Newstone House provides accommodation and nursing and personal care for up to 59 older people, including people living with dementia. There were 53 people living there when we visited.

At the last inspection in January 2015 a breach of legal requirements was found. Some people required restrictions on their liberty to keep them safe. We saw the correct processes were not always carried out which meant people’s legal and human rights were not being upheld. Following that inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach. At our focused inspection on the 11 August 2015, we found that the provider had followed their plan and legal requirements had been met.

There was a registered manager in post, who has worked in this role since January 2017. 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.

Staff had a good rapport with the people they supported. People appeared comfortable with staff and able to ask for their support. Staff demonstrated they knew people well. They were able to tell us about the people they supported including their history, family, likes and dislikes. This demonstrated staff knew people well and listened to their preferences.

Safe systems were in place to protect people from the risks associated with medicines. Medicines were managed in accordance with best practice. Medicines were stored, administered and recorded safely. People were supported to access external health professionals, when required, to maintain their health and wellbeing.

People’s risk had been assessed and measures were in place to minimise the risk to the person.

Staff and records confirmed that all staff received training in how to recognise and report abuse. Staff spoken with had a clear understanding of how they kept people safe. They were confident any concerns reported would be fully investigated and action would be taken to make sure people were safe.

People were offered a varied choice of meals including soft textured food. Staff were clear about who required support to eat and when. We observed the midday meal being served on the ground floor and upper floor. Although people had a positive experience on the ground floor, people on the upper floor, did not have the same experiences. Improvement were in place to ensure people had positive experiences regardless of where they ate.

People were supported by sufficient numbers of staff who had a clear knowledge and understanding of their personal needs, likes and dislikes. Care plans were personalised to each individual and contained information to assist staff to provide care in a manner that respected their needs and individual wishes. People living at Newstone House told us they were happy with the care and support provided.

People were supported by staff who had undergone an induction programme which gave them the basic skills to care for people safely. In addition to completing induction training new staff had opportunities to shadow more experienced staff. This enabled them to get to know people and how they liked to be cared for. People told us they felt safe at the home, One person said, “I feel very safe, the staff are always on hand if I need them.”

Most people who lived at the home were able to make decisions about what care or treatment they received. Where people lacked capacity to make some decisions, the staff were clear about their responsibilities to follow the principles of the Mental Capacity Act (MCA) when making decisions for people in their best interests.

The service remained responsive to people’s individual needs. Care and support was personalised to each person which ensured they were able to make c

We carried out an unannounced comprehensive inspection of this service on 19 and 20 January 2015, at which a breach of legal requirements was found.

Some people required restrictions on their liberty to keep them safe. We saw the correct processes were not always carried out which meant people’s legal and human rights were not being upheld.

After the inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach. We undertook a focused inspection on the 11 August 2015 to check that they had completed the actions.

This report only covers our findings in relation to this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Newstone House’ on our website at www.cqc.org.uk.’ We will review ratings at our next comprehensive inspection.

Newstone House provides accommodation and nursing care for up to 59 older adults including people living with dementia. There were 59 people living in the home when we inspected.

The home’s registered manager has worked in this role since February 2013. 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.

At our focused inspection on the 11 August 2015, we found that the provider had followed their plan which they had told us would be completed by the May 2015 and legal requirements had been met.

People had their legal and human rights upheld. Staff had made applications to the appropriate supervisory authority for people whose liberty was being restricted, in order for them to receive the appropriate care and treatment. There was a record of all applications, dates of assessment, the outcome and a review date. Pre admission and admission paper work had been updated to include a checklist, to prompt staff to assess the persons capacity and if they needed any restrictions.

This inspection took place on 19 and 20 January 2015 and was unannounced. Newstone House provides accommodation and nursing and personal care for up to 59 older people, including people living with dementia. There were 53 people living there when we visited. There was 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 and associated Regulations about how the service is run.

The registered manager and the head of care had knowledge of the Deprivation of Liberty Safeguards (DoLS). Staff understood DoLS and had made applications to apply it in practice for some people. Deprivation of liberty safeguard is where a person can be deprived of their liberties where it is deemed to be in their best interests or their own safety. The registered manager had not made applications for other people whose liberty was being deprived in their best interest. They told us they were in the process of doing this.

Some people who used the service did not have the ability to make decisions about some parts of their care and support. Staff had an understanding of the systems in place to protect people who could not make decisions. They followed guidance from senior staff to ensure the legal requirements outlined in the Mental Capacity Act 2005 were met.

Staff received training to carry out their roles. Staff understood their roles and responsibilities, as well as the values of the home. Staff had support, induction and supervision (one to one meetings with line managers). All staff spoke positively about the support they received from the registered manager and other senior staff. Some staff had not received refresher training to ensure they provided care in line with current guidance and good practice.The registered manager told us that appraisals had not taken place and they had identified they needed to be arranged with staff. Staff told us the registered manager and other senior staff were approachable and there was good communication within the home.

People and their relatives told us people felt safe living at Newstone House and were protected from abuse. Staff knew how to identify if people were at risk of abuse and knew what to do to ensure they were protected. People were safe living in the home because staff had identified risks and plans were in place to manage these.

People were cared for by staff who treated them with respect and knew how they liked to be cared for. Staff supported people well with their mobility and nutritional needs. People had access to health care to meet their needs and health professionals told us staff followed their recommendations. People received their medicines as they were prescribed and medicines were stored safely.

People and their relatives told us the registered manager and the staff team were approachable and they could talk to them if they had any concerns. We saw action was being taken to resolve people’s concerns and complaints to their satisfaction.

Recruitment checks had been completed before permanent staff worked unsupervised at the home. There were enough staff to meet people’s needs. The home had recently experienced regular occurrences of unplanned staff absences due to staff illness. There were systems in place to use bank staff who were familiar with the home and people’s needs and management arrangements to resolve short notice staff absences. Some staff raised concerns about when unplanned absences took place but they told us the staff team worked together to ensure people’s needs were met.

The registered manager and other senior staff monitored the quality of service people received. Action was taken when any changes required were identified to ensure people’s needs were met.

The registered manager told us the home was part of a dementia care pilot to implement good practice. This was confirmed by the dementia care lead responsible for this pilot. The registered manager also used good practice around end of life care and they reviewed the care people received and after they passed away to reflect if all of their needs had been met along with their wishes.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. This was in relation to ensuring people’s rights were upheld. You can see what action we told the provider to take at the back of the full version of this report.