Care Home: Newton House Care Home

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What the care home does well Anyone new coming to the home is assessed prior to moving in to make sure their needs can be met. People receive the healthcare they need, using local healthcare services when needed and care is provided in a way that promotes people`s privacy and dignity. Activities are organised, including trips out, so people can spend time doing things they enjoy. Visitors are welcome at any time so people can keep in contact with families and friends. Routines in the home are flexible to take into account people`s wishes. The building was nice and clean and repairs are carried out as needed and staff work in a way that prevents the spread of any infection. There are sufficient staff on duty to meet the needs of people living in the home. The manager has got a lot of experience in her job and has got a professional qualification. People are asked to fill in surveys and comment on how the home is run. Safety checks are carried out on the building to make sure people do not face any unnecessary or avoidable risk. What has improved since the last inspection? A new care planning system has been put into place. There have been some improvements made to the building , including a new perimeter fence, refitted bathroom and kitchen. There is now a mini bus a the home allowing for a wider choice of activities and people have access to the internet. What the care home could do better: The Medicine Administration Records need to be signed when medication is given and an approved drugs cabinet is required. There should be a way for people to make requests for foods they would like to be included on the menu. The complaints book and safeguarding adults procedures must be accessible at all times. All records must be available for inspection when required and staff must have suitable training. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Newton House Care Home Shireoaks Road Shireoaks Worksop Nottinghamshire S81 8LX     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Stephen Benson     Date: 1 0 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Newton House Care Home Shireoaks Road Shireoaks Worksop Nottinghamshire S81 8LX 01909482960 Telephone number: Fax number: Email address: Provider web address: caroline.whiteman@tiscali.co.uk Name of registered provider(s): Name of registered manager (if applicable) Caroline Whiteman Type of registration: Number of places registered: Caroline Whiteman care home 12 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: No persons falling within categories DE(E) may be accommodated in this home when there are already 6 persons accommodated in this category. The maximum number of residents that the registered provider can accommodate in Newton House Care Home is 12. Date of last inspection Brief description of the care home Newton house is a care home providing personal care and accommodation for 12 older people. The home is owned by the manager who lives on site and provides continual support. The home is located in the village of Shiroakes, which has a few local amenities including a church, village hall and a pub. The home was opened in 1986 and consists of an adapted and extended former vicarage. Ten of the homes bedrooms are single and there is one double room. Bedrooms are located on two floors, the first Care Homes for Older People Page 4 of 29 Over 65 6 12 0 0 Brief description of the care home floor being on two different levels. There is a passenger lift to access the first floor and two stair lifts to access the change of levels on the first floor. The home has a large garden area that is well maintained and easily accessible and there is ample car parking available. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means that people who use this service experience good outcomes. The focus of inspections undertaken by The Commission for Social Care Inspection is upon outcomes or people accommodated and their views on the service provided. This process considers the providers capacity to meet regulatory requirements, minimum standards of practice and focus on aspects of service provision that need further development. This was our first visit to the home since 1st April 2008. This inspection involved one inspector; it was announced and took place in daytime, including lunchtime. Care Homes for Older People Page 6 of 29 Prior to the visit an analysis of the home was undertaken from information gathered over the last year including that from the Annual Quality Assurance Assessment they completed. We sent survey forms entitled Have your say about.. to a sample of people. The main method of inspection is called case tracking which involves looking at the quality of care received by a number of people living at the home. We also use evidence from our observations; we speak with them about their experience of living at the home; we look at records and talk with staff about their understanding of the peoples needs who they support. The premises were not inspected in detail but various areas of the home were visited as part of the inspection. The fees for the service range from 334 to 420. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Older People Page 8 of 29 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People coming to the home will know their needs can be met as they have been assessed. the home does not offer an intermediate care service. Evidence: It was stated on The Annual Quality assurance Assessment that there have been four people admitted into the home inn the last 12 months. Care files seen included a pre service assessment which had been completed by the manager. The deputy manager said that the manager goes out to see anybody who is interested in moving to the home and tells staff about them afterwards. Staff said they often meet people coming to the home when they come to look round. During a group discussion with people living in the home one person said, The manager came to see me and another said, I came to visit before I moved in. Care Homes for Older People Page 11 of 29 Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health, personal and