Inspection on 26/11/07 for Longrun House

This is the latest available inspection report for this service, carried out on 26th November 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Similar services:

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

2 Perhaver Park

The Vicarage

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Longrun House Longrun House Longrun Lane Bishops Hull Taunton Somerset TA1 5AY Lead Inspector Barbara Ludlow Unannounced Inspection 26th November 2007 10:30 Longrun House DS0000065092.V349229.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Longrun House DS0000065092.V349229.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Longrun House DS0000065092.V349229.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Longrun House Address Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Longrun House Longrun Lane Bishops Hull Taunton Somerset TA1 5AY 01823 272633 longrunhouse@aol.com also creamcare@aol.com Cream Residential Care Mr Jonathan Peter Basil Trevarthen Care Home 15 Category(ies) of Learning disability (15), Physical disability (15), registration, with number Sensory impairment (15) of places Longrun House DS0000065092.V349229.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Within the home’s maximum registered numbers of 15, one service user between the age of 16 - 17 years. 14/11/06 Date of last inspection Brief Description of the Service: Longrun House is a large detached converted farmhouse, which is at the end of a private lane, conveniently situated just behind the Somerset College of Arts and Technology in Taunton. The home benefits from a very private, peaceful location and is surrounded by views of the countryside. The home has been suitably adapted and has been furnished and decorated to an exceptionally high standard. All bedrooms are for single occupancy and are fitted with en-suite facilities. Longrun House is registered with the Commission for Social Care Inspection to provide personal care for up to 15 service users, between the age of 18 and 65 years, in the categories of learning disability, physical disability and sensory impairment. The home is not registered to provide nursing care. The registered provider is Cream Residential Care. The responsible individual is Mr Steve Petts. The registered manager is Mr Jon Trevarthen. The home’s fee charged per week is determined on the individual’s needs assessment assessed, which would be agreed pre admission. The fees checked at this inspection ranged up to £2250 per week. Longrun House DS0000065092.V349229.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of this inspection visit was to inspect relevant key standards under the Commission’s ‘Inspecting for Better Lives 2’ framework. This focuses on outcomes for service users and measures the quality of the service under four general headings. These are: - excellent, good, adequate and poor. The inspection was carried out over two visits, six hours on day one and two and a half hours at a second visit. The Annual Quality Assessment Audit was completed by the homes management and was submitted to the commission to be used in the assessment of the service. Feedback forms were sent out to people who live at Longrun House and their relatives, staff and visiting professionals. Analysis and comment from this feedback is included in the report. A tour of the premises was made and daily life was observed. A number of people living at the home (Longrun House which includes Longrun Lodge) were seen at different times during the inspection, lunchtime was observed at the first visit. Staff spoke with the inspector about their work and life at the home. No visitors were seen during the inspection. Records were sampled, these included care plans, staff recruitment and maintenance records. The inspection visits were well received. Staff and management gave their time and support with the process. The people who live at Longrun House were welcoming and their contributions were most helpful. The inspector would like to thank all who contributed to the inspection process. This was a very positive inspection. What the service does well: The service has been set up in the countryside, in a quiet and pleasant environment. The home is fitted to a high standard and is very comfortable. The records are maintained to a high standard and the care plans are person centred and very clear. The staff team are professional and many very experienced in caring for younger adults with complex care needs. Staff impressed with their personal commitment and enthusiasm for their work, which requires a broad range of capabilities and personal strengths. There is a lot of management input on a daily basis. Staff training has a high profile and the company trainer has a key management role on a day-to-day basis. Longrun House DS0000065092.V349229.R01.S.doc Version 5.2 Page 6 The outcomes for the people met at this inspection were excellent. There was a lot of well-organised activity that is arranged around the individual service users and how they are at that time. Efforts have gone into making the home restful and there is enough communal space for people to escape to find peace and quiet other than in their own room. Catering is well managed and care is taken to ensure people have a balanced and appealing daily diet. What has improved since the last inspection? What they could do better: The use of a nutritional assessment tool should be considered for initial and if necessary monitoring purposes. A record to confirm that staff have been assessed as competent at securing a wheelchair in the home’s vehicle ready for transportation should be made for staff drivers. This record should be kept with their work record and training evidence. The training and supervision matrix should be kept up to date to reflect the training and supervision given. The management should check the fire testing records periodically to ensure that gaps in recording or in testing such as occurred in December 2006 do not go unchallenged. PAT testing for 2007 should be confirmed as having been undertaken. No requirements have been made at this inspection. Longrun House DS0000065092.V349229.