Inspection on 06/11/08 for Newton Lodge

This inspection was carried out on 6th November 2008.

CSCI 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 21/10/09

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 31/03/2009.

Inspecting for better lives 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, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jane Poole     Date: 0 6 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. the things that people have said are important to them: They reflect 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 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): Name of registered manager (if applicable) Mrs Sandra Diane Taylor-House 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 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. 0 Over 65 12 Care Homes for Older People Page 4 of 27 Care Homes for Older People Page 5 of 27 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 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 service users and measures the quality of the service under four general headings. These are:- excellent, good, adequate and poor. This inspection was carried out over a one day period, during this time the inspector was able to meet with people living and working at the home, was able to tour the building, observe care practices and view records requested. The inspector was given unrestricted access to all area of the home and all records requested were made available. Care Homes for Older People Page 6 of 27 At the time of this inspection there were 4 people living at the home. Prior to the inspection the manager completed an Annual Quality Assurance (AQAA) giving details of the home and their plans for the future. All 4 people living at the home and 2 members of staff completed questionnaires before the inspection and some of their comments have been incorporated into this report. The following is a brief summary of the inspection findings and should be read in conjunction with the whole of the report. What the care home does well: What has improved since the last inspection? What they could do better: There are now only 4 people living at the home and staffing levels have been reduced to reflect this. During the night there is only a sleep-in member of staff. A generic risk assessment has been completed but there needs to be an individual care plan and risk assessment for each person living at the home to ensure their health, safety and dignity is not compromised. Staffing levels must be kept under review to ensure they continue to meet the needs of the people who live at the home. Staff are now receiving regular training, most is video based and staff would benefit from more indepth training in health and safety issues and other subjects specific to the people who live at the home. Care Homes for Older People Page 8 of 27 Quality assurance measures need to be more systematic and measurable to ensure that they inform continuous improvements. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 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 10 of 27 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. Anyone wishing to move to the home has their needs assessed to ensure that it is the right place for them. Intermediate care is not provided. Evidence: No new people have moved to the home since the last key inspection. The home has a clear admission policy that includes carrying out a needs assessment. The first 4 weeks of any admission is a trial period to ensure that the home is able to meet the needs of the new person and that the person is happy with the care they receive. Fees at the home range from 368 to 700 pounds per week. This fee does not include personal items and services such as hairdressing, chiropody and toiletries. Care Homes for Older People Page 11 of 27 Evidence: The home has an up to date statement of purpose that sets out the services and facilities offered. Care Homes for Older People Page 12 of 27 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. People have access to health care professionals according to individual need. Care plans are personal to the individual but would benefit from further development to ensure that they clearly set out out night time needs and risks. Evidence: Everyone living at the home has a care plan that is individual to them. 2 care plans were looked at in detail, both contained details of the persons needs as well as their likes and dislikes. Daily records are written which record significant events and mood. At the end of each month the care plan is reviewed with the individual and a short summary is written. There was evidence that care plans are updated when needs or wishes change. No one living at the home has a care plan which outlines their night time needs or routines. Currently the home only employs sleep-in staff overnight and a generic risk assessment has been drawn up in respect of this practice. Individual care plans and risk assessments, which are regularly reviewed, need to be in place to ensure that this practice provides an appropriate level of care for everyone living at Care Homes for Older People Page 13 of 27 Evidence: the home. Everyone who completed a questionnaire prior to this inspection answered ALWAYS to the question Do you receive the medical support you need. Daily records show that people living at the home have access to health care professionals according to their individual need. One person said that they are seen regularly by a district nurse and another said that they were assisted to make and attend appointments with their GP. On the morning of the inspection one person attended an outpatient appointment at the hospital. Everyone is weighed on a monthly basis and records seen showed that people were