Inspection on 26/07/07 for Newtown House

This inspection was carried out on 26th July 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Newtown House 02/06/06

Newtown House 07/11/05

Newtown House 20/05/05

Newtown House 06/07/04

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Newtown House Waterford Road Highcliffe Christchurch Dorset BH23 5JW Lead Inspector Carole Payne Key Unannounced Inspection 26th July 2007 08:20 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 Newtown House DS0000060895.V344923.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. Newtown House DS0000060895.V344923.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Newtown House Address Waterford Road Highcliffe Christchurch Dorset BH23 5JW 01425 272073 01425 274719 kwatts.newtownhouse@tiscali.co.uk 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) Highcliffe Nursing Services Ltd Mrs Karen Elizabeth Watts Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26) of places Newtown House DS0000060895.V344923.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. A minimum of 30 hours per week of the registered manager hours to be supernumerary to the staffing rota. The registered manager must complete the NVQ level 4 award in management by 31st December 2006. 2nd June 2006 Date of last inspection Brief Description of the Service: Newtown House is a large detached older style property set in its own grounds in a residential road. The home is within walking distance of Highcliffe High Street and sea front/cliff top. The home offers accommodation to a maximum of 26 service users in the category OP (old age) and provides nursing care. Highcliffe Nursing Services Limited owns the home; the directors are Mr & Mrs Harris and Mr Harris is the Responsible Individual for the organisation. Karen Watts is the registered manager. Accommodation is on two floors with a lounge area, kitchen, nurse’s station and communal open plan area on the ground floor with nine single bedrooms and two bathrooms. There are eleven single bedrooms and three double rooms on the first floor and two bathrooms. All bathrooms are fitted with equipment for assistance. There is a passenger lift between floors. There are pleasant gardens to the rear of the property and the front of the home provides off road parking. Current fees are: £529 to £750. See the following website for further guidance on fees and contracts: http:/www.csci.org.uk/about_csci/press_releases/better_advice_for_peop le_choos.aspx Newtown House DS0000060895.V344923.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection was carried out on the 26th July 2007 and took a total of 11.5 hours, including time spent in planning the visit. The inspector was made to feel welcome in the home during the visit. This was a statutory inspection and was carried out to ensure that the twenty-two residents who are living at Newtown House are safe and properly cared for. Requirements and recommendations made as a result of the last inspection visit and key standards met at the last inspection on 2nd June 2006 were also reviewed. The premises were inspected, records examined and the daily routine observed. Time was spent in discussion with five residents living in the home and three staff members on duty. Five resident survey forms were received by the Commission for Social Care Inspection prior to the visit; one comment card from a health and social care professional who visits the home, three General Practitioner comment cards and two comment cards from relatives and/or friends of people living at the service. The home returned a detailed Annual Quality Assurance Assessment (AQAA) prior to the visit. Throughout the inspection the manager and staff team demonstrated a positive and proactive commitment to addressing any issues raised and continuously improving the quality of life for people living at Newtown House. What the service does well: Comments from residents in survey forms returned included: I am very happy with the level of service, staff are very caring.’ Three General Practitioners (GP) returning comment cards said that they are satisfied with the overall care provided by the home. One GP said ‘in my experience high quality care.’ People considering moving into Newtown House and their families are welcome to come and look around the home and experience what it is like to live at the home. Comprehensive care planning supports staff members in care giving, ensuring that residents’ total needs are met. Residents’ health care needs are fully met. People living at Newtown House are cared for sensitively with respect for their privacy and dignity. Newtown House DS0000060895.V344923.R01.S.doc Version 5.2 Page 6 People living at Newtown House are offered choices about their daily lives, which enables them to enjoy interests, relationships that are meaningful to them and daily events such as meals and mealtimes in the surroundings and at the times of their choice. The home has an open approach to the receipt of complaints, enabling residents to feel that any concerns will be listened and responded to. The environment at Newtown House provides warm and welcoming surroundings, which are maintained to a good standard of cleanliness, providing residents with a comfortable, homely and hygienic place to live. The service has plans in place to upgrade the standard