social needs are met by care practices in the home. Evidence: A new care planning system has been introduced since our last visit. There were care plans seen for various activities including bedtime preparation, hair care, activities and interests, dietary preferences and promoting independence. There was an entry showing plans are reviewed monthly and discussed with the person concerned and their family every three months. The files included risk assessments and these included ones for traveling in the homes mini bus, preventing skin sores developing, preventing falls and moving and handling. The care plans were clearly written and said what support people require. All care plans and risk assessments were kept in a plastic wallet, making them difficult to refer to. Care Homes for Older People Page 13 of 29 Evidence: The deputy manager said that she is responsible for writing the care plans and that she reviews them with people and their relative every three months. Staff said They complete the daily record section every shift. There is a section in the care file to record any healthcare appointments. The deputy manager said that people are able to access community based healthcare services and that staff keep an eye on people when assisting them to make sure there are no health concerns. Staff said that they encourage people to have a healthy diet and ask them how they are feeling. staff said they encourage people to take part in exercises and were seen doing so during the morning. Staff said they had called a doctor out the previous day when one person complained of a pain in her leg. During a group discussion people said they felt their healthcare is looked after and comments included, We will say if we are not feeling well, We have regular visits from the nurse and It would be nice to have a bit more exercise. Staff had completed giving the morning medication out and were seen completing the Medicine Administration Records. When asked if they were aware this was not the safest practice to follow said that they were not. Medicine Administration Records were fully completed with the exception of one persons tablets the previous day. These were not in the medicine card and staff checked with the person on duty who said she had given the medication but forgotten to sign the record. Medication is kept in a locked cupboard in the kitchen, which does not comply with current guidance. The deputy manager said that she checks all medication in and out of the home. People said they always get their medication when required. The deputy manager said part of her role is to be the dignity manager, who people can raise anything they wish, if they feel their dignity has not been promoted. The deputy manager said that no one has done so so far. Care Homes for Older People Page 14 of 29 Evidence: Staff spoke of good practices when assisting people, including talking in private and keeping people covered when providing personal care, to prevent them feeling embarrassed. People said in a group discussion that felt their privacy and dignity are promoted and comments included, Staff are very good and Our privacy is respected, staff are so kind. Care Homes for Older People Page 15 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home are able to make decisions for themselves and have opportunities to satisfy their social and recreational interests. Evidence: It was stated on the Annual Quality Assurance Assessment that a monthly church service is held and there are visits from the library and a musical group. A record is made of all activities in an activities book. The deputy manager said that part of her job is being the activities coordinator and she organises activities in the afternoons doing things like arts and crafts, exercises, board games and using a computer. Some people have email addresses so they can have contact with their families. People spoke of having made lavender bags the previous day with lavender from the garden. Another person said, I am growing some tomatoes in my room. In a group discussion one person said, There are things for us to join in if we want to and another said, Some people have emails, Im not interested. Care Homes for Older People Page 16 of 29 Evidence: A mini bus has been purchased to take people out. This has included trips to the shops and local parks. There have also been trips to local areas where some people used to live. The deputy manager said one person had been to see if her grandmothers house was still there in a nearby village. Staff said they welcome visitors at any time and they can join in with what is going on. One person said, I enjoy going out on trips in the mini bus. The deputy manager said people are able to make choices as they are asked and encouraged to express their views and wishes. Staff said they offer people choices over everyday things. In a group discussion people said they are able to make choices. One person said, We make our own choices, if needed staff will help us. There is a four week menu and the main meal is had at lunchtime. Examples of types of dishes include gammon, chicken curry and rice, chilli con carne and corned beef hash. A lighter meal is had at tea time with such things as pilchards on toast, garlic bread, scotch egg and pork pie with pickles. There is a pudding at lunch and tea time and there is a roast dinner on Sundays and a fish dish on Fridays. In a group discussion people spoke positively about the food saying their likes and dislikes are respected. One person said, I think we are lacking in fresh fruit and vegetables and another said, I would like to have more bacon, a bacon sandwich would fit the bill. Also a fried egg would be nice. Care Homes for Older People Page 17 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People feel that if they had cause for concern this would be dealt with seriously and they feel safe in the home. Evidence: It was stated on the Annual Quality Assurance Assessment that a complaints book is freely available, however this could not be shown as it was locked in the managers office who was on a day off. It was also stated that there have not been any complaints made in the last 12 months. Staff and people living