Inspection on 28/04/08 for Langdale Court Care Home

This inspection was carried out on 28th April 2008.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Langdale Court Care Home 27/04/09

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 28/09/2008.

CARE HOME ADULTS 18-65 Langdale Court Care Home 1 Colville Street Nottingham NG1 4HQ Lead Inspector Lee West Unannounced Inspection 28th April 2008 11:30 Langdale Court Care Home DS0000002295.V363405.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 Langdale Court Care Home DS0000002295.V363405.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. Langdale Court Care Home DS0000002295.V363405.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Langdale Court Care Home Address 1 Colville Street Nottingham NG1 4HQ 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) 0115 947 2167 Mrs Cordelia Nwafor Ogbakaeko Mr Bernard Okenwa Ogbakaeko Mrs Cordelia Nwafor Ogbakaeko Care Home 7 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (7) of places Langdale Court Care Home DS0000002295.V363405.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd May 2007 Brief Description of the Service: 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 resident’s 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 range between £288.65 and £382.21, according to level of need. The home’s service user guide and statement of purpose are available on request to the provider, together with a copy of the latest Inspection Report. The Registration Certificate is displayed on the wall, and is up to date. Langdale Court Care Home DS0000002295.V363405.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for people who use the service and their views on the service provided. This process considers the provider’s capacity to meet regulatory requirements, minimum standards of practice; and aspects of service provision that need further development. This inspection was unannounced and involved one inspector. The main method of inspection used is “case tracking”, which involves selecting three people and looking at the quality of the care they receive by speaking with them, observation, reading their records, and asking staff about their needs. Two members of staff and the remaining people who use the service were also interviewed in private. Documents, including care plans, medication administration records, staff recruitment and financial records were inspected to help form an opinion about the health, safety and welfare of people at the home Information supplied to the commission by the manager, on the Annual Quality Assessment, with information received by the Commission about the home, since the last inspection, were also considered, and helped the decision of which areas to focus on. The quality rating for this service is 1 star. This means people who use this service experience adequate quality outcomes. What the service does well: People using this service said, “ the food is good here and I can come and go as I please, so long as I let staff know where I am going.” They also said they enjoyed, “doing the chores.” This improves outcomes for them, helping them feel of value by contributing to the routines of the home. Interactions between staff and people using the service were positive, supportive and cheerful and people using the service, who have lived there for a long time, said they felt comfortable and “at home”, which supported the positive outcomes. Langdale Court Care Home DS0000002295.V363405.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: 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. Langdale Court Care Home DS0000002295.V363405.R01.S.doc Version 5.2 Page 7 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 Langdale Court Care Home DS0000002295.V363405.R01.S.doc Version 5.2 Page 8 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): 1,2, Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The improved service user guide and statement of purpose provided sufficient information for people thinking of using the service to help them make the choice. EVIDENCE: The statement of purpose had been updated and included information about the facilities available. People spoken with said they had enough information about the home before choosing to live there. Opportunities were available for people to have trial visits, but the people already living there said they had not taken these up. New people using the service were offered a three-month trial period, to help them make the long term decision about staying at the home, which also provided the management with time to assess the placement and how everyone got on together. One resident said, “I haven’t been here long, but its ok and suits me.” People had individual pre-admission assessment, to determine whether their needs could be met, recorded in their care plans, and written terms and conditions in an individual, written contract. Langdale Court Care Home DS0000002295.V363405.R01.S.doc Version 5.2 Page 9 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 adequate This judgement has been made using available evidence including a visit to this service. Each person had a care plan, which included mainly basic information, was not detailed, or person centred and did not include any reference to their particular diversity needs. EVIDENCE: Only one of the care plans case tracked contained any information about the person’s personal history, but this had not been used within the care plan to develop a person centred approach to care. Individual diversity, such as race, religion, belief, disability, gender, personal preferences, goals and wishes were not identified. Care plans, however, did contain evidence of people being able to make decisions about the assistance they needed, in particular about personal care and also about their participation in chores around the home. Langdale Court Care Home DS0000002295.V363405.R01.S.doc Version 5.2 Page 10 People were observed setting the table, emptying bins and another was asked if he would like to clean the windows, which he said was something he enjoyed. One person said, “I enjoy doing my chores.” All the people using the service 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. It was noted, in the plan of one person, who liked to go out every day, that he should have his