Care Home: Newhaven Residential Home

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What the care home does well The care home offers a clean and comfortable environment. The people staying in the home told us that they were well looked after and were happy with the services being provided by staff. They confirmed that staff ensure their privacy and dignity is protected and that their care is provided in a sensitive manner. The care home works very effectively with community health care services, local consultants and hospitals. Staff are well trained and recruited safely. People are happy with the home`s menu which meets their individual dietary needs. What has improved since the last inspection? The environment of the care home has been enhanced since the last visit. The outside garden area now has a summer house and outside seating area which has been added since the last inspection. Care plans have been more personalised and contains greater detail. Care records have been reviewed and improved. What the care home could do better: Initial assessments can be improved. They need to be more personalised and contain greater details of residents` needs. Key inspection report Care homes for older people Name: Address: Newhaven Residential Home Mumby Road Huttoft Lincs LN13 9RF     The quality rating for this care home is:   three star excellent 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: Ken Hague     Date: 2 2 0 1 2 0 1 0 This is a review of 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 2 1 0 stars - excellent stars - good star - adequate 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. that people have said are important to them: They reflect the things 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 Older People Page 2 of 25 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. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Newhaven Residential Home Mumby Road Huttoft Lincs LN13 9RF 01507490294 01507490251 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Eric W Brown,Mr Stephen Brown,Mrs Christine E Brown Name of registered manager (if applicable) Mrs J Brown Type of registration: Number of places registered: care home 25 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability old age, not falling within any other category Additional conditions: No one falling within the category of OP to be accommodated at Newhaven when there are 25 persons already accommodated in the home One named service user to be accommodated at Newhaven under the category LD The maximum number of persons to be accommodated at Newhaven is 25 Date of last inspection Brief description of the care home The Newhaven Care Home is situated in the coastal village of Huttoft on the main A52 between the coastal resorts of Skegness and Mablethorpe. There is a car park at the rear of the home and large well-maintained gardens. Newhaven Care Home is registered to provide services for 25 elderly service users - one of whom may have a Care Homes for Older People Page 4 of 25 Over 65 0 25 1 0 Brief description of the care home learning disability. The accommodation is arranged on 2 floors and consists of 19 single bedrooms, 2 double bedrooms and communal space in the form of lounges, dining room and conservatory. The Care Home is a family business owned by Christine and Eric Brown. Their son Stephen is also registered as a Proprietor and their daughter in law Jane is the Registered Manager. Care Homes for Older People Page 5 of 25 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: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The service has been awarded a three star rating. This means that the outcomes for people are excellent. The service did not know we were coming to carry out an inspection. This is referred to as an unannounced inspection. We visited on the 33nd of January 2010. The visit lasted five hours. The inspection was carried out by a single inspector. The purpose of the visit was to establish how the care home is functioning and the outcomes for people who use the service. We also checked that the practices are safe and that staff understand how to recognise abuse and report it appropriately. Any previous information held by the Care Quality Commission about the care home was taken into account. Before the visit the provider returned the Annual Quality Assurance Assessment (AQAA). This document enables us to have additional information about how the home is meeting the needs of people using the resources of Care Homes for Older People Page 6 of 25 the care home. It is normal practive to send out surveys to people who use the service but this could not be achieved in the time period before the inspection date. We spoke to people during the site visit and their views and opinions are reflected within this report The method of inspection used in this report is called case tracking which involves selecting a proportion of the people who use the service and tracking the care they receive. At this visit we tracked three people who use the service. This was done by checking records, discussions with them and the staff who care for them, and observations of care practice. During this visit we spoke to people using the service, staff and senior management. This gave us an overview of the service and enabled us to award the star rating shown above. Care Homes for Older People Page 7 of 25 What the care home does well: What has improved since the last inspection? 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. Care Homes for Older People Page 8 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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. New residents receive a detailed comprehensive individual assessment. Evidence: Peoples files contained a detailed full assessment completed prior to them being admitted to the home. It included the care and social needs of each person, their medical history, current medication and any potential area of risk. The registered manager stated that all new residents are sent a letter confirming that their needs can be met by the home. Staff stated that no resident has been admitted without a full assessment being completed. Residents being case tracked confirmed that they had been provided with sufficient information to allow them to make an informed choice before coming to stay at the home. Initial assessment was signed by the resident and the assessor. The home does not offer a dedicated intermediate care service. Care Homes for Older People Page 10 of 25 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Comprehensive and individualised care plans instruct staff how to ensure peoples needs are met safely. Evidence: The information gathered at the initial assessment had been used to write a care plan for the residents being case tracked. Care plans included details of the residents extended family and their preferred choice of name along with their marriage status and the community support services who help them. The next of kin details were also recorded on each individual residents record. Care plans were written after 14 different areas of need had been evaluated. These included bathing, dental care, eye care and chiropody. A nutritional assessment was found on all sampled files. Tissue variability had been assessed and equipment