The Care Quality Commission
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Archived: Newlands Residential Home

Overall: Inadequate read more about inspection ratings

2 Wellington Parade, Walmer, Deal, Kent, CT14 8AA (01304) 368193

Provided and run by:
Uday Kumar and Mrs Kiranjit Juttla-Kumar

All Inspections

3 June 2016

During an inspection looking at part of the service

The inspection took place on 03 and 08 June 2016 and was unannounced.

Newlands Residential Home provides care for up to 17 older people some of whom may be living with dementia. The service is situated on the seafront at Walmer, near Deal, with accommodation on two floors. At the time of the inspection there were 10 people living at the service.

We carried out an unannounced comprehensive inspection on 17 February 2016. After that inspection we received concerns in relation to the safe care and treatment of people living at Newlands Residential Home. As a result we undertook a focused inspection to look into those concerns. This report only covers our findings on those concerns. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Newlands Residential Home on our website at www.cqc.org.uk.

There was no registered manager at the service. The service had been without a registered manager for over five years even though a condition of the provider’s registration is that there should be a registered manager. The provider was fully aware of their responsibility to have a registered manager because the condition was recorded on their registration certificate dated 29 September 2010. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The provider was present on the first day of the inspection.

People were not consistently protected from avoidable harm. Accidents and incidents were not accurately recorded and prompt action was not taken to reduce the risks of further events.

Risks to people had not always been identified and assessed. When guidance was in place for staff to follow they had not consistently followed this to ensure people were safe. When staff had received advice from health care professionals this had not been consistently followed.

The premises and grounds of the service were not adequately maintained to ensure people’s safety. Paths leading from fire doors were not clear for people to move through safely.

There were insufficient numbers of staff deployed and there were shortfalls in staff training. Staff did not have the skills and competencies to recognise when people needed further medical attention.

There was no manager to provide oversight and scrutiny of the day to day running of the service and the quality of the service delivered.

People received their medicines safely and were protected against the risks associated with the unsafe use and management of medicines.

People told us that they felt safe living at the service. People looked comfortable with other people, staff and in the environment. People said they would speak with the staff if they had any concerns.

This focused inspection has been carried out within six months of a comprehensive inspection. In line with CQC methodology the rating has been reviewed.

The overall rating for this provider is ‘Inadequate’. This means that it has been placed into ‘Special measures’ by CQC. The purpose of special measures is to:

• Ensure that providers found to be providing inadequate care significantly improve.

• Provide a framework within which we use our enforcement powers in response to inadequate care and work with, or signpost to, other organisations in the system to ensure improvements are made.

Services placed in special measures will be inspected again within six months. The service will be kept under review and if needed could be escalated to urgent enforcement action.

We found four continued breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We are taking enforcement action against the providers Uday Kumar and Kiranjit Juttla-Kumar to protect the health, safety and welfare of people using this service.

17 February 2016

During a routine inspection

The inspection took place on 17 February 2016 and was unannounced.

Newlands Residential Home provides care for up to 17 older people some of whom may be living with dementia. The service is situated on the seafront at Walmer, near Deal, with accommodation on two floors. On the days of our inspection there were 11 people living at the service.

There was no registered manager at the service. The service was run by a manager who was present on the day of the inspection. The service had been without a registered manager for over five years even though a condition of the provider’s registration is that there should be a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The provider was present for part of the day.

People told us that they felt safe living at the service. People looked comfortable with other people, staff and in the environment. Staff understood the importance of keeping people safe. Staff knew how to protect people from the risk of abuse and how to raise any concerns they may have.

The environment was not adequately maintained inside and out. There was no clear plan of when the required work would be completed or who was going to do it. Fire doors were not all working properly. There were procedures in place for emergencies, such as, gas / water leaks.

Sufficient numbers of staff were deployed. Staff received regular one to one supervision. However, there were a large number of shortfalls in staff training. Recruitment processes were in place to check that staff were of good character.

Risks to people had been identified and assessed but guidelines to reduce risks were not always available or were not clear.

People received their medicines safely and were protected against the risks associated with the unsafe use and management of medicines. Accidents and incidents were recorded and analysed to reduce the risks of further events.

People were provided with a choice of healthy food and drinks which ensured that their nutritional needs were met. People’s health was monitored and people were referred to and supported to see healthcare professionals when they needed to.

