Care Home: Newton House

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What the care home does well Service Users care needs are assessed and documented to ensure their safety and that of the staff assisting them. Risk is recognised and planning put in place to lessen risks to people. We saw that they have good access to healthcare services to meet their individual needs. Service Users feel they are treated with respect and their privacy and dignity is recognised. Service Users have a number of choices based around their individual needs, promoting people`s independence and decision making. There are a number of planned outings where people are assisted with trips out to the shops, cinema, library, pubs, leisure centres, and places of worship. Peoples opinions about meals and menus, pastimes and outings is assessed at the regular Service User meetings. Decisions that the Service Users make are recorded in the daily notes. Complaints information is available in the home, and staff are aware of how the complaints process works. Staff supervision continues on a regular basis, this is the process where the manager oversees the staff working practices on a one to one basis, and helps toward planning training events. The safety of Service Users and staff is seen as important and there are a number of the safety processes in place to ensure this. Comments made on the day from service users and staff included:"A (staff) takes me to the temple, I went yesterday" "The food is fine, it is good, we have chicken and fish I like that" " It makes me unhappy to go on outing, I like to play scrabble and enjoy shopping" "I can have money when I want, I can buy cigarettes" "The food is delicious, we get a good variety" "My sisters and daughter visit me" "I have visits from my brother" "The manager takes us to the park" "We get a good service here" "The manager takes us to the shopping centre" What has improved since the last inspection? A number of areas have improved since our last visit to the home, and the outstanding requirements made at that visit have been completed. There have been improved information in the Service User Guide, care plans and risk assessments. The monitoring of peoples health is better with a number of forms having been improved. Quality Assurance is improved with consultation to the Service User group at meetings and the outcomes being recorded. Questionnaires have been sent to relatives and others with an interest in the home. The internal decoration programme is continuing and new equipment has been purchased for the laundry The AQAA had more concise information, this assists in the pre planning of visits and gives important information on the home. What the care home could do better: Training and input around Person Centred Planning (PCP`s) could be more intense, as there seems to be little progress since our last visit. The information on medication that is transferred from month to month could be improved. There were no comments from the service user or staff group on how the service could improve. Key inspection report Care homes for adults (18-65 years) Name: Address: Newton House 47 Prospect Road Leicester LE5 3RR     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Keith Williamson     Date: 2 6 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 26 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 Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Newton House 47 Prospect Road Leicester LE5 3RR 01162516112 01162516112 easterncare.ltd@tiscali.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Eastern Care Ltd Name of registered manager (if applicable) Mrs Farah Anwar Type of registration: Number of places registered: care home 26 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia Additional conditions: Service User Numbers No person falling within categories MD/LD may be admitted to the home unless she/he also falls within category MD - ie dual disability. Service user numbers No person falling within categories MD/LD may be admitted to the home where there are 5 persons in total of these combined already accommodated within the home. Date of last inspection Brief description of the care home Newton House is registered to provide care for twenty-six people with a mental disorder, including five people with additional learning disabilities. In the main home the majority of the bedrooms are single, with five shared bedrooms located throughout the three floors of the home. The service users have access to two lounges. The dining room leads onto the kitchen where the residents meals are prepared. In the two smaller parts of the home, which are situated across the road from the main home Care Homes for Adults (18-65 years) Page 4 of 26 Over 65 0 0 5 26 2 3 0 7 2 0 0 9 Brief description of the care home there are three places in each. Both provide one double and one single bedroom with additional lounge and personal space, and one is solely allocated to residents who smoke. The home is situated in a multi-cultural area close to local amenities and a fifteen-minute bus journey to the city centre. There are local shops, community centres, places of worship and a cinema within walking distance to the home. Street parking is available outside the home. The range of fees charged begin at £350.00 per week and the upper limit is decided on what peoples individual needs are at the time. The current inspection report is available from the office for prospective residents and their relatives for information purposes. Care Homes for Adults (18-65 years) 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 Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The focus of inspections is on outcomes for people who use the service and their views of the services provided. The main method of inspection used was case tracking which involves selecting a sample number of people and tracking the care they received through talking with them where possible, looking at their records and accommodation, in this case three people were chosen. This visit took place over one day, commencing at 9.30pm and took six hours to complete. An opportunity was taken to observe the people, talk with the Manager and staff, look around the home, and view records, policies and care plans. Information was also obtained from the Annual Quality Assurance Assessment (AQAA), which gives information on the people, home and the staff group. Surveys were sent to residents and staff, and comments received have been added to this report. Care Homes for Adults (18-65 years) Page 6 of 26 Ten residents were seen and three spoken with; two staff were also spoken with, and their exchanges with the staff group observed. The