Archived: Newnham Green

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.

People were supported by staff who understood safeguarding procedures and were able to recognise the signs of potential abuse.

Risks to people had been thoroughly assessed and plans put in place to manage these risks while enabling people to live their lives without unnecessary restriction.

Robust recruitment procedures had been employed to ensure that staff were suitable to work with people who used the service. There were sufficient numbers of staff deployed to meet people’s needs. Staff received comprehensive training to enable them to meet people’s needs.

People were given support to take their medicines as prescribed. Their nutritional needs were met and they were supported to access healthcare if they needed it.

People were supported by staff who showed respect and cared for them as individuals whilst maintaining their dignity. People were encouraged to make their own decisions where possible and their consent was sought appropriately.

People and those important to them were involved in planning their care, how it was delivered and their independence was promoted as far as possible. People’s care was delivered in the way they wished by staff who were knowledgeable about their needs.

People who used the service and staff who supported them were able to express their views on the service. People were supported to make complaints and were confident that these would be heard and acted upon. The service maintained good communication with people who used the service and their families.

The management team maintained a good overview of the service and had systems in place to monitor the safety and quality of the service. Staff were supported by the management team and felt valued by the provider.

Additionally, staff meetings had not been taking place regularly. This meant that staff did not have formal opportunities to discuss whether they were following consistent practice in supporting people. It also meant that they may not be up to date with information in respect of the home's policies, legal changes or good practice guidance.

For this review we looked at the plan of action the provider had submitted to us, which outlined the improvements they intended to make. We also had a telephone discussion with the provider and looked at a copy of the minutes from the most recent staff meeting, which had taken place on 21 August 2014.

We concluded that the provider's arrangements had improved in respect of holding staff meetings, supervisions and appraisals on a more regular basis. This meant that people living in the home were being cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

As part of this inspection we spoke with three people who used the service although their complex needs meant they could not tell us verbally what they thought about the service. We observed how people were being supported. We were not able to use a formal observational tool because people were independently mobile around their home. We spoke with the registered manager and two other members of staff.

We reviewed records relating to the management of the service. This included three care plans, daily records, policies and procedures, staff records and the provider's monitoring records.

Below is a summary of what we found. The summary describes what the manager and the staff told us, what we observed and the records we looked at.

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

Is the service safe?

People were treated with respect by staff. The duty rosters took into account people's needs and ensured that safe staffing levels were maintained. Risks to people's health and welfare had been assessed and staff understood how they were to minimise these.

Systems were in place to ensure that the manager learnt from incidents and concerns and took action to reduce any risks as well as improving the service. Systems also ensured that the service was clean and hygienic and staff were clear about how to minimise the risk of any infection spreading. Standards of cleanliness were checked to ensure people's safety was promoted. We noted that other checks were made on the safety of the home and the management of medicines so that people were protected from avoidable risk.

The home had procedures in place in relation to the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS) and staff had training in this. We noted that information was displayed on the office wall so that the manager had easy access to guidance and telephone numbers to seek advice if this was required.

Is the service effective?

People's health and care needs had been assessed and used to develop plans of care reflecting how each person was to be supported. Advice from health professionals had been included in care plans to ensure people's needs were met, including for support with eating and drinking or communicating. Staff were able to tell us about people's needs. This meant that staff knew how to support people properly.

Staff had relevant training so that they knew what was expected of them and had knowledge to support people effectively. However, they were not appropriately supported by means of supervision and appraisal to carry out their work. We have asked the provider to tell us what they are going to do to meet the requirement to support staff in their work.

Is the service caring?

We observed that people were supported by kind and attentive staff. We saw that staff gave encouragement to people, that people showed no signs of being ill at ease around staff and smiled at staff who were on duty. Arrangements had been made for people to join in celebrating someone's birthday and go out for the evening.

Staff told us they were confident that people were treated with respect. They knew how people showed whether they were content, distressed or becoming unwell so that they could provide support people needed.

Is the service responsive?

We saw that people engaged in activities inside and out of the home. Our discussions with staff and the manager showed that the staff team were looking to increase the opportunities people had to go out, particularly at weekends and to find activities that people would enjoy.

We noted that if there were concerns that someone was becoming unwell these were followed up promptly so they could get advice or treatment. Assessments of risk were reviewed regularly and plans of care were updated if people's needs changed.

Is the service well-led?

The manager ensured that the quality of the service was monitored regularly. Although there was no formal survey process, people and their representatives were involved in reviews so that they could comment on standards of care. Staff said they could raise suggestions for improvement.

During our inspection we observed the people living in the service and their interaction with staff. We saw that staff treated people with respect and offered them choice. On the day we inspected the service had ordered a take away meal as the evening meal. We saw a member of staff assisting a person to choose what they wanted from the pictures on the menu.

We saw three people's care plans which showed that their needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

The service had a garden at the back and front of the premises which were well maintained. The rear garden had garden furniture and a swing. Internally the building was clean and well maintained. People had individual bedrooms which were decorated with pictures of their choice.

Staff told us they enjoyed working in the service and felt supported in their work.

We saw one person being supported appropriately during their lunch time meal. They were smiling and laughing in response to staff interaction with them and this indicated that they found this experience positive.

We saw that Deprivation of Liberty (DOLS) screening check lists were completed for each person. This showed us that the service was monitoring the care and support provided to check that people were not being deprived of their liberty.

We looked at the care records of three people who used the service. There was evidence in the records that people and their families or advocates were consulted about the care and support they were provided with, including participation in their initial assessments and annual care review meetings.

We saw evidence in staff training records of induction training provided for staff to common induction standards which included training in the safeguarding of vulnerable adults. There was also evidence of training in infection control, fire safety and the safe handling of medicines.