Below is a summary of what we found when we inspected Newton House on 22 July 2014.
Our inspection team was made up of three inspectors and an expert by experience. They helped answer our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?
The summary is based on our observations during the inspection, speaking with people who used the service, their relatives and the staff supporting them. We also looked at people's care records and other documentation.
If you want to see the evidence supporting our summary please read the full report.
Is the service caring?
During our inspection on 10 and 11 March 2014 we found that people's care and treatment was not always planned and delivered in a way that was intended to ensure people's safety and welfare.
The provider was asked to send us an action plan which set out the actions they would take to meet compliance.
We saw evidence that people's care was monitored through care plan audits and observational audits. This ensured that care was delivered as detailed in a person's care plan.
We found that staff had on-going refresher training that ensured they had the skills to carry out their role.
People were supported by kind and attentive staff. We saw that staff showed patience and gave encouragement when they supported people.
We observed staff interact with people and help people to maintain their independence.
People's preferences, interests and diverse needs had been recorded in their care plan's. People told us that care and support had been provided in accordance with their wishes.
Is the service responsive?
We saw when staff had raised concerns about people's health and social care needs, that the provider had contacted appropriate health and social care professionals. The individual care files identified this and a record of actions taken were recorded.
We saw the provider had contingency plans in place in event of an emergency situation.
The provider had a complaints policy in place and information was displayed around the home, should people who lived there or their relative wish to raise a concern.
People completed a range of activities in and outside the home. We were made aware that the provider was currently recruiting a third member to their activities team which would ensure that all people had access to planned activities in the home.
Is the service safe?
The provider had policies and procedures in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). The MCA states that every adult has the right to make their own decisions about their care and treatment and must be assumed to have capacity to make them unless it is proved otherwise.
The Deprivation of Liberty Safeguards are part of the MCA. DoLS supports people in care homes and hospitals to be looked after in a way that does not unlawfully restrict their right to freedom.
We saw the provider had policies and procedures in relation to safeguarding vulnerable adults and whistle blowing.
We spoke with staff who understood what was meant by abuse and knew how to report their concerns.
Systems were in place to make ensure that the manager and staff learnt from events such as complaints, concerns and investigations. This reduced the risks to people and helped the service to continually improve.
We reviewed the staffing rotas and we saw that they took into account people's care needs, when making decisions about the number, qualifications, skills and experience required. We generally received positive comments about the staffing levels within the home from people and staff.
The provider had taken action to recruit additional members of care staff to reduce the number of agency staff currently working within the home.
Is the service effective?
We found staff attended training courses to meet the individual needs of people in their care such as the care of a person living with dementia.
People's health and care needs were assessed. People, and where appropriate, their relatives, were involved in reviewing their care plans. Specialist dietary, mobility and equipment needs had been identified in care plans where required.
We looked at people's records which showed that care plans set out people's individual care needs. They were current and the records showed they had been reviewed on a regular basis and amendments made when a person's care needs changed.
During our inspection we observed that members of staff knew people's individual health and wellbeing needs. We saw that people responded well to the support they received from staff members.
Records showed people had access to a range of healthcare professionals.
Is the service well led?
During our inspection on 10 and 11 March 2014, we found that the provider had failed to notify the Care Quality Commission of incidents that affected the health, safety and wellbeing of the people who used the service. This meant that we could not be confident that important events were reported appropriately, or in a timely manner to us so that appropriate action could be taken if required.
We asked the provider to send us an action plan which demonstrated how they planned to address our concerns.
Since April 2014 we have continued to receive monthly records from the provider which documented all incidents that affected the health, safety and wellbeing of the people who lived at Newton House.
We saw evidence during our inspection on 22 July 2014 that the provider had implemented clear protocols for staff to follow as part of the notification process for the CQC.
The service worked well with other agencies and services to make sure people received their care in a joined up way.
The service had a quality assurance system and records seen by us showed that shortfalls were addressed promptly. As a result the quality of the service and the environment of the home were improving.
Staff told us they were clear about their roles and responsibilities. They told us that they felt supported and had access to a range of training to ensure they were equipped to carry out their role.