Inspection on 03/05/07 for Langdale Court Care Home

This inspection was carried out on 3rd May 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 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 28/04/08

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 09/07/2008.

CARE HOME ADULTS 18-65 Langdale Court Care Home 1 Colville Street Nottingham NG1 4HQ Lead Inspector Lee West Key Unannounced Inspection 3rd May 2007 11:00 Langdale Court Care Home DS0000002295.V336067.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.V336067.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.V336067.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.V336067.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th November 2006 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. 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 and the home’s service user guide and statement of purpose are available on request to the provider. Langdale Court Care Home DS0000002295.V336067.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit on 3rd May 2007, starting at 11.30am and ending at 3.30pm. It formed part of the inspection process, which included information gathered by interviewing residents and staff and other professionals. Also used was information from service user surveys, returned to the Commission, the pre-inspection questionnaire, completed by the manager and records kept within the home and also by the commission. The method used was case tracking, where a number of residents were asked about their experiences and expectations of living at the home. Staff were interviewed, care plans and other records analysed and the areas of the home used by the service users were inspected. What the service does well: What has improved since the last inspection? The Medication storage and administration system has been improved and the new system reduces the risks to residents of mistakes being made. The complaints procedure has been improved, helping residents have a clear understanding of the results of any complaints. The furnishings and décor have been improved and repairs carried out, which improves the surroundings for the residents. Staff supervision has been started and this helps carers to provide competent assistance and staff with their personal development. Langdale Court Care Home DS0000002295.V336067.R01.S.doc Version 5.2 Page 6 The Manager is enrolled on a National Vocational Qualification Level 4 course and staff’s training records show other staff members are also receiving training, to support the residents’ in their care. 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.V336067.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.V336067.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, 3, Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The home’s service user guide and statement of purpose do not cover all the information a prospective resident might require to make an informed choice of moving into the home, but pre-admission assessments are completed for each individual to identify that the home can meet their needs. EVIDENCE: The printed statement of purpose did not contain any information for people who may have mobility problems, particularly access to the rooms, which are up two flights of stairs, with no other form of access. The therapeutic activities section requires updating as conversations with the service users identified very few of the activities in the guide take place. All the people have been resident in the home for quite some time, but their files contained records of assessment and a statement of terms and conditions signed by the resident. Langdale Court Care Home DS0000002295.V336067.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. Care plans have been improved since the last inspection, but require further improvement, especially where freedom to make choices or take risks has been reduced, which may lead to residents feeling distressed and limited . EVIDENCE: Care plans have improved, but still require information on interests and social activities to help develop an individualised plan. The plans did not contain any information on the reasons for restrictive practices. For example, when residents have been “stopped from going out,” the reasons for this restriction, or any agreement to this have not been recorded. Neither was there any evidence of encouragement of residents in acceptable risk taking, part of being independent. Residents said they were encouraged to go out and about and one said, “I like to go out as often as I can.” Langdale Court Care Home DS0000002295.V336067.R01.S.doc Version 5.2 Page 10 Responses to the service user surveys’ question, “do you make decisions about what you do each day?” Five said “always” and one “sometimes.” Residents said they liked to do their chores around the home and they were observed carrying out various tasks, including setting the table, emptying the bins and were encouraged whilst doing these. Langdale Court Care Home DS0000002295.V336067.