Archived: Newton Lodge

The service is registered to provide accommodation and personal care for up to five adults. The service supports people with a learning or psychological difficulty and/or relatively low dependency physical or mental health needs. At the time of the inspection there was one person living at the home, who only required prompting and limited assistance from staff. Another person, with an autistic spectrum condition and limited speech, stayed at the home on a regular short break respite care basis. The service was considering down-sizing to a smaller family home and changing their Care Quality Commission registration to accommodate and support just two people to reflect the level of service they currently provided.

The service had 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.

There was a friendly family atmosphere in the home and everyone appeared to get on well together. Feedback received from a relative of a person who previously lived at the home stated “I feel it is a family atmosphere. No recommendations for improvements, just keep doing what you do”.

The interactions we observed between people and staff were caring and respectful. From what we saw and heard it was clear the registered manager and staff were supportive of the people who used the service and wanted the best for them. A person who used the service said “They are very caring. I try to maintain my independence as much as I can; but here, everyone treats me well and they help me through down periods” and “I do feel safe here. The staff are there when I need them”.

People were supported to see their friends and relatives, access the local community and participate in a range of social and leisure activities of their choice on a regular basis. People were encouraged to be as independent as possible and had choice and control over their daily routines. Staff respected and acted on the choices people made and sought input from relatives where people were unable to fully express their preferences. The service knew how to protect people’s rights if they lacked the mental capacity to make certain decisions about their care and welfare.

The service employed a small team of consistent staff who knew people’s individual needs and preferences well. There were sufficient numbers of staff to meet people’s needs and to keep them safe. Staff received training and supervision to ensure they had the necessary knowledge and skills to provide the care and support needed. The person who lived in the home said “I can’t fault them at all”.

People, relatives and staff said the registered manager was very accessible and supportive. They said they could speak with the registered manager whenever they needed and they always received the help or advice they required.

The provider had a quality assurance system based mainly on personal contacts between the registered manager, people and their relatives. This was effective in maintaining a good and safe standard of care for people who used this small care service.

Systems were in place to ensure people who needed medicines received them safely. Checks were carried out to ensure the correct medicines were administered in the right doses and at the right times.

• Is the service caring?

• Is the service responsive?

• Is the service safe?

• Is the service effective?

• Is the service well led?

This is a summary of what we found:

Is the service safe?

People who lived in the home said they felt safe and they were treated properly by the staff. One person said “I’m treated well by the staff. It’s more like a family environment than a care home”. Another person said “Nobody treats me badly. If I did have any problems I would talk to the manager. They always listen”.

People and staff told us they knew how to report any concerns. They said they would report any concerns to the manager in the first instance. However, if necessary they knew which external authorities they could go to.

The service identified, assessed and managed risks to the health, safety and welfare of people. People’s care plans contained individual risk assessments and plans to minimise these risks. We saw recruitment processes helped to reduce the potential risk of abuse for people in the home. Staff carried out regular in-house checks of the environment, fire safety systems and other risk areas. Specialist contractors were employed to check and maintain essential safety protection systems and other equipment.

Arrangements were in place to deal with foreseeable emergencies. We saw records of regular fire drills and an emergency evacuation plan. Staff said they received first aid training and would not hesitate to call the emergency services or the local GP practice as and when needed.

The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. The manager said they had not needed to submit any Deprivation of Liberty Safeguards applications but they knew about the procedures to follow if an application was ever needed.

Is the service effective?

People were supported to live their lives in a way that suited their personal needs and preferences. This helped promote effective care outcomes and a good quality of life for the people who lived in the home. People told us they were happy with the care and support they received. One person said “I’m very happy here. I’ve settled down well”. Another person said “I haven’t really got any complaints and I get on fine with all the staff”.

Care plans and discussions with people who lived in the home showed people’s care needs had been assessed and appropriate support was provided. Staff we spoke with had a clear understanding of each person’s individual support needs and how they should be met. There were enough qualified, skilled and experienced staff to meet people’s needs. People also had access to more specialist staff when needed.