of facilities and services available. What has improved since the last inspection? What they could do better: Full details of a person’s needs should be included in the pre-admission assessment carried out, ensuring that the home is able to make a decision regarding whether the home is able to meet prospective residents’ needs and preferences. Individual records of residents’ participation in events and social engagement should be maintained so that ongoing social needs can be monitored, identified and met. Newtown House DS0000060895.V344923.R01.S.doc Version 5.2 Page 7 A full audit must be undertaken of staffing levels in the home to include the needs for staffing in the laundry, maintenance and for activities to ensure that there are always sufficient staff members on duty to meet residents’ changing needs. Full and rigorous recruitment checks must be undertaken prior to new staff members starting work in the home, protecting people living at the service. 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. Newtown House DS0000060895.V344923.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 Newtown House DS0000060895.V344923.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 adequate. This judgement has been made using available evidence including a visit to this service. Pre-admission assessments do not contain adequate details. However full information from other professionals and the opportunity to visit and assess the facilities and services at the home, ensure that no one moves into the service without some assurance that their needs will be met. EVIDENCE: Pre-admission assessments were viewed for two people who had recently moved into the service. Information included relevant details from external health and social care professionals. It was advised that the format used for the assessment could be more informative. Tick boxes are used for some sections, which do not allow a personal description of a prospective resident’s needs. For example ‘partial assistance’ does not describe what help is actually Newtown House DS0000060895.V344923.R01.S.doc Version 5.2 Page 10 required. It was also advised that it would be helpful to know who is involved in the assessment and that this is recorded. The AQAA returned by the service confirms that the manager normally responds to enquiries about the home and either the manager or deputy carry out the pre-admission assessment, both of whom are well qualified to assess the needs of prospective residents. A letter was seen on one file, confirming with a prospective resident that the home is able to meet their needs. At the time of the inspection three people came to look around the home. The manager made them very welcome and gave them a tour of the service and time to look at the home’s brochure and ask any questions they may have. They were offered tea and the opportunity to experience a little of what it is like to live at Newtown House. Four people returning survey forms said that they felt that they received enough information about the home prior to moving in. Newtown House DS0000060895.V344923.R01.S.doc Version 5.2 Page 11 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. Comprehensive care planning supports staff members in care giving, ensuring that residents’ total needs are met. Tracking the audit trail of medicines will support the good care received by people living in the home. EVIDENCE: Detailed assessments and care plans inform care giving in the home. Care plans include reference to residents’ individual needs, choices and preferences. Assessments include the use of clinical risk assessment tools. Care plans are regularly reviewed and updated according to changing needs. There is evidence of consultation with residents or their representatives in drawing up the care plans. Detailed daily recording supports care giving. Newtown House DS0000060895.V344923.R01.S.doc Version 5.2 Page 12 Three residents returning survey forms said that they usually receive the care and support that they require, one said sometimes, and one said that this always occurs. Healthcare plans have been devised using the specialist knowledge of a resident’s individual condition. Where specific needs are identified such as diabetes or epilepsy, clear details are stated regarding the condition as it effects the resident; this includes monitoring, identification of any risks and details of how to recognise and what to do in the event that the condition becomes unstable. External specialists had been consulted regarding the needs of two residents case tracked and information and support provided included training when relevant, so that staff members’ have an understanding of the underlying condition. An external health care professional responding in a questionnaire said that they are consulted regarding issues arising as required. Risk assessments include reference to potential risks including responding to a heat wave, taking into account the particular needs of the resident in the event of a heat wave and measures to put in place to ensure that the resident is kept safe and comfortable. Visits from local General Practitioners are clearly recorded as are visits from other external health and social care professionals. Outcomes and action required are clearly documented and carried out. Regular checks are undertaken of