Care Home: Newland House

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What the care home does well Good systems are in place to make sure that people have enough information about the service before they come to live in the home. Assessments are carried out properly before people come to live at the home so that staff know what support they need. People using the service receive good care that is organised to suit their individual needs. Staff have appropriate training to meet the needs of the people living at Newland House. Good information is kept about peoples` care needs that ensures that they get consistent care. Care plans are updated to reflect any changes to peoples` care needs. Social activities are well organised and planned to suit the needs of the people using the service. The people living in the home benefit from flexible routines that suit their individual lifestyle. The food is well cooked and presented with good options available at each mealtime. People feel able to make their views about the service known and have plenty of opportunities to raise issues with the manager and owner. Newland House provides comfortable accommodation that suits the needs of the people living there. The home is very clean, well maintained and decorated. Good levels of staff who are well trained are available to meet the needs of the people living at the home. Recruitment practices and procedures are clear and protect people using the service. What has improved since the last inspection? The Statement of Purpose now includes information about how the service meets the needs of people with dementia. Staff have received training in dementia care so that they have a better understanding of how to meet the changing needs of people living in the home who have this condition. Policies and procedures relating to the use of bed rails have been revised to make sure that they reflect good health and safety practices. What the care home could do better: Hand written entries in the medication records should be signed by two staff members. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Newland House 304-308 Norton Road Stockton-on-Tees TS20 2PU     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Anne UrwinBrown     Date: 1 9 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Newland House 304-308 Norton Road Stockton-on-Tees TS20 2PU 01642535702 F/P01642535702 johnrobbo65@yahoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr John Robinson,Mrs Pearl Robinson care home 30 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: One named individual who is under the age category is allowed to reside in the home. The number of persons shall not exceed 18 elderly frail people and 12 elderly mentally infirm people Date of last inspection Brief description of the care home Newland House Care Home provides residential care for 30 older people. The home comprises two units, one with 12 places for older people with dementia, the second with 18 places for frail older people. The property comprises three terraced houses combined internally into one establishment. Single storey extensions have been added to the rear of the home over the years since it was originally registered. The two units operate separately, but not independently, and access between the units is by keypad 0 0 Over 65 12 18 Care Homes for Older People Page 4 of 26 Brief description of the care home locked internal doors. The home is situated in an urban area on a main road into Stockton, with access to frequent public transport to the local town and amenities. There are gardens and seating areas to the front and rear of the property. A copy of the Statement of Purpose and other information about the service provided is available at the home. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home 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 quality rating for this service is 2 stars. This means that the people who use the service experience good quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use the service are not put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. How the inspection was carried out Before the visit: We looked at: Information we have received since the last visit. How the service dealt with any complaints & concerns since the last visit. Any changes to how the home is run. The providers view of how well they care for people. Care Homes for Older People Page 6 of 26 The Visit: An unannounced visit was made on 19th March, 2009. The visit lasted a total of five hours. During the visit we: Talked with people who use the service, staff, the manager, the owner & visitors. Looked at information about the people who use the service & how well their needs are met, Looked at other records which must be kept, Checked that staff had the knowledge, skills & training to meet the needs of the people they care for, Looked around the building to make sure it was clean, safe & comfortable, Checked what improvements had been made since the last visit. We told the owner and manager what we found. 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 set out on page 4. Care Homes for Older People Page 8 of 26 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 9 of 26 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 10 of 26 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. Before people move into the home they have enough information about the service to make an informed choice about living there. Evidence: There is a Statement of Purpose in place that provides comprehensive information about the service provided. Information about the service provided at Newland House is available for people considering moving into the home and covers the type of people who can be offered a service. The Statement of Purpose has been amended since the last inspection to provide more information about the support offered to people with dementia. Before each person moves into the home a pre-admission assessment is completed to ensure that staff are able to meet their needs. Information from the assessment and from relatives and/or care management plans is also used to prepare an individual plan outlining each persons care needs. The home understands the importance of Care Homes for Older People Page 11 of 26 Evidence: having good information about peoples needs before agreeing a placement. Staff said that they felt there was enough information about peoples needs available when they came to live in the home. One person living in the home said she received good support and had always been satisfied that staff were aware of her care needs. Intermediate care is not provided at Newland House. Care Homes for Older People Page 12 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home receive good quality care that is organised to suit their individual needs in a