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Longrun House DS0000065092.V349229.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Longrun House DS0000065092.V349229.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is excellent Admissions to Longrun House are thoughtfully made. Time is taken to get to know the person and make sure the home is the place for them and that the home can meet their care and social needs in a life enhancing and fulfilling way. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has produced a Statement of Purpose and Service User Guide and has a brochure, these documents set out the aims and objectives of the home and services offered by Cream Residential Care. These documents are made available to service users, prospective service users and their representatives. Care plans were sampled and one person was case tracked to review the admission process. Staff visit to assess people referred to the service. Time is spent with them to build and develop a relationship. Transition visits are made where the key people in a persons life are met and are spoken with, this can include families, friends, teachers and carers. Weekend visits may be organised where the person can come to Cream and have lunch and spend time looking around the home. Longrun House DS0000065092.V349229.R01.S.doc Version 5.2 Page 10 All transition notes are used to formulate the care plan. One care plan was examined in detail; the pre admission process had been carried out in detail and at a pace to suit the person. This means the transition to Cream can be made as smoothly for them as is possible and also for the existing residents at the home. Feedback comments included: Relatives / carers: All responded that they received sufficient information about the service. All responded positively with regard to needs being met, people said ‘exceptionally so’, ‘excellent’, well looked after’, ‘go the extra mile and cannot be faulted in their ability to meet there relatives needs’ another said ‘My son is very happy here’, People who live at the service some of whom said they were unable to speak and confirmed having assistance to respond, wrote that ‘My parents made the choice for me’, another ‘I visited before I moved in’. Professional comment included that ‘a client’s health has remained stable for over one year since placement at Longrun House’ and they had been ‘supported to attend all health appointments’. Longrun House DS0000065092.V349229.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is excellent. Care plans reflect a person centred approach to individualised care offered at Longrun House. There is thoughtful consideration given to daily life for each individual living at this home. Feedback spoke of the ‘excellent’ standards of care and confirmed excellent outcomes. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Five care plans were examined. The care plans are written in a person centred way and were very detailed. Contact information and personal information was clearly recorded. Care plans contained information on how to communicate with individuals and how they should be supported to express their needs/wishes/choices. During the inspection staff were seen with people who had difficulties with Longrun House DS0000065092.V349229.R01.S.doc Version 5.2 Page 12 communication, the assistance given to them was considerate and sensitive to their needs at the time. One parent had commented that ‘the staff have the right skills’ and said their relative had improved since being at Longrun House and had not shown any of their previously exhibited distressed behaviour. Records were made of day to day care and activity plans, health care input, special events and important dates such as family birthdays. Care plans are reviewed and updated on a regular basis. Risk assessments were completed. Behaviour guidelines were included with risk assessment underpinning any activity that might exacerbate behaviour. Where there was any special monitoring this was clearly stated and a rational was evident. Care plans examined demonstrated the involvement of appropriate care professionals and health care and health promoting interventions and appointments. Since the recommendation at the last inspection missing person profiles have been added to the care plans, the care plans sampled at this inspection all had these on file. CSCI feedback forms from people who live at the home, their relatives and healthcare professionals were all very positive and spoke highly of the care of individuals and of the outcomes for people living at Longrun House. Comments included; ‘kept in touch’, the home is ‘keen to keep in touch about everything’. The care records demonstrated contact between staff and families regarding health and welfare but also as a means of regular contact to promote family involvement in home life. Longrun House DS0000065092.V349229.