Care Home: Newlands Care Home

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What the care home does well This service is good at providing up to date information about the care and services they can provide to people. They are careful to only admit people they know they can care for and who will fit in with the existing group of residents. People receive good standards in nursing and personal care. Medicines are managed well and people are supported when they need specialist health care. Staff help people to retain their privacy and dignity and treat people in a respectful way: Newlands Care Home DS0000069261.V375620.R01.S.doc Version 5.2 •“The nursing staff are very efficient. The care workers are generally friendly and helpful, some outstandingly so...”.Some people were happy with the activities on offer. The routines of the day are flexible and people are encouraged to be as independent as possible. People told us they were happy with the food provided: • “They have a good food choice and the food is done to a high standard.”They manage complaints and safeguarding matters well. No one had any complaints or concerns on the day. People told us they were happy with their rooms and enjoyed spending time in the shared areas. The dementia care unit has special features that help people who may be disorientated. The home was clean and fresh on the day of the visit and people were happy with the arrangements for preventing cross infection and with the laundry service • “I feel the laundry does well as my clothes are always fresh and clean.”Staff numbers are now more than adequate to allow people to receive good standards of care and services. Staff are suitably trained and recruited. The home has a new manager. Staff and residents were enthusiastic about her appointment and are looking forward to the improvements and developments she has planned. There are systems in place to make sure there are regular checks on quality. Peoples’ views are taken into account. Money held on behalf of people who live in the home is managed correctly. There are suitable arrangements in place to ensure that health and safety matters are dealt with correctly. The home has a 4* ‘Very Good’ rating from environmental health for food safety and fire safety is managed well. Generally this is a well managed home that is moving forward with a new manager. We had very positive responses from people who live in the home: • “I am very happy here. It makes me feel safe and independent. I am very content.” What has improved since the last inspection? Since our last visit two years ago the home has responded to the things we suggested as good practice improvements. Newlands Care Home DS0000069261.V375620.R01.S.doc Version 5.2 They have tightened up some procedures around medicines. They now keep better records of activities. Equipment is stored more safely. There is a full staff complement. A number of improvements have taken place during this period. These include ongoing decoration and purchase of replacement furniture and equipment. There has been some improvement to the grounds. Staff continue to receive suitable training and several initiatives have been started. These include training staff in what is called ‘Person Centred Thinking’ (a way of looking at the whole person when helping them plan their care and social needs) and improvements to the way staff work with people with dementia. We judged that these things now need to become established and we look forward to the development of the home. Here is what one member of staff told us in a survey: • “The last few months haven’t been the easiest ...but staff have pulled together. I feel great progress has been made recently with dementia care and person centred thinking...” What the care home could do better: There was nothing of concern seen on the day but we made two good practice recommendations. They need to continue to review the care planning systems and update some individual plans. Work on activities needs to continue so people can have a wide range of options for their social, cultural and recreational needs. Key inspection report CARE HOMES FOR OLDER PEOPLE Newlands Care Home Newlands Park Workington Cumbria CA14 3NE Lead Inspector Nancy Saich Key Unannounced Inspection 08:15 25 September 2009 th DS0000069261.V375620.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Newlands Care Home DS0000069261.V375620.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Newlands Care Home DS0000069261.V375620.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Newlands Care Home Address Newlands Park Workington Cumbria CA14 3NE 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) 01900 872257 01900 607429 www.barchester.com Barchester Healthcare Homes Ltd Manager post vacant Care Home 35 Category(ies) of Dementia (12), Old age, not falling within any registration, with number other category (23) of places Newlands Care Home DS0000069261.V375620.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only: Care home with nursing - Code N, to people of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category: Code OP (maximum number of places: 23) Dementia: Code DE (maximum number of places: 12) The maximum number of people who can be accommodated is: 35. Date of last inspection 27th June 2007 Brief Description of the Service: Newlands Care Centre is a purpose built care home and provides nursing and personal care for people over the age of 65, some of whom have dementia. The home is in a quiet residential area and has easy access to the town of Workington and its amenities. Newlands Care Centre is wholly owned by Barchester Healthcare Homes Ltd. The home is a modern single storey building that is light and spacious and has wide corridors and ample communal space for people. The home is divided into two units with separate staff for each. One unit, Lonsdale, offers nursing care to 12 people who have dementia care needs and nursing care is provided for frail elderly residents on the other unit. There is a secure garden area for the people on Lonsdale unit to enjoy and use. Many bedrooms also have pleasant views out over the gardens and grounds at the front and side of the home and these are accessible to people on the nursing unit. There is adequate car parking for visitors and staff at the front of the home. Information is made available to people living in the home or considering coming to live there in the combined statement of purpose and resident’s guide that forms the welcome pack to the home and is given to all people coming to live there or to their relatives. The fees charged range from £442 to £774 per week depending on assessed need. This does not include the cost of personal magazines and newspapers, hairdressing, private chiropody treatment and the cost of any private travel arrangements. Newlands Care Home DS0000069261.V375620.