lunch before going out to make sure he had sufficient to eat, as he liked to stay out in the community for a number of hours. Langdale Court Care Home DS0000002295.V363405.R01.S.doc Version 5.2 Page 11 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 good This judgement has been made using available evidence including a visit to this service. People using the service were able to make some choices about their life style and maintain contact with family and friends. EVIDENCE: Activities organised inside the home, consisted of watching television, bingo, quizzes, videos and board games, with some craftwork. Some people had done some glass painting, which was displayed in the dining area, but some people said they didn’t have much to do, and spent a lot of time in the lounge, smoking and watching television. People spoken with said they didn’t like to be organised, one said, “I like to stay in my room and keep myself to myself.” Another said, “It gets a bit boring, there’s not much going on that I like to do. I would really like a computer so I could search the net, or play computer games.” Langdale Court Care Home DS0000002295.V363405.R01.S.doc Version 5.2 Page 12 During the morning, staff, who were busy preparing the meal, did not have time to interact with people, who were observed aimlessly wandering into the lounge area, smoking and watching television and wandering out again. However, after lunch, interaction was observed. The staff and people living at the home were cheerfully chatting and joking positively. People said they were able to go out generally whenever they wanted, but that they would really like to go on a holiday, or have more trips outside the home. Visits to and from relatives were encouraged and people were encouraged to take part in local activities. One had taken part in the Sport in Nottingham event. Another said he enjoyed going to the local pub and keeping in touch with his friends. All living at the home said they enjoyed the meals, they said, although they were “not fancy” they enjoyed them and the lunchtime meal served looked nutritious and well cooked. People spoken with also all said they had choices of food and when to eat. Langdale Court Care Home DS0000002295.V363405.R01.S.doc Version 5.2 Page 13 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 adequate This judgement has been made using available evidence including a visit to this service. Physical and emotional needs were not always identified and met, negatively impacting on the well being of people. EVIDENCE: One person said he felt his health needs were not being met as he would like. “I get very depressed and feel as though nobody cares,” was a comment made. Another said, “I need help and would like to stay in my room, but staff insist I get up and have my food in the dining room.” Care plans case tracked did not contain any indication of the people’s emotional needs, or how to deal with them. Some people living at the home were observed to be agitated but this, and how to deal with it had not been recorded in the care plans. However, staff were observed trying to reduce levels of agitation with different strategies, like Langdale Court Care Home DS0000002295.V363405.R01.S.doc Version 5.2 Page 14 getting the person involved in conversation, or asking them to carry out a task to help the carer. People living at the home did not control their own medication, and the system for ordering, storage and administration was observed to be appropriate. The Medicines Administration Record sheets (MAR) were checked and were completed accurately and medicines were stored in accordance with the regulations. The community pharmacy had carried out an audit in November, and records of this evidenced the medication was being appropriately stored and administered. Langdale Court Care Home DS0000002295.V363405.R01.S.doc Version 5.2 Page 15 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 This judgement has been made using available evidence including a visit to this service. People who use the service were able to express their concerns and were protected from abuse. EVIDENCE: The service’s complaints procedure was clearly written and easy to understand. Everyone spoken with said they would speak to Cordelia, the manager, or any other member of staff if they had a problem. They also all said they felt safe in the home. One said, “Sometimes things don’t get sorted, but Cordelia does listen to me.” Staff spoken with also commented they tried to support people living at the home to solve any concerns. Discussions with staff about safeguarding adults and their roles, showed 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. Staff records indicated they had received training in safeguarding adults, and also dealing with challenging behaviour. Langdale Court Care Home DS0000002295.V363405.R01.S.doc Version 5.2 Page 16 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, 30, Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The home was clean and hygienic, but some areas were in need of repair and redecoration. EVIDENCE: The manager stated in the Annual Quality Assurance report that the outside of the home was to be painted, and that there was an ongoing programme of refurbishment. Although there had been some improvements to the environment, some of the individual bedrooms required refurbishment and redecoration. One bedroom viewed, had paint peeling from the window frame, bedding, carpeting and curtains in poor condition and furniture in need of repair or replacement. The person living in the room said, “Its ok, but getting a bit shabby now.” Langdale Court Care Home DS0000002295.V363405.R01.S.doc Version 5.2 Page 17 The furniture in the lounge, also the smokers’ area, was still to be replaced, as this was worn and in need of repair, although, people using the room said, “its ok,” and “it suits me.” Everyone said they were satisfied with their bedrooms, that they could have their personal things around them, but some people said they felt their rooms could be, “a bit better looked after.” Care staff, who maintain the cleanliness and hygiene of the home, were observed cleaning the kitchen area following the lunchtime meal and this was completed to a high standard. . Langdale Court Care Home DS0000002295.V363405.R01.S.doc Version 5.2 Page 18 