Care Home: Newnham Green

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What the care home does well The home is well maintained and people can choose how they keep their rooms. They benefit from a homely, comfortable, clean and safe home. One person living there says they like it and that: "It is much better than where I used to live." Staff work hard to support people with their social lives and with their personal and health care. Where they need to they show they act on the advice that other health professionals give them. Most of the people living in the home find it difficult to communicate. Despite this staff make efforts to help them make decisions and they are trying to develop different ways of doing this. They have a good understanding of people`s needs and respond to any signs of distress and concern. Staff are checked and trained so that the owners do what they can to put measures in place to help protect people living in the home. One relative wrote to us that they felt: "Whatever the level of ability the resident has the feeling of being safe and well looked after!" The staff have good training and most of them are qualified. The owners make sure that staff have opportunities to learn skills to help them support people properly. The owners show that they care about making the home even better, by taking into account the views of other people and showing what they have done about these. What has improved since the last inspection? The owners have done some more decorating and they have replaced the damaged bath (and the rest of the bathroom suite). This has improved the standard of the home for people living there. Staff are having more regular meetings with their manager to discuss their work. This gives more opportunities for the manager to see how well staff understand what they should do and what the aims of the home are. He can also look at problems with staff. The manager has finished the training he needed to do and now has the qualifications he needs to help him run the home and support people more effectively. Staff training has continued to improve and it is recorded better so that the manager can see when it needs to be updated. This means that he can make sure staff are always up to date and competent to support people properly and safely. What the care home could do better: There isn`t anything that the owners need to do by law but there are some things they could think about doing to make things better. They need to make sure that they keep up to date with reviewing people`s support plans so that they can recognise progress and make sure they always show what people`s needs are now. The manager and staff should look at the things they write down about the care they have given. They should make sure this matches what support plans say they need to do. This is so they can see more easily that people have the support, prompting or assistance that they need. We discussed with the owners, some other things they might like to think about and they looked at these things while we were there. The report can tell you about this in more detail. CARE HOME ADULTS 18-65 Newnham Green 67 Newnham Green Gorleston on Sea Gt Yarmouth Norfolk NR31 7JS Lead Inspector Mrs Judith Last Unannounced Inspection 19th June 2008 03:20 Newnham Green DS0000062045.V366815.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Newnham Green DS0000062045.V366815.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Newnham Green DS0000062045.V366815.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Newnham Green Address 67 Newnham Green Gorleston on Sea Gt Yarmouth Norfolk NR31 7JS 01493 651787 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) colin.hallam3@ntlworld.com Mr Colin Graham Hallam Janet Hallam Mr Colin Graham Hallam Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Newnham Green DS0000062045.V366815.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th July 2006 Brief Description of the Service: 67 Newnham Green is a semi-detached house situated in a residential housing estate in the coastal town of Gorleston. It is registered as a residential care home that provides accommodation and care for up to six people with a learning disability. Residents have the use of accommodation and facilities on both the ground and first floor of the home and there is no assisted passage to the first floor. The home has four single and one shared bedroom, all containing a washbasin and there is communal use of a shower room with toilet and a bathroom on the first floor, a toilet on the ground floor, lounge, dining area and kitchen. The home has a well-kept garden to the rear of the property, roadside parking at the front and is close to a row of local shops and a pub. There is local public transport available to the larger seaside towns of Great Yarmouth and Lowestoft. The service users guide does not yet set out the fees for the service. However, it does specify charges for transport. Most people living at the home would need help to understand what the inspection reports say about the service. Newnham Green DS0000062045.V366815.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. We spent about four and a half hours at the home. Before making our visit we reviewed all the information we have about the home and looked at detailed information that the manager was asked to send to us. We also wrote to people before we visited to ask what they think about the service. We had written comments from five staff members, one health professional and one relative. Staff helped people living at the home to complete their comments. During our visit the main method of inspection used was called “case tracking”. This system is used to see what records say about people’s needs, and to find out from observation and discussion what happens in the daily lives of people living at the home and the outcomes they experience. We also looked around the home, communicated with people and watched and listened to what was going on so we could see how people were being supported. We used this information and the rules we have, to see how well people were being supported in their daily lives. What the service does well: The home is well maintained and people can choose how they keep their rooms. They benefit from a homely, comfortable, clean and safe home. One person living there says they like it and that: “It is much better than where I used to live.” Staff work hard to support people with their social lives and with