To help promote people’s independent living skills a separate kitchenette was available in the home for people who were able to prepare their own meals and drinks when they wished. Staff prepared at least one cooked meal for everyone during the day and provided all the meals for people who were less independent.

People were supported in promoting their independence and community involvement. People told us they engaged in the local community in a variety of ways. They went to college, did voluntary work and went out on their own. Staff also took people out on regular trips.

Is the service caring?

We observed staff treated each individual with dignity and respect. They spoke to people in a friendly and caring manner and addressed people by their preferred names.

Staff respected people’s privacy and did not enter people’s rooms without knocking and asking their permission to enter. Each person had their own individual bedroom with an en-suite bathroom which helped to maintain their privacy and dignity. People were given space to spend time on their own but staff were on hand whenever needed.

Staff supported people to make their own daily living choices and to be as independent as they were able to be. This helped promote people’s self-esteem and gave them a sense of achievement.

We observed people’s rooms contained individualised furnishings and personal belongings. This helped people feel more at home and ensured their rooms were individualised to suit each person’s tastes.

Is the service responsive?

The service was responsive to people’s needs. People's needs were assessed and their care was planned and delivered in line with their individual needs and personal preferences. Staff had a clear understanding of each person’s support needs and how they should be met. For example, the service had responded well to an incident where a person who lived in the home had displayed aggressive behaviours. The person’s behavioural support plan was updated to ensure staff knew how to defuse such incidents in the future.

People told us they were involved in making decisions about all aspects of their care. One person said “I can pretty much do as I want”. People were consulted about menu choices and were free to have their own alternative meal if they wished. One person said “I mostly like what they have on the menu but if not I can choose something else”.

People could choose where and how to spend their time. They were free to move around the home and the grounds as they wished. They could choose to spend time on their own in their rooms or chat with each other or the staff in the various communal areas.

The manager organised quarterly meetings for people to have their say about the service. They also had regular conversations with each individual and their close family members about the person’s choices and preferences. This helped ensure the care and support provided remained appropriate to the individual’s needs.

Is the service well led?

The home was run as a family concern by two people who were registered with the Care Quality Commission as the nominated individual and registered manager for the service. Both lived on the premises and participated in the care staff rotas.

The manager said as a small care home they monitored the quality of service mainly through personal contact with people and their families. People said they could talk to the manager or staff if they had any problems and they would always try to resolve them. We observed the manager had a good rapport with each of the people living in the home.

There was a clear staffing structure in place with clear lines of reporting and accountability. A member of staff said there was a stable small team of care staff who all worked well together. They were able to report any issues directly to the manager and were confident appropriate action would be taken.

People told us they were happy with the care they were receiving. One person said “This is a lovely home. I’m happy and want to live here permanently”. People said they were encouraged to be as independent as they were able.

Care plans showed health and social care professionals were involved in the planning and delivery of people’s care. This helped ensure people’s safety and welfare.

We checked supplies of medication and found all were stored appropriately and were within the use by dates stated on the labels. Staff who administered medication had received training in safe handling of medicines.

The recruitment records showed appropriate checks were made before staff started work. This helped protect people from the potential risk of abuse. Staff completed a comprehensive induction programme which gave them the skills and training required to meet the needs of the people they supported.

People who lived in the home said they would speak with staff if they were not happy with any aspect of their care. One formal complaint had been made in the last 12 months. We saw this had been fully investigated and resolved to the complainant’s satisfaction.

People told us that they were free to decide on daily living activities such as when to get up or go to bed. We observed that staff treated people in a dignified and respectful way. They spoke to people appropriately and addressed people by the name they wanted to be called.

People were supported in promoting their independence and community involvement. This included participating in outside activities such as shopping, attending clubs and trips to local amenities.

People looked well cared for which indicated that their personal care needs such as washing and dressing were being met. People told us that they were treated properly by the staff. People said “The staff are all alright” and “none of them treat me badly”.

We observed that staff were experienced and competent in supporting people who lived in the home. This included helping people who had mobility difficulties and communicating with people who had limited verbal communication skills. One person said that staff were “Very helpful and look after me”.

People’s personal records including medical records were accurate and fit for purpose. Records were kept securely and could be located promptly when needed.