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is excellent. A whole range of leisure activities are available and are accessed for the people in residence. Family contact is supported. Meals are varied and mealtimes well organised to meet individual needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has two people carriers, one of which can accommodate wheelchairs, and a car. This transport is used by staff to take individuals and groups out into the community for social events and a wide range of activities. Local leisure facilities are used for swimming and sports. The home is well equipped with television, areas for relaxing quietly and a pleasant conservatory with a pool table. The outdoor space is safe and well kept; there are swings and a trampoline. Longrun House DS0000065092.V349229.R01.S.doc Version 5.2 Page 14 Longrun House work on a high staff/resident ratio to ensure that suitably qualified staff are available to support the resident’s access to leisure facilities. During the inspection visits trips out to different venues were made, for example, two people were taken to Exeter airport to see the planes and indulge their passion for aircraft. When people living at the home want to visit their families this would be supported by the home. Staff and transport would be arranged; this was discussed with staff that have undertaken long journeys to facilitate such visits for one person for whom they are appointed as their key worker. Relatives who are unable to make the journey to Longrun House to visit find the home very supportive and considerate. CSCI heard that regular telephone calls are supported and letters and email are also used to keep families in touch. One relative responded to CSCI that the visits their relative is supported to make are highly valued and looked forward to. People living at the home can be involved if they wish with the day to day chores such as the recycling of plastics, paper and glass. Relatives spoke of age appropriate activities being offered and their relatives being respected in all aspects of their lives. Staff undertake the catering, all those who cook have undertaken food hygiene training. The inspector was told that a small number of staff recently employed would be excluded from this duty until they have completed their food hygiene training. Mealtime was observed in the dining room on the first day of the inspection. There was careful and discreet assistance given on a one to one basis and independent eating was supported with specially shaped cutlery and the use of plate guards. Lunch was a social occasion with staff ensuring appropriate levels of support and encouragement were given. Drinks were served with the meal. Mealtimes at Longrun House are flexible to meet the needs and preferences of service users. Snacks and drinks are available to service users whenever they wish. The use of a formal nutritional risk assessment tool was not evident in the sample of care plans although the dietary likes and dislikes, requirements and risks were recorded. This may be an area that could be further developed for initial assessment and if necessary, monitoring purposes. Longrun House DS0000065092.V349229.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19, 20 Quality in this outcome area is good. Staff know the individuals and care is tailored and is sensitive to their needs. Health care is supported to ensure the best of health and health improvement. Medicines are safely managed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans examined contained information on the assessed needs and preferences of service users relating to personal and their health care needs. Care plans included assessment for an individual’s moving and handling needs and any equipment they may require. Staff spoken with confirmed they had received moving and handling training and had been assessed with specialist equipment such as the two overhead hoist facilities. All bedrooms are fitted with spacious en-suite bathing facilities. These have been fitted out to meet the needs and preferences of the individual service Longrun House DS0000065092.V349229.R01.S.doc Version 5.2 Page 16 user, one example being where a Jacuzzi bath was fitted, most have a shower facility. The staff confirmed that service users choose what time to go to bed and what time they get up, an exception being where they have to be up to meet an appointment. Staff support service users with their personal care and grooming and choosing what they would like to wear each day. All people seen looked to be appropriately dressed, very well kempt and comfortable. All people living at the home are allocated a key worker; staff spoke to the inspector about this role. People who live at the service and their relatives made reference to key workers. The inspector heard how important the role is when a new person comes to the home and of an example where someone was helped to settle in and adjust to living away from home. The care at Longrun House is holistic; one care plan examined in detail had the community care managers and service user assessment and review details. This was reflected in the care plan and the recorded risk assessments. Attention to all aspects of health and welfare, social care and family contact were considered. Personal health and development were supported with access to medical and health care as required and for the promotion of good health. Dental, chiropody, physiotherapy and complimentary health can be accessed from the local community. There were good links with care managers and community health care