their personal and health care. Where they need to they show they act on the advice that other health professionals give them. Most of the people living in the home find it difficult to communicate. Despite this staff make efforts to help them make decisions and they are trying to develop different ways of doing this. They have a good understanding of people’s needs and respond to any signs of distress and concern. Staff are checked and trained so that the owners do what they can to put measures in place to help protect people living in the home. One relative wrote to us that they felt: “Whatever the level of ability the resident has the feeling of being safe and well looked after!” Newnham Green DS0000062045.V366815.R01.S.doc Version 5.2 Page 6 The staff have good training and most of them are qualified. The owners make sure that staff have opportunities to learn skills to help them support people properly. The owners show that they care about making the home even better, by taking into account the views of other people and showing what they have done about these. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by Newnham Green DS0000062045.V366815.R01.S.doc Version 5.2 Page 7 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Newnham Green DS0000062045.V366815.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Newnham Green DS0000062045.V366815.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2 People who use 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 thinking about moving into the home (or their representatives if they need help) would have the information they need to make a decision about whether it is suitable and would meet their needs. EVIDENCE: The service users’ guide does not have information about fees, which is relevant where people might need representatives to help them decide about moving in. The manager started to put this right while we were there as he can print an extra page, depending on the person wanting the information. We have not made a requirement because people will now be able to have all the information they need about what the home can offer them. Each person who lives at the home has their own copy of the guide. It sets out what the home can offer, and includes the charge made for transport. It focuses on people’s rights to dignity and respect and their right to relationships. It also tells them who to talk to if they have concerns. Photographs help make it more understandable although some people would still find this difficult. The manager says in information he sent to us, that the guide to the home could be made more user friendly but that this has to be done at people’s own Newnham Green DS0000062045.V366815.R01.S.doc Version 5.2 Page 10 pace. He says he is thinking about other ways to make it easier for people to understand it. There are no vacancies in the home at present and the manager says that they have not been able to “test” the system for introducing people who might want to live there. He confirmed that people thinking about moving into the home would have their needs assessed. He said that usually the assessments would be from social workers when people are referred. He would follow this up and he also gave an account of the introductory process. This includes visits and overnight stays - and would take into account the needs of people already living there. This process if followed, means that people could be sure the home is suitable to meet their needs. Newnham Green DS0000062045.V366815.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 People who use 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. Where possible, some people are involved in decisions about their daily lives and in planning their care and support. EVIDENCE: We looked at support plans for three people. These show what staff are to do to support someone successfully. In one case we saw that someone had signed up to an agreed plan for what was to happen if they became agitated. We spoke to the person about this who recognised the need to learn skills to calm themselves down. This shows that the person was involved in developing and agreeing the support they need. A support plan reflects the need for “one to one” time with staff and that the person responds positively to this. However, daily notes of care delivered do not show clearly that it happens. The person told us it does happen, showing they receive the support that they need even though care records do not show it is given. Newnham Green DS0000062045.V366815.R01.S.doc Version 5.2 Page 12 People are encouraged to make choices verbally if they can, or by offering objects to select from (such as cereal boxes to select breakfast). Staff confirm what the manager said about starting to use photographs to help people to make choices too. Staff and the manager say this had to be done at people’s own pace and recognise some of the difficulties they have encountered when too many options were offered. One person is beginning to make choices about drinks, using three pictures. Support plans show staff take into account the communication methods of those who are not able to express themselves verbally – for example that one person’s presence and manner near the kitchen means that they are likely to be thirsty. One support plan reflects that staff are to be alert to and record other ways a person might communicate. These things show that although people might not understand their support plans, they are encouraged to make decisions, even where cognitive and communication problems make this difficult. The frequency of review of support plans has slipped in some cases – for example, parts of one had not been reviewed since October 2007, and another since September 2007. (Standards say this should happen at least every six months.) This means that support plans do not always show they are up to date in showing what people’s needs are. One person was not able to communicate verbally but we saw that the gestures and behaviour were recognised in the support plan as methods of communication. This means that staff are able to build up a picture of how someone might be feeling. There are risk assessments on file. However, in one case there was no evidence that the activities reflected in the risk assessment were offered or taken up (for example in making their own drinks and cooking). We discussed this with the owner and how records might show whether things are offered or refused. At present records do not show that staff act to support the person in the way they need, to develop and maintain their skills while managing risks. Risk assessments take into account the ratio of residents to staff in order to be able to go out safely. Staff showed that they know about these. The staff member we spoke to showed an awareness of situations that were likely to present problems and how these were taken into account (for example eating out in crowded places). This means that staff are aware of what they can do to make sure people are safe. Newnham Green DS0000062045.V366815.