way that respects their privacy and dignity. Evidence: Each person has a personal plan in place that provides good information about their care needs and how these are met to suit their individual needs. Personal support is responsive to peoples varied and individual needs and preferences. Plans clearly identified the support provided by staff. Assessment tools are used to identify changes in peoples needs. Healthcare information is well recorded and evidence was available that good systems are in place to ensure that healthcare needs are well met. Staff said that there is good support from the local district nurses and general practitioners. Evidence was available that peoples privacy and dignity is respected and that staff are sensitive to individual needs. One person said that she felt very lucky to be living at Newland House and she has found all staff to be very kind and approachable. One relative said that the care is excellent and the staff are good at keeping us up to date about any issues. My mother is very well looked after and the owner and manager always make time to talk to me. Care Homes for Older People Page 13 of 26 Evidence: There is in place an effective medicines policy that supports good procedures and practice. Staff training has been provided for all staff responsible for administering medicines. Medicines records are well completed and generally contain required entries. One hand written record had not been signed by two staff members. There are regular audits of medicine practice by manager. Arrangements for the storage of medicines are satisfactory. Care plans show evidence of peoples wishes, choices and decisions. Records show that care staff work consistently with support from the district nurses to support people living in the home who have degenerative conditions and terminal illnesses. Care Homes for Older People Page 14 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is good evidence from records and from talking to people at the home that peoples likes and dislikes, routines and lifestyle are identified. Staff demonstrated a good knowledge of peoples preferences and they are aware of the need to be flexible when providing care and support. People are able to make choices about whether or not to take part in planned activities that meet the social needs of all of the residents. Records of arranged activities are kept. One person said that there are organised activities, but I prefer to spend time in my room where everything is arranged to suit me and my needs. Staff know not to move things, because I find that affects my ability to move around the room. The food was well presented and residents said it was very good. Alternatives were available at each meal time. Menus were varied and staff said that they could request something different if they wished. Residents were complementary about the food and appeared to enjoy it. Kitchen staff have undertaken appropriate Food Handling training. The kitchen was clean, tidy and well stocked. Drinks are provided regularly through the day and there is a varied selection offered. The bedrooms are well decorated and presented, they are personalised according to the taste of the resident. Residents said they were happy with their rooms and that they had a lot their own personal items around them. Care Homes for Older People Page 15 of 26 Judgement: Residents have visitors at any time and are able to use their own rooms, or the lounges to see them. The relatives said that they are made very welcome by the owner, manager and staff. Residents said they were happy with the arrangements for visitors. Evidence: There is good evidence from records and from talking to people at the home that peoples likes and dislikes, routines and lifestyle are identified. Staff demonstrated a good knowledge of peoples preferences and they are aware of the need to be flexible when providing care and support. People are able to make choices about whether or not to take part in planned activities that meet the social needs of all of the residents. Records of arranged activities are kept. One person said that there are organised activities, but I prefer to spend time in my room where everything is arranged to suit me and my needs. Staff know not to move things, because I find that affects my ability to move around the room. The food was well presented and residents said it was very good. Alternatives were available at each meal time. Menus were varied and staff said that they could request something different if they wished. Residents were complementary about the food and appeared to enjoy it. Kitchen staff have undertaken appropriate Food Handling training. The kitchen was clean, tidy and well stocked. Drinks are provided regularly through the day and there is a varied selection offered. The bedrooms are well decorated and presented, they are personalised according to the taste of the resident. Residents said they were happy with their rooms and that they had a lot their own personal items around them. Residents have visitors at any time and are able to use their own rooms, or the lounges to see them. The relatives said that they are made very welcome by the owner, manager and staff. Residents said they were happy with the arrangements for visitors. Care Homes for Older People Page 16 of 26 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. People are protected by the good systems in place at Newland House for dealing with complaints and safeguarding. Evidence: There is a written complaints procedure that is freely available for people living in the home. This outlines how to make a complaint and the action that is taken by the service for dealing with complaints. There is a book for recording complaints, however none have been made since the last inspection. There was evidence from complaints made before this that there are good systems in place for dealing with complaints and reaching a satisfactory outcome for people using the service. One person said I have never had to make a complaint, but if I wanted to I could speak to any of the staff, the manager or the owner. They are all very approachable and helpful. I am satisfied that they would take any concerns I had seriously. One relative said that she had never had an occasion to make a complaint because everything is done that needs to be. She said that the staff are excellent and everyone is very friendly and supportive. No safeguarding referrals have been made since the last inspection. Policies and procedures are in place and staff were aware of the action to be taken in the event of an allegation being made. Records showed that all staff have completed safeguarding training. Care Homes for Older People Page 17 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Newland House provides comfortable, well maintained and decorated