quality rating for this service is 2 star. This means the people who use this service experience Good quality outcomes. Care Homes for Adults (18-65 years) Page 7 of 26 What the care home does well: What has improved since the last inspection? A number of areas have improved since our last visit to the home, and the outstanding requirements made at that visit have been completed. There have been improved information in the Service User Guide, care plans and risk assessments. The monitoring of peoples health is better with a number of forms having been improved. Quality Assurance is improved with consultation to the Service User group at meetings and the outcomes being recorded. Questionnaires have been sent to relatives and others with an interest in the home. The internal decoration programme is continuing and new equipment has been purchased for the laundry Care Homes for Adults (18-65 years) Page 8 of 26 The AQAA had more concise information, this assists in the pre planning of visits and gives important information on the home. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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. Service Users are offered a tailored introduction to the service Evidence: The staff have developed a comprehensive statement of purpose and service users guide, which is specific to the current group of people in the home. The information is available in different formats and languages when necessary. This ensures everyone in the home can understand it. People have their needs assessed prior to moving into the home. The assessments were detailed and included updated information, recognising any changes in the persons abilities and needs. The process is clearly directed to suit the individual, ensuring the move is well planned. Contracts are put in place to assist the residents understanding and limits of their stay. Care Homes for Adults (18-65 years) Page 11 of 26 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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. Peoples care plans are individual and risk assessed appropriately Evidence: We looked at the care records of people. We found them to be descriptive of the care and support offered to them. Care plans are put in place from the assessment information. Service users are given a copy, which they can refer to if necessary. Care plans are routinely up-dated to ensure they reflected the changing care needs of people living in the home. The transfer of care records to person Centred Plans has not progressed a great deal since our last visit. This is vital to ensure peoples personal goals are recognised and planned appropriately We saw that staff have a good understanding of the risks relating to people, and have put risk assessments in place to reduce risks associated with each person. During our visit we observed staff being very mindful of how people might react to the change in events our visit caused. Staff ensured that appropriate action was taken to reduce the possibility of challenging situations. Care Homes for Adults (18-65 years) Page 12 of 26 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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 encourage to develop a healthy and meaningful lifestyle based on self help skills. Evidence: We looked at the social care offered to people. This showed us people experienced a varied social life. People have individual programmes linked to their needs, self care and socialising. Service Users undertake a wide range of activities both in the home and local area. These are risk assessed to enable people to undertake them alone or with staff assistance, and are designed to assist in their personal development. We saw that staff are sensitive to the individual needs of people living at the home. We saw staff talk to and interact well with people who live there. Staff also were Care Homes for Adults (18-65 years) Page 13 of 26 Evidence: aware of how to effectively communicate with each person. We saw the menu on offer, this reflected residents individual needs and is compiled during the service user meetings. This enables people to directly affect their day to day choices. The menu offers a balanced and healthy diet. What the Service Users said the home did well. A (staff) takes me to the temple, I went yesterday The food is fine, it is good, we have chicken and fish I like that It makes me unhappy to go on outing, I like to play scrabble and enjoy shopping I can have money when I want, I can buy cigarettes The food is delicious, we get a good variety My sisters and daughter visit me I have visits from my brother The manager takes us to the park We get a good service here The manager takes us to the shopping centre Care Homes for Adults (18-65 years) Page 14 of 26 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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 have their health and medication needs met appropriately. Evidence: We looked at the personal and healthcare records of people. We saw that they have good access to healthcare services to meet their individual needs. On talking to staff as well as looking at the records, we found that staff act quickly on concerns they have about peoples needs, and these prompt actions have resulted in a good quality of life for those concerned. We looked at the way staff give out medication and found that staff are administering medication safely to people. The policy and procedures followed by the staff are comprehensive. Medicine audits are carried out very regularly, and medicines that require to be kept in the manufacturers packaging, are also counted. This makes the system safer as staff are aware if people have had the correct medication. We saw staff records and these showed us that staff have undertaken training in the administration of medication. Care Homes for Adults (18-65 years) Page 15 of 26 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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. The home has a complaints procedure that is clearly written and easy to understand and would enable people to raise concerns if needed. Residents are protected by the systems put in place by a well informed staff group. Evidence: We looked at the complaints procedure and saw that this was written in a way which people could understand it. We saw very good interaction between people who live in the home, and staff who support them. We were told in the AQAA that the views of people living in the home are important, and that the service takes time to get things right. We saw evidence where residents have the opportunity to have support and can make a complaint through several people independent of