Care Home: Newton Lodge

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What the care home does well This inspection was carried out to follow up on requirements made at the last inspection and look into concerns raised with the Commission. We were also able to speak with people living at the home and the member of staff on duty. What the care home could do better: The registered manager does not work full time in the home and there is a lack of direction and leadership. According to the duty rota for the period 29/03/10 to 25/04/10 the registered manager is at the home for only three days. The registered person needs to ensure that there are clear management arrangements in place and that all staff receive ongoing support and guidance. Due to the number of people living at the home there is only one member of staff on duty during the day and one person sleeping in at night. 2 of the staff have a National Vocational Qualification in care at level 2 and the other 2 staff members have limited experience of working with older people. With no clear management in the home it is difficult to see how practice is monitored or how staff are able to gain further skills and knowledge. Since the last inspection two people have moved into newly created en suite rooms on the ground floor. These rooms were pleasant and adequately furnished. It was noted that in one en suite there was no call bell and in the other, although there was a call bell socket, there was no lead. Risk assessment have been carried out for night care as there is no waking night staff at the home. The risk assessments state that if people need assistance during the night they must ring their call bell. For people living in these rooms they would be unable to summon assistance if they fell or became unwell whilst using their bathroom. This must be rectified as a matter of urgency. The radiators in these new rooms are not covered and may pose a risk to people and therefore personal riskassessments need to be carried out. At the time of the last key inspection, as part of the refurbishment of the lounge, a patio door had been installed leading to a small courtyard. Decoration in the lounge has not been completed and the courtyard area remains unusable. Work on the newly appointed bathroom has not been completed. Although the bath is in use there is no hand basin in the room and the walls remain bare undecorated plaster which does not create an inviting environment. There is only one member of staff on duty through the day and someone is employed to work occasional shifts to enable people to access the community. One person living at the home said that there were very few opportunities for social outings and the rota showed that the person employed to work occasional shifts had not been allocated any shifts for the 4 week period of the rota. (29/03/10 to 25/04/10) There is an activity record page in the care plan and the last recorded activity for this person was on the 2/11/09. Random inspection report Care homes for older people Name: Address: Newton Lodge 139 Berrow Road Burnham-on-Sea Somerset TA8 2PN one star adequate service 23/10/2009 The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Jane Poole Date: 3 1 0 3 2 0 1 0 Information about the care home Name of care home: Address: Newton Lodge 139 Berrow Road Burnham-on-Sea Somerset TA8 2PN 01278787321 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Sandra Diane Taylor-House Type of registration: Number of places registered: Conditions of registration: Category(ies) : C & K Homes Limited care home 12 Number of places (if applicable): Under 65 Over 65 12 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users who can be accommodated is 12. The registered person may provide the following category of service only: Care Home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (Code OP) Date of last inspection Brief description of the care home Newton Lodge is registered with the Care Quality Commission to provide care for up to 12 people over the age of 65. Accommodation is set over two floors and there is a stair lift between. At the present time only the ground floor of the home is used. All bedrooms are currently used for single occupancy. The home is owned by C & K Care Homes for Older People Page 2 of 10 2 3 1 0 2 0 0 9 Brief description of the care home Homes and the registered manager is Diane Taylor-House. Care Homes for Older People Page 3 of 10 What we found: This random inspection was carried out to look at progress being made to meet the requirements made at the last key inspection on the 23rd September 2009. We also looked into concerns raised with the Commission since the last inspection. There are 3 people living at the home and no new people have moved in since the last inspection. Requirement 1 Standard 7 Regulation 15 (1 & 2) The registered manager must ensure that staff have access to care plans at all times. To ensure that there is access to up to date information about peoples needs and wishes. At this inspection all care plans were available in the office. All care plans were viewed and some observations were made. Identified care needs were not always dated and one stated that it was due to be reviewed in February 2010. There was no evidence that this review had taken place. The National Minimum Standards (7.4) State that care plans should be reviewed at least once a month, up dated to reflect changing needs and current objectives for health and personal care, and actioned. The last recorded weights for people were dated December 2009. Requirement 2 Standard 9 Regulation 13 (2). Where medication is prescribed at a variable dose the actual dose given must be recorded. To ensure that there is a clear audit trail and the effectiveness of medication can be monitored. The medication administration records were viewed. These showed that people are now writing the number of tablets given to a person where a variable dose is prescribed. This enables the effectiveness of the medicine to be monitored. However the quantity of medication arriving at the home is not recorded and so there is still no clear audit trail. Requirement 3 Standard 26 Regulation 13 (3) Hand washing facilities must be made available in the laundry area. To promote good infection control measures. There is no sink in the laundry area for hand washing. Gloves and hand sanitiser are available. Requirement 4 Standard 27 Regulation 18 (1) [a] The on call and emergency contact arrangements must be easily available to everyone. To ensure that everyone at the home is aware of who