We carried out a review of the data available to us about Newlands on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Newlands, you can give feedback on this service.
Newlands is a residential care home accommodating up to eight adults who have a learning disability, are autistic or have mental health needs. Five people were living at Newlands at the time of the inspection.
People’s experience of using this service and what we found
People, their relatives and staff shared concerns about staffing and use of agency. The registered manager provided reassurances, although several staff had left, new staff had been recruited. Where there were vacancies, or gaps in staffing these were being covered by consistent agency staff. The registered manager was in negotiation with the local authority to review funding for three people where their needs had changed to increase staff numbers.
Systems were in place to keep people safe. Risks to people were assessed, regularly reviewed and managed well to ensure their safety and promote their independence. Staff recruitment processes were in place to ensure staff were suitable to work with people who used the service. Training was provided to staff including agency staff to ensure they had the right skills and knowledge to carry out their roles effectively.
Infection prevention and control and medicines were being managed well including risks associated with COVID-19. People and staff had received COVID-19 vaccinations and boosters to help minimise the risk of catching the infection.
People were supported to eat and drink enough to maintain a balanced diet. The registered manager and staff worked well with other professionals to ensure people had access to healthcare appointments and received the right support to manage their health needs.
People’s care plans were personalised to reflect how they wanted to be supported and what was important to them. Progress had been made to have conversations with people about their preferences regarding death and dying.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
Right support:
The model of care and setting maximised people’s choice, control and Independence. Newlands is a large detached single storey house situated in Colchester and close to all amenities. The premises provide each person with their own individual bedroom and adequate communal facilities. People had been involved in decisions about the refurbishment of their living accommodation to create a more modern and homely living environment. The environment met people's sensory and physical needs.
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 were supported to access the community, including college and places of interest.
Right care:
People’s care was person-centred. Staff were observed treating people with kindness, respect and compassion. Staff understood their responsibilities to respect people's human rights, including their right to privacy, confidentiality and to promote their independence.
Right culture:
People and their relatives told us the ethos, values, attitudes and behaviours of the registered manager and care staff ensured people using service lead confident, inclusive and empowered lives. Relatives and staff told us the culture in the service had improved under the new registered manager. People using the service were encouraged to take an active role as ‘champions’ to promote good practice, such as encouraging people, staff and visitors to maintain good hand hygiene.
Improved systems were in place to identify and manage risks to the quality of the service and drive improvement. Regular audits of the service had been carried out to identify what was working well and where improvements were needed.
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 13 August 2019). The previous inspection identified improvements were needed to the environment, hygiene and cleanliness and to ensure people’s care plans were person centred. Additionally, improvements were needed to ensure people were supported to access appointments to ensure their physical and mental health needs were met. The service had not explored how to have end of life conversations with people living with learning disabilities.
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
This was a planned inspection based on the previous rating.
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 that the service can respond to COVID-19 and other infection outbreaks effectively.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Newlands accommodates up to eight adults who have a learning disability and who may also have an autistic spectrum disorder and mental health needs. Newlands is a large detached single storey house situated in Colchester and close to all amenities. The premises provide each person using the service with their own individual bedroom and adequate communal facilities for people to make use of within the service.
The service had been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
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.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. For the purposes of this report we will only be reporting on this one person’s experience in the service but in parts will be written in group format when referring to parts of the service to protect their privacy.
People’s experience of using this service and what we found
The environment was tired and in need of updating. Processes to identify risks to peoples’ health from environment concerns and cleanliness where poor. However, plans were in place for a total refurbishment and the provider took immediate action to manage and mitigate those risks we found on inspection.
Improvements had been made to staff training. However, the service had not always pursued opportunities to meet peoples additional physical and mental health needs to support them to live to their fullest potential. We made a recommendation about this.
Staff were caring in responses to people and knew people well. People told us that staff were kind.
Care plans were not person centred. However, staff were able to tell us in great detail how they carried out personalised care and support and observations demonstrated that care provided was person centred.
However, people told us they were bored. We saw that people had limited access to the local community. Staff had not always explored barriers to local community engagement when people experienced social anxiety.
The service had not explored how to have end of life conversations with people living with learning disabilities. We made a recommendation about this.
The service was under new management. The manager was enthusiastic about their role and keen to make improvements. They were in the process of rolling out a new governance system to improve oversight and monitoring the quality of care provided.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was requires improvement (published 15 May 2018). The service remains rated requires improvement.
