Care Home: Newgrange Residential Home

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What the care home does well The home is very welcoming, safe and homely. The residents who were spoken to during the visit, stated they are very happy living at the home and feel that their needs are met very well; they are able to ask the staff who are very approachable and happy to ensure that the residents are happy. Whilst extensive building work is being carried out the manager and providers have ensured the safety of all who enter the home by completing comprehensive risk assessments and having them signed by the contractors to ensure that they are clear about their responsibilities in ensuring the safety of all who enter the home. The manager is very clear on her role within the home and ensures she is kept up to date on new legislation and good practise. Policies and procedures are reviewed and amended as appropriate and staff are informed of any changes through team meetings etc. Staff were observed to be assisting residents in a discreet manner and also encouraging residents to be independent as possible. What has improved since the last inspection? The providers have carried out some decoration and there is an on going programme. They have registered a further two rooms to bring their occupancy levels to 23. Newgrange Residential Home DS0000073093.V376663.R02.S.doc Version 5.2 There has been a change in provider and as such has brought in new ideas and enthusiasm which benefits both the residents and the staff. What the care home could do better: Whilst there has been no identified areas for improvement during this inspection. The manager and providers need to continue to ensure that residents and visitors are kept safe during the continuation of the building work. Key inspection report CARE HOMES FOR OLDER PEOPLE Newgrange Residential Home Cadmore Lane Cheshunt Herts EN8 9JX Lead Inspector Alison Butler Key Unannounced Inspection 21st July 2009 10:00 DS0000073093.V376663.R02.S.do c Version 5.2 Page 1 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. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The 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. Newgrange Residential Home DS0000073093.V376663.R02.S.doc Version 5.2 Page 2 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 Newgrange Residential Home DS0000073093.V376663.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Newgrange Residential Home Address Cadmore Lane Cheshunt Herts EN8 9JX 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) 01992642449 01992620884 www.newgrangehome.co.uk Newgrange of Cheshunt Ltd Mrs Alison Jane Wood Care Home 23 Category(ies) of Dementia (23), Old age, not falling within any registration, with number other category (23) of places Newgrange Residential Home DS0000073093.V376663.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Both Whose primary care need on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE The maximum number of service users who can be accommodated is: 23 24 April 2007 2. Date of last inspection Brief Description of the Service: This building was purpose built and is located in Cheshunt, close to local shops and amenities. The accommodation comprise of 23 bedrooms, 17 bedrooms with bath ensuites, 5 bedrooms with shower ensuites and 1 bedroom with a hand basin and toilet. There are number of offices on the ground floor. The main lounge dining room and conservatory are open plan and provide a variety of communal spaces that residents may use for their own purposes. There are two assisted bathrooms and toilets which are in easy reach of the communal areas. The outside grounds are landscaped and provide pleasant views from the home. There is limited parking to the front of the building. A copy of the Statement of Purpose, Service Users Guide and the most recent inspection report can be found in the entrance hall of the home. Newgrange Residential Home DS0000073093.V376663.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 star. This means that people who use the service experience excellent outcomes. This unannounced inspection was conducted with the manager, duty manager, staff and the people who use the service. Although the inspection is conducted by one inspector on behalf of the Commission the report will refer to this as ‘we’. This report has been written following a visit to the home, and information that has been gathered since the last inspection in April 2007. There has been a change in provider who took over in December 2008, but the management structure and staffing levels remains the same. The home remains to be run to the same high standard prior to December 2008 What the service does well: The home is very welcoming, safe and homely. The residents who were spoken to during the visit, stated they are very happy living at the home and feel that their needs are met very well; they are able to ask the staff who are very approachable and happy to ensure that the residents are happy. Whilst extensive building work is being carried out the manager and providers have ensured the safety of all who enter the home by completing comprehensive risk assessments and having them signed by the contractors to ensure that they are clear about their responsibilities in ensuring the safety of all who enter the home. The manager is very clear on her role within the home and ensures she is kept up to date on new legislation and good practise. Policies and procedures are reviewed and amended as appropriate and staff are informed of any changes through team meetings etc. Staff were observed to be assisting residents in a discreet manner and also encouraging residents to be independent as possible. What has improved since the last inspection? The providers have carried out some decoration