Newline Care Home

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

This key question has been rated good. We reviewed 5 quality statements for this key question. Staff worked together and reported they had a good working relationship with external professionals. Care plans were not completed or reviewed in a timely manner, this is a breach of the legal regulations.

This service scored 67 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and relatives told us care plans were not reviewed. A relative told us, "We have not been involved in a review of their care since admission over a year ago." However, since the assessment the provider has demonstrated they are involving relatives in reviews of care.

Staff and leaders were able to explain the robust pre-assessment process in place for assessing people’s needs, and staff showed their knowledge of people and their needs . However, on reviewing pre assessments completed for new admissions, the documentation was not always completed robustly.

Care plans were not in place or not reviewed in a timely way. When we visited in February 2024 care plans were not in place for people who had been newly admitted into the service. Care plans for people who had lived at the service for some time had not been fully completed and we found this remained at our next visit in August 2024. The providers quality assurance measures had not identified these omissions, putting people at an increased risk of experiencing poor or unsafe care. We did not find evidence people were harmed but this was a continued breach of regulation 12 (safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014.

People told us they enjoyed the food and received enough food and drink. One person told us, “I had a nice breakfast this morning.”

People at risk of choking, did not have a risk assessment in place. Where risks were known, staff did not always act to minimise the risk of harm to people. The manager told us people's needs and preferences were fully discussed to formulate care plans, however, we found examples where staff had documented a choking risk and asphyxiation risk but no action had been taken to review this and there was no risk assessments in place.

The processes in place to oversee the risk of harm to people through eating and drinking were insufficient. Quality assurance measures did not ensure people were always provided with suitable or appropriate meal choices in line with their specific needs. Food choices for some people increased the risk of choking. We found 2 choking incidents which were not appropriately assessed, this continued to put people at risk of further incidents of choking. Where serious incidents related to choking had occurred, risk assessments were subsequently put in place.

People and relatives said they thought the provider worked well with other agencies to provide good support and care. People told us they had visits by their GP. Relatives said they were happy with the visits by other professionals but also felt confident the provider would request support from the GP if needed.

Staff and leaders were confident in explaining the process for involving other health professionals in the contributing to the care provided to people. The service was part of the Telemedicine initiative. This meant staff and people were able to access remote video consultations with health professionals using a lap top in the service. A visiting professional told us staff were timely in seeking advice and communication was excellent.

Feedback from partners was positive. No concerns or negative comments were raised by partners during a recent monitoring visit at Newline Care Home.

We saw evidence of effective partnership working with other health professionals regularly in people's daily notes. Pre assessment documentation also showed good working relationships were forged with outside agencies prior to, during and after referrals.

We saw people were provided with opportunities to access external professionals to support with their lifestyles and health, such as dieticians and diabetic services. Feedback was positive in relation to staff support.

Staff told us how they worked well together and with other professionals to promote healthier lifestyles for people, inclusive of specific activities conducted in the home.

The service had effective systems in place to refer people to the relevant external service where required to improve people’s health. For example, we saw good detail in people’s daily notes for the involvement of dietitians, GP's, chiropodists and dentist. Staff provided activities to people which stimulated their mind and body.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

People and relatives said they were routinely offered choice and control. People told us even when they were unable to make choices the staff would still talk through options of meals, personal cares etc. One person told us, "I choose what I want to eat, I can decline showers when offered, but I also feel comfortable asking for a shower when I want one."

Staff told us they asked for consent before providing care and were detailed in being able to explain how they involved people who required additional support with decision making. The manager provided detail on how consent was captured on admission and senior staff were able to explain how they would follow the requirements of the mental capacity act. However, we found concerns in how this information was being captured and documented.

The provider had systems and processes in place to capture consent to care. This was not readily available on the providers online personal care records system; however, hard copies were available. We saw consent was readily obtained by staff prior to commencing care activities. However, we had identified shortfalls in the recording of consents where restrictions were in use.