Newlands Hall

Updated 21 March 2023

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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was carried out by 1 inspector.

Service and service type

Newlands Hall is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Newlands Hall is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.

Prior to the inspection we reviewed all the information we had about the service including statutory notifications and other intelligence. We also contacted the local authority contracts department, safeguarding, infection control, the fire service, the Clinical Commissioning Group, and Healthwatch to assist us in planning the inspection. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all this information to plan our inspection.

During the inspection

We spoke with 5 people who used the service and 3 relatives about their experience of the care provided. We spoke with 4 members of staff including the, the manager and deputy manager. We spoke with 1 health professional who regularly visits the service. We reviewed a range of records. This included 3 people's care records and medication records. We looked at 3 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including training data, quality assurance records, policies and procedures were reviewed.

After the inspection

We sought clarification from the provider to validate evidence found.

Updated 21 March 2023

About the service

Newlands Hall is a residential care home providing nursing or personal care to up to 30 people, some of whom are living with dementia. The home has communal living areas on the ground floor and bedrooms are located on the ground and first floor. At the time of our inspection there were 22 people using the service.

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

Improvements were required in how the service assessed and managed risk to ensure risks were monitored or managed in relation to people's health and wellbeing. Staff were not consistently recording when they had met a person's care needs such as postural changes, oral care and personal hygiene needs. This meant the service was not able to evidence care had been provided on each occasion or that an accurate record was maintained.

Medicines were not always administered as prescribed and records did not always reflect the medicines received by people. People at risk of sore skin did not receive their topical medicines as prescribed.

Staff had been recruited safely and had received an induction into the service. Staff received training and supervision to ensure they were equipped for their roles. However, some induction training records had not been 'signed-off' by staff to verify that induction had been completed. Staff we spoke with were knowledgeable and were supported by the home manager.

People and their relatives felt they were safe and well cared for by staff. They told us their needs were met and they were able to make choices about their care. People were observed to be treated with respect and kindness.

Infection control processes were not always effective in minimising the risk of infection. We observed a clinical waste bag not properly disposed of and left unattended in a bathroom.

People had access to a balanced and healthy diet. People told us they enjoyed the meals provided by the home and they were offered choice of food options. Records were not always completed to show people at risk of poor nutrition were being supported to eat and drink.

People were encouraged to participate in different activities and spoke highly of the activities coordinator. Formal complaints were reviewed and responded to in line with company policy. People were supported to access healthcare professionals when required.

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.

The provider had updated their quality assurance monitoring procedures. Audits and checks were carried out; however, these were not always effective in identifying areas which needed to be improved. Further improvements were required to ensure these were robust and effective so that areas for improvement were identified and addressed.

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 22 October 2019). The service remains rated requires improvement.

Why we inspected

This inspection was prompted by a review of the information we held about this service. 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.

This report only covers our findings in relation to the Key questions Safe, Effective and Well-led. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Newlands Hall on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified 2 breaches in relation to safe care and treatment and good governance at this inspection. Please see the action we have told the provider to take at the end of this report

Follow up

We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.