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 People who use 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 have opportunities to lead a fulfilling lifestyle subject to their wishes and abilities. The manager is aware of the need to ensure that all staff share responsibility for supporting people using the community. EVIDENCE: People participate in structured routines during the week. Some people use “traditional” day services and opportunities for learning and education are provided there. Others have community support workers who help them to experience new activities. One staff member wrote expressing the view that there could be a greater priority attached to meeting people’s social and recreational needs as part of their programmes. We spoke to staff and the manager about this. They say the service generally focuses at weekends on the two service users who have more traditional day services. This is because they have fewer opportunities Newnham Green DS0000062045.V366815.R01.S.doc Version 5.2 Page 14 for a variety of social and recreational outings than do the people who have community support workers. There are records of activities that people do, although these are held in two different places. One record, in a support plan showed a total of 15 entries in a period of four months, with 9 of these being for the same activity. This meant that record does not show the person has opportunities to experience a varied and stimulating lifestyle. However, there are separate activity books also showing where people have been and what activities they have joined in with, both inside and out of the house and these are more complete. The manager suggested that the other record sheets could be removed so that evidence of people having a fulfilling lifestyle would be improved and more consistent. The staff member we spoke to says that the duty roster is flexible where special outings or trips are planned and extra cover will be arranged. She says that the owners are always available to help with this. She gave examples of extra cover for a birthday outing and for another person going to Romford on a coach trip. This means that the owners try to ensure people’s opportunities are not unnecessarily restricted because of staffing levels. Two people are going on holiday in the near future and one of them told us they had chosen this. A person confirmed what the manager said about being supported with managing money and says this includes helping budget for their holiday. They showed us their record book they keep so they know how much money they have to spend. These things mean people have opportunities to make decisions about their daily lives. One person’s records show different times of getting up and going to bed and they confirmed this, telling us they have a lay in at weekends. The support plan recognises that staff may need to encourage the person to bed at a reasonable time where the weekly activities might result in them becoming overtired if they stayed up late watching television. This means that where people are able to, they are supported to make informed decisions but that routines are also flexible. One relative says that the home always helps the person to stay in touch. One person told us about arrangements to meet with a friend at the weekend. The owners told us about efforts they had made to ensure someone kept in touch with an elderly relative. This shows that people are supported to maintain contact with friends and family. One person likes to eat with staff, as they need less assistance or supervision at mealtimes than some of the other people living at the home. They told us Newnham Green DS0000062045.V366815.R01.S.doc Version 5.2 Page 15 about this and we saw it happen. Records show where the person might decide to eat with others as a group, and the person confirmed this to us. We saw evidence that advice from speech and language therapy about diet has been incorporated into one person’s support plan. This was linked with monitoring of weight. This support plan also recognises the need to encourage fluids and avoid dehydration. This means that advice from other professionals is taken into account in meeting people’s needs. Newnham Green DS0000062045.V366815.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 People who use 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 are supported in a way that meets their individual personal and health care needs. EVIDENCE: People’s needs for prompting, supervision or assistance with personal care are set out in their individual plans. One person is recorded as needing assistance in relation to washing their back but can do the rest and they confirmed staff helped them just with this when we spoke to them. This means that staff help them to be as independent in bathing or showering, as possible. One review reflects some success in promoting continence and an improvement since the person first arrived at the home. However, records of care delivered do not always show that the support set out as needed, is given. However, staff we spoke to were clear about what they needed to do to be successful in supporting people with their personal care. Newnham Green DS0000062045.V366815.R01.S.doc Version 5.2 Page 17 We heard staff knock on doors when they needed to enter someone’s room. We also saw care being taken about how discreetly a bathroom door was opened after knocking, when staff needed to help with personal care. This shows that efforts are made to respect people’s privacy and dignity. Records show that health related conditions are followed up promptly, with specialist advice where this is needed. One person had undergone tests and examination because of health concerns and there were information leaflets available to staff about their condition. This means that there are measures in place to help people stay well or to manage any difficulties. This person’s support plan had