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 good This judgement has been made using available evidence including a visit to this service. Staff in the home were skilled and supported the people who use the service. EVIDENCE: Two carers were working during this visit, with one of them preparing the lunch. The rota indicates sufficient staff to meet the needs of people living at the home. Information in the Annual Quality Assurance report showed 6 people living at the home, with no requirement for personal care, only support with mental health issues. Staff spoken with said the people living there had no personal care needs, so they were able to carry out the cleaning and cooking, then activities with them during the afternoons. People living at the home said they didn’t need much help, but knew the carers were around if they did. Langdale Court Care Home DS0000002295.V363405.R01.S.doc Version 5.2 Page 19 Staff records were examined and each contained evidence of recruitment checks carried out before employment at the home. They had two references, Criminal Records Bureau checks, application forms, as well as evidence of identity in place. Evidence of training, including challenging behaviour and administration of medication was seen in the staff files and staff spoken with said they had received training. They also said they had regular supervision with the manager and records of this were seen. Everyone living at the home said the staff, “do a good job.” Langdale Court Care Home DS0000002295.V363405.R01.S.doc Version 5.2 Page 20 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 adequate This judgement has been made using available evidence including a visit to this service. The management of the home was based on openness, but there was no effective quality assurance system in place to influence the standards set in the home, or any financial and business planning. EVIDENCE: Records were seen of the provider’s monthly visits, which included comments from people living at the home, as well as the provider’s assessment of the service, but there was no evidence of these being used to support quality reviews of the standards. Questionnaires used to gather information about the service from the people who use it, were not used to plan the business activity, manage finances or develop a business plan. Langdale Court Care Home DS0000002295.V363405.R01.S.doc Version 5.2 Page 21 Although the manager stated in the Annual Quality Assurance report, “the information returned from service users questionnaires will enable us to plan for effective service care,” she also said, “the home will probably make arrangements to put this information into a computer to guide the registered manager where effort needs to be concentrated and improvements made…” There were no records seen of any audit of the information gathered, and there was no computer available within the home to carry out this input of information. The manager also identified within the Annual Quality Assessment report, “we could do better by sending some of our interested clients to college, which might help to keep them occupied instead of stopping at home most of the time, staff could encourage them to choose subjects to help them do something useful for themselves.” However, there was no record of any plans to implement this, or any support for each person’s diversity and culture. During discussions with the manager she said they hold regular meetings with people living at the home and staff and that more thought was being given to the annual development plan for the home, to make sure that what was identified would be achievable, but at the moment there was no evidence of this. People spoken with said they didn’t know of any meetings, but they spoke to Cordelia, the manager, if they wanted to. They did confirm they had completed questionnaires in the past, but said they weren’t really sure what they were for. The Annual Quality Assessment report also contained information about the servicing and testing of equipment, for example the portable electrical equipment was tested in January 2007 and records seen in the home supported the accuracy of this information. Langdale Court Care Home DS0000002295.V363405.R01.S.doc Version 5.2 Page 22 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 3 2 3 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 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 2 X LIFESTYLES Standard No Score 11 x 12 3 13 2 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 x 2 x 2 x x 3 x Langdale Court Care Home DS0000002295.V363405.R01.S.doc Version 5.2 Page 23 No Are there any outstanding requirements from the last inspection? 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. 1. Standard YA6 Regulation 15(1) Requirement Timescale for action 01/09/08 2. YA6 15(1) 3. YA24 23(2)d 4. YA39 24(1) Care planning for individual personal and healthcare support must be developed using a person centred approach and must include personal history, and individual diversity, such as race, religion, belief, disability, gender, personal preferences and wishes, to improve and support the well being of people using the service. Each person’s emotional needs 01/09/08 must be identified and addressed within the care plans, to provide support for emotional and mental well being. To improve the environment for 30/10/08 people using the service, you must ensure all areas of the home are properly maintained, reasonably furnished, decorated and suitable and safe for use. To support effective quality 01/09/08 assurance and monitoring of standards and outcomes for people, there must be an annual development plan for the home, based on planning-action-review, and using feedback from people who use the service, to improve DS0000002295.V363405.R01.S.doc Version 5.2 Langdale Court Care Home Page 24 outcomes for them. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Langdale Court Care Home DS0000002295.V363405.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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. Extracts may not be used or reproduced without the express permission of CSCI Langdale Court Care Home DS0000002295.V363405.R01.S.doc Version 5.2 Page 26 - 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. 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