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This was the main or Key Inspection for this service. The home had an Annual Service Review in 2008 which does not involve a visit to the home. The lead inspector, Nancy Saich, asked the company to complete the Annual Quality Assurance Assessment (the AQAA). This is a document that registered providers must, by law, complete annually. It asks for statistics about the service and for information about how the home has been operating in the last year and for future plans for the coming year. This was done within the timescale and completed in detail. We (the Care Quality Commission) also look at other information sent to us throughout the year. This includes incidents that they must tell us about and covers things like accidents and safeguarding matters. There was nothing of major concern noted in this information. We then delivered a number of postal surveys for people who live in the home, their relatives and staff team. We had a good response to the surveys and include quotations from them in the report. We made an unannounced visit to the home on the above date. We arrived just after 8 in the morning and stayed until late afternoon. We met people on both units, shared a meal with them and spoke to them individually and in groups. We met with the nurses, carers and housekeeping staff on duty and spent some time with the new manager. We met a number of visitors on the day. We observed how things are in the home and we read a wide range of files and other documents that backed up what was seen and what was said. What the service does well: This service is good at providing up to date information about the care and services they can provide to people. They are careful to only admit people they know they can care for and who will fit in with the existing group of residents. People receive good standards in nursing and personal care. Medicines are managed well and people are supported when they need specialist health care. Staff help people to retain their privacy and dignity and treat people in a respectful way: Newlands Care Home DS0000069261.V375620.R01.S.doc Version 5.2 Page 6 • “The nursing staff are very efficient. The care workers are generally friendly and helpful, some outstandingly so...”. Some people were happy with the activities on offer. The routines of the day are flexible and people are encouraged to be as independent as possible. People told us they were happy with the food provided: • “They have a good food choice and the food is done to a high standard.” They manage complaints and safeguarding matters well. No one had any complaints or concerns on the day. People told us they were happy with their rooms and enjoyed spending time in the shared areas. The dementia care unit has special features that help people who may be disorientated. The home was clean and fresh on the day of the visit and people were happy with the arrangements for preventing cross infection and with the laundry service • “I feel the laundry does well as my clothes are always fresh and clean.” Staff numbers are now more than adequate to allow people to receive good standards of care and services. Staff are suitably trained and recruited. The home has a new manager. Staff and residents were enthusiastic about her appointment and are looking forward to the improvements and developments she has planned. There are systems in place to make sure there are regular checks on quality. Peoples’ views are taken into account. Money held on behalf of people who live in the home is managed correctly. There are suitable arrangements in place to ensure that health and safety matters are dealt with correctly. The home has a 4* ‘Very Good’ rating from environmental health for food safety and fire safety is managed well. Generally this is a well managed home that is moving forward with a new manager. We had very positive responses from people who live in the home: • “I am very happy here. It makes me feel safe and independent. I am very content.” What has improved since the last inspection? Since our last visit two years ago the home has responded to the things we suggested as good practice improvements. Newlands Care Home DS0000069261.V375620.R01.S.doc Version 5.2 Page 7 They have tightened up some procedures around medicines. They now keep better records of activities. Equipment is stored more safely. There is a full staff complement. A number of improvements have taken place during this period. These include ongoing decoration and purchase of replacement furniture and equipment. There has been some improvement to the grounds. Staff continue to receive suitable training and several initiatives have been started. These include training staff in what is called ‘Person Centred Thinking’ (a way of looking at the whole person when helping them plan their care and social needs) and improvements to the way staff work with people with dementia. We judged that these things now need to become established and we look forward to the development of the home. Here is what one member of staff told us in a survey: • “The last few months haven’t been the easiest ...but staff have pulled together. I feel great progress has been made recently with dementia care and person centred thinking...” 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. Newlands Care Home DS0000069261.V375620.