accommodation that suits the needs of the people living there. Evidence: The home is clean, well decorated and odour free. The building has been adapted to suit the needs of the people living there and provides comfortable accommodation. The lounges and dining areas are spacious and people are able to move around freely. There are safe paved areas to the rear of the building that people can use for sitting outside when the weather is good. These areas are easily accessible with level pathways and raised beds so that people are able to make the best use of the areas outside. There is a small lounge that is used as a smoking area. There is a shaft lift fitted and a stair lift and both are regularly serviced and maintained. Residents said that they are comfortable and happy with the quality of the accommodation provided. One person said that she finds her room very comfortable and all the facilities are available that she needs. She said I like having my own ensuite toilet and the room is arranged to suit my needs. Maintenance is well managed and issues are addressed promptly by the owner. Evidence was available that there is a rolling programme of upgrading and redecoration. There is an ongoing programme of redecoration and refurbishment. Care Homes for Older People Page 18 of 26 Evidence: Bathrooms and toilets are tidy and clean. Liquid soap and paper towels should be available to minimise risks of cross infection. Bedrooms are well decorated and furnished offering good personal space. People are encouraged to bring in items from their previous homes. Staff showed that they were aware of good health and safety practice during the inspection. The laundry was clean, well organised and equipped. Staff working in the laundry are aware of infection control procedures. There is sufficient laundry equipment to meet the needs of the number of people cared for. Infection control procedures are in place and staff training is provided. Care Homes for Older People Page 19 of 26 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. There are sufficient appropriately skilled and trained staff to meet the needs of the people living in the home. Evidence: Staffing levels are sufficient to meet the needs, activities and aspirations of the people living in the home. During the visit to the home there were adequate numbers of staff to meet the needs of the residents including carers, domestic and catering staff. People living in the home said that they were happy with the staff and they spoke positively about the level of support they received. One person said staff are very good and I am very happy with my life here. Rotas were well organised to ensure that peoples needs are met effectively particularly in the mornings and evenings. There was flexibility for covering staff holidays and sickness. Staff records showed that appropriate recruitment procedures are followed and the manager recognises the importance of effective recruitment in protecting people living in the home. Appropriate checks including reference, Criminal Records Bureau and POVA checks are carried out and records confirmed this. All staff receive relevant training and individual records confirmed this. National qualifications in care have been achieved by all staff apart from two new staff who will be undertaking their training. Training is focused on achieving better outcomes for Care Homes for Older People Page 20 of 26 Evidence: people living in the home. External providers are used to deliver training for staff. Staff said that they get enough training opportunities and are well supported by the senior staff. Individual training records are in place and are kept up to date. Staff meetings are held regularly and a staff supervision programme is in place. Staff said that they feel well supported by the owner, manager and senior staff. Good communication is fostered. There is a settled staff team with a very low turnover and this contributes to the smooth running of the home. Care Homes for Older People Page 21 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from living in a well managed home and are encouraged to put forward their views. Evidence: The manager has the experience and qualifications to run the home. She understands the need to keep up to date with practice and to attend training courses to further her professional development. She is well supported by an experienced senior staff team and has good support from the owners of the home. The home has a clear statement of purpose that sets out the aims and objectives of the service. There is evidence that the owners and manager have effective systems in place that monitor practice and compliance with the plans, policies and procedures of the home. Questionnaires from people living in the home and their relatives were available and information from these is used to inform development plans for the home. Care Homes for Older People Page 22 of 26 Evidence: People are encouraged and supported to retain control of their own money. Money is held on behalf of some people who are unable to manage this on a day to day basis for the purchase of small items. All transactions relating to money held are clearly recorded and appropriate procedures for managing residents money are in place so that staff are clear about their responsibilities. Lockable storage is provided in each persons room so that they can keep money or valuables safely. Health and safety policies and risk assessments are in place and staff receive appropriate mandatory training at regular intervals. Regular checks and servicing of fire equipment are carried out and records show staff have received appropriate fire training. Good records are kept of all accidents and there was evidence that these are monitored by senior staff. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 1 4 The registered persons 31/05/2007 should ensure that the statement of purpose includes information to show how the home meets the needs of the residents with dementia. The registered persons 30/09/2007 should ensure that where appropriate, the staff receive specific training in dementia care, so that they have a greater understanding of how to meet the changing needs of this particular group of residents. The policy and procedures in 30/04/2007 respect of the use of bed rails needs developing further to include specific detail to ensure the health and safety of the residents. Outstanding from the last inspection. 2 30 18 3 38 13 Care Homes for Older People Page 24 of 26 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 1 2 9 21 Hand written entries in the medication records should be signed by two members of staff. Liquid soap and paper towels should be available in bathrooms and toilets. Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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