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Newlands House - Care Home with Nursing Physical Disabilities Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 28 November 2018

The inspection took place on 27 September 2018 and was unannounced. Newlands House - Care Home is a is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home provides care in an accessible building including electronic door openings because everyone who lives there uses a wheelchair to mobilise. It is a care home for 35 people with physical disabilities and at the time of our inspection 32 people were living there. However, only 28 people were present as 4 were either on holiday or visiting family.

They were last inspected on 14 September 2017 and were found to require improvement. At this inspection they still required improvement.

There was 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.

Risk was not always assessed and actions were not always considered to reduce it. The review of when things went wrong was not always thorough enough to reduce the risk of repetition. Some incidents which could have been reviewed independently as a safeguarding concern, had not been considered as such and had therefore not been reported to the relevant safeguarding authority.

People did not always receive personalised care which was based on their preferences. They also did not always have enough opportunity for meaningful engagement. Information had not been adapted to meet people’s individual needs. Some information in care plans did not give enough guidance and daily records were not always fully completed. The audits and reviews conducted did not always fully consider this and ensure that people were at the centre of their care. Although there were enough staff to meet people’s needs and this was kept under review, the audits did not consider the quality of interaction some people experienced.

Staff received training and support to enable them to fulfil their role effectively and were encouraged to develop their skills. They had developed caring, respectful relationships with people and ensured that their dignity and privacy were upheld. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The environment was planned to meet their needs and encourage independence.

People were assisted to maintain good health and had regular access to healthcare professionals. Medicines were managed safely and people received them when they needed them. Mealtimes included a choice of meal and people received patient support to assist them when needed. There were systems in the home to keep it clean and free from infection.

Visitors were welcomed at any time. People and their relatives knew the registered manager and felt confident that any concerns they raised would be resolved promptly. There were regular meetings with people which people told us they enjoyed and that they felt listened to. There were good relationships with other organisations and professionals; including working closely with commissioners to meet actions on improvement plans.

Staff felt well supported by the registered manager and there were regular meetings with them to ensure they were consulted and informed of changes.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Full information about CQC's regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.

Inspection areas

Safe

Requires improvement

Updated 28 November 2018

The service was not consistently safe.

Risks to people’s health and wellbeing were not always fully assessed and reviewed. This meant that lessons were not always learnt when things went wrong to avoid repetition. Staff did not always recognise and report concerns to protect people from harm. People were supported to take their medicines safely and there were systems in place to store them securely. There were sufficient staff to ensure that people were supported safely. Safe recruitment procedures had been followed when employing new staff. Infection control procedures were embedded.

Effective

Good

Updated 28 November 2018

The service was effective.

Staff received training and support to enable them to work with people effectively. They understood how to support people to make decisions about their care. If they did not have capacity to do this, then assessments were completed to ensure decisions were made in the person’s best interest. People were supported to maintain a balanced diet and to access healthcare when required. This was done through close collaboration with other professionals. The environment was designed to meet people’s needs.

Caring

Good

Updated 28 November 2018

The service was caring.

Staff had developed caring, respectful relationships with the people they supported. People were supported to make choices about their care and their privacy and dignity were respected and upheld. If they could not communicate their choices independent advocates were provided. Relatives and friends were welcomed to visit freely.

Responsive

Requires improvement

Updated 28 November 2018

The service was not consistently responsive.

People did not always receive care and engagement based on their personal preferences and choices. People did receive good care at the end of their lives. Complaints were investigated and responded to in line with their procedure.

Well-led

Requires improvement

Updated 28 November 2018

The service was not consistently well led.

The provider did not always respond to concerns thoroughly too ensure they improved the quality of people’s service. People knew the registered manager well and reported that they were approachable. The staff team felt well supported and understood their responsibilities.