health, including weights, temperature, blood pressure and respirations, according to individual needs. Pressure sore risk assessments are in place and from this care planning to minimise presenting risks. Relevant measures are put in place such as pressure relieving equipment to ensure that presenting risks are minimised. During the visit an extend session took place reflecting that residents’ health and well being is promoted. Three GPs returning comment cards said that they are satisfied with the overall care provided. Psychological health is considered in assessments and care planning. From observation and discussion with the manager and residents this planning informs support given. Clear Medication Administration Records (MAR) charts detail medicines to be administered. Allergies or none known are written on the MAR charts. Records of medicines administered were fully recorded on charts seen. The manager said she audits medicines given, so that any failures to record medication, are followed up to ensure that people living in the home receive medication as prescribed. The temperature of the drugs fridge is routinely monitored. Newtown House DS0000060895.V344923.R01.S.doc Version 5.2 Page 13 Medication for one resident checked against the MAR chart corresponded to amounts held, aside from paracetamol, which is kept separately. The manager said that she had identified that amounts in paracetamol boxes do not correspond to records for individual residents and is taking action to ensure that Registered nurses use the box for whom the medicine is prescribed. The home does not routinely record the application of creams. The home has a policy for the disposal of medicines, which reflects current guidelines and clear records of medicines to be disposed of are maintained. The manager carried out the administration of medicines on the day of the visit and ensured the security of the trolley, whilst she was giving medication. Where it is stated give one or two tablets, the number given was not recorded on the MAR charts sampled. The number of tablets carried forward is now clearly stated on the MAR chart as applicable. The need to introduce a formal, written process of auditing medicines was discussed with the manager. Three residents said in survey forms that they usually receive the medical support that they need, two said that this is always the case. One health care professional returning a comment card said that they are usually consulted regarding residents’ health care needs and that these are usually met. Throughout the visit staff members were observed providing gentle and sensitive care to residents. This included knocking on residents’ doors as appropriate. A health care professional returning a comment card said that residents’ privacy and dignity is usually respected. Newtown House DS0000060895.V344923.R01.S.doc Version 5.2 Page 14 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at Newtown House are offered choices about their daily lives, which enables them to enjoy interests, relationships that are meaningful to them and daily events such as meals and mealtimes in the surroundings and at the times of their choice. EVIDENCE: From the home’s AQAA the activities coordinator visits new residents on admission to discuss their interests. A Catholic priest visits the home and Holy Communion is held monthly. The home’s activities coordinator spoke enthusiastically about her role in the home. She has completed family trees for residents, so that staff members have an awareness of people’s backgrounds and previous interests. Currently the recording of participation in events is recorded on a sheet with a list of all residents’ names. It was advised that this should be recorded individually, so that confidentiality is maintained in record keeping and that personal needs can be more easily tracked and identified. Newtown House DS0000060895.V344923.R01.S.doc Version 5.2 Page 15 The activities coordinator currently works twelve hours per week; given the number of residents and their individual needs, this is a relatively short allocation of time to meeting social needs. In the home’s AQAA it is stated that the activities coordinator’s hours could be extended to 18 hours per week under what we could do better. (See staffing.) The manager said that shorter visits are being planned for the warmer weather so that residents are not too tired; she outlined local places of interest that people living in the home enjoy visiting. On the afternoon of the visit five residents enjoyed an extend session in one of the communal areas. One resident returning a survey form said that ‘a little more social activity would help.’ The activities coordinator explained that many residents are poorly and she therefore finds that they most enjoy one-to-one time when she can perhaps play a board game or chat with the resident. Details of residents close contacts were included in records seen and a record is maintained of people visiting the home and any discussions with staff, so that residents needs and wishes can be monitored and identified. One relative returning a survey form said ‘You are welcome to call anytime.’ One resident said that their visitors always receive a warm welcome. When the inspector arrived most residents were still in bed. Personal routines are clearly respected. One resident said that they do what they like during the day. From one resident’s notes their right to make decisions was clearly respected with regard to their care. One of the care plans in each file seen referred to night care and reflected people’s wishes about their routine at night. During the day some residents chose to stay and eat in their own rooms, others preferred to come and sit downstairs and have lunch with other residents. Residents returning survey forms said ‘I am not always given the meal I have chosen.’ Lunch on the day of the visit looked well presented and appetising. The chef chatted with residents during the day and clearly consults with them about their likes and dislikes. Homemade cakes were served with afternoon tea. Specialist dietary requirements are met, including a diabetic diet and soft and pureed diets. People needing help with eating were given sensitive support. Newtown House DS0000060895.V344923.R01.S.doc Version 5.2 Page 16 One relative returning a survey form said that ‘a more diverse menu for afternoon tea and supper’ would improve the overall menu. On the day of the visit hot and cold alternatives were offered for supper and the manager confirmed that there is always kitchen staff on duty at suppertime to ensure that the meals are prepared and served to a good standard. In the home’s AQAA it stated that fewer complaints have been received regarding meals, and a recent survey suggests that all residents are happy with meals served. It also states that the service would wish to improve the capacity of the dining room so that more residents can enjoy a meal with other people living in the home. Newtown House DS0000060895.V344923.R01.S.doc Version 5.2 Page 17 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. The home has an open approach to the receipt of complaints, enabling residents to feel that any concerns will be listened and responded to; more rigorous recruitment procedures will support the home’s commitment to protect residents from harm. EVIDENCE: The home has a clear complaints policy, which is included in the home’s service user’s guide, a copy of which is in all residents’ rooms. Some of the complaints were read that have been received in the last twelve months, and have been recorded in the complaints log. Clear details are provided of the nature of complaints received, the course of any investigations and outcomes. It is advised that complaints should be recorded separately for the purpose of Data Protection. The home has had eight complaints in the last eight months, which were substantiated; this is a reflection of the home’s open approach to the receipt of any concerns and the home’s commitment to provide a personal service, which meets all of residents’ wishes. The home has had two allegations concerning the Protection of Vulnerable Adults in the past twelve months. The first was not substantiated and the Newtown House DS0000060895.V344923.R01.S.doc Version 5.2 Page 18 manager has confirmed that she will write to outline the outcome of the second, which was also not substantiated. Staff members receive training in the Protection of Vulnerable Adults from an external training company. The home must ensure that its recruitment procedures are rigorously followed in order to ensure that residents are protected from harm. (See staffing.) The home has policies, which are presented so that they are accessible to staff members; this includes whistle blowing and adult protection. Newtown House DS0000060895.V344923.R01.S.doc Version 5.2 Page 19 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. The environment at Newtown House provides warm and welcoming surroundings, which are maintained to a good standard of cleanliness, providing residents with a comfortable, homely and hygienic place to live. EVIDENCE: Individual rooms visited were decorated to a good standard. Communal areas are comfortably arranged with matching furnishings. The home has a warm and welcoming environment. Some areas of the home are in need of some upgrading and the home has plans in place to achieve this. Newtown House DS0000060895.V344923.R01.S.doc Version 5.2 Page 20 Accommodation is individual, with personal possessions. Many individual rooms benefit from either full length windows with views over the garden, or windows that are at eye level, when the resident may spend a lot of time in bed. The home has pleasant gardens, which are well maintained. The home has plans to improve and extend facilities and services at Newtown House. This includes improving the bathing facilities available to residents to meet nursing needs in terms of safe bathing. Bath water temperatures sampled were suitably regulated. The maintenance person confirmed that a toilet that has just been converted from a staff to a residents’ toilet and the water temperature from the sink water outlet was very hot will be fitted with a temperature control valve. A warning sign is placed above the sink. There is a toilet at the end of a corridor on the ground floor, which was fitted with a freestanding heater, which was not guarded. The manager advised that this would be removed and it would be ensured that safe suitable heating is in place when the weather gets colder. During the visit the home was clean and free from unpleasant odours. Alcohol hand gel is used to reduce the risk of