The manager understood how the Mental Capacity Act (MCA) 2005 was applied to ensure decisions made for people without capacity were only made when this was in their best interests. However, not all staff had completed MCA training and some were not aware of how the MCA principles should be applied. The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes, the requirements of DoLS were met.

People and their relatives were involved with the planning of their care. People’s needs were assessed and care and support was planned and delivered in line with their individual care needs. Staff knew people well and were kind and caring. People received consistent and personalised care and support. Care plans were kept up to date to reflect people’s changing needs and choices.

There was a complaints system and people knew how to make a complaint. Views from people and their relatives were taken into account and acted on.

The range of activities was limited and people said they would like to do more. Staff were aware of people who chose to stay in their rooms and were attentive to prevent them from feeling isolated.

There were systems in place to monitor the quality of the service. Staff spoke with people individually to make sure they were happy living at Newlands. They listened to any suggestions people had and took action to make changes to address these. Staff raised concerns with the provider at staff meetings; however action was not also taken in a timely manner to address these concerns. The manager had submitted notifications to CQC in a timely manner and in line with CQC guidelines.

We found one new breach and five continued breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We are taking enforcement action against Uday Kumar and Kiranjit Juttla-Kumar to protect the health, safety and welfare of people using this service.

18 & 22 June 2015

During a routine inspection

The inspection took place on 18 and 22 June 2015 and was unannounced.

Newlands Residential Home provides care for up to 17 older people some of whom may be living with dementia. The service is situated on the seafront at Walmer, near Deal, with accommodation on two floors. On the days of our inspection there were 13 people living at the service.

The service was run by a manager who was present on the second day of the inspection. The service had been without a registered manager for over four years. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered person was present on both days.

We last inspected Newlands Residential Home in December 2014. On 13 March 2015 we wrote to the registered person with a copy of the final report and requested that they complete an action plan, to address the breaches of regulations, and return the action plan to CQC by 27 March 2015. The registered person did not complete and return the action plan. On the first day of our inspection we asked the registered person to show us the CQC action plan and he was not able to produce it. On the second day of our inspection the registered person showed us an action plan with estimated start dates and completion dates to address the breaches in the regulations. This action plan did not address all of the shortfalls highlighted in the CQC report of December 2014.

The registered person did not financially invest in improving the service. The registered person’s lack of investment prevented the manager and staff putting the needs of people first and improving the quality of the service. The registered person did not consistently ensure that the manager had access to sufficient petty cash to enable them to make any urgent payments if the need arose. There was a lack of empowerment for the manager and staff and staff were unhappy and felt they were unsupported by the registered person. Staff did not trust that the registered person would do the things he said he would.

The environment was not adequately maintained inside and out. Painting had been started on the outside of the building but then stopped. Some areas inside had been painted. There was no clear plan of when this work would be completed or who was going to do it. People were at risk of not being moved safely because they did not have slings that they had been individually assessed for.  Slings are specialist equipment that staff used with a hoist to help people move safely. Each person should have an individual sling that specifically meets their needs, size and weight and that they had been assessed for, so that it was safe.

Fire doors were not all working properly. We have reported our concerns to the local fire and rescue service. There were procedures in place for emergencies, such as, gas / water leaks.

People said and indicated that they enjoyed their meals. People were offered and received a balanced and healthy diet. They had a choice about what food and drinks they wanted. If people were not eating enough they were seen by dieticians or their doctor and supplement nutrition was provided.

The registered person did not ensure that sufficient numbers of suitably qualified, competent, skilled and experienced staff were deployed. Relatives said there were not enough staff. We reviewed the staff rota from 18 May 2015 to 14 June 2015 and 11 of the 28 days the manager was the third member of care staff on ‘the floor’ which meant that they were not able to keep up to date with their management duties, such as, staff appraisals. Staff said they would like to be able to spend more time with people. There was no contingency plan in place to cover staff shortfalls like sickness and the shortfall of staff on the first day of our inspection.

People told us they felt safe living at the service. Staff understood the importance of keeping people safe. Risks to people were identified and staff had the guidance to make sure that people were supported safely and that risks were reduced or eliminated. Staff knew how to recognise and respond to abuse and understood the processes and procedures in place to keep people safe.

People received their medicines safely and were protected against the risks associated with the unsafe use and management of medicines.

