Care Home: Newhaven

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What the care home does well Residents spoken to during the inspection by the inspector and the Ex by Ex were very positive and full of praise for the staff and felt they provided them with the care they need, although at times the staff are very busy. Relatives were also complimentary on the care provided at Newhaven and had found this to be one of the best they had looked at. Some care plans contained detailed action required by staff to meet individual needs. Whilst medication was being administered the staff member was seen to be encouraging and patient in trying to get people to take their medication. Residents were complimentary about the food that was served and they are offered alternatives if they do not like or choose to have the meals of the day. The environment is warm and friendly and well maintained. Staff are knowledgeable about the needs of the residents and attend regular training to keep their skills and competences up dated. What has improved since the last inspection? Staffing levels have been reviewed to ensure that enough staff are available at peak times to meet residents needs. Dining furniture, garden furniture has been replaced; also new flooring has been laid in the lounge/dining rooms improving the environment for residents, visitors and staff. A new deputy has been employed and taken on the responsibility of training to ensure that all staff have up to date skills necessary for their roles. Staff meeting are held regularly to ensure staff are kept informed of developments and any changes. What the care home could do better: A number of improvements have been identified at this inspection and they include ensuring that information contained within the care plans is consistent throughout, to ensure that the best possible care is provided. Whilst a requirement could have been made on this occasion our previous experience of the manager has shown that action is taken in light of verbal recommendations made during the inspection and those made will be followed up at the next inspection. Risk assessments should be individual and relevant to the person, where information is not relevant it should be deleted to provide staff with the correct information to support the residents in risk taking. Where the residents weight is to be recorded but due to their residents frailty this has become difficult other ways should be examined to how that weight is being monitored for example a tape measure or changes in looseness or tightness of their clothing. Although a weekly plan of activities was available these should be displayed in larger print and/or pictures, which would make it easier for residents to see. It is also recommended that daily menus are available and placed on tables so residents can remind themselves what they ordered the previous day. The manager should continue to review staffing levels to ensure that adequate staff are available at peak times such as meal times and provide additional staff to support residents with activities. CARE HOMES FOR OLDER PEOPLE Newhaven Drakes Drive Stevenage Hertfordshire SG2 0EY Lead Inspector Alison Butler Unannounced Inspection 6th December 2007 10:00 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 DS0000019481.V356143.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 DS0000019481.V356143.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Newhaven Address Drakes Drive Stevenage Hertfordshire SG2 0EY 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) 01438 354811 014 38 758223 newhaven@quantumcare.co.uk www.quantumcare.co.uk Quantum Care Limited Kerry Ann Stevenson Care Home 42 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (42), Old age, not falling within any other of places category (42), Physical disability over 65 years of age (42) Newhaven DS0000019481.V356143.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd January 2007 Brief Description of the Service: Newhaven was purpose built about 30 years ago in a residential area of Stevenage and provides accommodation on three floors for up to forty-two service users over sixty-five years of age that may also have dementia or a physical disability. Service users occupy single rooms in-group living units. Each unit has an open plan lounge/dining area and kitchenette. Bathrooms and toilets are conveniently situated throughout the home and are fitted with appropriate aids. There is a large activities room on the ground floor, where the kitchen, laundry and administration areas are also located. The garden to the rear of the home is not overlooked and provides outdoor space where service users can spend their time. Information regarding the service is available in the Statement of Purpose and Service User Guide. These documents, copies of CSCI inspection reports and up to date fees can be obtained on request from the manager of the home. Newhaven DS0000019481.V356143.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report has been written following an unannounced visit to the service where the inspector was accompanied by an expert by experience (Ex by Ex). The report includes information received from the responses to the questionnaires that were sent out to staff and any information already known to the Commission. Time was spent talking to and observing the staff at work. Talking with residents and visitors to the home. Discussions also took place with the manager. Care records were also examined. Where information remains the same this has been brought forward into this report. What the service does well: What has improved since the last inspection? Newhaven DS0000019481.V356143.R01.S.doc Version 5.2 Page 6 Staffing levels have been reviewed to ensure that enough staff are available at peak times to meet residents needs. Dining furniture, garden furniture has been replaced; also new flooring has been laid in the lounge/dining rooms improving the environment for residents, visitors and staff. A new deputy has been employed and taken on the responsibility of training to ensure that all staff have up to date skills necessary for their roles. Staff meeting are held regularly to ensure staff are kept informed of developments and any changes. 