• Care Home
  • Care home

Archived: Newtown House

Overall: Requires improvement read more about inspection ratings

Waterford Road, Highcliffe, Christchurch, Dorset, BH23 5JW (01425) 272073

Provided and run by:
Highcliffe Nursing Services Limited

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Background to this inspection

Updated 21 February 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014’

The inspection was prompted in part by notification of two incidents. One was concerned with the safe management of medicines and the second related to an unexpected death. These incidents are subject to a police investigation and as a result this inspection did not examine the circumstances of the incidents.

However, the information shared with CQC about the incident indicated potential concerns about the management of medicines and end of life care. This inspection examined those risks.

The inspection began on the 21 January 2019 and was unannounced and the inspection team consisted of an adult social care inspector. It continued on the 22 and 23 January 2019 and was announced.

Before the inspection we looked at notifications we had received about the service. A notification is the means by which providers tell us important information that affects the running of the service and the care people receive. We also spoke with local commissioners to gather their experiences of the service.

Due to technical problems, the provider was not able to complete a Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We gathered this information during our inspection.

During our inspection we spoke with four people who used the service and three relatives. We spoke with the manager, a nurse and two agency nurses, six of the care staff, the chef and two housekeepers.

We reviewed seven peoples care files and discussed with them and care workers their accuracy. We checked two staff files, care records and medication records and the complaints log. We walked around the building observing the safety and suitability of the environment and observing staff practice.

After our inspection we asked the manager for a copy of the staff training matrix and details of agencies that commissioned care. This information was provided on the 29 January 2019.

Overall inspection

Requires improvement

Updated 21 February 2019

The inspection took place on the 21 January 2019 and was announced. It continued on the 22 and 23 January 2019 and was announced. The inspection was carried out by one adult social care inspector. When we last inspected in October 2018 we found a breach of regulation as people were not having their risks monitored and reviewed and people were not having their medicine administered safely. At this inspection we found improvements had not been made and there was a continued breach of regulation.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key question ‘Safe’ to good.

Newtown House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided and both were looked at during this inspection. Newtown House is registered to provide care and accommodation for a maximum of 26 people. Accommodation is provided over two floors and all rooms are single occupancy. A passenger lift provides access to the first floor. People have the use of a communal lounge and dining room and there is a level, secure outside garden.

At the time of our inspection there was not a registered manager in post. 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.

Risks to people had not always been assessed, monitored or reviewed. This included the use of bed rails, using equipment to restrain a person, falls, accidents and incidents. Medicines were not always administered safely. A person had received an incorrect dose and the persons GP and the local safeguarding team had not been informed. That meant any associated safety risks had not been considered by the appropriate professionals. One person had complex symptoms and had medicine prescribed for ‘as and when’. There was no protocol in place to ensure the persons symptoms were managed effectively.

No audits or monitoring of the service had taken place since our last inspection in October 2018. Accurate records of the care and treatment people received had not been maintained. Examples included people’s mobility needs and managing people’s risks. Lessons had not always been learnt when things went wrong. Accident and incidents had been recorded but not reviewed which meant lessons had not always been learned when things went wrong. A complaints process was in place but had not been followed. A complaint had been received but not responded to in a timely manner. Records did not include an acknowledgement to the complainant, details of an investigation or the outcome.

Changes in the management structure of the home had led to reduced nursing hours which impacted on the length of medicine rounds and keeping records up to date. People were supported by staff that had been recruited safely including checks for their suitability to work with vulnerable adults.

Staff had an induction and ongoing training which enabled them to carry out their roles. Since the last inspection staff had not received any supervision and no staff meetings had been held which had left staff feeling unsupported. Staff morale was low and they lacked confidence in the management and organisation.

Pre admission assessments had taken place and captured people’s needs and choices. This information had been used to create an initial care and support plan. Care and support plans were not always reflective of the care people were receiving. People had access to healthcare when needed including dentists, opticians and dieticians. People had their eating and drinking needs understood and met.

The principles of the Mental Capacity Act were not always followed as assessments had not always been completed and there were not always records to demonstrate decisions were made in a person’s best interest and in the least restrictive way.

People did not have comprehensive end of life care plans that included the management of symptoms. Legal reporting responsibilities for reporting an unexpected death had not been followed and was at the time of our inspection being investigated by the police.

People spoke positively about the care they received and felt involved in day to day decisions about their care. People told us staff were respectful of their dignity and privacy.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.