infection and staff members were observed wearing white aprons when carrying out personal care and blue when handling food. The home has small sluices on the ground and first floors that are fitted with sluice disinfectors. Two members of domestic staff were on duty at the time of the visit. From observation they are very conscientious in the work that they do. One staff member was watering the residents’ plants for them. Both enjoyed good relationships with the people for whom they provide a service. The home has a new laundry. The old laundry still had some washing hanging from a discoloured bar. A member of staff said the room is damp. It is not appropriate for clean clothes to go back into the old laundry. Newtown House DS0000060895.V344923.R01.S.doc Version 5.2 Page 21 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 poor. This judgement has been made using available evidence including a visit to this service. The home’s recruitment procedures are not currently adequate. Training is recorded and takes place to ensure that staff members develop the skills that they need to care for residents. The home did not demonstrate at the time of the visit that staffing levels are sufficient at all times to meet the needs of residents. EVIDENCE: Clear rosters are maintained indicating staff members on duty. Rosters are maintained for all staff working in the home. The manager came across a resident who needed help during the course of the visit, and waited until the bell had gone to an emergency call for assistance. The emergency call bell is activated after two minutes. Staff members had been attending to the needs of other residents. The manager said that she does periodic audits of responses to the call alarms. As the level of dependency is increasing and may vary, it is required in this report that a full audit be undertaken for staff employed in the home to ensure that there are always sufficient staff on duty to meet residents’ needs. Newtown House DS0000060895.V344923.R01.S.doc Version 5.2 Page 22 From observation and feedback during the visit and the results of the home’s own quality assurance audit, it would be beneficial to have someone with clear responsibility for the laundry. The manager is endeavouring to ensure that staff members allocated to laundry duties have experience in caring for clothing. In the home’s AQAA the care of residents’ laundry has been highlighted as an area for improvement. With the manager’s clear and open commitment to identify and address any issues raised, this will be approached positively and any action taken will be for the benefit of residents. The maintenance person works for twenty-three hours per week, this has been reviewed by the home since the inspection and adjusted to ensure that it is sufficient to adequately maintain all areas of the home, including the garden and routine checks such as fire checks. From information provided by the manager four members of staff currently have a National Vocational Qualification at level 2 and one member of staff has an NVQ at level 3. In addition to this six members of staff are starting or in the process of undertaking NVQ’s. Three files were viewed for staff members who had started work in the home since the last inspection. There was no photo on two of the files seen. Protection of the Vulnerable Adult’s register had been undertaken prior to the staff members starting work in the home; under supervision until a Criminal Records Bureau check is received. There was only one reference on file for one member of staff, which was not from the person’s last place of work. It also needs to be ensured that reasons for gaps in work histories are explored and that applicants are asked to give a full work history. The home has adopted the new Skills for Care induction programme. No records were available to view at the time of the inspection. Ensuring that a record is maintained of the progress of learning was discussed. A summary record of training is maintained. A lot of training takes place by videos, supported by external training. The knowledge sets on the Skills for Care website were discussed. Records of training were seen on individual files viewed, together with copies of certification. Newtown House DS0000060895.V344923.R01.S.doc Version 5.2 Page 23 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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Good systems of quality assurance support improving systems for the health and welfare of residents, ensuring that the home is run in the best interests of residents. Attention to outstanding areas with regard to health and safety will support the home’s commitment to keep people safe. EVIDENCE: The manager is a Registered nurse and is currently undertaking the Registered Manager’s Award. The manager said that she has submitted the final units of the award and is awaiting confirmation of the outcome. There was a condition in place at the time of the visit that the manager achieves the Registered Manager’s Award by December 2006. As she is currently at the point of completing the qualification this condition will be removed. A deputy manager Newtown House DS0000060895.V344923.R01.S.doc Version 5.2 Page 24 supports her. At the time of the visit, it was clear that staff members have a good understanding of their roles and responsibilities. The