specialists. Medication management was inspected. The home has photographic identification with the medication administration charts and this is crossreferenced with photographic identification on the medication pot lids. Medications were all signed for; no gaps in the records were seen. There is a procedure for checking as required medication stock and charts each week. All medication is checked and is signed in by two people. There were no medications requiring refrigeration. The home does not have a medications fridge but a locked box is available if required for use in the domestic fridge. Medications for returning to pharmacy with one exception for 27/11/07 was all signed for. Overall the standard was good. The home’s trainer was advised that the Royal Pharmaceutical Association has issued new policy guidance for care homes. Longrun House DS0000065092.V349229.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. People living at Longrun House are respected by staff. They are also supported by the company policies and management practice, which is used to protect them from harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a complaints procedure that includes the contact details of the Commission for Social Care Inspection. (Please note that a centralised contact number will be issued for CSCI in 2008). The inspector was informed that the home has not received any complaints and there have been none made to CSCI. CSCI comment cards from GP, healthcare professionals and relatives, all indicated that they had not made or received any complaints. One relative said they were given a pack when their son moved in which included how to complain. Two people living at the service indicated that they would raise concerns through their families, if they had any. Families asked indicated they felt confident that if that ‘any suggestions would be acted upon’ others said they ‘never needed to raise any concerns’ and with reference to concerns being raised they, ‘had never had to’. Longrun House DS0000065092.V349229.R01.S.doc Version 5.2 Page 18 The home has a whistle blowing policy, which is written in accordance with the Public Interest Disclosure Act 1998. Since the last inspection the home has revisited this policy in response to the Somerset’s policy for Safeguarding Vulnerable Adults and the Department of Health ‘No Secrets’ guidance. The policy was dated 9/06/07. The home’s staff recruitment files were sampled. The procedures were satisfactory reducing the risk of harm or abuse to service users. The home’s arrangements for the safekeeping/management of money for people who live at the home. This was discussed at this inspection; there were no people in residence who were able to manage their own finances. Some of the people have their own bank accounts but where required or requested, small amounts of money can be held at the home. Monies were found to be securely stored. Receipts are obtained for purchases and balances are checked regularly. Longrun House DS0000065092.V349229.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,29,30 Quality in this outcome area is excellent. The environment at Longrun House is clean, hygienic and safely maintained. The communal areas are comfortable, interesting and there is plenty of space for people to move around. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Longrun House is a converted farmhouse, which is at the end of a private lane, conveniently situated just behind the Somerset College of Arts and Technology in Taunton. The home benefits from a very private, peaceful location and is surrounded by views of the countryside. Longrun House has been converted and extended to an exceptionally high standard by the registered provider Mr Steve Petts. Longrun House DS0000065092.V349229.R01.S.doc Version 5.2 Page 20 To enable service users to live in smaller groups, the home has been divided into two parts. Longrun House accommodates up to ten service users. It has four bedrooms on the ground floor and six on the first floor. Access to the first floor is via stairs. There are two very large lounges, conservatory and dining room. The main kitchen and offices are also situated in the house. A door, fitted with a keypad, gives access to Longrun Lodge. All accommodation is situated on the ground floor thus giving easier access to those with mobility difficulties. Longrun Lodge has a total of five bedrooms, which conveniently lead out into the very large lounge area. All bedrooms have doors that open out onto their own private patio area. There is a generous sized dining room with small kitchen where service users can be supported to cook and make drinks as appropriate. Throughout the home there are large corridors and seating areas (in addition to lounges) which enables service users to move freely around the home and to choose where they wish to sit and relax. All bedrooms are very spacious and exceed sizes recommended in the National Minimum Standards. All bedrooms benefit from spacious en-suite facilities, which are fitted with a toilet, washbasin and bath with overhead shower. Bathing facilities in bedrooms were agreed with the current service users to ensure that needs and preferences were met. For example, one ensuite/bedroom has been fitted with overhead tracking to enable the use of a hoist, some bedrooms have showers and one service user had requested a Jacuzzi bath. The home has been furnished and decorated to an exceptionally high standard. Large plasma televisions are available in lounges and bedrooms and service users have access to