and there is an on going programme. They have registered a further two rooms to bring their occupancy levels to 23. Newgrange Residential Home DS0000073093.V376663.R02.S.doc Version 5.2 Page 6 There has been a change in provider and as such has brought in new ideas and enthusiasm which benefits both the residents and the staff. What they could do better: 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 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. Newgrange Residential Home DS0000073093.V376663.R02.S.doc Version 5.2 Page 7 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 Newgrange Residential Home DS0000073093.V376663.R02.S.doc Version 5.2 Page 8 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standard 6 is not applicable to Newgrange People who use the service have their needs assessed prior to admission, this ensure that the home is able to meet their needs. EVIDENCE: The statement of purpose has been updated to include the registration of two new rooms bringing the total number the home is able to accommodate to 23. Prospective residents are able to visit the home at any reasonable time and they encourage them to spend time at the home before making a decision this provides both parties time to ensure that the home is able to meet their needs, choices and preferences, during this time a written assessment is completed. Prospective residents are provided with a copy of the Statement of Purpose and the most recent report, this provides them with information on what the Newgrange Residential Home DS0000073093.V376663.R02.S.doc Version 5.2 Page 9 home is able to provide and enables them to make an informed choice. A member of the management team who hasapprorpiate skills and experience will carry out an assessment. Newgrange Residential Home DS0000073093.V376663.R02.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans provide the staff with details of how resident’s needs are to be met and ensure that a consistent approach is given. EVIDENCE: Care plans looked at showed that they contained details on how care needs are to be met. Whilst daily records record information some of them need to be clear on the detail for example where somebody has not eaten their meal they need to explain the reason for this to ensure that everyone is clear and further observation can be taken. Medication records were examined and were well kept this ensures that residents are protected to ensure they are administered their prescribed medication in line with the GP’s instruction. Where medication has been omitted this has been recorded on the medication recording sheets. Those residents spoken to during the inspection told us “its lovely here dear” “ the staff are wonderful”. Staff were seen to promote independence and they Newgrange Residential Home DS0000073093.V376663.R02.S.doc Version 5.2 Page 11 were treated with respect. Residents receive a good quality end of life care and wishes are recorded on the care plans, they are able to spend their final days in their room and are able to have friends and family visit at any time. Additional support can be accessed via the GP to ensure they remain comfortable and pain free. Newgrange Residential Home DS0000073093.V376663.R02.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the 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 who use the service are able to enjoy a daily life and take part in activities that meet their preferences and expectations. EVIDENCE: There is a range of activities on offer for the residents for example quizzes, bingo, with various events that take place including a couple who come in and provide entertainment. Photos are taken of the events that take place and are available to all the residents and families to take a look at, they can also be used for reminiscence purposes. A Church of England communion service is held every month which residents who wish to, attend. They organise other faith visits to those who wish to have some spiritual support to meet their needs can also be organised as required. The cook has been at the home for a considerable number of years and knows the residents extremely well. They offer a four week rolling menu and if the meals of the day are not to the residents liking alternatives are offered. We joined the residents for lunch which was a very pleasant experience and the meal was very tasty and well presented. The residents were very happy with Newgrange Residential Home DS0000073093.V376663.R02.S.doc Version 5.2 Page 13 the meals and say “it is like home from home cooking”. Residents are able to request drinks and snacks throughout the day. Newgrange Residential Home DS0000073093.V376663.R02.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the 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 who use the service can be confident that any concerns they have would be listened to and actioned. EVIDENCE: The home have produced a simple complaints procedure which is accessible to residents, family and friends. No complaints have been received in the last year but there is an appropriate recording procedure in place where the action taken and any outcome is recorded and can be viewed at any time. All staff receive training in dealing with complaints, safeguarding and whistle blowing. The home have received a number of compliments and these are recorded and staff are able to see the comments about the good work they do at Newgrange. Newgrange Residential Home DS0000073093.V376663.R02.S.doc Version 5.2 Page 15 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the 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 who live at the service can be assured that it is clean, safe, well maintained to make their time at Newgrange a very positive experience. EVIDENCE: A tour of the home