Archived: Newtondale

Newtondale 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. The service provides personal care and accommodation for one person with a learning disability and/or autism.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The care service has been developed and designed in line with the values that underpin the 'Registering the Right Support' and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

Systems and processes were in place to keep people safe and risks associated with the person’s care needs had been assessed. There were sufficient staff to meet the person’s needs and staff recruitment processes and procedures were robust.

Staff received appropriate induction, supervision and training to provide safe and effective care. The registered manager worked in partnership with healthcare professionals and other organisations to meet the person’s needs.

Observations showed staff were compassionate, kind and caring and had developed good relationships with the person using the service. Staff knew the person well and promoted their dignity and respected their privacy. Care plans detailed and provided staff with guidance on how to meet the individual’s needs. The person using the service was provided with the care, support and equipment they needed to maintain their independence.

The person was supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; policies and procedures in the service supported this practice.

Medicines were managed safely and the individual’s nutritional needs were met. A range of activities were available for the person to participate in. The person using the service was supported to maintain relationships that were important to them.

The registered provider had a procedure for receiving and responding to complaints about the service. Staff spoken with were fully aware of their responsibilities in supporting people if they needed to complain about the service they received. The person using the service had access to an advocate.

The provider and registered manager consistently monitored the quality of the service and made changes to improve and develop the service, taking into account people’s needs and views. The person knew the registered manager and was confident in approaching them. Staff told us the registered manager was approachable and listened.

Further information is in the detailed findings below.

This inspection took place on 22 March 2016 and was announced. At the last inspection on the 4 April 2014, the registered provider was compliant with the regulations we assessed.

There was a registered manager in post. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. However, an application has been submitted to remove the current registered manager and add another manager from within the organisation. Both the new and previous registered manager were present during the inspection.

The person who lived at the service received continuous support from staff and needed to be supervised whenever they went out. We saw support was individual and the person’s needs were fully understood by staff. Staff worked with the person to develop and equip them with the necessary life skills to live as independently as possible and we saw their best interests were promoted.

The person who used the service had complex needs and was not always able to tell us in detail about their experiences. We relied on our observations of care and our discussions with staff and other professionals involved.

The environment was safe and staff had a good knowledge and understanding of how to safeguard the person; there were clear and available safeguarding procedures within the home. Risk assessments were completed to help minimise risk such as supporting the person in the community or with day to day support.

Staff had been recruited safely and the registered provider’s recruitment procedures ensured, as far as practicable, the person was not exposed to staff who had been barred from working with vulnerable adults.

Medicines were handled safely and staff had received training in this area.

The person who used the service was provided with a varied and individual diet. We saw they were consulted and involved with meal choice.

We saw the person was supported to access health care professionals when needed and staff supported them to take part in an activities which they enjoyed and were very enthusiastic about.

The management and care staff were trained in, and understood the principles of, the Mental Capacity Act 2005 [MCA] and promoted a least restrictive approach with the person.

Staff had access to induction and on going essential training, supervision and appraisal. This ensured staff had the skills and knowledge to support the person using the service both safely and effectively.

We observed that positive relationships with the staff and the person who used the service had been developed.

The person who used the service was involved with the development of their plan of care and activity programme. Their preferences were detailed and how they would communicate in different circumstances.

There was a complaints procedure in place which was available in a suitable format that enabled the person who used the service to access this if needed.

Audits were undertaken to ensure the person received a safe and effective service which met their needs. However, we saw that some were limited with the type of questions asked and this did not allow for a more in depth analysis in how the service could be improved. The registered manager had developed their own system to record and analyse incidents and accidents, which promoted a learning culture within the service.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

The person who used the service told us they were happy and that they felt safe.

The home had policies and procedures in relation to safeguarding vulnerable adults. Relevant staff had been trained to understand how to manage behaviour that could challenge the service and who to contact if they thought abuse had occurred.

This means that people were safeguarded as required.

Systems were in place to make sure that managers and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduces the risks to people and helps the service to continually improve.

The registered manager sets the staff rotas, they took the person's care needs into account when making decisions about the numbers, qualifications, skills and experience required. This helps to ensure that the person who used the service needs are always met.

Staff knew that risk assessments were in place and who to contact if they needed to when they were out of the home with the person who used the service.

Is the service effective?

The manager had contacted an advocacy service so that people could get help if they needed it, this meant that when required the person who used the service could access additional support.

The person who used the service had their health and care needs assessed. Specialist professionals had in put in the person's care plans where required. We saw the care plans reflected the person's current needs.

The person who used the service told us, 'Of course I'm happy here', 'I'm lucky' and when we asked about the staff we were told, 'They are great.'

Staff supported people to be as independent as possible.

Is the service caring?

The person who used the service was supported by kind and attentive staff. We saw that staff showed patience and gave encouragement when supporting people.

The manager told us that monthly meetings were held and the person who used the service made decisions about what activities they wanted to and what food they wanted to buy.

Preferences, interests and diverse needs had been recorded and care and support had been provided in accordance with the person's wishes.

Is the service responsive?

The person who used the service completed a range of activities outside the service. A member of staff told us, 'He loves going to the shops, car boots and markets anywhere where we can meet and talk to people.'

Staff knew the person they cared for and understood their preferences and personal histories.

The manager told us there had been no complaints since our last inspection.

Members of staff listened and acted in respect of the person' views and decisions. The person who used the service was given information at the time they needed it, in a way they could understand.

Is the service well-led?

The service worked well with other organisations and services to make sure the person who used the service received their care in a joined up and inclusive way.

The service has a quality assurance system, records seen by us showed that identified shortfalls were addressed promptly. As a result the quality of the service was continuingly improving.

Staff told us they were clear about their roles and responsibilities. This helped to ensure that people received a good quality service at all times.

Staff enabled the person who used the service to make choices about their care and how they wanted to spend their time, even where their understanding and communication was limited.

Records showed the person's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. Staff demonstrated a good knowledge of the needs of the person who used the service.

Staff encouraged the person who used the service to eat their food and drink as independently as possible, providing support and assistance where required. They were provided with a choice of suitable and nutritious food and drink.

Appropriate arrangements were in place for the safe administration of medicines. Staff had received training in medicine management.

There were enough qualified, skilled and experienced staff to meet the person's needs. They were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.