Care Home: Newhaven

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What the care home does well People like the staff that care for them. Comments were made such as " the staff are kind" and "it`s a really nice atmosphere here". People maintain their links with the wider community by being supported to attend day centres, religious groups and visit other services in the local area. The staff team share information and best practice with the other local care home within the group. This allows staff to discuss future developments and plan changes that help in making the service a better place for people to live. People enjoy the meals that they have stating " we have choice and its good stuff". What has improved since the last inspection? Improvements have been made to the environment. New flooring has been put in all bedrooms and large areas of the service have been redecorated, including the addition of a new shower room. This provides a nice place for people to live. Policies and procedures have been put in place with regard to equal opportunities. People living at the service also have access to this information. This ensures people are treated fairly. Care plans have been re designed to make sure there is enough detail for staff to provide care to people who need it. Staff, including the registered manager, have undertaken large amounts of training. This helps to make sure that staff are able to provide a high standard of care. What the care home could do better: Care plans should be further developed into pictorial format to make them easier for people to understand. Recruitment procedures need to be tightened to ensure that all staff that work at the service are suitable to work with vulnerable people. The service needs to support staff to achieve their NVQ qualifications to meet the target of 50% of staff trained to this level. This will help improve the quality of care at the service. The system for seeking the views of people living at the service should be made more formal to ensure that suggestions and ideas are acted upon. CARE HOMES FOR OLDER PEOPLE Newhaven 5 Sunningdale Road Wallasey Wirral CH45 OLU Lead Inspector Natalie Charnley Key Unannounced Inspection 09:30 27th February 2008 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 Newhaven DS0000018915.V334648.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. Newhaven DS0000018915.V334648.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Newhaven Address 5 Sunningdale Road Wallasey Wirral CH45 OLU 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) 0151 639 6420 Mr Danny So Mrs Lynda So Mr Danny So Care Home 16 Category(ies) of Learning disability over 65 years of age (16) registration, with number of places Newhaven DS0000018915.V334648.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Only five adults with a learning disability and eleven elderly people with a learning disability may be accommodated within the maximum number of sixteen. One named adult with a learning disability under the age of 65 years (six weeks respite care) within the maximum number of sixteen. 8th January 2007 2. Date of last inspection Brief Description of the Service: Newhaven is registered to provide care for 16 elderly people with a learning disability. The home consists of two adjacent semi-detached houses in a quiet residential area of New Brighton. The home is close to a bus route which gives easy access to local shops, the seafront and other community facilities. Accommodation is provided in six single and five shared rooms. Six bedrooms have en suite facilities. Communal areas consist of a lounge/dining room and a small lounge at the side of the main living area. The home has a large back garden which has fixed garden furniture and is reached via a patio door. The service is part of a group of two homes, both within easy reach of each other. It costs £354.24 per week to live at the home. Newhaven DS0000018915.V334648.R01.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 2 star. This means the people who use this service experience good quality outcomes. The site visit to the service was unannounced and was carried out over a period of one day. We spoke with 4 staff, the registered manager/owner and 4 residents about what it was like living and working at the home. No visitors were available at the time of the visit. The manager was asked to provide a selection of information in the form of an annual quality assurance document (AQAA), which was used as part of the inspection process. Comment cards were sent to the home for people who live at the home and staff to complete. This gave them the opportunity to contribute to the inspection process. We completed the inspection by looking at the homes records, a tour of the building, formal and informal interviews and information from previous inspection reports and AQAA document. Feedback was given to the person in charge during and at the end of the inspection. What the service does well: People like the staff that care for them. Comments were made such as “ the staff are kind” and “it’s a really nice atmosphere here”. People maintain their links with the wider community by being supported to attend day centres, religious groups and visit other services in the local area. The staff team share information and best practice with the other local care home within the group. This allows staff to discuss future developments and plan changes that help in making the service a better place for people to live. People enjoy the meals that they have stating “ we have choice and its good stuff”. Newhaven DS0000018915.V334648.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: 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. Newhaven DS0000018915.V334648.R01.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 Newhaven DS0000018915.V334648.