satellite TV. The home provides an enabling and very homely environment for the service user group and the registered provider is commended for his commitment to providing a very high standard of living for service users. A selection of bedrooms were seen with the permission of the residents. People are encouraged to personalise their private space. The exceptionally high standard of furnishings and décor continues in bedrooms. Bedrooms are fitted with plasma TV’s and satellite connection as requested. The home was very clean and fresh on both inspection visits. Relatives commented that the home is always clean and is very comfortable. They said they are welcomed and enjoy visiting. Longrun House DS0000065092.V349229.R01.S.doc Version 5.2 Page 21 The inspector was impressed with the quiet and relaxed atmosphere of the home. Staff were welcoming and people living at the home have access to move freely around the home. There are infection control measures in place. Staff hand washing facilities are appropriately sited throughout the home. Because owing to the needs/risks to service users, liquid soap and paper towels are not appropriate in all areas staff have access to hand cleansing gel. This has been addressed since the last inspection. Staff have access to personal protective clothing, such as gloves and aprons when required. Longrun House DS0000065092.V349229.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Quality in this outcome area is excellent. Staff are carefully selected, many are very experienced and committed to providing a good caring service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff were spoken with at the site visits and staff had returned feedback forms to CSCI. Staff expressed personal commitment to working at the home. One person described their work with people who have learning difficulties and complex care as an ‘ideal job’. Staff were asked in detail about their recruitment and induction. Staff described having applied and waited until they had their Criminal Record Bureau (CRB) checks before commencing working at the home. Staff described being on a trial day, having one week’s induction and working shadow shifts when they had their CRB clearance. All staff have a trial period of six months during which time they receive training and supervision. Staff impressed with their individual knowledge of the people they care for at Longrun House and their enthusiasm for their work and their confidence in their respective roles. Longrun House DS0000065092.V349229.R01.S.doc Version 5.2 Page 23 Staff work in teams over a two week period and have a changeover period once per fortnight where there is an in depth handover. This system staff commented upon saying it is important for the continuity of care for the people living at the home. Records are held to allow a smooth transition between the staff shifts each day and in turn these reflect a record of care, whereabouts and any relevant individual health issues such as seizures. Staff training for fire was seen, the last being in March 2007.The home training matrix only records external training input, a copy of this was supplied at the inspection. Not all training on this was up to date, the training manager was to address and update this. New staff recruitment records were seen and CRB checks for all staff recruited at the home. These records demonstrated good recruitment practice that will protect service users from the risk of harm or abuse. A sample of new staff induction was seen and induction was discussed with new staff spoken with at this inspection. Staff supervision was seen. Staff described supervision as an opportunity to ‘have you say’ and a ‘forum to put across grievances and ambitions’. Supervision is recorded on a table pinned on the office wall, this record was checked against personal files and was found to be out of date. A sample of annual appraisal was seen; this was scheduled for January 2008 however it wasn’t clear if it had been completed the previous year. These recording systems need to be kept up to date to reflect the work that is being completed. Regular staff meetings are held for all staff groups. For care staff and day support workers there is a communication file held in the kitchen for all relevant information to be passed on. Written feedback was received from 15 members of staff. All indicated that training and supervision is delivered. Comments were all very supportive of the management and working at the home. No staff said they ever have to deal with situations they feel unprepared to undertake. All staff said they were clear what duties they must not undertake. People who live at the home indicated that they are all always treated well by staff and that staff listen and act on what they say. One person said they ‘are very happy with the way they are treated at Longrun House’. Relatives commented that ‘they are fantastic’, ‘very happy with the care at this home’, ‘well trained staff….a way of life for them not just a job’. I am made very welcome by staff when I visit. Longrun House DS0000065092.V349229.R01.S.doc Version 5.2 Page 24 When asked how they could improve, one relative said ‘by constantly maintaining the high standard they have set themselves’. Longrun House DS0000065092.V349229.R01.S.doc Version 5.2 Page 25 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good. The home is well run. The best interests and the safety of people who live at the home is paramount in the day to day service delivery and management of the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has