This comprehensive inspection took place on 31 January and the 1 February 2019.

Newton Hall is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided and we reviewed both areas during this inspection. The service is a registered care home providing accommodation and personal care for up to 34 older people. The home is a detached property on the outskirts of Frodsham in Cheshire. Bedrooms are located on the ground and first floor. Many of the rooms on the first floor are for people who have been diagnosed with dementia. At the time of our visit, 21 people were living there.

At our last inspection in February 2016 we rated the service as good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection or ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service did not 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 2008 and associated Regulations about how the service is run. A person had applied to become the registered manager and the registration process was being undertaken at the time of this visit.

Medication management was safe although we have raised two recommendations in relation to the storage of medicines in a refrigerator and records relating to disposal.

People told us that they felt safe with the staff team and trusted them. They told us that there was always enough staff to respond to their needs and for those taking medicines; always received them when required. The registered provider had appropriate systems in place for the reporting of abuse.

There were sufficient staff to meet the needs of people. People told us that there were always staff around to assist. Staff recruitment was safe.

The premises were clean and hygienic. The building was well maintained and well decorated.

Assessments were in place to ensure that people were not at risk from malnutrition, pressure ulcers or falls.

Staff received the training and supervision they required to perform their role. Staff new to the service received a structured induction.

The nutritional needs of people were met. People were given choices at mealtimes and staff were attentive to the wishes of people at these times.

The registered provider was working within the principles of the Mental Capacity Act 2015. Staff were aware of the principles and had received training in this.

The health needs of people were promoted. People were supported in a respectful and dignified manner. People’s sensitive information was kept secure at all times. People could access independent advocacy services of they wished.

Care plans were person-centred and reflected the preferences and routines of people.

A meaningful programme of activities was in place with activities provided in-house and from the local community. People who did not wish to join in group activities were given the chance to enjoy time with staff on a one-to-one basis.

A robust complaints procedure was in place.

The registered provider had a series of effective audits in place to measure the quality of the service provided.

People and their families were invited to comment on their experiences. Where suggestions were made, these were acted upon.

The service always notified us of any incidents that affected the wellbeing of people who used the service. The registered provider had displayed the ratings from our last visit prominently.

We carried out an unannounced inspection of Newton Hall on the 1 March 2016.

Newton Hall is a registered care home providing accommodation and personal care for up to 34 older people. The home is a detached property on the outskirts of Frodsham. Bedrooms are located on the ground and first floor. Many of the rooms on the first floor are for people who are living with dementia.

The service has 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 2008 and associated Regulations about how the service is run.

People told us that they were happy living at Newton Hall and felt safe living there. They told us that they felt cared about and had their needs met. They told us that that they were given a choice in how they wanted to live their lives and were complimentary about the Registered Manager.

People lived in an environment that was clean and hygienic. The premises were in need of decoration and refurbishment and this had been recognised by the registered provider. An extensive programme of refurbishment had commenced in 2016 and the refurbishment of bathroom and corridor areas had already been completed. The environment was designed to enable people to move independently and remain safe.

Medication was well managed and promoted the health of people who used the service. People were further protected by the robust recruitment of new staff.

The registered provider demonstrated that staff received up to date training on topics which related to the needs of people. Staff demonstrated a good understanding of the Mental Capacity Act and associated safeguards. The nutritional needs of people were met and when people were at risk of malnutrition, prompt action was taken.

People received care that was personalised and met their needs effectively. Care plans had been recently re-written to enable a person centred approach to care. Care plans included an acknowledgement of the health needs of people but also placed emphasis on their social history and interests. We saw that care practice matched the information included within care plans.

An activity programme was in place and ensured that people had the opportunity to join in if they wish as well as them being able to maintain links with the local community. People did not have any complaints but were confident that the registered manager would listen to them and act upon them. Where complaints had been made, the registered manager showed evidence of investigation and feedback to the complainant to their satisfaction.

The registered manager adopted an open and transparent style of manager and sought the views of all concerned about how the standards of care in Newton Hall could be maintained and improved upon. The registered manager also demonstrated a thorough knowledge of the individual needs of people living there and had sought to refine organisational records to achieve a smoother running of the service of findings.

We spoke with seven people who used the service. They all told us they were happy at Newton Hall and had no concerns with the care provided. Comments from them included; "I like everything here" and "The staff look after us well."

We saw staff were always present in the dining area throughout lunchtime. We saw they interacted positively with people encouraging them to eat when required. Drinks were served throughout lunch to ensure people remained hydrated.

We saw that Criminal Record Bureau (CRB) disclosure checks were completed for all members of staff before and during employment. It was evident that references where also obtained before a member of staff started work at the service.

We saw there were team meetings and supervision meetings for all staff with the manager on a regular basis. Appraisals were completed on an annual basis. This showed that staff had the opportunity to review their roles and look at their personal development.

We found there was an effective system in place to deal with complaints. It was evident there was a detailed audit trail of how concerns were managed and dealt with to the complainants’ satisfaction where possible.

We found that people’s privacy, dignity and independence were respected. People’s views and experiences were taken into account in the way the service was provided and delivered in relation to their care. One person who uses the service said, "The staff are lovely. Very patient and thoughtful. We don't do badly at all."

People experienced care, treatment and support that met their needs and protected their rights. Everyone we spoke with liked living there. One person who uses the service said, "The care is very good. The staff are lovely." Another said, "I am very happy here. It's very good."

People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

There were enough qualified, skilled and experienced staff to meet people’s needs. One person who uses the service said, "The staff are very good. Very nice. They look after us very well."

We found that the provider had an effective system to regularly assess and monitor the quality of service that people receive. The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who use the service and others. One family member told us, "My relative is very happy here. The girls are very good and friendly. They go out on lots of trips. It's fantastic. I am full of praise."

We spoke with people living at Newton Hall and asked their views about living there. They all said that they were happy at the home and that they could make choices about how to spend their day, what they wanted to eat and whether to join in any activities that were offered.

People spoken with said that they liked living at the home and felt safe there. They said that staff were “very approachable” and that “ the new manager listens to me anytime I want to talk” . People knew how to make a complaint but said that they had no cause to complain.

Comments from people living in the home were ; “ the staff are wonderful”; “we have a great bunch of staff“; “staff can’t do enough for you”; “this is a lovely place to live and the staff are second to none”.

People said that the staff supported them in the way they like. They said that staff are lovely and are always on hand to help.

One person said “staff are brilliant and nothing is too much trouble”. Another said, “I like living here there is always something going on and staff are always there”.