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 adequate This judgement has been made using available evidence including a visit to this service. Residents take part in activities in the local community, but very few leisure activities within the home. Meals are nutritious and served at times they prefer. EVIDENCE: Activities observed during this inspection consisted of the residents mainly sitting in the lounge, smoking, with the television on, but no-one watching it. Some cheerful, jokey, interactions were observed between the staff and residents. One resident said, “there’s not much to do around here, but I can please myself if I go out.” Another said, “I like to go to the pub because I can keep in touch with my friends.” Langdale Court Care Home DS0000002295.V336067.R01.S.doc Version 5.2 Page 12 During the morning all of the residents who wanted to had voted in the local elections and one said, “it doesn’t matter who gets in they are all the same, but at least I can have my say.” All the residents spoken with were satisfied with the meals provided and said, “the food is good and there’s plenty of it.” Residents can have their meals whenever they wish and this was seen, as a resident was eating breakfast later than everyone else, as he had chosen to get up later than usual. Langdale Court Care Home DS0000002295.V336067.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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents’ physical needs are met in a way they prefer and the home’s medication administration system has been improved to support and protect the residents. However, their emotional needs are not always identified and met, leaving residents feeling frustrated and unhappy. EVIDENCE: “The staff don’t interfere too much and I can do things for myself” one service user said. Responses in the surveys reflected this satisfaction with the level of care provided at the home. However, care plans did not reflect any emotional health needs, or how to meet these, although staff and resident interactions were observed to be supportive of emotional needs. One service user was distressed because he had been restricted from going out following concerns expressed to the provider, by local people and there was no evidence of any strategies to reduce this distress, or provide suitable, Langdale Court Care Home DS0000002295.V336067.R01.S.doc Version 5.2 Page 14 alternative arrangements for him to go out, or for activities within the home to improve his mental well-being. The system for ordering, storage, and administration of medicines has been improved with the introduction of the blister packs kept in a locked cupboard. The Medicines Administration Record (MAR) sheets were observed to be completed appropriately in the records case tracked and the medication was found to be in date and stored in accordance with the regulations. Due to the complexity of their needs, residents do not control their own medication, preferring to have the staff dispense it for them. “Cordelia makes sure I get the pills I have to have,” one resident quoted. Langdale Court Care Home DS0000002295.V336067.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. Complaints are dealt with and residents are protected from abuse or neglect. EVIDENCE: The Pre-inspection questionnaire completed by the registered manager identified five complaints, which had been dealt with, and records seen on the visit confirmed these complaints had been addressed. The residents’ survey responses also said they were satisfied with the way complaints are dealt with. Residents spoken with during the visit said they were satisfied with the way the manager deals with any of their complaints, but one felt his complaints were not listened to or taken seriously. But staff spoken with said they tried to deal with his complaints as they came up. Staff interviewed, were aware of their role within safeguarding adults procedures and records kept in the staff files contained certificates of attendance for training in this subject. Langdale Court Care Home DS0000002295.V336067.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, 25, 27, 30, Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The home is clean and hygienic, meeting the residents’ needs. Steep stairs to the bedrooms would cause problems for residents who may become less able. EVIDENCE: The staircases to both storeys in this Victorian house are steep, but there are handrails on both sides. However, this home would not be suitable for any residents who may have mobility problems. The pre-inspection questionnaire identified the purchase of a new television for the lounge, a new kitchen unit, with other maintenance and decoration having been carried out. The toilet on the upper floor had been repaired and a new toilet unit fitted on the ground floor. This was observed during the visit. Langdale Court Care Home DS0000002295.V336067.R01.S.doc Version 5.2 Page 17 The lounge, dining room, corridors and some personal rooms had been redecorated. However, the furniture in the lounge, particularly the sofas, require repair or replacement and during our conversations, the manager confirmed that these were being replaced within the maintenance programme. Residents, who use the lounge as a smoking area, said they were comfortable with the furniture in the room, and the responses in the resident surveys were also positive about the rooms. One resident spoken with said, “I like my room just as it is, it’s homely.” This comment was made even though the paintwork on the windowsill was peeling and this room was awaiting redecoration. Langdale Court Care Home DS0000002295.V336067.