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 6 is N/A Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Assessments done prior to people moving to the service ensure that they can have their needs met. EVIDENCE: There had not been an admission to the service since the last key inspection. Three people using the service were case tracked during the visit, which included looking at their care plans. All three residents had received an assessment by the home prior to moving in. This ensures that the service checks that they are able to meet any needs individuals may have. Files also showed that information from social services assessments were also gathered, allowing further information to check the needs that people may have. Newhaven DS0000018915.V334648.R01.S.doc Version 5.2 Page 9 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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People have their health care needs met by staff that treat them with respect. EVIDENCE: The service has worked on developing care plans since the last inspection. Care plans demonstrated what care individual people require and how staff must assist them in providing such care. Plans were being reviewed on a regular basis to ensure that they were kept up to date. Plans must now be put into a format that people who use the service can understand, such as using pictures. People spoken with during the visit were happy with the care that staff were providing, and were aware of what care they needed. One person commented, “ I am well looked after here, I am very happy”. Newhaven DS0000018915.V334648.R01.S.doc Version 5.2 Page 10 Records and comments from people showed that the service have a wide range of other health professionals that assist in the care of people. This includes GP’s (General Practitioners), District Nurses and Social Workers. The service has good links with local support networks and day care that provide the service with specialist advice and facilities when needed. This also helps to ensure people receive the correct care. Staff confirmed that they had been given training on administering medications. Medication records were well recorded and ensured that people had their health care needs met. People who have medications as and when they need them had very good records in place to assist staff when making the decision to given them or not. This is an example of good practice as it makes it clear for staff when and why medications must be given. People spoken to all felt they were treated with dignity and respect. One person commented, “ I feel safe here, not like other places I have been to”. Staff were observed to be talking and interacting with people in appropriate ways, taking into account individuals needs. Newhaven DS0000018915.V334648.R01.S.doc Version 5.2 Page 11 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): 12,13,14 and 15 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People are supported to keep an active and fulfilled lifestyle of their choosing. EVIDENCE: Discussion with staff found that it was sometimes hard to get people to join in with activities. Staff reported that many people simply wanted to be “left to their own devises” and often preferred their own company. Discussion with people using the service showed that this was in fact the case. One person commented “ I just like to keep myself to myself, I am not one for joining in group things, perhaps only every so often”. Another person stated, “I like the fact I can do what I want when I want to here, there is no pressure to join in”. Records showed that recent activities had been arranged that included board games, painting and musical entertainment. A daily plan is available with activities, however the staff stated that this often changed to accommodate what people wanted to do on a particular day. Staff support three people to access local day centre services and one person attends church. These activities support people to remain active within the local community. Newhaven DS0000018915.V334648.R01.S.doc Version 5.2 Page 12 People were observed for a short time in the main lounge. People were seen to be offered choices such as what they wanted to watch on television and if they wanted to attend a birthday party at a near by home. One person commented “ Its very relaxed here, we like getting visitors”. Staff confirmed that visitors are welcome at any time. There is a designated smoking area within the home, however when the weather is fine, people are encouraged and supported to smoke outside in the large patio area. People stated that they enjoyed the meals they were provided with. Comments were made such as “ food is very good”, “ there is always plenty” and “ most of my food is ok, if I don’t like it I can ask for something else”. Meals are cooked by staff that take it in turns to work as ‘cooks’. Staff commented “ this arrangement works well, as we have a small home, we know what people like”. When staff are on cooking duty, they are not engaged in any direct care to minimise any risk of cross infection to maintain the well being of people at the home. Newhaven DS0000018915.V334648.R01.S.doc Version 5.2 Page 13 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 and 18 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Complaint and protection issues are handled well by well trained staff, ensuring people are kept safe. EVIDENCE: There has been one recorded complaint at the service since the last inspection. Records showed that this was dealt with in a suitable way and was dealt with quickly. This ensures that the people using the service feel their concerns are taken seriously. The complaints procedure is now written in a pictorial format to allow people at the service to fully understand what to do if they have a complaint. People spoken with were clear about what to do in such an event and stated they felt able to approach the manager about their concerns. Staff, including the manager have all attended recent training on safeguarding adults. Certificates were available in staff files and staff interviewed were aware of the service policy and what to do in the event of allegations being made at the home. One member of staff commented, “ this training was really good, it has opened our eyes up”. This ensures people using the service are kept safe. Newhaven DS0000018915.V334648.R01.S.doc Version 5.2 Page 14 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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People are provided with a safe and homely environment in which to live. EVIDENCE: People living at the service were happy with the accommodation that they had. One person commented, “ I love my room. It’s kept clean and I can have all my things from home here”. Another resident stated “ its really nice here, really homely”. The home environment was clean, bright and airy. Furnishings were in good condition and people felt at ease using communal areas. Bedroom areas were filled with peoples personal belongings, creating a homely and pleasant atmosphere. Newhaven DS0000018915.V334648.R01.S.doc Version 5.2 Page 15 Records were seen that showed that a designated member of staff checks all areas of the home on a regular basis and identifies any maintenance issues. Records also showed that these issues were addressed, ensuring a safe place in which people can live. Staff, including the domestics, have all attended training on infection control. This ensures that they are familiar with policies and