maintaining a stable weight. People felt that their privacy was respected and it was noted that people were able to spend time in their personal rooms as well as communal areas. The home is currently in the process of installing more en-suite bathrooms to further enhance privacy. The home uses a Monitored Dosage System (MDS) for medication and all staff have received training from the dispensing pharmacy. One person living at the home self administers their medication and a risk assessment has been completed in the care plan. Medication Administration Records (MARs) were viewed, these were correctly signed when entering the home and when administered or refused. Since the last inspection photographic identification has been added to the MARs to reduce the risk of errors. The quantity of medication passed to the person who self administers was not not recorded and it was not clear on the current MAR that they kept, and administered, their own medication. Care Homes for Older People Page 14 of 27 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. People are free to choose how they spend their day but there are limited organised activities. Visitors are welcome at anytime. Evidence: People living at the home said that they were able to choose what time they got up, when they went to bed and how they spent their day. On the morning of the inspection one person was watching TV in the lounge, another person was spending time in their room and someone else was having a lie in. There are very limited organised activities and staff spoken with stated that because of the small number of people living at the home any activities were on an individual basis. Care plans showed that people are assisted to go out to do personal shopping and to collect money from the bank or post office. One person said that they continued to attend a club in the village that they previously lived in. In answer to the question Are there activities that you can take part in?. 1 person said ALWAYS and the other 3 people said USUALLY. People asked said that they are able to have visitors at anytime. Care Homes for Older People Page 15 of 27 Evidence: The main meal of the day is at mid-day with a lighter meal in the evening. A weekly menu is drawn up taking account of the likes and dislikes of people living at the home. People are able to choose whether to eat in the dining room or their own rooms. 3 people said that they usually liked the food in the home and 1 person said that they always liked it. It was observed that hot and cold drinks were made available and people said that they could always ask for a drink. The manager stated in the Annual Quality Assurance Assessment that they are planning to instigate a simple satisfaction system so that people can rate their meals and this will assist with future menu planning. Currently the days menu is not clearly displayed in the home and one person asked did not know what was for lunch. Care Homes for Older People Page 16 of 27 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. Reasonable steps have been taken to minimise the risks of abuse to people who live at the home. Evidence: The home has policies and procedures in respect of recognising and reporting abuse, making a complaint and whistle blowing. All 4 people living at the home who completed a questionnaire said that they knew how to make a complaint and staff said that they knew what to do if someone living at the home, or their advocate, expressed concerns about the home. No complaints have been received since the last inspection. Staff working at the home undertake training in the protection of vulnerable adults as part of their induction programme. Staff spoken with were aware of the ability to take serious concerns outside the home. New staff are checked against the Protection Of Vulnerable Adults (POVA) register before they begin work in the home. Care Homes for Older People Page 17 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Newton Lodge is currently undergoing refurbishment but continues to provide a comfortable, safe environment. Evidence: Newton Lodge is an older style property that has been extended over the years to provide accommodation for up to 12 people over two floors. There is a stair lift to enable people to access the rooms on the first floor. All areas are fitted with a call bell and fire detection system. Communal areas consist of a large lounge/diner and a small conservatory. Outside there are pleasant gardens. All communal areas are accessible to people with all levels of mobility. The Annual Quality Assurance Assessment (AQAA) states that the owners are gradually upgrading the environment to ensure that it continues to meet the changing needs of the people who live there. Work has begun on providing additional en-suite facilities and changing the laundry area. At the time of this inspection the laundry room was not in use but a washing machine and tumble drier are available for use. The manager gave assurances that this arrangement meets the needs of the people currently living Care Homes for Older People Page 18 of 27 Evidence: at the home. Hand washing facilities are available throughout the home. On the day of the inspection all areas seen were clean and odour free. Everyone who completed a questionnaire answered ALWAYS to the question Is the home clean and fresh? Care Homes for Older People Page 19 of 27 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. Staffing levels need to be kept under review to ensure that they do not compromise the health, safety and dignity of the people who live at the home. Staff would benefit from more in-depth training in health and safety matters and issues specific to the needs of the people living at the home. Evidence: The home employs 4 care staff and one domestic assistant. 