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Newton Court Care Home Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 6 December 2017

This inspection took place on 18 and 20 September 2017 and was unannounced. Prior to this on 30 August 2017, a medicines inspector and a shadowing medicines support officer undertook an inspection and looked at supply, storage, administration and audit records for medicines used in the home. The previous comprehensive inspection took place on the 19 July 2016 and the service was compliant with the regulations at that time.

Newton Court Care Home is a purpose built care home located close to Middlewich town centre and is part of the Bupa Care Homes group. All bedrooms are single with en-suite toilet and washbasins. The home is registered to provide care for up to 60 people, at the time of the inspection there were 56 people in receipt of a service.

There was a registered manager in place, who had been registered with The Care Quality Commission since October 2010. 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 2008 and associated Regulations about how the service is run.

We identified three breaches of the relevant legislation, in respect of safe care and treatment, the need for consent and good governance. You can see what action we told the provider to take at the back of the full version of the report.

Overall, the people and relatives we spoke with were positive about the care and support they received at Newton Court.

We found shortfalls in the safe management of medicines. There were a number of issues relating to the storage, administration and recording of medicines. The registered manager immediately implemented an action plan to address the issues raised.

We reviewed how risks to individuals were managed and found that potential risks had not always been fully assessed, acted upon and recorded within people’s care records. We found two examples where staff had not taken appropriate action to mitigate against identified risks.

We saw that accidents and incidents, along with any pressure ulcers and weight loss or gain were monitored. However, we found that the system to monitor and analyse accidents had incidents was not robust because some incidents had not been reported to the registered manager.

We found in some cases that staff had not acted in accordance with the Mental Capacity Act (2005). One person’s liberty had been restricted without the person’s consent and another person’s wishes were not respected because a member of staff believed they were acting in the person’s best interests but had not followed procedures correctly.

Staff understood their responsibility to protect people from abuse and harm. The provider had policies in place for safeguarding vulnerable adults and whistleblowing. Staff we spoke with had an understanding of the signs of abuse and told us that they knew how to report any safeguarding concerns.

We found there were enough staff available to meet the needs of people living at the home. We saw that there were processes in place to ensure the registered manager regularly assessed and monitored staffing levels and ensure sufficient staff were available to provide the appropriate levels of support. The registered manager told us there were some staff vacancies and the home was actively recruiting staff, and that if necessary agency staff were used to maintain staffing levels.

The environment was very clean, well decorated and maintained to a good standard. The home was also free from odours. We observed domestic staff cleaning areas around the building throughout the inspection.

Staff received a thorough induction and ongoing training. Staff said that they felt supported by the management team to carry out their roles effectively.

We found that people’s nutritional needs were met. Most people preferred to have their meals in their rooms, but knew they could go to the dining room if they wanted to. The people we spoke with were happy with the quality and frequency of meals, and relatives found them to be good nutritious meals, they told us that overall options were good.

We observed that staff had developed caring relationships and treated people in a kind and compassionate manner. People told us that they were treated with dignity and respect. The service was working with the End of Life partnership to improve people’s care and experience at the end of life.

People told us that they were given choices and their preferences were respected about the way they would like their care to be provided.

The registered manager explained that the provider had already identified the need to make improvements to people’s care records to ensure they were up to date and reflected people’s individual needs. During the inspection we found examples where care plans had not been updated to reflect changes to people’s needs. There were occasional gaps in the recording on daily charts, such as charts to record that people had been supported with personal care or oral hygiene.

People and staff were positive about the management team. We found that the registered manager was keen to make any necessary improvements. The registered provider had some quality assurance systems and a home improvement plan in place. However, we found some shortfalls in the effectiveness of these. We found that the registered provider had failed to have robust systems in place to recognise and address the breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, we found as part of our inspection.

Inspection areas

Safe

Requires improvement

Updated 6 December 2017

The service was not consistently safe.

Medicines were not always managed safely in accordance with best-practice.

Potential risks to people had not always been fully assessed, acted upon and recorded within people’s care records.

Staff understood their responsibility to protect people from abuse and harm.

There were enough staff available to meet the needs of people living at the home.

Effective

Requires improvement

Updated 6 December 2017

The service was not consistently effective

Staff had not always acted in accordance with the MCA.

Staff undertook a comprehensive induction and regular training was provided.

People were happy with the quality and frequency of their meals and their nutritional needs were supported.

People were supported to maintain good health and receive health care support.

Caring

Good

Updated 6 December 2017

The service was caring.

Staff were kind and caring in the way that they approached people and observed some very positive and friendly interactions.

We found that staff were knowledgeable about people’s needs and had developed caring relationships with them.

People told us that they were treated with dignity and respect.

Responsive

Good

Updated 6 December 2017

The service was responsive.

People told us that their preferences and choices were respected by staff.

People and their relatives told us that they contributed to the planning of their care.

The provider had already identified the need to make improvements to people’s care records to ensure they were up to date and reflected people’s individual needs.

People were supported to follow their interests and we saw that information about people’s interests and lifestyle preferences were recorded within their care plans.

Well-led

Requires improvement

Updated 6 December 2017

The service was not consistently well-led.

The registered provider had some quality assurance systems in place. However we found some shortfalls in their effectiveness.

The service had already developed a home improvement plan to make some improvements

People and staff told us that the registered manager was approachable. Staff said that they felt able to raise any concerns and that these would be acted upon.

There was a system in place to gain views from people and relatives on their experience of the care provided.