Newlands

up to 26 people with physical disabilities. The home was divided into three separate 'households', each with

their own lounges, dining and small kitchen areas. The home had several communal spaces which people could enjoy. There were 25 people living there when we visited including one person who was staying on a short respite visit.

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

People felt safe around staff who knew how to support people safely. Staff understood the importance of raising concerns and understood the process for doing so. People’s risks were reviewed and documented for staff to refer to. Staff understood the risks to people’s health and how to minimise risks to their health. People received support with their medicines. Any learning from people’s care was shared with staff to improve people’s experience of care.

People’s care was assessed and planned in line with best practice and staff received training to support people’s individual health and support needs. 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 liked and enjoyed their food and received support where appropriate. People saw additional health professionals and received help to attend appointments.

People liked the care staff supporting them who understood their needs. Staff understood the importance of valuing individual needs and how to care for people with dignity and respect.

Peoples were involved in planning and reviewing their care to meet their needs and preferences. People were encouraged to pursue interests and hobbies. People understood they could complain if needed. Staff understood how to support people with End of Life care.

People and staff liked and felt supported by the registered manager. Systems were in place to review and monitor people’s experience of care and ensure practices were safe and centred around people’s changing needs. The registered manager was supported by a management team that knew people at the home and worked together to develop people’s care so that they overcame barriers. The registered manager worked with a number of stakeholders to improve people’s care.

Rating at last inspection.

The last rating for this service was Outstanding [the report was published 06 October 2016].

Why we inspected

This was a planned inspection based on the previous rating.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our reinspection programme. If any concerning information is received, we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Newlands provides accommodation for people in a residential setting and is registered to provide care for up to 26 people with physical disabilities. The home was divided into three separate ‘households’, each with their own lounges and dining areas. The home had several communal spaces which people could enjoy. There were 22 people living there when we visited.

A requirement of the provider’s registration is that they have a registered manager. 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 and associated Regulations about how the service is run. There was an experienced registered manager in post at the time of our inspection who had been at the service for several years. We refer to the registered manager as the manager in the body of this report.

The service had a strong, visible person centred culture and was exceptional at helping people to express their views. Staff developed inventive communication techniques to include people in making their own decisions. People always planned their own care, with the support of their relatives, advocates and staff. This ensured care matched their individual needs, abilities and preferences, from their personal perspective. This philosophy and the provider’s vision and values were understood and shared across the staff team.

People enjoyed living at Newlands and they considered it their home. People valued their relationships with staff and felt they went the ’extra mile’. Staff encouraged people to maintain their independence, and had an in depth understanding of people’s diversity and cultural needs.

People were supported to maintain their purpose and pleasure in life. Activities, hobbies and interests were based around each person's interests, people were engaged in innovative ways in activities that stimulated and interested them. Events and activities were organised both inside and outside the home and included events in the local community. Staff offered people ways to maintain and develop their independence and increase their life skills.

The provider was innovative and creative and strived to improve the quality of people’s lives by working in partnership with experts. Planned improvements were focused on improving people’s quality of life and independence.

People were actively encouraged to maintain and form links with friends and relations. Care staff treated people with respect and dignity, and supported people to maintain their privacy. Staff were caring and involved people in developing their environment to meet their life and support needs.

Excellent quality assurance procedures were in place across the provider’s group of homes to exploit learning opportunities wherever possible. Information was shared across each of the provider’s homes to ensure lessons learnt drove forward improvements. All the staff were involved in monitoring the quality of the service, which included regular checks of people’s care plans, medicines administration and staff’s practice. Accidents, incidents, falls and complaints were investigated and actions taken to minimise the risks of a re-occurrence. There was a culture within the home to learn from feedback, audits, and incidents to continuously improve the service provided.

The manager and staff understood their responsibilities under the Mental Capacity Act (MCA) and the Deprivation of Liberty Safeguards (DoLS) to ensure people were looked after in a way that did not inappropriately restrict their freedom. The manager had made applications to the local authority where people’s freedom was restricted, in accordance with DoLS and the MCA.

Staff received training in safeguarding adults and understood the correct procedure to follow if they had concerns. All necessary checks had been completed before new staff and volunteer staff started work at the home to make sure, as far as possible, they were safe to work with the people who lived there. The manager and staff identified risks to people who used the service and took action to manage identified risks and keep people safe.

