CARE HOME ADULTS 18-65
The Newlands Royal Walk Cheadle Stoke on Trent Staffordshire ST10 1EL Lead Inspector
Sue Jordan Unannounced Inspection 6th February 2006 11:30 The Newlands DS0000033400.V282214.R01.S.doc Version 5.1 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 The Newlands DS0000033400.V282214.R01.S.doc Version 5.1 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 Adults 18-65. 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. The Newlands DS0000033400.V282214.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service The Newlands Address Royal Walk Cheadle Stoke on Trent Staffordshire ST10 1EL 01538 752210 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) Staffordshire County Council, Social Care and Health Directorate Mrs Tracey Shirley Joinson Care Home 12 Category(ies) of Dementia (4), Dementia - over 65 years of age registration, with number (4), Learning disability (12), Learning disability of places over 65 years of age (5), Mental disorder, excluding learning disability or dementia (2), Physical disability (4) The Newlands DS0000033400.V282214.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. 4. 12 Learning Disability (LD) - Minimum age 40 years on admission 4 Physical Disability (PD) - Minimum age 40 years on admission 2 Mental Disorder (MD) - Minimum age 40 years on admission 4 Dementia (DE) - Minimum age 40 years on admission. Date of last inspection 6th September 2005 Brief Description of the Service: The Newlands is a Local Authority Home accommodating up to 10 people with learning disabilities, currently between the ages of 50 and 81 years and with differing levels of dependency. It is situated in a quiet cul-de-sac close to the local hospital and town centre. The home is set in a private and attractive garden, which contains a gazebo, garden furniture and flower beds. There is adequate car parking provision. The property consists basically of two semidetached houses modified over the years to create four distinct living areas, each with its own lounge/dining and/or kitchen/kitchenette facilities. One area is self contained for the three more independent service users and has its own entrance with service users having their own keys. Accommodation is on two floors with access being provided by stairs and a shaft lift. All bedrooms are of single occupancy with all but one being on the first floor. An adequate number of toilets are provided on both floors. Service users are able to remain at this home for as long as their needs can be appropriately met or until they progress sufficiently to move into accommodation in the community. Nine of the ten present service users attend some form of day service provision within the community and those who are over retirement age and choose not to continue with day care provision, remain in the home and determine how their time is spent. The Newlands DS0000033400.V282214.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This report must be read in conjunction with that from September 2005. The key standards have all been inspected over a twelve-month period and the manager was successfully registered with the Commission for Social Care Inspection in August 2005. What the service does well: What has improved since the last inspection? What they could do better:
The Local Authority and the Commission for Social Care Inspection, (CSCI), are presently working together to ensure that The Statement of Purpose, Service Users’ Guide and the contracts contain the required information. A meeting was held on 13/06/05 to discuss the facilities included in the residents’ contract price and what they may be expected to fund themselves. This includes the provision of holidays and bedroom furniture replacement and decoration, although this is not exhaustive. The CSCI were satisfied that the department and individual homes have robust arrangements in place to ensure that those residents without the capacity to make decisions are supported independently and that appropriate records are kept. As discussed at this meeting, these arrangements should be made clear in the homes’ admission documentation, in order that potential residents and/or their families can make an informed choice as to whether they wish to live in the home. Clear and
The Newlands DS0000033400.V282214.R01.S.doc Version 5.1 Page 6 transparent information will protect both the residents and the organisation from the suspicion of financial abuse. These documents were examined at this inspection and there were no changes or the additional information required. 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 Newlands DS0000033400.V282214.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Newlands DS0000033400.V282214.R01.S.doc Version 5.1 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 5 The information available to the residents must be clear, transparent and current, ensuring that they and/or their representatives/advocates are fully aware of their rights. EVIDENCE: The Local Authority and the Commission for Social Care Inspection, (CSCI), are presently working together to ensure that The Statement of Purpose, Service Users’ Guide and the contracts contain the required information. A meeting was held on 13/06/05 to discuss the facilities included in the residents’ contract price and what they may be expected to fund themselves. The CSCI were satisfied that the department and individual homes have robust arrangements in place to ensure that those residents without the capacity to make decisions are supported independently and that appropriate records are kept. As discussed at this meeting, these arrangements should be made clear in the homes’ admission documentation, in order that potential residents and/or their families can make an informed choice as to whether they wish