home is well organised and staff members consulted with the manager if they needed any help or advice. The manager has started to introduce a formal programme of quality assurance. There is an action plan from the home’s annual audit, which included consulting relevant people involved with the life of the home, collating information and setting out how the service intends to improve the quality of care and service. This was reflected in the home’s AQAA, which was completed within the timescale and returned to the Commission for Social Care Inspection. There was also a good response to survey forms sent out by the home, as part of the inspection process. The home keeps a record of any monies kept on behalf of residents; money is stored separately and corresponding receipts are kept on file. Two sampled amounts corresponded with records held; although for one resident the home was holding 10p in excess. Loyalty card points were detailed on two of the receipts seen. Although, the manager explained that staff members had done this innocently, this is not acceptable. Records sampled for maintenance were up to date. However, the home’s AQAA indicated that checks of electrical systems had not been undertaken. The maintenance person said that checks of portable electrical appliances have been undertaken; but the manager said that the last certificate for the check of routine wiring couldn’t be found, although it was believed to be up to date. She said that a check has, therefore, been arranged. There were hazardous substances in bathrooms and toilets in the home and the domestics left their cleaning products unattended whilst moving around the home. This was brought to the attention of the manager, who took immediate action to ensure that the substances are safely stored at all times. Although the risk is minimal given that most residents are in receipt of nursing care and do not move about the home without assistance, the manager realized that it is essential that all substances, which may present a hazard are safely stored at all times. The manager’s prompt action is recognised and awareness that she is accountable for ensuring that substances are always safely stored. The home maintains a fire log where routine checks of fire equipment and services are recorded. Fire drills and training are also detailed in records kept. Training in aspects of health and safety is undertaken. The home has a fire risk assessment. Tasks listed on the fire risk assessment have not currently been fully completed. The maintenance person confirmed that the external company who are carrying out the assessment will be visiting the home and he will be confirming with them actions to be carried out. There are bolts applied to two doorways, which lead through to an area, which is no Newtown House DS0000060895.V344923.R01.S.doc Version 5.2 Page 25 longer in use aside from as an office. It needs to be ascertained that this is acceptable in relation to the protection of residents and staff in the event of a fire. Newtown House DS0000060895.V344923.R01.S.doc Version 5.2 Page 26 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 2 X 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 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 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 1 X X 1 Newtown House DS0000060895.V344923.R01.S.doc Version 5.2 Page 27 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 OP9 Regulation 13 Requirement The audit trail of medicines received into the home must be monitored, to ensure that good practices are maintained in the safe handling of medication in the home. A full audit must be undertaken of staffing levels in the home to include the needs for staffing in the laundry, maintenance and for activities to ensure that there are always sufficient staff members on duty to meet residents’ changing needs. Full and rigorous recruitment checks must be undertaken prior to new staff members starting work in the home, protecting people living at the service. Staff members’ loyalty cards cannot be used for purchases made on behalf of residents. Action identified in the Fire Risk Assessment as required to ensure good practice in fire prevention must be completed to ensure the fire safety of Newtown House is maintained. DS0000060895.V344923.R01.S.doc Timescale for action 30/09/07 2. OP27 18 30/09/07 3. OP29 19 15/08/07 4. 5. OP35 OP38 13 23 15/08/07 15/09/07 Newtown House Version 5.2 Page 28 (Timescale 31/07/06 not fully met.) 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 OP3 Good Practice Recommendations It is recommended that full details of a person’s needs are included in the pre-admission assessment carried out, ensuring that the home is able to make a decision regarding whether the home is able to meet prospective residents’ needs and preferences. It is recommended that individual records of residents’ participation in events and social engagement are maintained so that ongoing social needs can be monitored, identified and met. It is recommended that the home submit evidence that checks of electrical wiring in the home have been carried out. 2. OP12 3. OP38 Newtown House DS0000060895.V344923.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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. 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