There were enough staff employed at the service to care for people safely and effectively. People were supported by a staff team that knew them well. New staff completed an induction programme when they started work to ensure they had the skills they needed to support people effectively. Staff received training and had their practice observed to ensure they had the necessary skills to support people. Staff had regular meetings with their manager in which their performance and development was discussed and development plans were agreed.

People were supported with their health needs and had access to a range of healthcare professionals where a need had been identified. Health professionals provided positive feedback about their relationships with the management and staff, which demonstrated people received effective healthcare. There were systems in place to ensure medicines were administered safely. People were encouraged to eat a balanced diet that took account of their preferences and, where necessary, their nutritional needs were monitored.

People who used the service and their relatives, were encouraged to share their views about how the service was run. People knew how to make a complaint if they needed to and the complaints received at the home were fully investigated and analysed so that the provider could learn from them. The provider used the information from complaints and feedback to improve their service by acting on the information they received.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

We found people's needs were assessed and care and support was planned and delivered in line with their individual care plans. We saw risks associated with people's care had been assessed so these could be appropriately managed to keep people safe.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. The provider had worked with the appropriate authorities to assess whether any applications were necessary. No applications had been made by the provider.

We found some records were not well organised to enable information to be easily located. A commitment was given by the service to address this.

Is the service effective?

We saw people being cared for and supported in accordance with their plans. Staff we spoke with had a good understanding of people's needs and how they wished their care and support to be delivered. We saw people's independence was being supported where possible.

People we spoke with told us their needs were met and they would recommend the home to others. They told us, 'I do not have one complaint, everyone is very happy here.' 'I go out nearly everywhere.' 'Everything is on the ground floor, the doors are electronic, if you go out you write you name in the book and time and take your phone with you.'

Staff received training on an ongoing basis so they could meet people's needs safely and effectively.

Is the service caring?

People and relatives were positive in their comments of the staff. One relative told us staff were, 'Kind, respectful and polite.' A person told us, 'The care is top quality as far as I am concerned.'

We saw staff talking with people in a kind and considerate manner. We saw staff took the time to make sure people were engaged in activities of their choice.

Is the service responsive?

We saw people's needs were regularly reviewed to make sure the support being provided was sufficient and appropriate.

People had access to a range of activities that were linked to their interests and wishes.

Care records identified likes and dislikes to make sure people received care and support in accordance with their wishes.

We saw people were given opportunities to be involved in regular meetings where they discussed the care and services provided at the home.

We found the provider had planned and implemented changes to the service to improve the service as a result of quality monitoring.

Is the service well-led?

The provider carried out quality checks on a regular basis to make sure staff were working to the required policies and procedures.

People who used the service, relatives and care staff told us they found the manager of the home approachable and always listened to their views.

We saw complaints received were appropriately investigated and responded to.

We saw people were given opportunities to be involved meetings where they discussed issues relating to the home.

Some people were not able to tell us about their experiences so we spent time observing care to find out about their experiences.

People told us that they liked their home, making comments such as, "I get the care that I need" and "I love it to bits here, the care is first class."

Visitors to the home we spoke with told us that they were satisfied with the care received by their family members and friends. One visitor said, " "He couldn't be cared for better anywhere else"

We observed that people appeared comfortable and relaxed in their surroundings and chatted easily with the staff member on duty. Where people were not able to vocalise we saw that they responded to staff with smiles or thumbs up signs. We saw that staff treated people with dignity and respect, and demonstrated kindness and compassion.

People had assessments and care plans in place that provided staff with the information they needed to be able to care for and support people in line with their individual needs.

We saw that there was a variety of specialist equipment available which was well maintained and fit for purpose.

We saw that people's records were maintained in good order and stored in a way that maintained confidentiality and ensured that they were secure.

People using the service told us staff were kind and they felt well cared for. One person told us, "I like it here. I can look after myself but if I need help staff will support me." Another person told us, "I am very happy with the staff and everything here."

People using the service told us activities were provided for them and we noted that support for people to continue with their specific interests such as art and gardening was provided.

We found that staff understood the needs of people using the service and we observed positive interactions between the people using the service and staff members.

We asked relatives about the care provided to their family and they each told us that the care delivered to people was good. They told us, "I am very happy with Newlands" and "Staff are really good and very friendly." Relatives told us they were consulted with regularly and provided with a feedback questionnaire on annual basis.

The registered manager had undertaken a review of the care planning process and was in the process of implementing an improved system when we visited. We took this into account when looking at care plans and were satisfied that people's needs were being met appropriately.