stepped down and Mr S Petts is in the process of registering with CSCI as the registered manager as well as provider for the service. The home benefits from the input and expertise of the homes management team on a day to day basis. Longrun House DS0000065092.V349229.R01.S.doc Version 5.2 Page 26 Mr Petts gave time on the first day of the unannounced inspection to ensure all information required was made available for the inspection. Administration staff and the homes training manager were available and provided the information that was stored securely and that which is computerised for inspection purposes. Senior staff and the homes previously registered manager were available to speak with the inspector and gave an overview of the management and day to day operation of the service. Staff spoken with were positive about the management style at the home and stated that they were well supported. Relatives said they felt the home was well managed and said they felt confident and expressed their high regard for the proprietor, Mr S Petts. Comments from the CSCI comment cards from healthcare professionals and relatives included: ‘We are very happy with Longrun’, ‘well run’, ‘Very happy with the way it is’, ‘Cream is an excellent organisation’ and ‘well established, excellent’. Records were sampled for maintenance, these included: FIRE SAFETY –In-house weekly checks are made on the home’s fire detection systems and fire fighting equipment; the last test was dated 20/11/07. There were gaps in the records for December 2006 from 28/11/06 to 11/1/07 however the records since this time indicated regular testing. The AQAA stated that the home now has a full time maintenance man to ensure that the maintenance of the home is kept up to date. A recommendation will be made to act as a reminder to the management to ensure this task is completed. The last alarm service record seen was dated 20/10/06.half year maintenance was dated 3/10/07. Emergency lighting is checked monthly. The last check was November 2007 was seen. The Fire Risk Assessment was in place and dated May 2007.The fire safety policy includes evacuation of the building. The last fire drill was 21/9/07 when all residents were evacuated. ELECTRICAL SAFETY – At the last inspection the home had an up to date electrical hardwiring certificate dated 25/04/06, which is valid for 3 years. Portable appliances were checked on 21/06/06, no records were seen for 2007. EQUIPMENT SERVICING – There is a service contract for the hoists, these were next due in January 2008. Hoist and bed rail visual checks were recorded as done on 25/11/07. Wheelchairs were checked against a checklist dated November 2007. Longrun House DS0000065092.V349229.R01.S.doc Version 5.2 Page 27 Risk assessments were in place for the trampoline and ladder safety and workplace transport. No staff competency record is made for safe wheelchair transportation, this is recommended at this inspection. HOT WATER OUTLETS AND SURFACES – All hot water outlets have been fitted with thermostatic controls. Weekly checks are conducted by the home to ensure that temperatures do not exceed upper limits as recommended by the Health & Safety Executive (HSE). Hot water outlets had been checked for safe temperature ranges on 25/11/07. The home has oil fired central heating and low heat surface radiators are fitted throughout the home to reduce the risk of burns. REDUCING THE RISK OF LEGIONELLA – The home has completed a risk assessment, which indicates that all water outlets not regularly used will be flushed weekly. CONTROL OF SUBSTANCES HAZARDOUS TO HEALTH (COSHH) – All hazardous materials were seen to be appropriately stored. The AQAA stated that the policy was reviewed in 06/2007. A range of information sheets were seen at the last inspection for the cleaning materials in use, this information is stored in the office and was to be made available in the cleaning store. This was not checked at this inspection. ACCIDENT RECORDS- All accident recording was satisfactory. All records examined were appropriately stored in accordance with the Data Protection Act 1998. Longrun House DS0000065092.V349229.R01.S.doc Version 5.2 Page 28 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 4 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 4 26 4 27 4 28 4 29 4 30 4 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 4 14 X 15 4 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 N/A X 3 X 4 X X 3 X Longrun House DS0000065092.V349229.R01.S.doc Version 5.2 Page 29 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA42 Good Practice Recommendations A record to confirm that staff have been assessed as competent at securing a wheelchair in the home’s vehicle ready for transportation should be made for staff drivers. This record should be kept with their work record and training evidence. The training and supervision matrix should be kept up to date to reflect the training and supervision given. The management should check the fire testing records periodically to ensure that gaps in recording or in testing such as occurred in December 2006 do not go unchallenged. PAT testing for 2007 should be confirmed as having been undertaken. A nutritional assessment tool should be considered for use as part of the initial assessment and for periodic review. 2 3 YA35 YA42 4 5 YA42 YA17 Longrun House DS0000065092.V349229.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Taunton Local Office Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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