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 Newhaven DS0000019481.V356143.R01.S.doc Version 5.2 Page 7 be made available in other formats on request. Newhaven DS0000019481.V356143.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Newhaven DS0000019481.V356143.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents can be confident that a full assessment is carried out prior to admission to ensure their needs can be met at Newhaven. EVIDENCE: An examination of newly admitted residents showed that full assessments had been completed prior to admission and information had been gathered from their families and other professionals. Newhaven DS0000019481.V356143.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at Newhaven can expect that their health and personal care needs will be set out in care plans for staff to follow which ensures that they receive the care they require and are treated with dignity and respect. People living here can also be assured that they will be safeguarded by the medication policies and procedures in place. EVIDENCE: Examination of the care records showed that on the whole good information was available on the action required by staff to meet the health and personal care needs of individuals. However, where some information had changed this was not consistent throughout the plan as one plan described how an individuals needs are met whilst they are on bed care, but this individual is no longer cared for in bed, when you read the daily notes. When changes are made to the plan the information should be signed and dated and this helps when looking at the reviewing of the plans. Newhaven DS0000019481.V356143.R01.S.doc Version 5.2 Page 11 A plan examined states the weight should be recorded although no record has been made, a discussion took place with the manager and due to the residents needs they are unable to weigh the person. Therefore they should look at other ways to monitor this necessary information. Risk assessments were in place although some required additional information to give a full picture of the risk e.g. a reclining chair was being used to transport a resident around the home and this was not noted within the risk assessments and also the use of the lap belt etc. Daily records were not very detailed on how care needs are met in line with the care plan, some were seen that stated “ate well” “sat in lounge”; care observed was good and staff interacted well with the residents. The ex by ex reported that comments made by residents were “excellent…service is good…staff are excellent… never thought I’d like a place like this … lovely people who work here”. “Alright, no trouble with the people… nice young people”…. “alright …can’t grumble … need anything. ..only ask .. slippers, handkerchief”. “ Staff knock on the door … help dress … always busy”. - Visitors and a resident stated “ Excellent … staff accommodating, helpful …feeling one of the family [like] an extended family.. …[staff] always knock ”. Some visitors reported that they felt this was the best home that they had been to look at in the area. The residents stated they were treated with respect, dignity and consideration. Medication policies and procedures were in place and an observation of the administration of medication was conducted, the staff member was seen to encourage in an appropriate and caring manner a resident to take their medication stating what it was for and that it would make them feel better if they took it. The person took some of the liquid but the staff were unable to persuade them to take it all. A note was made on the records. The staff were knowledgeable about the needs of the residents. There is a company pharmacist who carries out regular checks within the home and reviews the policies and procedures. Newhaven DS0000019481.V356143.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live at Newhaven can expect to be offered a range of social activities, which meets their needs, preferences and expectations. EVIDENCE: The home have been unable to employ a permanent full time activities coordinator, although they have at present a casual member of staff who is responsible for organising the activities. On the day of the inspection various floor activities such as skittles and quoits were being played and all residents were given the option to join in. Staff on the top floor were seen reading and colouring pictures with individual residents. There is a file on each floor where activities are recorded and which residents take part. The ex by ex noted that residents stated “that they were notified of events”, “ always ask “ and could opt not to join “ best out of it “. Quantum Care have arranged a large Christmas lunch to be held at Knebworth House and each home asks who would like to attend and they are supported by staff, 3 residents have taken up the offer from Newhaven. Newhaven DS0000019481.V356143.R01.S.doc Version 5.2 Page 13 The manager holds residents meetings to discuss what they would like and information is recorded within their care plan. In the coming months they are looking to continue to promote a varied and balanced diet in consultation with the residents and will continue to ensure staff are clear on the importance of residents food requirements in relation to their health. The main meal choice is made the previous day and as such residents were unable to recall what they had chosen. The supper choice is asked for at lunchtime of the day it is required. No menus were on display, which could be provided, in an appropriate format for the benefit of residents. The ex by ex observed 6 residents at lunch on the middle floor. They were all seated at tables at 12.20pm, the food trolley arrived at 12.50 and all were served by 12.57 by 2 staff. The trolley showed a temperature at 84 and the plates were suitably