1 Member of the care staff team have a National Vocational Qualification (NVQ) in care at level 2. Another staff member is currently working towards this award. During the day the home is staffed by one member of staff with an additional person at busy times. Overnight there is one person sleeping in. The duty rota clearly shows what staff are on duty and there is a notice board in the hallway to inform people living at the home who is on duty. A risk assessment for staffing levels has been carried out but as previously stated this needs to be personalised to each individual at the home. During the morning of the inspection there were two male members of staff on duty. Care Homes for Older People Page 20 of 27 Evidence: Currently all women living at the home are independent with personal care but this must be kept under review and discussed with people living at the home to ensure that their privacy and dignity is not compromised. The home does not have a lone working policy and this needs to be put in place. Everyone who completed a questionnaire said that staff listened and acted on what they said. 3 people answered ALWAYS and 1 person answered USUALLY to the question Are staff available when you need them? The recruitment files of the two most recently appointed members of staff were viewed. These gave evidence of a robust recruitment procedure which includes obtaining written references and undertaking appropriate checks before people begin work. Staff undertake an induction programme in line with the skills for care core standards. The home uses videos for the majority of staff training such as food hygiene, moving and handling and first aid. Staff who completed questionnaires were happy with the induction that they received and felt that they were being given training that was relevant to their job. Care Homes for Older People Page 21 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Taking into account the number of people living and working at Newton Lodge, the home is adequately managed. Quality assurance measures need to be more systematic and measurable to ensure that they inform continuous improvements. Evidence: The registered manager and joint owner of the home is Diane Taylor-House. She has obtained the Registered Managers Award (NVQ level 4). The manager has worked in care settings for some years but has limited experience of working with older people. The manager gave evidence that she is attending relevant training to enhance her knowledge of working with older people. Prior to this inspection the manager completed an Annual Quality Assurance Assessment (AQAA) which gave details about the home and their plans for the future. The manager works in the home on a full time basis and provides direct care to people as well as a fulfilling a management role. Care Homes for Older People Page 22 of 27 Evidence: The home assists one person with personal finance and clear records were seen of all transactions. Some quality assurance systems are in place and the staff meet regularly with individuals to ensure that they are happy with the quality of care that they receive. Satisfaction questionnaires are available in the hallway for people to complete if they wish to. The manager demonstrates a commitment to continuous improvement but quality assurance measures need to be more systematic and measurable. The AQAA states that annual quality assurance questionnaires are sent out to all interested parties. There was no quality assurance audit available and only one returned questionnaire was seen during the inspection. Therefor there was no way of ascertaining how action plans were drawn from views expressed. A fire risk assessment is in place. Alarms are tested on a weekly basis and emergency lighting is tested quarterly by outside contractors. The fire risk assessment states that emergency lighting should be tested on a monthly basis. As stated staff have received basic training in health and safety issues. Fire training is due to be up dated this month. There is evidence that equipment in the home is regularly serviced and tested by outside contractors. All accidents are recorded and give no cause for concern. Up to date certificates of insurance and registration are displayed in the home. Care Homes for Older People Page 23 of 27 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 24 of 27 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 12 Care plans must give details of the night time needs of people. To ensure that staff have clear guidelines to follow and risks to people living at the home are minimised. A dedicated laundry area must be provided. To ensure that good infection control practices can be maintained. 07/01/2009 2 26 13 07/06/2009 3 27 18 The home must keep the staffing levels under review. To ensure the health, safety and dignity of people at the home. Quality assurance measures must be more systematic and measurable. To ensure that they inform continuous improvements. 19/12/2008 4 33 24 07/03/2009 Care Homes for Older People Page 25 of 27 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 It should be clearly recorded on Medication Administration Records when someone administers their own medication and the quantities of tablets passed to the person. The daily menu should be clearly displayed in the home. A lone working policy should be in place to minimise the risks to people living and working at the home. The manager should continue to develop their knowledge of older peoples care and share knowledge with all staff. The emergency lighting should be tested in line with the recommendations in the fire risk assessment. 2 3 4 5 15 27 31 38 Care Homes for Older People Page 26 of 27 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!