Medication Administration Records (MARs) and found that all medication is signed into the home when it arrives and records were correctly signed when administered or refused giving a clear audit trail. Hand written entries on MARs had not been signed and witnessed in line with good practice guidelines. Throughout the inspection the inspector observed that staff interacted with service users in a friendly respectful manner. Service users stated that their privacy was respected and no one was asked to carry out tasks that they felt uncomfortable with. Service users are able to spend time in the communal areas or in the privacy of their personal rooms. Newton Lodge DS0000069330.V353319.R01.S.doc Version 5.2 Page 12 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. Service users have opportunities to access the local community and maintain contact with friends and family. Service users maintain control over their day to day lives. EVIDENCE: Newton Lodge supports people with differing needs and abilities. Some people are able to access the community without assistance whilst others rely on staff to take them out. People spoken to took part in a variety of activities, one person stated that they continue to attend a social club in the village where they previously lived, another goes out unsupported to visit family members, one service user enjoys football matches and the staff facilitate this. Service users stated that they have opportunities to go out with staff to local towns, garden centres and pubs. Newton Lodge DS0000069330.V353319.R01.S.doc Version 5.2 Page 13 People are able to carry on with their hobbies and one person spends much of their time sewing and doing puzzles, another person said that they enjoyed reading and staff assisted them to get books from the local library. There are TVs and radios in communal areas. One person said “I love it here, we play cards.” Everyone asked stated that there are no strict routines in the home with people choosing when they get up, when they go to bed and how they spend their day. Everyone asked stated that they are able to have visitors at any time. People were happy with the food served in the home. The weeks menu is clearly displayed on the notice board and it states that if people want an alternative they only have to ask. The inspector saw the minutes of a service user meeting. These gave evidence that food was discussed with people living at the home and it was emphasised that if people wanted drinks or snacks they should ask a member of staff no matter what time of day or night it was. Everyone spoken to stated that they would be comfortable to request alternative meals or additional snacks. The inspector viewed the food storage areas and noted that they were well stocked. Newton Lodge DS0000069330.V353319.R01.S.doc Version 5.2 Page 14 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 adequate. This judgement has been made using available evidence including a visit to this service. There are systems in place to minimise the risks of abuse to service users, these would be enhanced if all staff received training in the protection of vulnerable adults and whistle blowing. EVIDENCE: The home has a complaints procedure and a policy on recognising and reporting abuse. The whistle blowing policy is not displayed\however staff were aware of the ability to take serious concerns outside the home. Some staff have completed training on the Protection Of Vulnerable Adults and the assistant manager gave assurances that all staff will complete this training. Since the last key inspection three concerns have been raised with the Commission for Social Care Inspection, two random inspections were carried out in response to this. Requirements made at the random inspection have complied with. The homes complaints log was not available at the time of this inspection and staff did not know if any complaints had been made directly to the home. Newton Lodge DS0000069330.V353319.R01.S.doc Version 5.2 Page 15 Service users asked said that they would talk to a member of staff if there was any aspect of their care that they were not happy with. Service users were seen to move freely around the home and had unrestricted access to communal areas and their personal rooms. The inspector noted that the subject of bullying was raised at a service user meeting and openly discussed. No new members of staff have started work since the random inspection (01/08/07) when staff files gave evidence of a more thorough recruitment process that minimises the risks to service users. As the manager was not at the home on the day of the inspection staff files were not available. Newton Lodge DS0000069330.V353319.R01.S.doc Version 5.2 Page 16 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 & 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. One bedroom is now being used as an office and sleep in room. All areas of the home are fitted with a fire detection and call bell system. Newton Lodge DS0000069330.V353319.R01.S.doc Version 5.2 Page 17 Communal areas are located on the ground floor and consist of a large lounge/diner and a small conservatory. Outside there are attractive grounds that service users are able to access. Two of the bedrooms have en suite facilities and there is a communal bathroom and toilet on the ground and first floor. The laundry is located on the ground floor and is appropriate to the needs of the current service user group. On the day of the inspection the laundry door was open and cleaning products were on display and easily accessible. All areas seen by the inspector were clean and fresh. Newton Lodge DS0000069330.V353319.R01.S.doc Version 5.2 Page 18 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 & 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Recruitment practices are now robust and minimise the