been regularly reviewed and updated in response to their health condition and problems. A written comment from one health professional says: “to my knowledge they provide a caring and professional service alerting me appropriately to medical need.” There are records on file showing that people have appointments for check ups where these are needed. The manager has attended Mental Capacity Act training and says he takes up any issues of concern about informed consent for treatment or tests, with people’s care managers. This shows that people’s best interests are taken into account in the way the home promotes their health and welfare. Medication is stored in a lockable metal cupboard. This has the facility for internal storage of controlled drugs was this to become necessary. Medicines are supplied in a monitored dosage system and there are records of what has been received and disposed of. Medicines not in blister packs but prescribed for occasional use, have amounts carried over recorded, and a daily total when they have been administered to show balances remaining. This means that there are measures in place to help monitor that people get the treatment they need to keep them well. Records we saw were complete and clear and one of the owners takes responsibility for checking. However, one medication had been signed a day early, suggesting that the person responsible was not clearly following procedures and checking entries and so minimising the risk of errors. The owners are aware of the need to address this so we have not made a requirement. One person receives medication for a thyroid condition and records confirm that blood tests are arranged to monitor this. This shows that care is taken to ensure that people’s health is properly monitored. The owners told us about the process of supervision and training of staff about medicines, that they would watch experienced staff, be supervised themselves and only assume responsibility when they felt confident and had been assessed Newnham Green DS0000062045.V366815.R01.S.doc Version 5.2 Page 18 as competent. A staff member appointed within the last six months confirmed this to us. Two people are due to attend formal training in the management of medicines, at Yarmouth College. Both staff on duty showed us that they hold the cupboard keys on their person. This means that there are measures in place to help make sure medicines are stored and administered safely. Newnham Green DS0000062045.V366815.R01.S.doc Version 5.2 Page 19 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People who use 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. There are measures in place to help ensure that people are protected and their concerns are addressed. EVIDENCE: All staff completing comment cards know what to do if someone has concerns about the service. One person living at the home told us they could talk to staff or the owners. A relative wrote to say that they know how to make a complaint if they need to and that any concerns are always dealt with appropriately. The relative goes on further to comment that they feel: “Whatever the level of ability the resident has the feeling of being safe and well looked after!” Comment cards from people (assisted by staff) reflect that everyone knows who to speak to if they have concerns. One goes on to say that person’s verbal communication is not good but staff know the signs that they are upset or unhappy. These signs and behaviours are also recorded in communications assessments. The owners are committed to ensuring that staff have training about recognising and responding to abuse, soon after they are appointed. The person we spoke to confirms that they have had this. They also say that they know that they must report any concerns they have promptly. This means that there are things in place to help promote people’s safety and to try to get to the bottom of any concerns. Newnham Green DS0000062045.V366815.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 People who use 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 live in a homely environment that suits their needs and is clean and well maintained. EVIDENCE: We had a brief look around the home including people’s rooms and communal areas. These are well maintained and we were told people chose how they were to be decorated. One person showed us their room and has many items in it that reflect their interests. They say they really like their room and like living at the home. They say, “It is much better than where I used to live.” The owners told us in information they sent last time that they had replaced the bathroom suite because it had not been in good condition when we last visited. There are cleaning schedules showing what needs doing when. There were no immediate concerns for cleanliness, infection control, or health and safety. We Newnham Green DS0000062045.V366815.R01.S.doc Version 5.2 Page 21 saw that staff had protective clothing (aprons and gloves) available to them for carrying out personal care tasks and when this was necessary. This means that there are measures in place to help ensure people are not at risk from infection. Cleaning materials are held in a secure cupboard to reduce the risk to people living in the home. Newnham Green DS0000062045.V366815.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36 People who use 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 are supported by a skilled and competent staff team. EVIDENCE: The manager tells us that all staff have induction to the proper standards and four out of five staff say that their induction training covered what they needed to know to do the job “very well”. The other person said it “mostly” covered things. The staff member we spoke to said they had been able to shadow colleagues while they were getting used to the home and this had gone on for six weeks. During this time they were an extra person on shift. This induction process means that the owners take care to ensure that new staff understand the work they are to do, and how they need to support people, before they assume full responsibility for working on shifts. The manager says that he tries to get new staff onto training to help them protect vulnerable people and for first aid, as soon as possible after they are recruited. Now he has training materials and is able to deliver food hygiene training himself, he says that this will be delivered more promptly as they will not have to wait for courses. He also