Newgate Lodge Care Home

We found the following examples of good practice.

Staff were following the current government guidance in relation to infection prevention and control. The provider had arrangements in place to help prevent the spread of COVID-19 and other infections. All staff received training on the correct use of personal protective equipment (PPE) and infection control. The management team regularly audited infection control practices to ensure staff were following them. The home was clean and well maintained throughout.

There were restrictions on visitors to the service which were in line with current government guidance. There was a system for visitors in place to ensure they followed the current guidance on the use of PPE, testing and social distancing. The provider had ensured that people were able to maintain contact with relatives using technology whilst visiting was restricted.

The provider had arrangements in place to ensure people and staff were tested for COVID-19 in accordance with current government guidance. Risk assessments were carried out with people and staff to ensure they could safely live and work at the service.

People’s experience of using this service: People we spoke with told us they were very happy living at Newgate Lodge Care Home. People we spoke with and their relatives said they felt safe and there were enough staff to meet people’s needs.

Staff took steps to safeguard vulnerable adults and promoted their human rights. Incidents were dealt with appropriately, which helped to keep people safe. People’s health needs were identified and external professionals involved if necessary. People and staff were also supported with their well-being by the provider and management team.

People told us care staff were caring, supportive and kind. We observed staff members supporting people in a dignified and confidential manner. There was also lots of laughter and fun and people we spoke with and their relatives said that people enjoyed positive and therapeutic relationships with the staff team. The environment had been adapted to promote the needs of people living with a dementia in relation to colour, signage and lots of tactile and age appropriate displays.

The chef and staff had received training in relation to promoting good nutrition for older people. Staff were encouraging people who were under-weight to eat fortified foods. A fortified diet describes meals, snacks and drinks to which additional nutrients have been added through foods such as cream, butter, milk and milk powder. We found a range of menu choices were available and consideration had been given to ensuring people from different cultures received acceptable meals. We also saw that staff and visitors were invited to eat meals with people which promoted a sociable, family environment.

Care plans were detailed and showed people were involved in planning their own lives with staff support where able. Plans were person-centred, meaning people were at the heart of how they wanted their care and support to be provided. We discussed ensuring specific techniques used to support people when they became distressed were more clearly recorded for staff to follow and the management team agreed to address this straight away.

Staff told us they felt well trained and supported and spoke of the management team and provider in a positive light, stating that they felt listened to and always had access to managers or the directors. Checks were made on the ongoing competency of staff and we saw the service actively promoted staff to take further learning opportunities for their personal and professional development.

We saw staff upheld and promoted people’s rights relating to equality and diversity and people’s religious and cultural needs were well catered for.

People participated in a range of activities that met their individual choices and preferences. Staff provided the structured support people required and people we spoke with told us they enjoyed entertainment events and accessing the community with staff support. This promoted a good quality of life.

The service was well run. The management carried out lots of checks to make sure that the service was safe and of a good quality. People, relatives and staff said they found the management team approachable and people’s feedback was listened to and acted upon.

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Rating at the last inspection: The service was rated as good and the report was published in August 2016.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

A registered manager was in post at the time of the inspection. 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.

This inspection was carried out on 30 June and 1 July 2016 and was unannounced.

Staff understood the types of harm that can take place and were trained to report any incident of harm that people may experience.

Risk assessments were in place in order to support staff with reducing the risk of harm to people.

People were cared for by sufficient staff to support them with their individual needs. The necessary pre- employment checks were completed on staff before they were allowed to start work at the service.

People were supported to take their medicines as prescribed, and medicines were safely managed.

People had sufficient amounts of food and drink that they enjoyed. People were enabled to access a range of health care services and their individual health needs were met.

People’s rights to make decisions in relation to their support and care were respected and upheld. Where people were not able to make these decisions, their needs were decided in their best interests.

People were supported by staff who were trained and knowledgeable about their role. The CQC monitors the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) which applies to care services. When required, DoLS applications had been made to the appropriate authorities to ensure that people's rights were protected.

People were supported by staff that were caring and kind. People and their relatives were involved in creating people’s individual care plans.

Care and support was given that was based on people’s individual needs by staff who knew them well.

People took part in a wide range of activities and interests, including going outside the home environment. There was a complaints procedure so that any concerns could be listened to and addressed.

People found the registered manager was approachable, and there was an open and caring culture. Staff, people and their relatives were able to make suggestions about the quality of care provided and actions were taken as a result. Regular checks were carried out in order to review and maintain the standard and quality of people’s care.

We saw evidence that people were consulted before receiving care. One person who used the service told us, 'I am independent and able to do things for myself; the staff don't force me to do things.' A relative we spoke with told us, 'The staff make sure they (family member) understand what is happening by talking to them.'

We saw that the building was safe, clean and adequately maintained. One relative told us, 'The building is safe and seems to meet their (family member's) needs.'

Staff were supported to deliver care and support safely and to an appropriate standard. One person who used the service told us, 'The staff seem very knowledgeable, I have no complaints.'

We saw that records relevant to the management of the service were accurate and up to date and reflected the current needs of people who used the service.

People who used the service and the relatives we spoke with told us that the staff were very kind and caring. One relative told us, 'I have every confidence in the staff and consider that we were very fortunate to find this place for our relative.'

A district nurse told us, 'The staff are very prompt at referring people who use the service if they have any concerns about their health.'

A visiting GP told us that in their opinion staff at the home provided good care and good social activities for people using the service.

We found that the manager was ensuring that people were supported with dignity. The manager was also ensuring that the staff had access to training in dementia care.

Some records were not always accurately maintained and required improvement.