protect the welfare of people using the service. Staff were observed to be following correct procedures when dealing with people during the visit and ensuring that the risk of infection was kept minimal. Newhaven DS0000018915.V334648.R01.S.doc Version 5.2 Page 16 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 and 30 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. People like the staff that care for them, however recruitment practices need to be tightened to ensure the correct staff are employed. EVIDENCE: Five staff files were sampled, including the file for a new member of staff who started work in November 2007. All staff had received Police checks to show that they were suitable to work with vulnerable people. The new member of staff only had one reference in place, which meant the service had not waited for a second reference before employing the staff member. This means the service could not be sure of the suitability of this staff member to work. The application form used by the service is very basic and should be improved to ensure that people can record details about gaps in employment history. This is another way in which the service can ensure people are suitable to employ. Records and discussion with staff showed that the manager has made an improvement with providing staff with training. Staff had recently undertaken training in dementia, health and safety and COSHH (control of substances hazardous to health). Staff felt that this training had allowed them to get Newhaven DS0000018915.V334648.R01.S.doc Version 5.2 Page 17 better at their jobs and commented “ We have had training on all sorts of topics” and “the video training has been good as we can fit it in around work”. 45 of care staff have NVQ (National Vocational Qualification) level 2 or above, which is slightly less than the required 50 target. Three staff are currently awaiting stating this qualification, which is a specialist qualification in care, and will allow the service to meet their target. People living at the service liked the staff who care for them and commented “ staff are lovely, so kind” and “ You can’t get better staff than this”. Observation around the service showed that staff care about the people that they care for and take a pride in their work. Rotas and comments from people using the service showed that there was always enough staff on duty. This ensures that the staff have the time to provide the care to people that they need. One person commented, “ Staff are there when I need them”. Newhaven DS0000018915.V334648.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service is well run and protects the welfare of the people who use it. EVIDENCE: The registered manage/owner of the service discussed his plans to promote the deputy manager within the next twelve months. In preparation for this, the deputy manager is half way through her registered managers award. Both the manager and deputy manager have undertaken large amounts of additional training in order to ensure they are up to date with current practice. Staff commented that the manager was very supportive and was available at the service on a daily basis. Staff were able to give examples of how the manager had supported them during recent times. Newhaven DS0000018915.V334648.R01.S.doc Version 5.2 Page 19 The manager has worked hard on quality assurance issues since the last inspection. There are now monthly spot checks on laundry, medication and healthcare equipment. This is to help improve services that are offered. Questionnaires were sent to health professional and families. Results showed that people were happy with the care the service provides. Records showed that a district nurses had commented, “ In my professional opinion, Newhaven is the best care home in Wallasey” and “the deputy manager is extremely motivated and efficient”. Work is currently taking place to develop a questionnaire for people using the service that is easy to understand. Currently the deputy manager asks people their opinions on an informal basis. The service has provided individuals with personal bank accounts. The manager keeps a small amount of money on the premises for people to cover costs of things such as newspapers and hairdressing. Samples of money held for three people was checked along with receipts. Totals were correct and entries of spends were clearly logged and regularly audited. This ensures people’s money is being managed correctly. Samples of safety certificates were seen and were up to date. Staff had received regular fire drills, however records must be kept of all individuals that attend. This ensure that all staff receive appropriate drills. Accident records were well recorded and staff had all been provided with health and safety training. This allows staff to ensure that people are kept safe. Newhaven DS0000018915.V334648.R01.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 X 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 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Newhaven DS0000018915.V334648.R01.S.doc Version 5.2 Page 21 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 OP29 Regulation 18 Requirement Staff must have two written references in place before commencing work. This is to ensure they are suitable to work with vulnerable people. Outstanding from previous inspection Timescale for action 01/03/08 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. 2. 3. Refer to Standard OP7 OP28 OP29 Good Practice Recommendations It is recommended that care plans be developed in a format that people who use the service can understand. It is recommended that the service increase the number of care staff who are trained to NVQ level 2 or above. This will allow staff to develop their skills around care. It is recommended that the application form be changed in order for the correct information to be recorded regarding peoples previous employment. This will tighten up recruitment practices. It is recommended that quality assurance practices are further developed to formally record the opinions of people DS0000018915.V334648.R01.S.doc Version 5.2 Page 22 4 OP33 Newhaven 5 OP38 who use the service. It is recommended that the names of individual staff that participate in fire drills be recorded. This will ensure people receive the correct training they need. Newhaven DS0000018915.V334648.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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. Extracts may not be used or reproduced without the express permission of CSCI Newhaven DS0000018915.V334648.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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