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 Newlands Care Home DS0000069261.V375620.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1,3 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in this service receive good information so that they can make an informed decision about coming into the home. EVIDENCE: We were given copies of all the information available to people who may wish to choose Newlands as their new home. We found this to be detailed and up to date. Copies were readily available and people told us they had been given the right amount of information to make an informed decision. We spoke to a number of people about how they came to the home and we learned that new people are visited by a manager or one of the nurses. We also saw good assessments of need and preference in peoples’ individuals files. Newlands Care Home DS0000069261.V375620.R01.S.doc Version 5.2 Page 10 Staff told us that they were careful before admitting a new person so that they were as certain as they could be that they could give people the right level of care and that the new resident would fit into the existing group. Newlands Care Home DS0000069261.V375620.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People in this home receive good standards of personal and nursing care that allow people to be as healthy and content as possible. EVIDENCE: We read a number of the written plans that help staff give people the care and services they want and need. We found the plans to be, in the main, up to date and suitably detailed. We spoke to people who were aware of their plans and were happy with the way these were carried out by staff. We did think that some of the care plans would benefit from updates and revision. We learned from the new manager that there were plans to update care planning to make it more person centred. We also learned that she had plans to improve and develop the way people with dementia are cared for. Newlands Care Home DS0000069261.V375620.R01.S.doc Version 5.2 Page 12 We saw in care plans and through observation that people got the right kind of health care support. Someone was unwell on the day and the GP was called straight away and her family informed so they could sit with her. We noted that in the afternoon this person got very good attention from staff and we judged that this responsive nursing input helped the person to be more comfortable. Residents and visitors told us that they judged the nursing input to be very good and that other health professionals were brought in when people had health concerns. One person spoke at length about the very good post operative care she had received after a major operation. Her file showed that good health care intervention and good nursing had helped with wound healing and skin care. This person had achieved improved health and she judged that staff had attended to her psychological and emotional needs during this time. We checked on medicines kept in the home and we saw nurses give out medicines. These were being managed correctly. There had been an error noted but we had been informed of this straight away and we saw the new manager’s action plan that would help lessen the risk of what was a simple ‘human error’. People are assessed so that where they wish they may take some or all of their own medicines and things like inhalers and creams. Controlled drugs are being managed correctly. The local pharmacist visits regularly and staff have had appropriate training and updates. Medicines are reviewed regularly by GPs and staff do their best to get people seen by specialists when necessary. We observed staff in different parts of the home working with people who live there. We saw a number of pleasant, friendly interactions and people were treated in a respectful way. Things like moving and handling and help with personal care were done in a dignified way. Discussions with people and surveys told us that staff attitude and approach was appropriate. We were told that people were given their rights in things like privacy and we saw examples of this during the visit. We could also judge that peoples’ strengths were used to help them remain as independent as possible. Nurses we spoke to were keen to tell us that they judged that they were good at giving good ‘end of life’ care and we had evidence to show that this aspect of care was given high priority and that specialists were brought in for advice. We learned that local health care providers were happy with the way this is done. We also spoke to family members who were satisfied that they were included in this important aspect of care. Newlands Care Home DS0000069261.V375620.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. We saw an improving picture for activities and entertainments for people who have plenty of choice in how they live their lives. EVIDENCE: The inspection started just after 8 a.m and very few people were up and dressed. We were told by residents that they got up when they wanted and went to bed as they chose. A lot of people enjoy breakfast in their own rooms but socialise at lunchtime. We learned that some people like to spend a lot of time in their rooms to follow their own interests and hobbies. People can have meals in their rooms if this is what they prefer. We had a number of surveys from families and friends and they confirmed what residents told us about visiting. Visitors are welcome at all times of the day and we met with a number of very satisfied relatives. People told us that local groups visited the home from time to time and that there were regular church visitors from all denominations. Newlands Care Home DS0000069261.V375620.R01.S.doc Version 5.2 Page 14 Just under half of the surveys we received stated that they wanted more entertainments and more activities. We spoke to some people who were quite satisfied with what was on offer and we saw that the specialist dementia care unit did provide some specialist activities. The home has its own mini-bus and there was evidence of people coming in to entertain. We looked at the activities register kept by the activities organiser and we saw that this part of