This inspection took place on 9 October 2018. Newton Care Homes Limited is a care home registered to provide care and accommodation for up to four people with learning disabilities. The service is also registered to provide personal care to people living in supported living accommodation. At the time of our inspection, the care home provided accommodation, care and support for three adults with complex needs, including learning disabilities. People who lived in the supported living accommodation had varying needs, and required a range of support including personal care, prompting and monitoring. At the time of the inspection, eight people were receiving personal care in supported living accommodation.
This service also provides care and support to people living in a ‘supported living’ setting, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living. In respect of supported living, this inspection looked at people’s personal care and support. 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. The service worked towards the goal of enabling people with learning disabilities and autism to live as ordinary a life as any citizen.
We have combined the reporting on the services provided by the care home and in the supported living accommodation.
At our last inspection on 12 and 13 April 2016 the service was overall rated Good.
At this inspection we found the service remained Good.
We spoke with some people who received care and support from the service. However, some people were unable to provide us with verbal feedback due to their complex needs. We therefore spent time observing interactions. Following the inspection, we spoke with relatives of people and care professionals. People, their relatives and care professionals told us that they were satisfied with the care provided at the service. We observed that people were well cared for and appropriately dressed at the time of the inspection. People who used the service said that they felt safe in the home and supported living accommodation and around staff. Relatives of people who used the service and care professionals we spoke with told us they were confident that people were safe in the home.
Appropriate policies and procedures ensured people who used the service were safe from abuse and harm. People’s relatives told us people were safe living at the care home or in receipt of care from the care agency. Staff had received training in safeguarding adults and knew how to recognise and report any concerns or allegations of abuse.
People who used the service had various risk assessments and risk management plans, which ensured they were protected from harm in relation to their care. Individual risks faced by people were identified with plans in place to control the risks.
Accidents and incidents were documented and investigated and responded to appropriately.
We observed that there were sufficient numbers of staff to meet people’s individual care needs and staff confirmed this. Staff did not appear to be rushed and were able to complete their tasks and they confirmed this.
Systems were in place to make sure people received their medicines safely at the home and supported living accommodation. Arrangements were in place for the recording of medicines received, their storage, administration and disposal.
We found the premises we visited were clean and tidy and there were no unpleasant odours. There was a record of essential inspections and maintenance carried out. The service had an infection control policy and measures were in place for infection control.
Staff had been carefully recruited and provided with an induction and training to enable them to care effectively for people. Staff had access to a variety of training, which helped them to update and maintain the skills and knowledge in relation to providing care to people. Regular supervisions and appraisals were provided to review staff performance and set learning objectives for the future.
People’s health and social care needs had been appropriately assessed. Care plans were person-centred, detailed and specific to each person and their needs. Care preferences were documented and staff we spoke with were aware of people’s likes and dislikes.
Staff we spoke with had an understanding of the principles of the Mental Capacity Act (MCA 2005). Capacity to make specific decisions was recorded in people’s care plans.
The CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. DoLS ensure that an individual being deprived of their liberty is monitored and the reasons why they are being restricted is regularly reviewed to make sure it is still in the person’s best interests. The service had made necessary applications for DoLS and we saw evidence that authorisations had been granted.
Staff were kind, caring and respectful towards the people they supported. They had a clear understanding of people's individual needs, preferences and routines. Staff supported people to remain as independent as possible. There were policies and systems in place to support this practice.
People who used the service had choice of a nutritious and well balanced diet. The service ensured that people’s health was monitored and if required external health care support was sought to ensure people’s health and wellbeing were maintained.
People were offered a variety of activities and outings both in groups and as individuals. Each person had an individual activities programme which was devised based on their individual interests. Activities outside the service were available to all people and included attending the day centre, social club and nightclub. Within the service, people participated in reflexology, movie nights and arts and craft.
The service carried out a satisfaction survey in July 2018 and the feedback was positive. People and relatives told us that the registered manager was approachable and willing to listen.
There was a management structure in place with a team of care support staff, deputy manager and the registered manager. Staff told us that the morale within the service was good and that staff worked well with one another. Staff spoke positively about working at the service. They told us management were approachable and the service had an open and transparent culture. They said that they did not hesitate about bringing any concerns to the registered manager.
There was a comprehensive quality assurance policy which provided detailed information on the systems in place for the service to obtain feedback about the care provided at the home. The service undertook a range of checks and audits of the quality of the service and took action to improve the service as a result. The service also carried out spot checks and observations to ensure that the service was running well.