Newton House

Updated 28 June 2022

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 Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

Two Inspectors carried out the inspection.

Service and service type

Newton house 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 registered with the Care Quality Commission. This means that 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

This inspection was unannounced.

What we did before inspection

Prior to the inspection we looked at all the information we had collected about the service including previous inspection reports and notifications the registered manager had sent us. A notification is information about important events which the service is required to tell us about by law. The provider had completed 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. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We observed the people who use the service and staff interactions and support. People who use the service who were unable to talk with us used different ways of communicating including using Makaton, pictures, photos, symbols, objects and their body language.

We spoke with the registered manager and received feedback from five staff. We reviewed a range of records. This included four people’s care records and all people’s medication records. We looked at four staff files in relation to recruitment. A variety of records relating to the management of the service, quality assurance, maintenance and incidents/accidents, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found such as staff information, further training data, premises and quality assurance records. We spoke with five relatives of the people who use the service.

Updated 28 June 2022

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Newton House is a residential care home providing personal care and support for up to seven people with a learning disability, some of whom also have needs associated with autism. Twenty-four hour support is provided by a team of staff. At the time of inspection six people were living in the service.

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

Right Support

• The registered person did not use safe recruitment procedures to ensure people were supported by staff who were of good character, suitable for their role and had appropriate experience.

• We have made a recommendation about the management of some medicines.

• We have made a recommendation that ongoing staff training be updated in line with the latest best practice guidelines for social care staff.

• The registered manager and the staff team supported people to have the maximum possible choice, control and independence, and they had control over their own lives.

• Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life.

• People were supported by staff to pursue their interests and achieve their aspirations and goals.

• The service gave people care and support in a safe, clean, well equipped, well-furnished and well-maintained environment that met their sensory and physical needs.

• People had a choice about their living environment and were able to personalise their rooms.

• Staff supported people to take part in activities and pursue their interests in their local area.

• Staff enabled people to access specialist health and social care support in the community.

• Staff supported people to make decisions following best practice in decision-making. Staff communicated with people in ways that met their needs.

• Staff supported people to play an active role in maintaining their own health and wellbeing.

Right Care

• Staff promoted equality and diversity in their support for people. They understood people’s diverse needs and provided appropriate care.

• People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs.

• Staff and people cooperated to assess risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks.

• Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

• The service had enough appropriately skilled staff to meet people’s needs and keep them safe.

• People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs.

• We observed people had individual ways of communicating, using body language, sounds, Makaton (a form of sign language), pictures and symbols. They could interact comfortably with staff and the registered manager in their care and support because staff had the necessary skills to understand them.

• People’s care and support plans reflected their range of needs and this promoted their wellbeing and enjoyment of life.

• People could take part in activities and pursue interests that were tailored to them. The service gave people opportunities to try new activities that enhanced and enriched their lives.

Right culture

• The registered person did not always follow their quality assurance policy effectively so they could assess, monitor and mitigate any risks relating the health, safety and welfare of people using services, the service and others.

• People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff.

• People received good quality care, support and treatment because competent and caring staff and the registered manager could meet their needs and wishes. Staff knew and understood people well and were responsive.

• People were supported by staff who understood best practice in relation to the wide range of strengths, impairments or sensitivities people with a learning disability and/or autistic people may have. This meant people received compassionate and empowering care that was tailored to their needs.

• The registered manager and staff placed people’s wishes, needs and rights at the heart of everything they did.

• People and those important to them were involved in planning their care. Relatives felt included and well informed about their family member. They felt the service provided great support and care to people.

• The service sought views from people and those important to them, and other professionals about the quality of the service. Staff valued and acted upon people’s views.

• The registered manager and staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and positive culture in the service.

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

Rating at last inspection and update

The last rating for the service under the previous provider was good, published on 15 February 2019.

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.

Why we inspected

We undertook this inspection to assess that the service is applying the principles of Right support right care right culture.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to recruitment 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.