Care Home: Newgate Street, 67

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What the care home does well The staff ask people about their needs and choices and keep good records of this. The staff give people choices about how they spend their time. People are supported to take part in leisure activities inside the home..... And away from the home. What has improved since the last inspection? The kitchen has been redecorated. What the care home could do better: Make sure that some things are followed up so that the building is at its best and all areas are safe. Key inspection report Care homes for adults (18-65 years) Name: Address: Newgate Street, 67 67 Newgate Street Morpeth Northumberland NE61 1AY The quality rating for this care home is: two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Anne Brown Date: 2 2 0 6 2 0 0 9 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should:  Be safe  Have the right outcomes, including clinical outcomes  Be a good experience for the people that use it  Help prevent illness, and promote healthy, independent living  Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home:  3 stars – excellent  2 stars – good  1 star – adequate  0 star – poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. They reflect the things that people have said are important to them: 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 Care Homes for Adults (18-65 years) Page 2 of 28 Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) 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 mission of the Care Quality Commission is to make care better for people by:  Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice  Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983  Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services.  Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Newgate Street, 67 67 Newgate Street Morpeth Northumberland NE61 1AY 01670512482 01670512482 gm.e.ntawnt.newgate@nhs.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Northumberland, Tyne & Wear NHS Trust care home 3 Number of places (if applicable): Under 65 Over 65 3 0 learning disability Additional conditions: Date of last inspection A bit about the care home 67 Newgate Street is a small residential care home offering accommodation for three male adults with learning disabilities. It is registered to provide personal care, but not nursing care. It is a two-storey terraced house in the centre of Morpeth, close to all facilities and transport networks. There are three single bedrooms on the first floor and two lounges and a dining kitchen downstairs. Care Homes for Adults (18-65 years) Page 4 of 28 Care Homes for Adults (18-65 years) Page 5 of 28 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: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 6 of 28 How we did our inspection: This is what the inspector did when they were at the care home We talked to people who were living in the home. We sent surveys to the people living in the home and the staff. We looked at some of the policies and procedures, Policies are rules about how to do things. Procedures tell people how to follow the rules. What the care home does well The staff ask people about their needs and choices and keep good records of this. The staff give people choices about how they spend their time. People are supported to take part in leisure activities inside the home..... And away from the home. Care Homes for Adults (18-65 years) Page 7 of 28 What has got better from the last inspection What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Anne Brown St Nicholas Building St Nicholas Street Care Homes for Adults (18-65 years) Page 8 of 28 Newcastle upon Tyne Tyne and Wear NE1 1NB 01912333300 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line - 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 28 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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. Good information about the home is available and thorough assessments are carried out to help ensure individual needs are met. Evidence: The statement of purpose and service user guide contain the full range of information required. This helps people decide if the home can meet their needs. These documents are available in various formats, for example easy read, braille, audio and large print. The home carries out thorough pre-admission assessments. This includes obtaining a care management assessment and, where applicable, information is sought from carers, relatives and relevant health care professionals. Copies of the assessments are available on the individual case files so staff can refer to these to help ensure needs are met. No new admissioins have taken place since the last inspection. There was evidence on the case files to show that needs are re-assessed on a regular basis and changes are made to the care plans. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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. There is good information available to help the staff deliver care according to individual preferences and people are encouraged to make decisions on all aspects of their lives. Evidence: The care plans give clear guidelines to the staff about how care and support should be delivered. Detailed guidelines which have been completed by relevant professionals are also in place. People are encouraged to be involved in their care plan so they can be supported accordingly to their own preference. One person confirmed that he had helped complete his care plan and signed it. The plans are reviewed on a regular basis and all interested parties are invited to attend after consultation with the person living in the home. The monthly evaluations on some plans were out of date. The could mean that changing needs may not be fully met, although the staff in the home were well aware of each Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: persons needs. People are supported to take calculated risks to enhance their lifestyles. Two people are able to go to the local shops alone. Risk assessments have been completed to help reduce the risk as far as possible. Any restrictions that are set, are fully recorded along with the reasons for this. The staff encourage people to make decisions and provide them with information so they can make informed choices, for example how to spend their time, where to go on holiday, mens etc. Meetings are held on a regular basis to discuss all aspects of life in the home and every effort is made to take peoples views into consideration. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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. The people living in the home are well supported to take part in activities of their choice and are encouraged to mix with people in the local community. Evidence: Each person living in the home chooses how they spend their time and what activities they wish to take part in. They all attend day care placements which include Bedlington Adult Training Centre, Parkhead Day Centre, Azure Printers, Hepscott Park and Alnwick College. Each person has a day off during the week when they help to clean their bedroom and help staff with other household tasks. During the inspection one person had been doing the food shopping with a member of staff. Another was getting ready to go to a local shopping centre and then have lunch at McDonalds. Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: All three people have contact with their families and one person sees his mother and father on a weekly basis. One person said he was going to The Hoppings later this week with his father. Activities include trips to Newcastle Arena, shows, tribute bands and outings in the car to local places of interest. The staff often make a picnic if the weather is good and head off into the countryside. One person likes watching local football games and had recently enjoyed a trip to Wembley with a staff member. Another person has a season ticket for Newcastle United. The manager had recently accompanied one person to complete the Great North Walk. Two people are booked to go to Spain in September and another person is going to Edinburgh Tattoo. He enjoyed a holiday in Portugal earlier this year. The menus are based on peoples known likes and dislikes. The staff said they are always trying to find new menus and provide interesting things for people to try. Two people who were present said they enjoyed all the food served to them. One said their favourite foods were Chinese Takeaways and pasta. One person is on a gluten free diet and staff have researched into this to find a good variety of products so he is able to have more choices. Fresh fruit and vegetables are served in home and drinks and snacks are provided whenever people want them. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home receive personal support when they need it and staff monitor and promote their health to maintain their well-being. Evidence: People living in the home have individual health care plans. Their health and welfare is constantly monitored by the staff. If there are any concerns about someones health appropriate action is taken. One person said he had been to the hospital recently to see his consultant. Details of health checks, hospital appointments, visits to GP, dentist, optician etc. are recorded on the individual case files. The staff are provided with clear guidelines on how each persons care and personal support should be delivered. The staff on duty felt that had been given good training to meet the needs of the people living in the home. They were fully aware of peoples needs and how to deal with certain behaviours. The system for administering medications is appropriate. The majority of medications are Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: received in a blister pack and unused medications are returned to the pharmacist. A minor discrepancy was apparent on one record. The manager stated he would discuss this with the staff member as soon as possible. If it is thought to be safe following a risk assessment, people can control their own medication. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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. Complaints are properly dealt with and training on adult protection has been provided for the staff, whcih helps protect people from abuse. Evidence: The home has an appropriate procedure for dealing with complaints. A complaints book is maintained to record any complaints and the outcome of the investigation. No complaints have been received since the last inspection. The complaints procedure is available in various formats, e.g. easy read, audio, large print. The home has a Tell Us policy which supports people living in the home to make a complaint if necessary. One person living in the home said he would speak to the staff if he needed to complain. He said the staff had supported him to make a complaint to the Trust in the past and he had received a good outcome. There is a whistle blowing procedure and the staff were confident to use this if they observed any bad practice. All staff have received training on safeguarding vulnerable adults and the various forms of abuse. Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: The people living in the home are unable to manage their own finances so their personal allowances are held by the home. All transactions are fully recorded. Receipts are kept for any purchases made and two staff signatures are recorded. Care Homes for Adults (18-65 years) Page 19 of 28 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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. The home is clean, comfortable and provides people with a pleasant place to live. The bedrooms reflect the individual tasts of the people who live there. Evidence: The home is clean and comfortable and provides people with a nice place to live. Each person has their own bedroom. The rooms are personalised and reflects the interests and hobbies of each individual. The hall, stairs and landing carpet was showing signs of wear and tear at the last inspection and has still not been replaced. It is now badly stained in the hallway and has stretched in some areas. Some areas are become threadbare on the stairs which could cause a trip hazard. The staff reported that the outer casing on the side of the oven becomes very hot to touch. This could pose a health and safety hazard for the people living in the home and the staff. The gardens are well maintained. The staff are planning to purchase some fruit bushes so encourage people to become involved in maintaining them. Care Homes for Adults (18-65 years) Page 20 of 28 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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. There are sufficient staff employed in the home who are well trained to meet the individual needs of the people who live there. Evidence: The staffing rotas showed there were sufficient staff on duty to meet the assessed needs of each person living in the home. Two staff are on duty every day and there is one member of staff who sleeps there overnight. There are training programmes in place to help ensure the staff receive mandatory health and safety training at appropriate intervals. Staff are also provided with specialist training to meet individual needs. The staff on duty confirmed they had received appropriate training and one person said they were soon to attend a training course on risk assessment. The home employs five home support workers. Two staff have achieved a National Vocational Qualification (NVQ) Level 2, two have achieved Level 3 and another staff member has been enrolled to commence this training. No new staff have been employed in the home since the last inspection. The manager confirmed that Criminal Records Burear checks and two written references would be Care Homes for Adults (18-65 years) Page 21 of 28 Evidence: obtained before staff have employed in the home. The staff on duty were well aware of the individual needs of the people living in the home. Two people said they got on well with the staff and good relationships were evident. The staff team are committed to enhancing the lifestyles of the people living in the home and providing them with new opportunities. Care Homes for Adults (18-65 years) Page 22 of 28 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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. The culture and systems in the home help to ensure that the service is led by the needs and wishes of the people living there, and helps to protect them from harm. Evidence: The manager has experience in working with adults with learning disabilities. She has completed NVQ Level 4 in management and care, holds a Learning Disability Certificate and has completed a course on Leadership and Management. Regular meetings are held to discuss any issues that arise and to ensure the home is run in the best interests of the people living there. Minutes of the meetings were available for inspection. There are comprehensive policies and procedures in place to safeguard the rights and best interests of the people living in the home. The routines in the home are flexible and revolve around the needs of the individuals living there. Staff felt they were able to spend one to one time with people and meet their individual needs and help them access preferred activities. Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: A visit had been made to the home by a senior manager and a manager from another home to ensure standards were being met. These visits were carried out in January 2009 and June 2009. The visits are not carried out on a monthly basis to help ensure that the people who live there get the care they need and their health, safety and welfare is promoted. The records showed that fire drills are carried out and fire equipment is checked on a regular basis. The staff receive regular health and safety training. The staff on duty confirmed that they receive health and safety training to help protect the safety of themselves and the people living in the home. Care Homes for Adults (18-65 years) Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes  No  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 Adults (18-65 years) Page 25 of 28 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 Description 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 Description Timescale for action 1 20 13 The registered manager must carry out an assessment to ensure all staff are competent when administering medication. 31/07/2009 This will ensure that the health needs of the people living in the home are fully promoted. 2 24 13 The hot surface on the outer 31/07/2009 casing on the oven must be made safe. To protect the safety of the people living in the home and the staff. 3 39 26 The registered provider must 31/08/2009 ensure monthly visits are made to monitor standards and produce a written report. This will help ensure Care Homes for Adults (18-65 years) Page 26 of 28 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 Description Timescale for action standards continue to be met and peoples opinions are taken into consideration. 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 2 6 24 Care plans should be evaluated on a monthly basis to help ensure any changes in need are fully met. The hall, stairs and landing carpet should be replaced as it is showing signs of wear and tear. This will help ensure peoples safety and enhance the environment. Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 or Email: enquiries@cqc.org.uk Web: www.cqc.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 © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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