Archived: Newlands

Updated 22 January 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by one inspector.

Service and service type

Newlands is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager who was registered with the Care Quality Commission. This means they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

The inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority, professionals who work with the service and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We spoke with nine people and two relatives about their experience of the care provided. We spoke with five members of staff. This included the registered manager, deputy manager, team leader and care staff.

We reviewed a range of records. This included five people’s care records and medication records. We looked at staff files in relation to training, recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek updates from the provider to mitigate the concerns found in respect of excessively high water temperatures.

Updated 22 January 2020

About the service

Newlands is registered to provide accommodation and personal care for people who have a learning disability and who need support with their personal care. Newlands is situated on the outskirts of Canterbury, accommodation is provided over two levels. Communal areas include a lounge and dining room, with access to gardens. Each person had their own personalised bedroom.

Newlands had not been designed in line with the values that underpin the Registering the Right Support and other best practice guidance. Newlands was designed, built and registered before the guidance was published. The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 21 people and 19 people were using the service. This is larger than current best practice guidance.

However, as to the size of the service having a negative impact on people, this was mitigated by the building design fitting into the residential area and the other domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, visible industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

While the design of the service did not meet current guidance, the service had however applied the principles and values of Registering the Right Support and other best practice guidance. These ensured that people who used the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people using the service reflected these principles and values by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible to gain new skills and become more independent.

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

People were happy living at the service, they appeared relaxed and comfortable with staff and each other. However, we found management checks were not consistent to ensure the environment was always safe. This was because checks had not taken place to ensure water temperatures were limited to prevent risks of scalding; the storage temperatures of some medicines were not monitored and some statutory notifications were not sent to us when they should have been. Audits and quality assurance processes had not identified or acted on these issues as was their intended purpose.

Otherwise, medicines were stored and managed safely. There were policies and procedures in place for safe administration of medicines. People received their medicines when they needed them from staff who had been trained and competency checked.

Staff monitored people’s health and referred them to healthcare professionals when required. Feedback from healthcare professionals praised the vigilance of staff and credited their actions with two people receiving lifesaving treatment. Family and friends placed great confidence in the staff and the service, they were without exception complimentary and supportive of the home.

Risks associated with people’s care had been identified and full risk assessments were in place. People were protected from abuse and staff had received regular safeguarding training.

Care plans were up to date and contained the level of detail needed. People’s care was based on their needs and preferences. People were supported to do things they enjoyed. People were independent and chose how to spend their time.

Staff followed guidance to keep people as healthy as possible. People were supported to eat a balanced diet. An appropriate complaints system was in place.

Staff were knowledgeable about the Mental Capacity Act 2005. They knew to seek consent for care and knew the process to help those who lacked capacity to make decisions. People’s needs were met by the adaptation and design of the service.

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.

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 Outstanding (published 29 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

At this inspection, we have identified breaches in regulations about the governance of the service and the requirement to inform us of some statutory matters.

You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and 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.