the home and its management. We saw by looking at staff training records and by talking to them that staff have a good understanding of safeguarding policies and procedures. Staff know what to do if they suspect that a person who lives in the home is being abused in any way. We also saw by looking at staff records, by talking to and observing staff that they understand how to work with people with challenging behaviour. People who live in the home have their own bank accounts. Staff support some people living at the home in being responsible for their money. We checked the financial Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: records at the home, and found accurate recording of money balances. Some Service Users can access their finances independently, though this process is firstly risk assessed to ensure the persons safety. This also ensures people are assisted toward independence in the community. Care Homes for Adults (18-65 years) 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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 live in a safe and secure environment. Evidence: We looked at the communal areas and the bedrooms of some of the people who live there. We found the communal areas to be very well decorated and homely. The bedrooms were individually decorated to the needs and preferences of the people using them. This included many personal items such as family pictures and electrical goods. The staff have an ongoing maintenance programme, this is regularly updated, as part of the quality control in the home and we saw how that translated in the home being well maintained. Staff are aware of hygiene and how to control the spread of infection. This is important as it keeps people safe in the home. Care Homes for Adults (18-65 years) Page 18 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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 supported and protected by the homes recruitment practices and number of staff on duty. Evidence: We saw good interaction between staff and people who live in the home, and staff demonstrated a very good understanding of the needs of people living there. We talked to staff and saw them communicating with people in a manor suited to each individual. People have a varying degree of support during the day, to ensure their needs are being met. We looked at a sample of staff recruitment records, and saw that all the necessary checks were made to safeguard people who live at the home. There are a number of staff who are undertaking a National Vocational Qualification (NVQ), and some of these staff need to have their working hours restricted, the manager agreed to look at this and reduce them appropriately. We looked at training records and this confirmed that staff have undertaken a wide range of training to help them in their roles, some of this before working with service users. Training included health and safety, medication management and working with challenging behaviour. Training is organised from in house as well as external sources, Care Homes for Adults (18-65 years) Page 19 of 26 Evidence: and staff have written tests following the courses. Staff have regular meetings and supervision. Supervision is where their interaction with residents and individual development is discussed. This indicates senior staff monitor how well staff perform within the home, and arrange further training accordingly. Staff confirmed they were supported well to do their job, through induction training, on going training and regular supervision. Care Homes for Adults (18-65 years) Page 20 of 26 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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 live and work in a home that is safe and well managed. Evidence: The registered manager has been in charge at the home for a number of years and has the experience and qualifications to provide a suitable and safe environment for people living there. There are many levels Quality Assurance(QA) and monitoring systems in place, and we noted a number of these. Staff are currently reviewing the style of the questionnaires and hope to have them in a more user friendly format the next time they are used. Other forms of QA include feedback from relatives and professionals, regular staff checks on the building and visits from senior managers. Outcomes from the quality assurance monitoring is made available to people in the home, their representatives and those considering coming to stay at the home. We viewed a number of the policies and procedures that are produced by the parent organisation, none were dated, so it was difficult to know when these were last Care Homes for Adults (18-65 years) Page 21 of 26 Evidence: reviewed. We need to be assured that these are reviewed regularly and provide good guidance for the staff to operate safe working practices. We looked at the records kept in the home, these are stored securely in the office and are up to date. We looked at a number of tests the staff do to monitor areas such as the fire detection system, the hot water regulating system, and other areas such as electrical testing. These were up to date and showed us the staff monitoring of health and safety helps keep people safe in the home. Care Homes for Adults (18-65 years) Page 22 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 23 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 1 22 22 The registered person shall establish a procedure (the complaints procedure) for considering complaints made to the registered person by a service user or person acting on the service users behalf. This is to ensure complaints information is added to all appropriate documents and so be available to all. 18/06/2010 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 6 20 Further input to Person Centred Planning is necessary to recognise peoples individual needs and aspirations. The total number of medication that is kept from one medication month to another could be marked into the Medication Administration Record also known as the (MAR chart). This would assist in the accounting of medication throughout the medication month. Care Homes for Adults (18-65 years) Page 24 of 26 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 3 20 A list of protocols or guidance notes for staff to refer to when giving PRN or occasional medicines would be useful. This would ensure staff have prompts in place to follow if or when this situation arises. Receipts could be numbered when monies are deducted from that held in the office. This would assist in auditing the monies. 4 23 Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. 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