was conducted and although there was major building work being carried out, the disruption to the residents was being kept to a minimum. It is hoped that the building works will be fully completed by December 2009. Risk assessments have been put in place and these had been signed by the builders to ensure they were clear of any risks and they were abiding by the measures that were put in place to minimise these risks. There was a responsibility on the builders to ensure that the areas they were working in were kept as clean as possible and an expectation at the end of each day that the areas were left safe. The number of rooms have been increased to 23 Newgrange Residential Home DS0000073093.V376663.R02.S.doc Version 5.2 Page 16 which have now been registered by the Care Quality Commission. There is work on going to eventually increase the number of rooms to 30. All bedrooms are ensuite with 17 having bath en-suite and 4 having walk in shower facilities. One of the new rooms has a shower ensuite and 1 has just a toilet and hand basin. They have relocated the two assisted bathrooms, and are going to address the design of one of these, to have the bath placed in the centre of the room, which would provide access to both sides, and this would help in meeting the needs of those residents who may require assistance from two members of staff. There are policies and procedures in place for the control of infection which includes the safe handling and disposal of clinical waste. Newgrange Residential Home DS0000073093.V376663.R02.S.doc Version 5.2 Page 17 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the 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 who live at the service are assured that there are robust recruitment procedures in place and that adequate numbers of staff are available to meet their needs. EVIDENCE: The home have good recruitment procedures and ensure that all relevant checks are carried out before the person commences employment in the home. An on going training programme is in place to ensure that residents are supported by staff who have the training to meet the residents needs. The company support staff to achieve a minimum of NVQ level 2 in care. Appropriate numbers of care staff are available to meet the needs of the residents. As the company are hoping to increase the number of rooms to 30 by December 2009, they state they will review the staffing levels to ensure they meet the needs of the people who live at Newgrange. There are appropriate numbers of ancillary staff which keep the home clean and tidy to a high standard and again this will be reviewed as numbers living at the home increases to ensure they maintain their high standard of cleanliness. Newgrange Residential Home DS0000073093.V376663.R02.S.doc Version 5.2 Page 18 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live at the home can be assured that home is well managed in their best interests with measures in place to protect the health and safety of all who enter the home. EVIDENCE: New providers took over the running of the home in December 2008. No other changes have been made with the management structure within the home. The manager was registered by the Commission in July 2007 when the previous manager of the service retired. She has completed the registered mangers award and had always been hands on in the service and has, and is responsible for ensuring all policies and procedures are kept up to date and in Newgrange Residential Home DS0000073093.V376663.R02.S.doc Version 5.2 Page 19 line within any changes in legislation etc. She has a clear understanding of the current legislation and is pro active in ensuring the team are clear of any changes that are happening and this is done through regular team meetings. A good management structure is in place consisting of the registered manager and two duty care managers. The staff are well supported and have regular supervision to look at any training needs or any support that they may require to perform their duties these are recorded and kept on file for future reference. Staff have received appropriate training in the Mental Capacity Act and Deprivation of Liberty Safeguards. A robust quality assurance system is in place and the providers ensure they recieve regular feedback from residents and their families to ensure that they continue to make changes to improve the service. The manager told us that families remain responsible for managing the residents monies personal allowances are not held in the home by staff. Staff and residents confirmed that there is an open and transparent leadership within the home and they feel comfortable in approaching the manager if there were any concerns or queries and they feel these would be actioned appropriately. The provider ensured that the AQAA (Annual Quality Assurrance Assessment) was received when requested, it was fully completed and idetified how they intended to improve the service over the coming year to the benefit of the residents. Records are well kept and were up to date. Health and Safety is well managed in the home. All equipment is serviced regularly to ensure that it remains safe and in good working order. Records relating to equipment and safety checks are well kept and up to date. Newgrange Residential Home DS0000073093.V376663.R02.S.doc Version 5.2 Page 20 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 X X 4 Newgrange Residential Home DS0000073093.V376663.R02.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Newgrange Residential Home DS0000073093.V376663.R02.S.doc Version 5.2 Page 22 Care Quality Commission Care Quality Commission Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 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. 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