purchased when necessary. Input from the community health care services was recorded. Care plans contained the individual choices and wishes of each resident, they detailed Care Homes for Older People Page 11 of 25 Evidence: the way people wished to be helped with their personal care and instructed staff how to maintain peoples privacy and dignity. Their choice of toiletries were recorded and the manner in which they wished their hair to be cared for and washed. Care plans were personalised. In the case of one resident staff were told that because this person could become breathless they should be sensitive in the way they helped them and allow time between tasks to ensure the person was always comfortable and felt safe. Care records contained the time individual residents wished to go to bed and the time they wished to get up. Staff were instructed how to maintain peoples skin integrity which included the actions to take if they had concerns regarding a residents skin condition. Care records reinforced that the registered manager must be kept informed of any problems. Peoples level of mobility and equipment needs were recorded on care plans. Personal diets were recorded including peoples choices, their likes and dislikes in respect of food. People stated that they are offered the opportunity to choose where they eat their meals which can be in their own bedrooms or in the lounges. Details of visits by chiropodists, general practitioners and district nurses were recorded. The registered manager stated that the home has a procedure to ensure the safe administration and storage of medication. She said only competent staff trained by an outside consultancy are allowed to give out medication. Staff confirmed this statement to be correct. Training records substantiated that staff are trained in the administration and storage of medication. The registered manager and senior staff confirmed that medication levels are checked on a monthly basis. There has been no mal-administration of medication in the last 12 months and no lost medication. The care home has a contract with a local pharmacy to return unused medication. A spot check of the medication system provided evidence that appropriate recordings are being completed by staff. Staff stated that they do not complete records until they have seen the individual resident take their medication. Residents confirmed that they had seen their own individual care plan which they had signed with the assessor. All three residents being case tracked stated that their needs are correctly met. A resident stated I feel staff know the things I can do safely and the things I need help with. They always treat me with courtesy and respect. The help we receive is given in a sensitive manner and staff make sure we can protect our Care Homes for Older People Page 12 of 25 Evidence: dignity and privacy. A second resident stated Staff understand my care plan and I am confident that I will be safe and cared for properly. Staff stated care plans instruct them how to provide care safely. Care plans were found to be reviewed and updated regularly. Residents stated that they are able to self-medicate when a risk assessment shows it is safe for them to do this. There were two residents self-medicating on the day of the site visit. Locker storage facilities are provided in bedrooms to enable residents to keep their medication in their rooms. Care Homes for Older People Page 13 of 25 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from a wide range of activities. A varied menu is provided which ensures peoples individual dietary needs are met. Evidence: The care home has a flexible and varied activity programme. Activities take place within the home and the community. There is an activity coordinator in post. The activities book was seen and provided evidence that a range of activities is offered to residents including visits to local garden centres, exercise classes and trips to local shops. A greenhouse is provided for the use of residents. Residents have access to a computer and the Internet. The registered manager uses quality assurance questionnaires to make sure that the home offers the activities that residents actually wish to take part in. A chalet type summer house has been built at the side of a large pond at the rear of the home which residents use as a quiet relaxing area. The chalet is fitted with a call system in case any resident needs help. Two residents stated We really enjoy sitting in the summerhouse. We go down to the house most days it is lovely and peaceful. Another resident stated We visited the Care Homes for Older People Page 14 of 25 Evidence: local garden centre recently it was a good day. Activities were seen to be taking place in the home during the site visit. One resident said that she organises the flower arrangements within home. Staff said that families and friends are encouraged to visit the home and take part in activities and social events. The care plans of the residents contained their likes and dislikes and choices in respect of food and activities. The homes menu was seen and offers choices to residents. A resident stated Staff discuss the menu for the next day with us so we can make a choice. If we do not like what is offered an alternative is provided. Staff confirmed this statement to be correct. The registered manager stated we vary our menu but always discuss this at the residents meetings in case there is need to make changes. A resident stated The food here is excellent you could not get any better food. It is always fresh hot and appetising. Care Homes for Older People Page 15 of 25 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. 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. Trained competent staff ensure that people are protected. Evidence: Training records provided evidence that all staff have received training in protecting people from potential abuse. Staff described how they protected people and would report any suspicions of abuse. Staff stated that would use the whistle blowing procedure if they have any concerns about the homes care practice. No complaints or concerns have been received by the home or Care Quality Commission since the last key inspection. Accident records had been completed and risk assessments reviewed when any incident had occurred. The registered manager stated that she monitors the accident and complaints records. There have been no safeguarding investigations held in the last six years. People stated that they felt happy and safe living in a care home. One person stated They look after us very well here we feel safe in his home. No health and safety issues were identified. There has been no concerns raised since the last key inspection by any outside agency which would also suggest residents are being protected. Care Homes for Older People Page 16 of 25 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, 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. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a well maintained and comfortable environment which enhances their quality of life. Evidence: The registered manager stated that home has an ongoing maintenance programme. Evidence was seen of improvements made to the home since the last key inspection. An outside seating area and summerhouse has been added at the rear of the property. People said they found this a lovely place to sit in the summer months and a peaceful place in which to relax. The registered manager states in the AQAA that there is an ongoing programme to replace furniture, soft furnishing and carpets as required. She stated there is a decorating program in place. New fly screens have been fitted to the kitchen and improvements have been made to toilet areas including replacing an extractor fan. The outside lighting has been reviewed and additional lights installed. Repairs have being carried out to footpaths. The manager states in the AQAA that the frequency for replacing furniture and carpets has been increased. All staff have been issued with a statement of individual daily tasks to ensure the environment is kept clean and safe. Fire extinguishers and hoists have been serviced. Staff take part in regular fire drills. Care Homes for Older People Page 17 of 25 Evidence: Records seen provided evidence hot water temperatures are being monitored. People said that they were very satisfied with the environment of the care home. They particularly enjoyed using the new summerhouse and outside sitting area.One person said They keep my bedroom clean and very tidy it is beautiful. I couldnt wish for a better room. There is a very large conservatory on the front of the home where people sit and watch the village life around the home. A person staying at the home commented I love sitting in the conservatory we can see our visitors coming and local people going about their shopping and daily walks. Its lovely warm and bright and a comfortable place in which to sit and relax and read my paper. No infection control problems or health and safety issues were identified at this key inspection. Care Homes for Older People Page 18 of 25 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. 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. Trained and competent staff ensure peoples needs are met. staff are recruited safely. Evidence: Staff confirmed that supervision and appraisals are carried out. Staff said that they feel supported by the managers of the care home. They confirmed that staff meetings are being held. Training records provided evidence that all staff have being trained in protecting residents from any potential abuse. Training records show that specialist training and core training has been provided to staff. Staff have been trained to understand the new Mental Capacity Act and have received training in fire awareness and moving and handling. The registered manager stated that all staff are taking NVQ training, staff interviewed confirmed this statement to be correct. The two members of staff interviewed both held NVQ qualifications; one had an NVQ 2 in care the second had a NVQ 3 in care. Training record substantiated that 79 of all staff have an NVQ two in care or equivalent qualifications. Staff stated that there were always sufficient staff on duty to meet the peoples needs. They stated that if the needs of people staying in the home increased staffing levels are adjusted accordingly. Staff stated that there are no health and safety issues within the home. They feel well supported by the homes management. Care Homes for Older People Page 19 of 25 Evidence: Staff were able to describe in detail the needs of the three people being case tracked. They were able to describe their social and care needs. They described the individual needs of each person and this information matched up to that recorded within individual care plans. They described the risk assessments for each person and where a risk had been identified the risk management strategy to be used. A sample check of the recruitment records for a new member of staff provided evidence that the homes recruitment procedure is being followed. The home had obtained all of the documents set out in the Care Home Regulations before offering employment. These included a CRB, proof of identification, two references including one from the past employer. A copy of the application form and interview notes was found to be kept on each member of staffs personal file. The registered manger stated staff are given an induction. The individual files for new staff members provided evidence that this statement was correct. All records was signed and dated by the member of staff and a member of the management team. The registered manager stated that staff are encouraged to expand their skills and training including night staff. She said 79 of staff now hold an NVQ two level or equivalent qualification. The registered manager stated that staff meetings and residents meetings are recorded. A sample of these records were seen. The care home managers are training senior staff to enable them to take part in the supervision and appraisal process. Staff were found to be well trained supported and motivated to ensure safe care is provided to residents. Care Homes for Older People Page 20 of 25 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this 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 home is efficiently and effectively managed ensuring that peoples needs are met. Evidence: This is a family run business. The daughter-in-law of the providers is the registered manager. She has completed successfully the registered manager course. She has over eight years experience in managing this care home. Staff stated that she is supportive and encourages them to increase their knowledge and skills. There have been no incidents which have caused concern since the last inspection. No safeguarding investigations are being carried out in the last seven years. No complaints had been received about the quality of care at this home by the home or the Care Quality Commission. The registered manager has continue to keep us informed of any incident which may affect the health and welfare of residents. Residents told us that the home is effectively and efficiently run and is a very friendly home and a comfortable place in which to live. Residents stated that they are given choices and their dignity and privacy is always respected by staff. No requirements Care Homes for Older People Page 21 of 25 Evidence: were made at the last two key inspections. Care records continue to demonstrate personalised and individual care records written to good quality. The registered manager told us that she carries out quality assurance checks. She uses one-to-one discussions, residents meetings and written questionnaires to establish the views of residents in respect of the services provided by the home. Staff and residents confirmed this practice does take place. There were no health and safety or infection control issues identified at this inspection. A resident stated This is a very comfortable home, staff are very kind, the managers approach is supportive to residents and staff. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R 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 Older People Page 23 of 25 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 Requirement 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 Requirement Timescale for action 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 Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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