Recruitment processes were in place to make sure that staff employed were of good character and safe to work with people. The manager kept a schedule of training to make sure staff had the skills and knowledge to carry out their roles. An online training system was used and training credits needed to be purchased for each course. The registered person failed to provide the manager with enough money to ensure sufficient credit was purchased for staff to complete their training. Staff were not consistently being paid correctly. On 19 June 2015 some staff had not been paid for the correct number of hours they had worked. Other staff had not been paid the annual leave hours they were due to be paid.

The manager and staff understood how the Mental Capacity Act (MCA) 2005 was applied to ensure decisions made for people without capacity were only made when this was in their best interests. The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The manager was aware of a judicial review which widened and clarified the definition of a deprivation of liberty.

People and their relatives were happy with the standard of care at the service. People were involved with the planning of their care. The manager assessed people’s needs before they moved into the service to make sure their needs could be met. People’s needs were assessed and care and support was planned and delivered in line with their individual care needs. People’s health was monitored and staff worked closely with health and social care professionals to make sure people’s health care needs were met. Staff were kind, caring and compassionate and knew people well. People were encouraged to stay as independent as possible. People received consistent and personalised care and support. Care plans were kept up to date to reflect people’s changing needs and choices.

There was a complaints system and people knew how to make a complaint. Views from people and their relatives were taken into account and acted on.

The range of activities was limited and people said they would like to do more. Staff were aware of people who chose to stay in their rooms and were attentive, when they had time, to prevent them from feeling isolated.

The manager coached and mentored staff through regular one to one supervision meetings. The manager had an open door policy and worked with the staff each day to maintain oversight of the service. Staff said that they were well supported by the manager.

There were systems in place to monitor the quality of the service. The manager had submitted notifications to CQC in a timely manner and in line with CQC guidelines.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and a breach of condition imposed on registration contrary to Section 33 of the Health and Social Care Act 2008.  We are taking enforcement action against Uday Kumar and Kiranjit Juttla-Kumar to protect the health, safety and welfare of people using this service.

16 December 2014

During a routine inspection

The inspection visit was carried out on 16 December 2014 and was unannounced.

Newlands Residential Home provides care for up to 17 older people some of whom may also have dementia. The service is situated on the seafront at Walmer with accommodation on two floors. On the day of the inspection there were 14 people living at the service.

The service was run by a manager, who had been in post since 10 August 2014 and who was present on the day of the inspection. The manager was in the process of going through formal registration with the Care Quality Commission. The service had been without a registered manager for over four years. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

There was a lack of empowerment for the manager and staff. The provider did not financially invest in improving the service. The provider’s lack of investment prevented the manager and staff from putting the needs of people first and improving the quality of the service.

The environment at the service was not adequately maintained and there were areas that were in need of repair. Some carpets were worn and stained. One bedroom smelt strongly of urine. The staff did not have access to a carpet cleaner. Repeated requests had been made to the provider but a carpet cleaner had not been purchased. Staff said they scrubbed the carpet but the odour remained. Staff said that the carpet needed replacing but the provider would not consent to this. One person said, “When I came here the owner told me that they would replace the carpet in my bedroom, that was 18 months ago and the carpet has not been replaced. As you can see it is very worn in places”. Other areas like bedrooms, hallways and ceilings were in need of repair and redecoration. The flooring in the laundry room was cracked with pieces of tiles missing. Pipe work was exposed where the plaster had fallen away from the wall. The outside of the property looked run down.

The provider had not purchased the equipment needed to make sure people received safe care and support to meet their individual needs. Weighing scales were shared between the provider’s two services, one in Kent and one in Medway. At the time of the inspection weighing scales had not been at Newlands for at least two months because they were being used at the providers other location. People needed to be weighed regularly to make sure they were maintaining a healthy weight.

Three people had been assessed as being at risk from falling and for three weeks the manager had asked for special alarmed mats to be purchased. At the time of the inspection these had not arrived.

Potential risks to people were identified but full guidance on how to safely manage the risks was not always available. This left people at risk of not receiving the support they needed to keep them as safe as possible.