risks of abuse to service users. The home needs to provide evidence that staff are receiving training appropriate to their roles. EVIDENCE: The home employs 12 members of staff, 4 have a National Vocational Qualification (NVQ) at level 2 or above. The duty rota is displayed and this shows that between the hours of 8am and 10pm there are two members of staff on duty with additional hours made available to take service users out. Overnight there is one waking night staff and another person sleeping in. Since the home was registered to C & K homes there have been many staff changes that some service users stated had been quite unsettling although they said that new staff were kind and helpful. Newton Lodge DS0000069330.V353319.R01.S.doc Version 5.2 Page 19 A new induction package has been introduced and at the random inspection carried out in august this year a new member of staff showed the induction programme to the inspector. The home has obtained training videos for staff. No records are kept of staff training and it was therefore difficult to tell if all staff were up to date in health and safety issues such as moving and handling and food hygiene. One member of staff spoken to stated that they had not attended any training sessions since March this year when the new owners took over the home. Since the last key inspection the home has introduced regular staff meetings and minutes are maintained. As previously stated the home gave evidence at the random inspection that recruitment practices are now robust and minimise the risks of abuse to service users. Newton Lodge DS0000069330.V353319.R01.S.doc Version 5.2 Page 20 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 & 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Communication in the home has improved with the introduction of staff and service user meetings, formal shift handovers and a communication book. EVIDENCE: The registered manager of the home and part owner is Mrs Diane TaylorHouse. She has a Registered Managers Award (NVQ Level 4.) Mrs TaylorHouse has many years experience of working in care but limited experience of working with older people. Newton Lodge DS0000069330.V353319.R01.S.doc Version 5.2 Page 21 The registered manager works shifts at the home and was not available at this inspection. Many service users stated that she tends to work the weekend shifts. In addition to the registered manager there is an assistant manager who takes responsibility for the day-to-day running of the home. The assistant manager stated that the manager or responsible individual was always available on the phone. Since the last inspection the home have begun to hold regular staff and service user meetings to improve communication and ensure there are opportunities to share opinions and views. Staff spoken to felt that communication was now good and that they were clear about their roles and responsibilities. The home has not yet fully implemented a quality assurance system, which seeks the views of interested parties. The home does not act as an financial appointee or power of attorney for anyone living at the home. Small amounts of money are held for two service users and records are maintained of all transactions. A fire log is maintained that shows that alarms are tested on a weekly basis by the home and emergency lighting is tested quarterly by outside contractors. At the random inspection a requirement was issued for risk assessments to be carried out on freestanding wardrobes and appropriate measures put in place to minimise the risk of them toppling and causing injury. Wardrobes in rooms that are occupied have now been more robustly secured. A previously stated there is no evidence that staff have received up to date training in health and safety issues. Records of equipment servicing and hot water tests were not available at this inspection. Certificates of registration and insurance are displayed. Newton Lodge DS0000069330.V353319.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 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 2 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 2 x 3 x x 2 Newton Lodge DS0000069330.V353319.R01.S.doc Version 5.2 Page 23 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 Standard OP33 Regulation 24(1) Requirement The registered manager must ensure that there are quality assurance systems in place that involve consultation with service users and their representatives. (Requirement made at previous inspection timescale 19/09/07 not met) The home must maintain a complaints log, which gives details of the complaint made and action taken to address it. The manager must ensure that all staff receive training in the protection of vulnerable adults and are familiar with the whistle blowing policy. The manager must ensure that all staff receive training appropriate to their role in the home. This includes health and safety issues. Records of all training must be maintained. Timescale for action 28/02/08 2 OP16 22 (8) 30/11/07 3 OP18 13 (6) 31/12/07 4 OP30 OP38 18 (1) [c] 31/12/07 Newton Lodge DS0000069330.V353319.R01.S.doc Version 5.2 Page 24 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 OP9 OP26 OP28 OP38 Good Practice Recommendations All hand written entries on Medication Administration Records should be signed and witnessed. The manager should ensure that cleaning products kept in the laundry are securely stored. 50 of care staff should hold an NVQ in care at level 2 or above. The manager should ensure that service users do not have access to rooms where wardrobes are not secured. Newton Lodge DS0000069330.V353319.R01.S.doc Version 5.2 Page 25 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.V353319.R01.S.doc Version 5.2 Page 26 - 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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