to contact in an emergency and can do so quickly. Care Homes for Older People Page 4 of 10 The initials of the person on call are now on the duty rota. There are only 4 care staff employed at the home and all take on on call responsibilities. Two staff have a National Vocational Qualification (NVQ) in care at level 2. The home needs to ensure that all staff who act as on call back up have the skills and experience to deal with an emergency situation should they be required to do so. Since the last inspection there have been some concerns raised with the Commission that the heating in the home is inadequate and that the home has been very cold through the day. Throughout the inspection the heating was on and the home was adequately warm. Due to the small number of people currently living at the home only the ground floor is being used and heated. All radiators have thermostatic valves which can be adjusted and it was noted that one person had chosen to turn off the radiator in their room. Two new en suite rooms have been created and people have now moved into these rooms. There has been a concern raised that one en suite window has not been fitted with a blind or curtain and therefore compromises the persons privacy and dignity. This was raised with the home manager by phone on the 15th February 2010. Assurances were given that a blind would be fitted that week. At this inspection the blind was not in place although there was evidence that someone had attempted to put up a curtain rail. The rail had not been put up meaning there were still no covering on this window. What the care home does well: What they could do better: The registered manager does not work full time in the home and there is a lack of direction and leadership. According to the duty rota for the period 29/03/10 to 25/04/10 the registered manager is at the home for only three days. The registered person needs to ensure that there are clear management arrangements in place and that all staff receive ongoing support and guidance. Due to the number of people living at the home there is only one member of staff on duty during the day and one person sleeping in at night. 2 of the staff have a National Vocational Qualification in care at level 2 and the other 2 staff members have limited experience of working with older people. With no clear management in the home it is difficult to see how practice is monitored or how staff are able to gain further skills and knowledge. Since the last inspection two people have moved into newly created en suite rooms on the ground floor. These rooms were pleasant and adequately furnished. It was noted that in one en suite there was no call bell and in the other, although there was a call bell socket, there was no lead. Risk assessment have been carried out for night care as there is no waking night staff at the home. The risk assessments state that if people need assistance during the night they must ring their call bell. For people living in these rooms they would be unable to summon assistance if they fell or became unwell whilst using their bathroom. This must be rectified as a matter of urgency. The radiators in these new rooms are not covered and may pose a risk to people and therefore personal risk Care Homes for Older People Page 5 of 10 assessments need to be carried out. At the time of the last key inspection, as part of the refurbishment of the lounge, a patio door had been installed leading to a small courtyard. Decoration in the lounge has not been completed and the courtyard area remains unusable. Work on the newly appointed bathroom has not been completed. Although the bath is in use there is no hand basin in the room and the walls remain bare undecorated plaster which does not create an inviting environment. There is only one member of staff on duty through the day and someone is employed to work occasional shifts to enable people to access the community. One person living at the home said that there were very few opportunities for social outings and the rota showed that the person employed to work occasional shifts had not been allocated any shifts for the 4 week period of the rota. (29/03/10 to 25/04/10) There is an activity record page in the care plan and the last recorded activity for this person was on the 2/11/09. 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 2. Care Homes for Older People Page 6 of 10 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 26 13 (3) Hand washing facilities must be made available in the laundry area. To promote good infection control measures. 31/12/2009 Care Homes for Older People Page 7 of 10 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, 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 (2) The registered person must ensure that a suitable system is in place for the audit of medicines. So that staff can check that medicines have been given as prescribed. 30/04/2010 2 10 12 (4) [a] The registered person 08/04/2010 must ensure that curtains or blinds are fitted to bathroom windows. To promote privacy and dignity. 3 18 1 (1) [a] The registered person 30/04/2010 must ensure that staff have the appropriate skills and experience to work unsupervised and carry out on call duties. To ensure that people are supported by a competent staff team. 4 31 12 The registered person must ensure that the home is effectively managed. 28/05/2010 Care Homes for Older People Page 8 of 10 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 To give leadership and direction to the home and ensure that there is ongoing monitoring of care and staff practice. 5 38 13 (4) The registered person must ensure that individual risk assessments are carried out on unguarded radiators. To minimise the risk of burns. 6 38 13 (4) The registered person must ensure that call bells are fitted in all areas that people living at the home have access to. To make sure that people are able to summon assistance throughout the day and night. 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 15/04/2010 15/04/2010 1 2 7 12 Care plans should be reviewed on a monthly basis. The registered person should ensure that people living at the home have access to a range of leisure and social activities. The registered person should ensure that all parts of the home are reasonably decorated. 3 19 Care Homes for Older People Page 9 of 10 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 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 noncommercial 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. 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