warm. Orange and lemon juice was served; there were two choices for the main courses. Staff served the vegetables without offering them a choice and when asked about this they stated “that they knew who liked what and how much”. The meal was appetising and nicely presented. A resident who had to remain in their room was sensitively helped and was provided with an appropriate eating aid. Resident’s comments received were. “ Meals are very good ”. “ food alright…not bad” although one resident felt that they had to “wait for breakfast” but a member of staff said that they usually started with a cup of tea at 7.30. . “ food pretty good … If they do not like the choice the chef will do something else”. A relative of a resident commented, “ they are looking better on the food”. The ex by ex spoke with the cook who stated that she adapts the menus from Head Office to better meet the needs of the residents; they are on a 5 weekly cycles with seasonal changes. They were told that elsewhere within the group there is an experiment to change the main meal to the evening; the question hinted at being whether this, if introduced widely, would be in the best interests of the residents. The impression of the cook is they are proud of their work and are keen to do well for the residents. Newhaven DS0000019481.V356143.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at Newhaven and their family’s can be confident that their views, concerns and complaints will be listened to and acted on. EVIDENCE: The company have a complaints procedure that is available to all who enter Newhaven. Those spoken to had no complaints to make about the service although they would speak to staff if the need arose. A complaint received early this year resulted in further training being offered in safeguarding which gave staff the information about different forms of abuse and how to respond if the need arose. Newhaven DS0000019481.V356143.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at Newhaven benefit from a well maintained environment that is kept clean and fresh. EVIDENCE: Although the environment does not meet the National Minimum Standards a new build is planned to begin in 2008. Dining rooms and lounges have been redecorated and new flooring has been laid. Where rooms become vacant they are redecorated to ensure they continue to live in a well-maintained environment. Good health & hygiene systems are in operation with appropriate liquid soap and soft hand towels available throughout the home. Newhaven DS0000019481.V356143.R01.S.doc Version 5.2 Page 16 The ex by ex took a tour of the home and found it to be homely and no odours were detected and the residents were happy with their accommodation. Newhaven DS0000019481.V356143.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at Newhaven can expect to have their needs met by appropriate numbers of staff who have been appropriately recruited and are adequately trained to ensure that vulnerable are safeguarded. EVIDENCE: An examination of the staff files showed that all the required information had been obtained prior to a member of staff commencing employment at Newhaven. Staffing levels are adequate although information received from the staff surveys showed that at peak times more staff would benefit the residents for example at meal times, and to support residents to access the local community. Staff also stated that there is a good working relationship between themselves and the residents. They felt that the work could be difficult when the needs of the residents increase due to ill health. This would be eliminated if more staff were available. They felt that the management team could spend some more time out on the floor to assist with the residents needs at times. Staff felt that a good training programme is in place and where specific subjects are not available the manager will try to source these externally. Newhaven DS0000019481.V356143.R01.S.doc Version 5.2 Page 18 Since the last inspection a deputy has been employed and is training to be a moving and handling trainer and has taken on the role of ensuring that all staff have the relevant training to do their job. Newhaven DS0000019481.V356143.R01.S.doc Version 5.2 Page 19 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 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at Newhaven can be confidant that the home is well managed and is run in their best interests and that their health, safety and welfare will be promoted. EVIDENCE: The manager has achieved her registered managers award and ensure that she maintains her skills and competence by attending regular training updates. There is a good management structure in place with each person being given set designated responsibilities. Newhaven DS0000019481.V356143.R01.S.doc Version 5.2 Page 20 There is an effective system in place for managing monies for those residents who are unable or choose not too. The company employ an auditor who carries out a yearly audit of monies within the home. Good systems are in place for recording and auditing accidents and where appropriate the Commission are notified of any under Regulation 37. There is an annual forum and questionnaires are sent out and the results are made available to all interested parties. Health and safety systems are in place with regular checks being carried out on fire equipment, moving and handling equipment, any maintenance issues are recorded and dealt with appropriately this is to ensure that all who enter Newhaven have their health, safety and welfare promoted at all times. Newhaven DS0000019481.V356143.R01.S.doc Version 5.2 Page 21 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 3 29 3 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 DS0000019481.V356143.R01.S.doc Version 5.2 Page 22 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 Newhaven DS0000019481.V356143.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Inspection Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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