in the home were aware of the complaints procedure and one person said, You can tell a carer, I am quite sure they would get it sorted and another said, It would be taken notice of if you had a complaint. It was stated on the Annual Quality Assurance Assessment that there have not been any safeguarding investigations in the home. The deputy manager said that staff have had training on safeguarding adults, but was unaware where the Nottingham and Nottinghamshire Safeguarding Adults procedure was. The training provided to staff is watching a video on adult abuse and courses put on by Care Homes for Older People Page 18 of 29 Evidence: the Local Authority have not been accessed. People said they felt safe in the home and one person said, I feel very safe, I sleep beautifully. Care Homes for Older People Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a safe well maintained environment that is kept clean. Evidence: The home provides a homely and comfortable environment that is well maintained and clean. The deputy manager said that any repairs are seen to straight away using local contractors. There was someone working on the boiler during this visit. In a group discussion people commented they like the new walk in bath. Staff were seen using protective clothing and the deputy manager said a course has been accessed at the local hospital on infection control next month. A member of staff said she is being trained up to be the housekeeper and to oversee infection control. When asked in a group discussion if they felt the home was kept clean people said, Absolutely one person added, There is always somebody cleaning. Care Homes for Older People Page 20 of 29 Care Homes for Older People Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a stable staff group to see to peoples needs however their training is limited and does not keep up to date with changing practice. Evidence: Information provided on the Annual Quality Assurance Assessment stated that there are eleven care staff employed. The rota showed there are two staff on duty during the day and one staff awake and one sleeping in at night time. Staff said they work as an effective team and cover for each other when needed. People said in a group discussion that they felt there were sufficient staff on duty and one commented, There is always someone around. It was stated in the Annual Quality Assurance Assessment that eight staff have completed National Vocational Qualification level 2, but the deputy manager said that all staff have now completed this qualification. Training records were not available as they were in the office and the manager who has the key was not on duty. This also meant that staff files could not be inspected, however it was stated on The Annual Quality Assurance Assessment that everyone who has worked in the home in Care Homes for Older People Page 22 of 29 Evidence: the last 12 months had satisfactory pre employment checks. The deputy manager showed a selection of videos used for staff training and said this is the main method of staff training. In a group discussion people said they felt the staff had the training they need to carry out their duties and one person said, They are very adapt. Care Homes for Older People Page 23 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are suitable management systems in place for the smooth running of the home. People living in the home are able to influence how the home is run to take into account their views and interests. Evidence: The manager, who is also the registered provider, has worked at the home for many years. She has successfully completed The Registered Managers Award and National Vocational Qualification level 4. Staff said that the manager is very approachable and the home is run very well. A comment was seen on a survey form that said, The home is well run, people are pleasant. It is a homely environment. People are asked to complete an annual survey commenting on how the home is run. A number of positive comments were seen about the staff, privacy being respected Care Homes for Older People Page 24 of 29 Evidence: and being happy living in the home. A report is prepared of the results of the survey and in the most recent one in July 2008 action was taken about the time one person went to bed and a shopping trip was organised. People either look after their own finances or are assisted in doing so by their families. It was stated on The Annual Quality Assurance Assessment that equipment is tested or serviced as recommended by the manufacturers or other regulatory body. The fire book was examined and this showed the safety checks and tests were carried out at the required frequency. Care Homes for Older People Page 25 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 29 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 9 13 Medicine Administration Records must be fully completed when medicine is administered This will make sure that people receive their correct medication 20/10/2008 2 9 13 Medicine must be stored in an approved medicine cupboard This will make sure peoples medication is safely stored 01/01/2009 3 16 17 The complaints book must be accessible at all times. So people can make a complaint if they wish 01/12/2008 4 18 12 The procedures to follow to ensure people are safeguarded must be available in the home. So staff know what actions to follow if someone needs to be safeguarded. 01/12/2008 Care Homes for Older People Page 27 of 29 5 29 17 Records required to be kept 01/11/2008 on staff must be avaiable for inspction at all times. To show that suitable people are employed to care for people living in the home 6 30 18 Staff must be provided with apprpriate training To ensure they incorpoate best and curreent practices into the way they care for people 01/01/2009 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 7 15 Organise care files so they are easy to refer to. Make arangements for people to request foods they would like to be included on the menu. Care Homes for Older People Page 28 of 29 Helpline: 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 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. 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