CQC report explained · a residential care home
What the CQC found at Newlands Hall
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, March 2023
Requires Improvement; inspectors found kind care and safe staffing, but risks, medicines records and quality checks were not managed reliably.
This was an unannounced inspection on 15 December 2022. One inspector spoke with people, relatives, staff and a health professional. They reviewed care, medicines, staff and management records.
The home was rated Requires Improvement overall. Safe, Effective and Well-led were each rated Requires Improvement. Inspectors found gaps in risk monitoring, medicines administration and care records. Infection control was also not always followed, including a clinical waste bag left unattended.
People and relatives said they felt safe and well cared for. Staff were recruited safely, staffing levels were suitable, people enjoyed the food and activities, and people were supported with healthcare and consent. However, the same overall rating remained as at the previous inspection in 2019, and two legal breaches were identified.
Kind and respectful care
People and relatives said they felt safe and well cared for. Inspectors observed respectful and kind treatment.
“People and their relatives felt they were safe and well cared for by staff.” from the report
Risks and care records
seriousRecords did not always show that people received repositioning, personal care, oral care or other planned support. Some risk assessments lacked important information.
“This meant the service was not able to evidence care had been provided on each occasion or that an accurate record was maintained.” from the report
Medicines
seriousMedicines were not always administered as prescribed, particularly topical medicines. Records and instructions for some medicines were unclear or incomplete.
“Medicines were not always administered as prescribed and records did not always reflect the medicines received by people.” from the report
Learning from incidents
seriousAccidents and incidents were recorded, but the home did not review trends or analyse root causes to understand what had gone wrong.
“There was no evidence of analysis to get to the root cause of accidents to understand what had gone wrong.” from the report
Infection control
needs fixingInspectors saw a full clinical waste bag left unattended in a bathroom and used medicine pots left soaking in a wash basin.
“We observed a full clinical waste bag left unattended on the floor of a bathroom accessed by people and visitors to the home.” from the report
Food and drink monitoring
needs fixingRecords did not always show what people at risk of weight loss had eaten and drunk, or whether enough support was in place.
“Records of what people had to eat and drink including target amounts were not always completed.” from the report
Leadership and quality checks
needs fixingAudits and checks did not reliably identify problems. There was no registered manager in post at the time of the inspection.
“Although audits had been completed, they had not identified the shortfalls with the current systems around the management of risks.” from the report
- 01How do you now check and record repositioning, oral care, personal hygiene and other planned care?
- 02What changes have been made to ensure medicines, including creams and as-required medicines, are given and recorded correctly?
- 03How are food and drink records checked for people at risk of weight loss?
- 04How do you review accidents and incidents so that lessons are learned and risk assessments are updated?
- 05What progress has been made with the action plan, and who is now responsible for quality checks while there is no registered manager?
This was an unannounced inspection covering Safe, Effective and Well-led; Caring and Responsive were not inspected and the overall rating used ratings from the previous inspection for questions not covered. This explanation was written from the published report of 21 March 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, October 2019
Newlands Hall is rated Requires Improvement; inspectors found kind, responsive care but ongoing gaps in risk records, training and leadership.
This was an unannounced inspection carried out on 16, 23 and 27 September 2019. Inspectors spoke with people, relatives and staff, and reviewed care records, medicines records, staff files and management records.
The home had made important improvements since the last inspection. Recruitment was safe, medicines were mostly managed safely, people liked the food, and staff were described as caring. Care records, activities and support for people's choices had also improved.
Some problems remained. Risk guidance was not always detailed enough, some training and supervision was still outstanding, and the call bell system did not provide enough information about response times. The overall rating and the ratings for Safe, Effective and Well-led were Requires Improvement. Caring and Responsive were rated Good.
Kind staff
People and relatives spoke highly of staff. Inspectors saw friendly and relaxed relationships, with people treated respectfully.
“People told us they were happy living at the service and were respected by kind and caring staff.” from the report
Safer recruitment
The previous recruitment concerns had been addressed. Inspectors found that recruitment practices were safe.
“At this inspection we found recruitment practices were safe.” from the report
Improved care records
Care files were easier to read and better presented. They included people's preferences and how they wanted care to be given.
“Improvements had been made to care records, which were easier to read and included people's preferences and how they wanted care to be provided.” from the report
Food and drink support
People were offered choices and staff knew their dietary preferences and requirements. Records showed food and fluid intake was being monitored.
“People told us they liked the food and were offered choice of food options.” from the report
Risk guidance was incomplete
seriousSome recorded guidance did not give staff enough information to move people safely, including when using equipment and portable ramps. Personal emergency evacuation plans also needed improvement before being updated during the inspection.
“Some further improvements were required in the recorded guidance provided to staff to ensure people were moved safely.” from the report
Training and supervision gaps
needs fixingMost staff had completed essential training, but some care training had not been identified as essential. Supervision was not regular for all staff, and not all staff had received end of life training.
“There were still areas of care, staff required to be trained in, which the registered manager had not identified as essential” from the report
Call bell system
needs fixingStaff had to enter the kitchen to find out who was calling and how urgent the call was. The system could not produce a report showing how promptly staff responded.
“the system did not generate a report to assess the promptness of staff to respond.” from the report
Records and checks still needed work
minorSome care information was out of date, and some audits did not identify issues found by inspectors. Some checks to prevent bacteria in the water system had also not always been completed.
“Some information was out of date and we raised this with the registered manager, but on the whole they had demonstrated sufficient improvements had been made.” from the report
- 01What has been changed in the risk assessments and moving guidance, including the use of portable ramps and other equipment?
- 02Which staff still need training, including end of life training, and how is completion being checked?
- 03How are staff responses to call bells monitored while the current system is still in use?
- 04How often will staff receive supervision and appraisals, and how will the home check that this is happening?
- 05What refurbishment and infection-control work has been completed, and what remains outstanding?
This was an inspection of all five key questions and looked at both the care provided and the premises, following the previous Inadequate rating and Special Measures period. This explanation was written from the published report of 23 October 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Newlands Hall
6 rated inspections over 7 years: the service has held its Requires improvement rating throughout.
- March 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2019Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- March 2019Inadequatedown from Requires improvementSafe: Requires improvementEffective: InadequateCaring: GoodResponsive: Requires improvementWell-led: Inadequate
- March 2018Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2017Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Inadequate
- April 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- February 2015
Registered with the Care Quality Commission on 19 February 2015.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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