Archived: Newstone House

We found the following examples of good practice.

Measures were in place to prevent the spread of infection by visitors to the service. The provider shared with us a new visitors protocol policy which was being implemented in line with the current government guidance.

Staff had received infection control training and followed up to date infection prevention and control guidance to help people stay safe. Staff used personal protective equipment (PPE) correctly and in accordance with current guidance to minimise cross infection risks to people.

There were sufficient stocks available including masks, gloves, aprons and hand sanitiser. The provider had issued staff with polo shirts which were laundered at the home. Staff were required to change into their uniforms when they arrived on duty and keep their footwear at the home to minimise the risk of cross infection. Staff breaks had been staggered to allow for social distancing to be maintained in the staff room.

Staff and people were regularly tested in line with the government's current testing programme. They supported people with social distancing and frequent handwashing to protect against Covid 19.

The home was clean and well maintained. Staff cleaned frequent touch points such as door handles and light switches every two hours. Activities equipment was cleaned after each activity.

To assure people and relatives about the measures they have in place to ensure good IPC practice at the home, the providers had produced videos which were available on their website. This included staff singing a covid-19 song reminding people about social distancing and good hand hygiene.

Infection prevention and control audits took place and spot checks were carried out. Every four weeks staff had their hand washing competency assessed, by using a light box to see how effective they had been in cleaning their hands. Staff had the opportunity to discuss IPC at every supervision and this enabled them to clarify queries and make suggestions. This ensured the registered manager and management team had effective oversight of infection control measures.

The provider had contingency plans in place in the event of any outbreak of Covid-19 or other emergency.

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

People told us they were very happy living at the home and received excellent care. People received well planned, co-ordinated person-centred care that was appropriate and inclusive for them. Relatives were universal in the praise for the quality of care and for the staff team.

People and those close to them were at the heart of the service. The management team, staff and provider were committed to providing high-quality, person- centred care. Staff were passionate about their roles and they care they provided.

People said they were safe. Staff received training and knew how to identify abuse and protect people from harm.

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 treated with kindness, patience and compassion; people were respected and treated as equals. There was a very wide range of activities, entertainment, events and trips which people said they chose and thoroughly enjoyed. End of life care was excellent.

There was a very homely, relaxed atmosphere. The environment was stimulating, varied and maintained to a very high standard. People's interest's and hobbies were incorporated into the design of the home and gardens in innovative ways.

Staff recruitment was safe, and staff were recruited in a way to ensure they shared the values of the service. Staffing levels were very high, so people's needs were quickly attended to. Staff were very proud to work at the home; they received excellent training and support.

The service was exceptionally well-led. Excellent initiatives and links with the community, external bodies and organisations had contributed to continual developments and improvements for people living at the home. There was a comprehensive governance structure in place to drive continuous improvement.

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 Good (Report published 15 September 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.

At the last inspection in January 2015 a breach of legal requirements was found. Some people required restrictions on their liberty to keep them safe. We saw the correct processes were not always carried out which meant people’s legal and human rights were not being upheld. Following that inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach. At our focused inspection on the 11 August 2015, we found that the provider had followed their plan and legal requirements had been met.

There was a registered manager in post, who has worked in this role since January 2017. 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.

Staff had a good rapport with the people they supported. People appeared comfortable with staff and able to ask for their support. Staff demonstrated they knew people well. They were able to tell us about the people they supported including their history, family, likes and dislikes. This demonstrated staff knew people well and listened to their preferences.

Safe systems were in place to protect people from the risks associated with medicines. Medicines were managed in accordance with best practice. Medicines were stored, administered and recorded safely. People were supported to access external health professionals, when required, to maintain their health and wellbeing.

People’s risk had been assessed and measures were in place to minimise the risk to the person.

Staff and records confirmed that all staff received training in how to recognise and report abuse. Staff spoken with had a clear understanding of how they kept people safe. They were confident any concerns reported would be fully investigated and action would be taken to make sure people were safe.

People were offered a varied choice of meals including soft textured food. Staff were clear about who required support to eat and when. We observed the midday meal being served on the ground floor and upper floor. Although people had a positive experience on the ground floor, people on the upper floor, did not have the same experiences. Improvement were in place to ensure people had positive experiences regardless of where they ate.

People were supported by sufficient numbers of staff who had a clear knowledge and understanding of their personal needs, likes and dislikes. Care plans were personalised to each individual and contained information to assist staff to provide care in a manner that respected their needs and individual wishes. People living at Newstone House told us they were happy with the care and support provided.

People were supported by staff who had undergone an induction programme which gave them the basic skills to care for people safely. In addition to completing induction training new staff had opportunities to shadow more experienced staff. This enabled them to get to know people and how they liked to be cared for. People told us they felt safe at the home, One person said, “I feel very safe, the staff are always on hand if I need them.”

Most people who lived at the home were able to make decisions about what care or treatment they received. Where people lacked capacity to make some decisions, the staff were clear about their responsibilities to follow the principles of the Mental Capacity Act (MCA) when making decisions for people in their best interests.

The service remained responsive to people’s individual needs. Care and support was personalised to each person which ensured they were able to make choices about their day to day lives. There was a varied programme of activities.

The service had a complaints policy and procedure which was available for people and visitors to view. People said they were aware of the procedure and knew who they could talk with. People and staff said they felt confident they could raise concerns with the registered manager and they would be dealt with appropriately.

We spoke with five people who used the service and five people's relatives. All people spoken with told us they were happy with the care and support provided at Newstone House. One person commented 'the carers are very helpful in every way'. Another person said 'they treat you well here and you get what you need'. People's relatives spoken with commented 'I don't worry about her now, staff are great, so patient and take in feedback', 'excellent, this home is by far leaps ahead of everybody else' and 'I know they are looking after her, mum would say if not'.

People who lived in the home and their relatives felt that staff treated them with dignity and respect. Care was planned and assessed regularly to ensure people's needs were met.

Sometimes people were not able to make their own decisions about their care and treatment. The home did not always follow the correct legal procedures to ensure people's rights were protected.

We saw where people had made a complaint this was dealt with appropriately. The home recruited staff who had received a number of checks to ensure they were appropriate for the role.