Inspection on 27/04/09 for Langdale Court Care Home

This inspection was carried out on 27th April 2009.

CQC found this care home to be providing an Adequate service.

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

Langdale Court Care Home 28/04/08

Langdale Court Care Home 03/05/07

Langdale Court Care Home 01/05/06

Langdale Court Care Home 29/09/05

Langdale Court Care Home 27/01/05

Langdale Court Care Home 12/08/04

Langdale Court Care Home 31/03/04

Extracts from inspection reports are licensed from CQC, this page was updated on 20/07/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Langdale Court Care Home 1 Colville Street Nottingham NG1 4HQ     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Angela Starr     Date: 2 7 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Langdale Court Care Home 1 Colville Street Nottingham NG1 4HQ 01159472167 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Bernard Okenwa Ogbakaeko,Mrs Cordelia Nwafor Ogbakaeko care home 7 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 0 mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home 7 Langdale Court, opened in 1987, is a converted Victorian style three-storey house with a small front and side garden, registered to provide personal care and accommodation for up to seven males with mental health needs. Situated near the city centre it is close to shops, pubs, the post office and other amenities. Car parking is street parking and a residents permit is required from the home. There are five single bedrooms and one double bedroom; none with ensuite facilities. The staircase to upper floors is steep, with handrails, but there is no lift to provide independent access and consequently the home is not suitable for wheelchair users, or, people with mobility difficulties. The fees for this home are 336 pounds and 43 pence per week. The homes service user guide and statement of purpose are available on request to the provider, together Care Homes for Adults (18-65 years) Page 4 of 28 Brief description of the care home with a copy of the latest Inspection Report. The Registration Certificate is displayed on the wall, and is up to date. A copy of the latest inspection report can be seen at www.cqc.org.uk Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The focus of inspections undertaken by the Care Quality Commission is upon outcomes for people who use the services and their views on the service provided. This process considers the providers capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provision that need further development. We ask managers to fill in a questionnaire called an Annual Quality Assurance Assessment, which tells us how well their service provides for the people who use it and how they intend to improve their service. We received this back from the manager within the required timescale but the form was completed in a manner which did not provide us with all the information we asked for. We did use this to assist in planning our visit and deciding what areas to look at. Care Homes for Adults (18-65 years) Page 6 of 28 We also reviewed all the information we have received about the service since we last visited in April 2008 and we considered this in planning the visit and considering what areas to look at. The main method of inspection we use is called case tracking which involves us selecting a number of people who use the service and looking at the quality of the care they receive by speaking with them, observation, reading records and asking staff about their needs. We also sent Have your say questionnaires to a random selection of people who use the service, some relatives and some staff members. The information provided in the replies we received, was also a contributory factor in the focus of our inspection visit. We spoke with the member of staff on duty, the manager and four people who use the service to form an opinion about the quality of the service being provided. We read documents as part of the visit and medication was inspected to form an opinion about the health and safety of people who use the service. A copy of the latest inspection report can be found by visiting the Care Quality Commission web site at www.cqc.org.uk What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who wish to live at the service have a full pre-admission assessment completed to ensure that their needs can be met. People are given accurate information about the service that is provided. Evidence: The manager told us in the written information she provided We provide good quality information to people who consider moving to Langdale Court. Each person is given a copy of our statement of purpose and service user guide and these are also displayed in the entrance of the home. We carry out full pre-assessments of need for each person to ensure their needs can be met and this is confirmed in writing to the person before they move to the home. We looked at the aims, objectives and philosophy of the home as well as the service user guide. These were specific to the people living at the service and were available in a suitable format. Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: Some people we spoke with who live at the service told us that they had visited before they moved to the home and they had been given all the information they needed to help them make a choice. The surveys that were returned to us also confirmed this. As part of our case tracking process, we looked at files for three people who live at the service. All three files contained pre-admission assessments and copies of letters sent to people confirming that their needs could be met and offering them a place at the home. A person we spoke with who lives at the service told us I liked this place when I came and wouldnt go anywhere else. Another person said I think this place is just right for me. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the service have their personal and health care needs and any identified risks, assessed and met. Evidence: The written information provided to us by the manager tells us that people living at Langdale Court are enabled to make choices. The files that we looked at showed us that people had been involved in the development of their care plans and people we spoke with confirmed this. Although the care plans were not written in a person centred manner, they did contain some comprehensive and relevant information about the person. Each care plan had been signed and agreed by the individual it related to and all had been reviewed monthly and updated where necessary. Care plans did contain evidence of people being able to make decisions about the Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: assistance they needed, in particular about personal care and also about their participation in chores around the home. The people we spoke with said they made their own decisions about what they chose to do every day and most said they liked to spend time in their own room. One person told us how they had spent time with the manager talking about all the things they were hoping to do, which included being able to move back into the community and live independently. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People mostly experience a flexible lifestyle which is in accordance with their needs, abilities and preferences. Evidence: Activities organised inside the home consisted of watching television, bingo, quizzes, videos and board games and some artwork. However, some people we spoke with said they didnt have much to do and spent a lot of time in the lounge watching television. People spoken with said they didnt like to be organised, one person said I like to stay in my room and keep myself to myself. Another person said It gets a bit boring, theres not much going on that I like to do. Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: During the morning staff were busy preparing the meal and did not have much time to interact with people who we observed to be wandering into the lounge or dining room and watching television for short periods then wandering out again. People said they were able to go out generally whenever they wanted but that they would really like to have more trips outside the home. Visits to and from relatives were encouraged and people were encouraged to take part in local activities. One person said he enjoyed going to the local pub and keeping in touch with his friends. People we spoke with said they enjoyed the meals even though they were plain cooking and they were not sure if a choice was offered, but added that they thought they could have something else if they didnt like what was given to them. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples physical and emotional needs are mostly identified and met. The principles of respect, dignity and privacy are put into practice. Evidence: As part of our case tracking process we looked at the care plans for three people living at the service. These did contain some information in relation to peoples emotional needs, and how to deal with them, although this still needs to be developed further. There was evidence that people had accessed community Health Care services such as Doctors and opticians and some of the people we spoke with told us that they had seen an optician recently. One person said that staff accompany them if they need to see the doctor. No one living at Langdale Court at the time of this inspection, was responsible for administering their own medication but each person had been assessed to see if this was a safe option for them. Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: The system for the ordering, storage and administration of medication was observed to be appropriate. We looked at the Medicines Administration Record sheets (MAR) and observed that these were completed accurately and medicines were stored in accordance with the regulations. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People know how to complain and have confidence that any concerns would be acted upon and responded to. People living at the service are safeguarded from harm and abuse. Evidence: We looked at the services policy and procedure regarding complaints and protection and found it to be detailed enough to advise people how to make a complaint. The surveys that were returned to us from people who use the service all said that they know how to make a complaint and who to speak to if they are not happy. People we spoke with told us that they would always tell any problems to the manager or the staff and they were confident they would be listened to. We discussed complaints and concerns with the manager and she told us that as soon as anyone raises an issue it is sorted out. Staff told us that they pass on any concerns that people raise with them and added that the manager is very proactive in sorting things out for people. Safeguarding Adults is a process of identifying and reporting suspected or potential abuse of vulnerable people and provides a framework of consistency to protect those Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: individuals at risk. As part of our case tracking process we looked at the files of three staff members. We saw evidence that the staff have had training in Safeguarding Adults and staff we spoke with demonstrated that they understood and worked within this. Discussions we had with staff informed us that they were aware of their responsibilities. They talked about how they would protect the person and immediately report any problems to the manager and described how they would deal with any issues if the manager was unavailable. People we spoke with told us that they felt safe I am alright here and safe and comfortable. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean, safe, comfortable and reasonably well maintained environment which meets their needs. Evidence: We conducted a partial tour of the home and looked at the communal areas, the bathrooms and some peoples bedrooms. The areas we saw were clean and reasonably well maintained and some benefitted from redecoration and new floor coverings. The environment smelled fresh and people we spoke with told us that the home is always clean and tidy. Maintenance records are kept and show that the handyman responds quickly to any problems that are identified and recorded by staff. The handyman calls at the home when he is required. There is a schedule in place to ensure that all areas are kept clean and tidy and these domestic chores are completed by care staff during their shifts. Staff are responsible for doing peoples laundry and when we asked people if this is done to their satisfaction, they all replied Yes. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: On the day of the inspection we observed that a pane of glass in the kitchen door was cracked. We discussed with the manager and she assured us that it would be replaced immediatley. We also observed water leaking through the kitchen ceiling from the bathroom above, as a person had spilled a large amount of water on the bathroom floor. The manager also said this would be attended to immediately. People we spoke with said that the home is clean and tidy and they all said they are warm and comfortable. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by experienced and competent staff in sufficient numbers to meet their needs. Evidence: As part of our case tracking process we looked at files for three staff members. Each contained evidence of recruitment checks carried out before employment commenced and they had two references, Criminal Records Bureau checks, and application forms as well as evidence of identity in place. Three staff members returned the questionnaires that we sent out before our visit. All three said they had received an induction when they commenced employment. We saw evidence of training that staff had received, including challenging behaviour and administration of medication. Staff we spoke with confirmed that they had received this training as well as a number of other courses including Safeguarding Adults. Staff also said they had regular supervision with the manager which they found to be useful and supportive. Supervision records were seen and showed us that this takes Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: place on a regular basis. Staff told us that they feel supported by the manager and that they feel part of a good staff team. People who live at the service told us that the staff are Alright Very good and I get on with all of them. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is well managed and is being run in the best interests of the people who live there. Evidence: The Annual Quality Assurance Assessment completed for us by the manager was returned within the required timescale and it contained some useful information about the service. The manager has been in post at the service for many years and has achieved the necessary qualifications to enable her to undertake the post. Since the last key inspection the service has achieved some of the goals that were identified in the homes annual development plan. These include some refurbishment and re-decoration of rooms. However, there is more maintenance work required to improve the overall condition of the home. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: People living at the service meet regularly with staff and are encouraged to discuss anything of concern or interest to them. The information gained at these meetings is used in the planning and development of the service. People we spoke with told us that they use the meetings to discuss any issues they may have. The service does complete quality monitoring and we looked at the questionnaires that people had completed. We discussed with staff how the information is used to inform any improvements. Individual issues that may be raised are dealt with at the time of the survey being completed. Two people we spoke with commented that the manager is lovely and easy to talk to. Staff we spoke with said that they feel very well supported by the manager who is available whenever they need her. They told us that she is approachable and is dedicated to the home. Staff files showed us that staff receive supervision two or three monthly and an annual appraisal. Staff told us that they find this useful to look at career development and progression but reinforced that the manager is always around if they have a problem. We found that the Health and Saftey testing and sevicing has been undertaken as required and staff told us that they consider their Health and Safety is well protected as well as the people living at Langdale Court. They told us they are up to date with all statutory courses and this was confirmed by training records. Records we saw showed us that one accident had occurred since the last key inspection. This was a fall and the record stated that the person had no apparent injuries. The records showed us that appropriate action had been taken and a risk assessment was in place on the persons file to avoid a recurrence. The Care Quality Commission have not received any regulation 37 notices. (This is a regulatory process which informs us of any reportable incidents that occur at a service.) Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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