A system of recruitment was not in place to ensure that the staff employed to support people were fit to do so. Staff did not always have the appropriate safety checks prior to working with people to ensure they were suitable. The staff had not received all the training they needed to make sure they had the skills and knowledge to carry out their roles. There were sufficient numbers of staff on duty throughout the day and night to make sure people were safe and received the care and support that they needed. People and their relatives said there was enough staff. They said that staff came quickly when they called for them and there was always staff around. Staff were respectful, kind and caring when they were supporting people.

People said that they would like to do more activities. An entertainer came fortnightly to play music. Staff tried to spend one to one time with people, but this was limited. There had been events, such as a summer BBQ for people and their friends and family in the Summer and a Christmas fair. People's relatives took them out regularly. Staff were able to support people to go out but this was dependant on the weather. Newlands had previously had a number of people coming to the service to provide entertainment but invoices had gone unpaid for so long that they chose not to return.

Each person who used the service had a care plan which was personal to them and that they or their representative had been involved in writing. The care plans recorded all the information needed to make sure staff had guidance and information to care and support people in the way that suited them best. The staff said they were committed to providing the individual care to making sure that each person was treated and cared for as an individual. Staff were familiar with people’s likes and dislikes, such as if they liked to be in company or on their own and what food they preferred.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Deprivation of Liberty Safeguards. The manager showed that they had considered their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). The manager had undertaken mental capacity assessments to identify if people were able to make decisions for themselves or if they needed specialist support to do this. The management had considered Deprivation of Liberty Safeguards for some people who may have been restricted.

People received their medicines safely and when they needed them and they were monitored for any side effects. At the time of the inspection the service was not monitoring the temperature at which drugs were stored. The manager took immediate action to rectify this.

People were protected from the risk of abuse, as staff had received appropriate safeguarding training and were aware of how to recognise and process safeguarding concerns. Staff knew about the whistle blowing policy and were confident they could raise any concerns with the manager or outside agencies if needed.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.

27 December 2013

During an inspection looking at part of the service

Our inspection of 16th May 2013 found that the provider did not have an effective system in place to identify, assess and manage risks to the health, safety and welfare of people using the service and others. We judged that this had a minor impact on people who use the service told the provider to take action.

At this inspection we looked at the outcome area which was non-compliant. Since our last inspection the provider had sent us an action plan showing how they intended to improve the service and achieve compliance.

We found that regular head office audits were being carried out and that the findings were recorded. This meant that the provider was identifying, monitoring and managing the risks to people who used, worked in or visited the service.

During our visit we observed people being spoken with and supported in a sensitive, respectful and professional manner that included assessment of their satisfaction and having their needs met.

16 May 2013

During a routine inspection

We made an unannounced inspection to the service and spoke with people who use the service, staff members and the deputy manager. There were 15 people using the service at the time of our visit. There had been no registered manager at Newlands since September 2012.

Everyone we spoke with expressed that they were very happy living at Newlands. We observed interactions between the people and the staff and also people's reactions to the staff. We observed to see how people were.

People told us that they had the care and support they needed to remain well and healthy. They said they were involved in decisions about their care and support. One person told us, 'I am looked after really well and the staff help me to stay as independent as possible'.

We found the home generally to be clean, tidy and free from unpleasant odours.

There were sufficient suitably skilled staff on duty during the day.

We found that there were both local and head office audits carried out regularly at the service. However, there was no documentary evidence that the head office audits undertaken at Newlands indicated that shortfalls had been identified and what actions had been taken to improve the service.

People's records including medical records were up to date and completed properly.

9 November 2012

During a routine inspection

We made an unannounced inspection to the service and spoke with people who use the service, staff members and the Provider. There were 16 people using the service at the time of our visit. There had been no manager at Newlands since mid September.

We met and spoke with some of the people who use the service and everyone we spoke with expressed that they were very happy living at Newlands.

We observed interactions between the people and the staff. We saw staff engaged in a warm and positive way and offered people support when they needed it. One person said, 'The staff are good, I get what I need'.

People said that they were involved with the planning of their care. One person told us, 'They went through everything with me when I came here'. However, care plans did not reflect the personalised and individual care being provided. In some cases we found that risks were not being assessed.

12 January 2011

During a routine inspection

The people using the service said that they liked the home. They said the staff were really nice and were patient when helping them. People said they felt safe and comfortable when they were being supported to move from one place to another using the hoists and aids.

People told us that the food was good and they always had enough. They said that their visitors came when they wanted. They felt that if they had a concern then they were comfortable talking to the staff and manager.