the care provided was gradually being built up. There are regular ‘movie days’ where people can watch films on the large screen TV, staff give people manicures and other ‘pampering’ treatments and aromatherapy is on offer. The manager has activities included in her improvement plan for the home and we look forward to hearing about how this develops. These plans include diverse ideas like a nail bar for pamper experiences and a poly tunnel for people interested in gardening. We were invited by residents to share a meal at lunchtime. There were two choices on offer but people were having a third preference and the cook offered us even more alternatives. The meal was quite nicely presented and well cooked. The kitchen had a good range of food available, with lots of choices for snacks and sandwiches at any time of the day or night. Basic foods like meat, fish and vegetables were of a high quality. People told us they were happy with the food on offer. We liked the fact that people could help themselves to the ‘snack basket’ or the fruit bowl. There were fruit drink and mineral water dispensers available for people to help themselves to drinks. We were again told of plans to improve meal times so that this standard would continue to be exceeded. The company and the new manager were busy implementing Barchester’s ‘fine dining experience’ and staff were looking at how this was working in practice. Newlands Care Home DS0000069261.V375620.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home judged that their complaints, concerns or allegations would be listened to and dealt with correctly. EVIDENCE: This company has a detailed complaints procedure that is readily available. Residents told us they were confident and happy to speak up if things were not to their satisfaction. We saw evidence to show that day to day issues were dealt with before they became complaints. There is a complaints file and we judged that complaints are being managed correctly. Neither we nor the company had received any formal complaints recently. There had been one incident when staff had considered a person to be at risk from harm from something outside of the home. This had been dealt with promptly and resolved appropriately and we were kept informed. One staff member said how much they had learned from this. Staff at all levels could explain their responsibilities in terms of safeguarding vulnerable people. The manager said she planned to update her own training and start to network with local safeguarding teams. Newlands Care Home DS0000069261.V375620.R01.S.doc Version 5.2 Page 16 The company has good policies and procedures about safeguarding, complaints and ‘whistle blowing’. Residents and relatives told us they had never heard or seen anything abusive in the home but that they would be confident in management or the company if they had any concerns. Newlands Care Home DS0000069261.V375620.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Newlands provides safe, comfortable surroundings for people and we judged that this allows people to feel relaxed and ‘at home’. EVIDENCE: Newlands is situated in a residential area with a bus stop within walking distance. It has its own secure grounds and an adequate car park for visitors. It is very near to the town centre and its amenities of shops, cafes, restaurants, theatre, museum and bus and train stations. The home is purpose built, single storey with suitable design features and equipment for people who may have mobility problems and for people who have dementia. Newlands Care Home DS0000069261.V375620.R01.S.doc Version 5.2 Page 18 We walked around the home at different times of the day and we judged that people were very relaxed and comfortable in their own surroundings. Several people used motorised wheelchairs and moved around very independently. We were shown around by these people when we were looking at different parts of the home. The access and space for people in wheelchairs is very good. Individual rooms were nicely decorated and furnished. Every person had a pine, rise and fall bed with matching bedroom furniture. All areas were tidy, clean and very homely. Even when people needed specialised nursing equipment this was not obtrusive. The dementia care unit has suitable signs and other features that support people with dementia and we were told that there were plans to update signage and other features. The entire building was clean and tidy even early in the day. People told us that their clothes and bed linens were looked after properly. Domestic staff were busy in all areas during our visit. Staff are trained to keep cross infection risks to a minimum. There were plenty of aprons, gloves and cleaning materials. We saw records showing when and how tasks are completed. This is part of ongoing quality monitoring. Newlands Care Home DS0000069261.V375620.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This home has a suitably trained team of staff who deliver good standards of care and services. EVIDENCE: We were given four weeks worth of rostered hours for the home. We took these with us and made a judgement based on this evidence and on what people in the home told us. We judged that there are enough staff to give people good levels of care. There is always a nurse in charge of both units and suitably trained care staff available to meet peoples’ needs. The rosters showed a good mix of staff ability and experience on each shift by day and night. More than half the staff group have National Vocational Qualifications in Care at level 2 or 3. A number of staff spoke enthusiastically about doing this training. New staff have arrangements in place for registration. We checked on the recruitment processes in the service and found them to be in order. New people have no access at all to vulnerable people until their background and references are checked and any criminal records or inclusion Newlands Care Home DS0000069261.V375620.R01.S.doc Version 5.2 Page 20 of lists relating to safeguarding are thoroughly scrutinised. Everyone had two references and had been given suitable induction training. New