delivers health and safety training. This shows that priority is given to keeping people safe. Newnham Green DS0000062045.V366815.R01.S.doc Version 5.2 Page 23 The manager told us that all but one staff member now have qualifications in care. He says four out of the six who have this, have qualifications at a higher level than the standards set out. We saw a sample of certificates. All of those who wrote to us say that they are given training that keeps them up to date and is relevant to their roles. The person we spoke to said that training was good. This means that people have underpinning knowledge to help them understand people’s needs. One person living at the home enjoys the company of staff and says, “They’re good”. We looked at records for three staff taken on since our last visit and saw that the checks needed before people start work are completed. Results from interviews are recorded and there are set questions. The owners also take into account how potential staff respond when they meet people living at the home and vice versa. This means that there is a robust procedure for recruiting staff that will help safeguard people living at the home. All the staff who wrote to us say that they regularly or often meet with the manager to discuss their work. We saw records of supervision showing that this has improved since the last inspection. The manager did not tell us about this improvement in the information he sent to us. This confirms what a staff member told us – that they feel “well supported” in their work. One relative says that the staff always have the right skills and experience to look after people properly and meet different needs. Newnham Green DS0000062045.V366815.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 People who use 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 benefit from effective and competent management who run the home in the best interests of people living there. Effective quality assurance processes help support this. EVIDENCE: Since we last visited, Mr Hallam has completed the qualification in care that he needed. He and his wife oversee the running of the home and have considerable experience of doing so. They divide their time between Newnham Green and another home they own in Suffolk. However, a staff member told us that they are always available and will help out when they are needed. They said they felt well supported and also told us that: “They never ask you to do anything that they are not prepared to do themselves.” Newnham Green DS0000062045.V366815.R01.S.doc Version 5.2 Page 25 The owners told us about people’s needs and difficulties and we were able to confirm that the information was reflected in care plans and known to the staff member we spoke to. This means that the home is being effectively and efficiently managed taking into account the support people need. The focus on information in the service users guide takes into account people’s dignity and respect as well as rights (e.g. to privacy and relationships). The owners recognise the need to progress further with communication methods and that this has to be done at the pace of the people living at the home. Mr Hallam worked cooperatively with us during our visit and did some of the things we spoke about while we were there. He also looked at some of the information we said might help him develop the service even further. This includes the rules that we use which he felt might help him to complete the information he sends to us more fully. This means that we are confident the manager acts in a way that will promote and improve the quality of the service even more. There is a comprehensive process for evaluating the quality of the service, taking into account a wide range of views about how well it is doing. This takes place annually in August and, given the communication difficulties of service users, the manager involves the community learning disabilities team, GP, dentist and social workers. One person is able to give clear responses about their views, with keyworker support. We saw that staff and relatives were also consulted. He has made efforts to consult with people’s day services too but has not always had responses. Mr Hallam was able to explain to us what he had done in response to issues raised and showed that people, or their representatives, are able to influence the development of the service and the way it is run. There are systems in place for ensuring the home is safe. We saw records showing fire detection, emergency lighting and fire fighting equipment are regularly tested and maintained. This means that there are measures in place to promote people’s safety if there was a fire. We saw risk assessments for activities that would help ensure staff and people living at the home are not exposed to unnecessary risk. The cooker and boiler were certified as safe in October 2007. Electrical equipment was tested in July last year and the wiring for the home in March this year. This means there are measures in place to help ensure equipment in use is well maintained and safe. Staff have access to clear guidance about health and safety. We saw this work in practice when a warning sign was put on a recently washed floor and someone living at the home was reminded that they should go round the other Newnham Green DS0000062045.V366815.R01.S.doc Version 5.2 Page 26 way to avoid slipping. This means that staff understand how they can help to promote the health and safety of people living and working in the home. Newnham Green DS0000062045.V366815.R01.S.doc Version 5.2 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x Newnham Green DS0000062045.V366815.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA6 Good Practice Recommendations There should be no further slippage in carrying out reviews of people’s needs and progress, so that support plans clearly set out people’s present needs and goals and they get the support they need. Records of support and care that is given should reflect what support plans set out is needed. This is so people are not at risk of having their needs overlooked and so that progress and difficulties are more easily identified. 2. YA6 Newnham Green DS0000062045.V366815.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Eastern Region Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Newnham Green DS0000062045.V366815.R01.S.doc Version 5.2 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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