Newgrange Residential Home

People’s experience of using this service and what we found

Following the previous inspection of this service the registered manager and provider had continued to improve and had addressed shortfalls previously identified in Safe, Effective and Well-led. People were safe and protected from avoidable harm because staff knew how to identify and report any concerns relating to the risk of abuse. Risks to people’s health, safety and well-being were assessed and measures put in place to remove or reduce the risks. People were supported by staff who had been safely recruited.

Before people started using the service the provider completed assessments to make sure people’s needs could be met at Newgrange Residential Home. Care plans were developed from these assessments for each person’s identified needs. Staff received training and support to enable them to carry out their roles effectively.

Staff and the management team knew people well and were able to promptly identify when people’s needs changed and sought professional advice appropriately. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People’s medicines were managed safely. Staff had received appropriate training and had their competency assessed to help ensure they were sufficiently skilled and knowledgeable in this area. Staff had received training in infection control practices and personal protective equipment such as gloves and aprons was provided for them. The management team took appropriate actions following any incidents and learning was shared with staff.

The management team was committed to providing a high standard of care to the people they supported as well as the staff team and understood their responsibilities under the duty of candour. People or their relatives were confident to raise any concerns with the management team. Everyone we spoke with during this inspection was satisfied with the care and support they received.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 05/10/2019).

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made.

Why we inspected

We carried out an unannounced inspection of this service on 26 June 2019. We found improvements were needed. The provider completed an action plan after the last inspection to show what they would do and by when to improve the safe care and treatment, safeguarding and governance systems at Newgrange Residential Home.

We undertook this focused inspection to check they had followed their action plan and to confirm improvements had been made. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those improvements. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance the service can respond to COVID-19 and other infection outbreaks effectively. This included checking the provider was meeting COVID-19 vaccination requirements.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Lodge Care Home on our website at www.cqc.org.uk

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

About the service:

Newgrange Residential Home accommodates 38 people in one purpose-built building spread across two floors. Each of which has separate adapted facilities and communal areas. At the time of the inspection, 17 people were living in the home and receiving the regulated activity of personal care.

People’s experience of using this service:

Incidents that occurred in the home were not always managed to keep people safe. Staff awareness of keeping people safe from harm varied and was not consistent.

Training in key areas had not been effectively provided for all staff, however people told us staff were competent and staff felt well supported. People’s consent had not always been sought in line with the legal requirements.

People lived in a purpose-built home that although newly refurbished did not meet the needs of people living there. Particularly people living with dementia. The environment was well maintained, and appropriate safety checks were regularly completed.

Quality assurance audits were not always effective in identifying people’s experience of the service. Care records were not reflective of people likes, dislikes, preferences and changing care needs, or care that had been provided and required monitoring.

People told us they felt safe. One person said, People told us they felt safe. One person said, “Absolutely I feel safe, it’s a very nice home with kind staff.” People were supported by sufficient numbers of staff. Staff recruitment checks were in place. Staff were clear about how to respond in an emergency such as a fire. Risks to people safety and welfare were identified and responded to promptly by staff. People were cared for in a clean and hygienic environment by staff who followed infection control procedures.

People, their relatives and staff told us that the quality of care received was sufficient and they were happy with the care provided. People’s dignity was maintained and people’s independence was promoted and respected.

People were happy with the food provided and meal times were a sociable event. People’s weight and dietary needs were monitored where necessary.

People told us their care was responsive and tailored to their preferences, although care records did not reflect this. People were able to take part in a wide range of activities and outings. People and their families were involved in their own care planning as much as was possible.

People and relatives felt able to raise complaints and an effective complaints procedure was in place.

Staff felt well supported by the registered manager. People and relatives were able to raise suggestions about the management of the service.

Rating at last inspection: Good (report published 01 December 2016)

Why we inspected: This was a planned comprehensive inspection based upon the previous Good rating. At this inspection we found that the service is now rated as Requires Improvement. More information is in the full report.

Follow up: We have referred our findings to the local authority. We will continue to monitor all information received about the service to understand any risks that may arise and to ensure the next inspection is scheduled accordingly.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

There was a manager in post who had registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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 and associated Regulations about how the service is run. The registered manager is also the provider for this location.

Relatives and staff were complimentary about the registered manager and how the home was run and operated.

People felt safe, happy and well looked after at the home. Relative’s told us and our observations confirmed that people were safe.

Staff had received training in how to safeguard people from abuse and knew how to report concerns, both internally and externally.

Safe and effective recruitment practices were followed to ensure that all staff were suitably qualified and experienced. Arrangements were in place to ensure there were sufficient numbers of suitable staff available at all times to meet people’s individual needs.

Plans and guidance had been drawn up to help staff deal with unforeseen events and emergencies. The environment and equipment used were regularly checked and well maintained to keep people safe.

Relatives were positive about the skills, experience and abilities of staff who worked at the home. Staff received training and refresher updates relevant to their roles and had regular supervision meetings to discuss and review their development and performance.

People were supported to maintain good health and had access to health and social care professionals when necessary. They were provided with a healthy balanced diet that met their individual needs.

Staff had developed positive and caring relationships with the people they cared for and clearly knew them well. People were involved in the planning, delivery and reviews of the care and support provided. The confidentiality of information held about their medical and personal histories was securely maintained throughout the home.

Care was provided in a way that promoted people’s dignity and respected their privacy. People received personalised care and support that met their needs and took account of their preferences. Staff were knowledgeable about people’s background histories, preferences, routines and personal circumstances.

Complaints were recorded and investigated thoroughly and responded to in line with the provider`s policy.

Following the comprehensive inspection, the provider wrote to us on 14 December 2015 to tell us how they would meet the legal requirements 31 January 2016. We undertook a further focused inspection on the 09 May 2016 to check if the necessary improvements were made. We found that little improvements had been made and the provider was still not meeting the legal requirements in relation to Regulations 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

This report only covers our findings in relation to these topics. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Newgrange Residential Home on our website at www.cqc.org.uk.

Newgrange is a purpose built care home and is registered to provide residential accommodation and personal care for up 38 older people some of whom are living with dementia. At the time of our inspection 35 people were living at Newgrange.

At this inspection we found some improvements had been made, however we also found further improvements were required in areas relating to the completion of people’s care records. The improvements made to governance systems were not sufficient, these did not effectively identify and address any areas in people`s care plans which needed updates or completion.

The provider and registered manager had implemented a new system of auditing and reviewing the quality of care people received since our last inspection. However, care plans, particularly in relation to nutrition and pressure care had not been completed, or if these were completed contained inaccurate information.

Care plans were individual to people and up to date. We found that people were given choices and supported to access a range of activities that promoted their independence. We found that people's medicines were managed safely.

There were enough trained staff to meet people's needs and we saw that the provider had supported their professional development. We found that a complaints system was in place and that people and their relatives were able to discuss concerns with staff.

We observed staff supporting people in a kind and calm manner. Communication was positive and staff spoke respectfully with people. Staff told us they very much enjoyed working at the home and felt well supported and were offered lots of training to carry out their roles in supporting people to meet their health and care needs

The organisation had systems in place to monitor the quality of the service provided and action had been taken to address any issues that were highlighted as needing improvement.

All the people we spoke with told us they felt safe living at the home.