to live in the home. Clear and transparent information will protect both the organisation and the residents from the suspicion of financial abuse. The Newlands DS0000033400.V282214.R01.S.doc Version 5.1 Page 9 The above text is copied from the inspection report dated 06/09/05. These documents were examined at this inspection and there were no changes or the additional information required. The information in the folder given was out of date and some of the records still referred to the previous manager and deputy. The information available in one of the lounges was also out of date. The Newlands DS0000033400.V282214.R01.S.doc Version 5.1 Page 10 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 9 Care records are a current reflection of individual need, ensuring that staff have the information required to support the residents at any given time. EVIDENCE: Observations of the handover between the manager and one of the care managers indicated that the care plans and risk assessments are continually updated and amended as needs change and situations dictate. The care records scrutinised during this visit confirmed this. The Newlands DS0000033400.V282214.R01.S.doc Version 5.1 Page 11 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These ‘Lifestyle’ standards were not assessed during this visit. However they were all assessed at the Announced Inspection on 06/09/05. EVIDENCE: The Newlands DS0000033400.V282214.R01.S.doc Version 5.1 Page 12 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 The Home continues to monitor health care needs and access medical support appropriately. EVIDENCE: Observations of the handover between the manager and one of the care managers indicated that health and personal needs are continually assessed and the records changed accordingly change. There is evidence of joint working with medical health professionals and appropriate health intervention. The residents are supported to access medical services as and when necessary. The care records scrutinised during this visit confirmed this. A dietician has been involved in developing healthy eating programmes for the residents with successful results and is due to review the assessments. New homely remedies protocols have been introduced since the last inspection and are presently being sent to the General Practitioners to sign. Staff responsible for administration are undertaking the ‘Safe Handling of Medicines’ course. The Newlands DS0000033400.V282214.R01.S.doc Version 5.1 Page 13 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 EVIDENCE: There have been no complaints made regarding this service to the Home or the Commission for Social Care Inspection. The staff team received instruction and guidance from the Local Authority Adult Protection manager on 31/01/06, as previously recommended. The Newlands DS0000033400.V282214.R01.S.doc Version 5.1 Page 14 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These ‘Environmental’ standards were not assessed during this visit. However the ‘key’ standards were assessed at the Announced Inspection on 06/09/05. EVIDENCE: The Newlands DS0000033400.V282214.R01.S.doc Version 5.1 Page 15 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34 The manager must ensure that staff files are maintained according to Schedule 4 of The Care Homes Regulations. EVIDENCE: There have been two new members of staff employed since the last inspection. The records were requested and whilst they were available for a completely new employee, they were not available for a member of staff promoted from another Home. The member of staff did confirm that she had undergone thorough recruitment procedures, including interview. Up to date records should be kept in the Home. The file available contained all of the relevant information and there is evidence of robust procedures, including Protection of Vulnerable Adults checks. The Newlands DS0000033400.V282214.R01.S.doc Version 5.1 Page 16 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 42 Health and Safety continues to be high priority within the Home. EVIDENCE: Random Health and Safety records were checked at this inspection, which bore evidence that procedures continue to be appropriately prosecuted. The Environmental Health Officer visited the Home on 20/12/06 and commended the staff for the cleanliness of the building. The Newlands DS0000033400.V282214.R01.S.doc Version 5.1 Page 17 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 2 X 3 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 X 33 X 34 2 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X 3 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 3 X X X X X X 3 X The Newlands DS0000033400.V282214.R01.S.doc Version 5.1 Page 18 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 YA1 Regulation 4(1b,c),5 (1b,c) Requirement The Department must ensure that The Statement of Purpose and Service Users Guide contain all of the required elements. Including what is and what is not included in the fees. Timescale for action 01/04/06 2. YA5 5 (1b, c) Previous Requirement 06/09/05 The Department must ensure 01/04/06 that terms and conditions include the facilities covered by the fees and the cost of facilities or services not covered by the fees. Previous Requirement 06/09/05 The elements listed in Schedule 2 should be maintained in the Home, for each member of staff. 3 YA34 Schedule 2 01/04/06 The Newlands DS0000033400.V282214.R01.S.doc Version 5.1 Page 19 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 YA1 Good Practice Recommendations It is recommended that The Statement of Purpose be dated at each amendment or review as evidence of the documents currency. The Newlands DS0000033400.V282214.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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