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, 36 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home’s recruitment practices support and protect residents, and staff are trained to competently carry out their responsibilities. Formal supervision has been commenced to help support staff and to protect residents, with properly a properly supervised team, but the recording of this requires simplifying. EVIDENCE: There was sufficient staff working, and identified on the staff rota, during the inspection, to support the needs of the residents, all of whom have been assessed as having low needs. There are 50 of care staff with National Vocational Qualifications and evidence was seen in the staff files of other mandatory training requirements being up to date. Criminal Records Bureau checks and references were seen in the staff files, which showed the staff member’s eligibility to work with vulnerable people. The manager had started to carry out regular staff supervision, but the recording for this was confusing, with notes from all sessions on one sheet, some dated, and not always in date order. Langdale Court Care Home DS0000002295.V336067.R01.S.doc Version 5.2 Page 19 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 home’s policies and procedures are in place to safeguard the residents and the manager has enrolled on the National Vocational Qualification Level 4, to improve management skills and support the residents. EVIDENCE: The manager has enrolled on the National Vocational Qualification at Level 4 and during our conversations she confirmed she had completed one unit so far, but this was waiting for assessment. There were copies of resident questionnaires in their files, but there was still no evidence of audit of these. The manager repeated that she reads them, takes note of what they say and deals with things that were not in order. Evidence of this was seen with an issue of food, which had been dealt with from the questionnaires. However, this was not recorded anywhere and the Langdale Court Care Home DS0000002295.V336067.R01.S.doc Version 5.2 Page 20 responses to the questionnaires are still not being gathered together and used to form a picture of the quality of service, or the areas needing improvement, provided at Langdale Court. This had been identified and made a requirement in the last inspection on the 2nd May 2006. There was no evidence of any monthly visits by a representative of the provider, required under Regulation 26, to monitor the standard of care, the condition and suitability of the premises, any incidents or untoward events to the residents and any complaints received during the month, which would, together with responses from the resident questionnaires, provide information for reviews of the quality of care for the residents The service user survey responses were positive, stating all the staff listen and act in the best interests of the residents. Those spoken with during the visit said they felt satisfied “Cordelia tries her best for us.” Langdale Court Care Home DS0000002295.V336067.R01.S.doc Version 5.2 Page 21 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 2 2 2 3 2 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 3 25 3 26 X 27 3 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 3 X 2 x LIFESTYLES Standard No Score 11 x 12 2 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 x 3 X 2 X X 3 x Langdale Court Care Home DS0000002295.V336067.R01.S.doc Version 5.2 Page 22 yes 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 YA1 Regulation 6(a) Requirement The Statement of Purpose and Service User handbook must be updated to current legislation and also include information about the stairs and lack of access to bedrooms by other means, to enable prospective residents to make an informed choice about the suitability of this home to cater for their needs. Individual care plans must be developed including how the home will meet the current, changing needs and aspirations of each resident. It must also identify any restrictions of choice and freedom, agreed with the resident, imposed as part of the protection of the resident. Timescale for action 30/08/07 2. YA6 15(1) 30/08/07 3. YA14 16(2)n Facilities must be provided for 30/08/07 residents to have access to a range of appropriate leisure activities to choose from, with special attention to therapeutic activities within the home, to provide for the mental well-being of those residents who do not, or DS0000002295.V336067.R01.S.doc Version 5.2 Page 23 Langdale Court Care Home should not, leave the home. 4. YA39 24(1)b A system for reviewing the quality of the service, which is produced from the quality assurance tools must be put in place to monitor the care provided, so residents receive a good standard of care, which meets their individual needs. Requirement set at previous inspection on 02/05/06 A monthly visit must be carried out by a representative of the registered provider, about the standards of care and condition and suitability of the premises, as required by Regulation 26, with a copy retained by the manager within the home, to monitor the standards of care and its suitability for the residents, as part of the quality reviewing of the service. . 30/08/07 5. YA39 26 30/08/07 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 YA36 Good Practice Recommendations Supervision notes should be recorded on individual sheets for each session, signed and dated by both the supervisor and the person supervised, and include information about professional and personal development needs, as well as the job role and responsibilities, to help staff members with their competence and skills development. Langdale Court Care Home DS0000002295.V336067.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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.V336067.R01.S.doc Version 5.2 Page 25 - 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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