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 to some areas, however, other areas had deteriorated.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Newlands on our website at www.cqc.org.uk.
Newlands accommodates up to eight adults who have a learning disability and who may also have an autistic spectrum disorder and mental health needs. Newlands is a large detached single storey house situated in Colchester and close to all amenities. The premises provides each person using the service with their own individual bedroom and adequate communal facilities for people to make use of within the service.
The care service has been developed and designed in line with the values that underpin the ‘Registering the Right Support’ and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
At the last inspection on 6 October 2015, the service was rated ‘Good’. At this inspection we found the service was now rated overall ‘Requires Improvement’. This is the first time the service has been rated ‘Requires Improvement’.
This inspection was completed on 23 March 2018 and there were five people living at Newlands.
A registered manager was in post and they managed both Newlands and a ‘sister’ service owned by the organisation. 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.
Improvements were required to the service’s arrangements to assess and monitor the quality of the service. The quality assurance arrangements had not identified the issues we found during our inspection to help drive and make improvements. Appropriate arrangements were not in place to review and investigate events and incidents and to learn from these.
Not all staff who administered medication had up-to-date medication training or training relating to the specialist needs of people using the service. The registered manager had not trained as an accredited trainer to enable them to provide and deliver staff with training in specific topics. Where staff had no previous care experience, a robust induction such as the ‘Care Certificate’ had not been considered at the earliest opportunity.
Staff understood and had a good knowledge of the key requirements of the Mental Capacity Act [2005]. Suitable arrangements were in place to ensure that people’s rights and liberties were not restricted. Staff supported them in the least restrictive way possible and people were routinely asked to give their consent to their care, treatment and support. Although people’s capacity to make day-to-day decisions had been considered and assessed, where more significant decisions were required, improvements were needed to ensure a ‘best interest’ assessment was considered.
People were protected from abuse and avoidable harm. People living at the service confirmed they were kept safe and had no concerns about their safety and wellbeing. Policies and procedures were being followed by staff to safeguard people. People received their medication as they should. Risks to people were identified and managed to prevent people from receiving unsafe care and support. People were protected by the registered provider’s arrangements for the prevention and control of infection.
People were treated with care , kindness, dignity and respect. People received a good level of care and support that met their needs and preferences. Support plans were in place to reflect how people would like to receive their care and support, and covered all aspects of a person's individual circumstances. Staff had a good knowledge and understanding of people’s specific care and support needs and how they wished to be cared for and supported. Social activities were available for people to enjoy and experience.
Comments about staffing levels from people using the service and staff were positive. The deployment of staff across the service was observed to be appropriate and there were sufficient staff available to meet people’s needs to an appropriate standard at all times.
People’s nutritional and hydration needs were met and they received appropriate healthcare support as and when needed from a variety of professionals and services. The service worked together with other organisations to ensure people received coordinated care and support.
Information about how to make a complaint was available. People confirmed they knew how to make a complaint or raise concerns.
This inspection took place on 6 October 2015 and was unannounced. Newlands is a residential care home that provides accommodation and personal care for up to eight people. Newlands provides a service to people who have a learning disability and/or autistic spectrum disorder and may have mental health needs or a physical disability. On the day of the inspection five people were using the service.
At the time of the inspection 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.
Our last inspection of this service was on 14 May 2014. We found the service under our inspection methodology of the time was non-compliant with regard to the safety and suitability of the premises. We asked the service to provide us with an action plan of what they intended to do regarding these matters. The service did supply an action plan within the timeframe set, which informed us of the actions taken. We checked this information when we inspected the service and found the service had taken the steps that it stated it would on the above concerns.
The provider had plans in place to deal with emergencies that may arise. Maintenance of the property was carried out promptly. Checks on fire safety and fire-fighting equipment had been completed in accordance with the provider’s policy and manufacturer’s instructions.
The service had systems in place to manage risks to both people and staff. The staff had a good awareness of how to keep people safe by reporting concerns promptly through procedures they understood well. Information and guidance was available for the staff to use if they had any concerns.
There were sufficient members of staff allocated to both day and night shifts to provide support to the people living at the service. The provider completed recruitment checks on potential new members of staff. New staff received induction training and there was on-going training for all staff plus supervision and an annual appraisal.
There was a system to ensure people received their medicines safely and appropriately. The quality of the service was monitored by the registered manager through gaining regular feedback from people and their representatives and the auditing of the service. The service had documents which recorded that people consented to the support provided.
The CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to registered care homes. The Deprivation of Liberty Safeguards (DoLS) is part of the Mental Capacity Act 2005. They aim to make sure that people in care homes, hospitals and supported living are looked after in a way that does not inappropriately restrict their freedom. We looked at the records and discussed (DoLS) with the manager. They told us that (DoLS) records and assessments were in place and we found the provider was following the necessary requirements.
People had access to food and drink and all people at the service were registered with GP’s and Dentists.
People were treated with kindness, dignity and respect. People were involved in decisions about their support as far as they were able to do so. People’s support needs were reviewed regularly. The manager ensured that up to date information was communicated promptly to staff.
Prior to anyone coming to the service an in-depth assessment of people’s needs was completed to ensure the service could meet their needs. The service operated a complaints procedure designed to support people make a complaint and resolve matters as far as possible to everyone’s satisfaction.
Staff felt well supported by the manager and said they were listened to if they raised concerns and action was taken straight away if necessary. We found an open culture in the service and staff were comfortable to approach the manager for advice and guidance.
We considered our inspection findings to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?
This is a summary of what we found;
Is the service safe?
When we arrived at the service we were greeted by a person who used the service and member of staff. We were asked for our identification and a person who used the service asked us to sign in the visitor's book. This meant that the appropriate actions were taken to ensure that the people who used the service were protected from others who did not have the right to access their home.
People told us they felt safe living in the service and that they would speak with the staff if they had concerns.
We reviewed staffing records regarding the Mental Capacity Act (MCA) 2005 in relation to Deprivation of Liberty Safeguards (DoLS) and saw this training was up to date. The CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. The manager, deputy manager and member of staff spoken with were able to demonstrate a knowledge and understanding of the MCA and DoLS. The manager informed us that no DoLS were in operation at the time of our inspection. While no applications have needed to be submitted, correct policies and procedures were in place.
People told us that the staff were available when they needed them to help and support them.
The service held weekly fire safety checks. However, there were risks to the people who used the service as the electrical meter and electrical wiring intake box did not have a cupboard door.
Is the service effective?
People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. The records were reviewed monthly and updated as required. This meant that staff provided information that was up to date about how people's needs were met.
Is the service caring?
We saw that the staff interacted with people who used the service in a caring, respectful and professional manner. The staff had arranged to work with other organisations to support people to follow their life-style choices.
Is the service responsive?
People who used the service were provided with the opportunity to participate in activities which interested them. People's choices were taken into account and listened to.
One person told us that they knew how to make a complaint if they were unhappy. We saw that the service had involved advocates appropriately to support people and had arranged for people who used the service to learn skills to help communicate with people.
People's care records showed that where concerns about their wellbeing had been identified, the staff had taken appropriate action to ensure that people were provided with the support they needed.
Is the service well-led?
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 in place and robust recruitment arrangements.
We inspected seven outcomes and learnt the service had a complaints policy in place and had arranged induction and on-going training and support for the staff. People who used the service were prompted and supported to take prescribed medication and their consent had been sought prior to them coming to the service. Each person had their own detailed care plan and we saw evidence that other providers supported the service to help meet the needs of the individuals.
We saw that the service had taken action to address issues which were non-compliant with the regulations at our last inspection and had upgraded the flooring and stopped the conservatory from leaking as well as decorating this area. We also saw the lighting had been improved and each individual room, as well the communal areas, had additional sockets in place which meant that and there was now no need for electrical extension cables. The communal areas had been decorated and new furniture bought and the people who used the service had been involved in the selection of the colours used.
People who used the service told us they were very happy at Newlands and the staff were great. One person told us "Newlands is the best place I have lived and I can always speak with the manager. They support me to do all the things I want to do, it's great here". Another person told us "I was very unhappy where I was before and I am happy now".
From our observation and time spent at Newlands we saw that the people living there were receiving the care and support they needed in an individual way and wherever possible staff tried to facilitate choice and independence. We saw that staff and management had a good rapport with people living in Newlands. Staff were supportive and interacted well with them.
We saw that staff were trained and supported although this could be more robust. The provider had systems in place to monitor the quality and safety of the service and again we found that this could be more robust.
Appropriate measures were not in place to ensure the premises are adequately maintained and fit for purpose and ensure the d'cor of the building is refreshed.
Some people spoke with us generally about what they liked about living at Newlands. They told us about the things they liked to do such as going into town shopping and their plans for Christmas.
One person told us that the they thought 'the manager is really good'.