starters work with experienced staff after this before working with residents. We also met two residents who had been involved in the last recruitment and had enjoyed having an impact on the way the service is staffed. We learned that they planned to do this again and the manager said how valuable their contribution had been. The company has continued to deliver training despite not having a manager for some months. The home has a dedicated training officer who works two days per week and delivers and sources external training. The new manager was getting to know her staff team and learning about their training and development needs. Nurses take the lead in varied areas of expertise and cascade their skills and knowledge to others. Nurses told us of training in things like back care, wound care and nutrition. Everyone spoken to was happy with the ongoing updates to their clinical practice. There is a training plan in place and the new manager hopes to supplement this with any specialist training that she or her staff may need. She plans to update staff training in terms of specialist approach and activities for people with dementia. Newlands Care Home DS0000069261.V375620.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management systems in this service work well and are under review from a new manager so that they continue to allow people to live a stress free life. EVIDENCE: On the day of our visit the new manager had only been in post for some three weeks. People in the home and staff were extremely positive about her and were looking forward to the future. She has a background in nursing and management and is keen to understand what is required of her in managing a nursing home. We had several examples of her ability to manage systems in Newlands Care Home DS0000069261.V375620.R01.S.doc Version 5.2 Page 22 the service. She had started the process of applying for registration with the commission. We were pleased to note that the home had been managed in a suitable way by senior officers of the company when the manager’s post was vacant. We were kept informed of the developments in the home and of the successful recruitment. The manager told us she had been given an induction and was receiving ongoing support. The manager from Barchester’s other home in Cumbria visited during our inspection to give any advice or support necessary. Residents told us they were glad to have a new manager but said things had run smoothly enough during this time without a manager. On the day of our visit we saw a number of up to date records showing how care was given, how the home was maintained and cleaned, how care plans were updated and good records relating to staff employment and training. We also learned that surveys are sent out regularly and that there are meetings for residents and staff. Together these things form part of Barchester’s quality assurance system. There was no recent review of these but we judged that this is appropriate as it is a task for the new manager. She did however provide us with an action plan for service improvement that she had put together from her observations and from discussions with residents and staff. We considered this interim plan covered aspects of the service we looked at and that she had recognised where there was the normal needs to develop and improve things. We look forward to seeing her first quality assurance audit once she has become established in the service. We checked on money kept on behalf of residents. There was very little money kept but these small amounts were suitably accounted for and cash reconciled to the accounts. A lot of people manage their own money and there is also a system whereby the home pays the accounts and then charges solicitors or family members for the expenditure. We also looked at this and found things were in order. We looked at records relating to health and safety and maintenance. We judged that the home met all the legislation around these matters. We looked at the fire log book and found that drills, instructions and tests were up to date. The kitchen was tidy, clean and very well organised. They had received a ‘very good’ outcome from a recent environmental health inspection. Staff had received updates to manual handling. The quality assurance system means that things like bed sides, mattresses, hoists etc are all maintained through a contract but that the staff also do their own quality checks. This home has two people who maintain, decorate and repair the home and deal with the grounds. We could see that they keep good records and make sure there are checks on things like the boilers, central heating and water systems and supplies. Newlands Care Home DS0000069261.V375620.R01.S.doc Version 5.2 Page 23 This home has good management systems in place that have helped things ‘tick over’ without a manager. They now have a manager who is aware of how to use these systems and how to delegate responsibility to others. We saw promise of improvement in what is already a very good service and look forward to updates to progress in all areas. Newlands Care Home DS0000069261.V375620.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 x 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 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 4 30 3 MANAGEMENT AN ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X X 4 Newlands Care Home DS0000069261.V375620.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? N/A 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. 1. Refer to Standard OP7 Good Practice Recommendations It is recommended that the care planning system is reviewed and that current plans are developed in consultation with residents so that they become more person centred. It is recommended that activities continue to be developed so that diverse social and cultural needs can be met. This should include developments in dementia care activities. 4. OP12 Newlands Care Home DS0000069261.V375620.R01.S.doc Version 5.2 Page 26 Care Quality Commission North West Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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