Inspection on 27/08/08 for Langdale Heights

This inspection was carried out on 27th August 2008.

CSCI 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 Heights 04/09/07

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

CARE HOMES FOR OLDER PEOPLE Langdale Heights 352 Burton Road Derby DE23 6AF Lead Inspector Rose Moffatt Unannounced Inspection 27th August 2008 09:45 X10015.doc Version 1.40 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 Heights DS0000070079.V370594.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 Older People. 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 Heights DS0000070079.V370594.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Langdale Heights Address 352 Burton Road Derby DE23 6AF 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) 01332 367429 01332 367429 Neemat Kassam Yasmin Kassam Vacancy Care Home 31 Category(ies) of Old age, not falling within any other category registration, with number (31), Physical disability (3) of places Langdale Heights DS0000070079.V370594.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered provider may provide the following categories of service only: Care Home only - PC To services of the following gender: Either Whose primary care needs on admission to the home fall within the following categories: Old Age, not falling within any other category Code OP, maximum number of places: 31 Physical Disability - Code PD, maximum number of places: 3 The maximum number of service users who can be accommodated is: 31 4th September 2007 2. Date of last inspection Brief Description of the Service: Langdale Heights provides nursing and personal care for up to 31 older people and is situated close to the centre of Derby. The property was originally a private house, which has been converted and extended into a nursing home. There are bedrooms on three floors, and all floors are accessed by a passenger lift and staircase. One shared room and two single rooms have en-suite facilities. The fees at Langdale Heights range from £465.00 a week to £583.00 a week, depending on the person’s needs. This information was given by the provider on 27/08/2008. Information about the home, including CSCI inspection reports, is available in the main entrance hall of the home, or from the acting manager. Langdale Heights DS0000070079.V370594.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. The focus of our inspections is on outcomes for people who live in the home, and their views on the service provided. The inspection process looks at the provider’s ability to meet regulatory requirements and national minimum standards. Our inspections also focus on aspects of the service that need further development. We looked at all the information that we have received, or asked for, since the last key inspection or annual service review. This included: • The annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. • Surveys returned to us by people using the service and from other people with an interest in the service. • Information we have about how the service has managed any complaints. • What the service has told us about things that have happened in the service, these are called ‘notifications’ and are a legal requirement. • The previous key inspection and the results of any other visits that we have made to the service in the last 12 months. • Relevant information from other organisations. • What other people have told us about the service. The registered manager for the home, Mrs Connie Hudson, retired in October 2007. The home’s deputy manager then took over as acting manager. Following the previous inspection visit in September 2007, we required the providers to complete an improvement plan. The home’s acting manager completed a response to the improvement plan and this was received by the date required. We carried out an unannounced inspection visit that took place over 7¾ hours on one day. The inspection visit focused on assessing compliance to requirements made at the previous inspection and on assessing all the key standards. Langdale Heights DS0000070079.V370594.R01.S.doc Version 5.2 Page 6 There were 22 people accommodated in the home on the day of the inspection visit, all assessed as needing nursing care. People who live in the home, visitors and staff were spoken with during the visit. The acting manager was available and helpful throughout the inspection visit. The area manager and the provider were also available for most of the inspection visit. Some people were unable to contribute directly to the inspection process because of communication difficulties, but they were observed during the visit to see how well their needs were met by staff. Before the inspection visit, we sent ten surveys to the home to be completed by people living there. All ten surveys were returned to us. Eight of the ten stated that a member of staff had assisted the person to complete the survey. We sent out ten surveys for staff to complete, and nine of these were returned. ‘Case tracking’ was used during the inspection visit to look at the quality of care received by people living in the home. Three people were selected and the quality of the care they received was assessed by speaking to them and /or their relatives, observation, reading their records, and talking to staff. What the service does well: What has improved since the last inspection? The Statement of Purpose and Service User Guide had been updated and made available to all people living in the home and their relatives. This meant that people had access to information about the home. The recording and storage of medication had been improved so that people were better protected. Many improvements had been made to the home to ensure a safer, better maintained and more pleasant environment for people to live in. For example, a bathroom had been refurbished to provide a shower room that was fully accessible for people with mobility problems, and new flooring had been provided in the main entrance area and in some of the bedrooms. People told us that the décor and cleanliness of the home had improved. Langdale Heights DS0000070079.V370594.R01.S.doc Version 5.2 Page 7 Staffing levels at night had been increased to ensure people’s needs were fully met. Additional hours had been allowed for domestic staff to ensure the home was always clean and fresh. 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 Heights DS0000070079.V370594.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Langdale Heights DS0000070079.V370594.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There was a satisfactory needs assessment process and sufficient information provided so that people were confident the home was able to meet their needs. EVIDENCE: Since the last inspection, the Statement of Purpose and Service User Guide had been updated to include all the required information. The Service User Guide was available in the main entrance hall of the home and also in each person’s bedroom. People spoken with were aware of the Service User Guide. Two people who completed surveys said they had received a contract and had been given enough information about the home. We looked at the care records of three people living in the home. All had a range of assessment information, including a pre-admission assessment by the Langdale Heights DS0000070079.V370594.R01.S.doc Version 5.2 Page 10 home, and assessments by social services and hospital staff. All had an assessment on admission to the home. Two people who completed surveys said they always received the care and support they needed. From speaking to people in the home and their relatives, and from observation, people’s needs appeared to be met at the home. The AQAA said the home carries out detailed pre-admission assessments, provides detailed information about the home, opportunities to visit the home, and a trial period for all new residents. Standard 6 did not apply as there were no people receiving intermediate care in the home. Langdale Heights DS0000070079.V370594.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There was a consistent, purposeful approach to care planning and delivery so that people received care and support to meet their individual needs. EVIDENCE: We looked at the care records for three people in the home. Each had a care plan that included all of their assessed needs. The care plans had been reviewed monthly. Care reviews were held monthly and indicated that the person and / or their relative was involved in the review. The care plans had sufficient detail of the action required by staff to meet the person’s needs. The care plans referred to how the person’s privacy and dignity should be promoted. The care plans included some details of the person’s preferences regarding routines and care. Langdale Heights DS0000070079.V370594.R01.S.doc Version 5.2 Page 12 The daily records were informative and showed that any changes in the person’s health or general condition were followed up and appropriate action taken. For example, one person was noted to have swelling in their legs so was seen by their GP and started on new medication. Records were kept of any visits and treatment by healthcare professionals, such as GP, chiropodist and optician. The daily records included a summary of information about the person, such as the monthly recording of their weight and visits from healthcare professionals, so that the information was easily to hand for the staff. Assessments were carried out of the person’s nutritional needs, risk of developing pressure sores, manual handling needs, and risk of falls. These assessments were reviewed every month. There was a keyworker system in place in the home. Keyworkers were given guidance about their role and responsibilities and records were kept to show the interaction between the person and their keyworker. Two people who completed surveys said they always received the care and support they needed, including medical support. They both said the staff listened to them and acted on what they said. They said “I am very happy with my care”, and, “The care is excellent and the staff very supportive”. People we spoke with said their needs, or the needs of their relative, were well met in the home. One relative was pleased that the person was “always clean and comfortable”. One relative said the staff were “very patient and caring”. We observed that staff showed a calm and respectful approach to people. Staff we spoke with were clear about how people’s privacy and dignity should be maintained and promoted. The nine staff who returned surveys and the staff we spoke with told us they always had up to date information about the needs of people in the home. They said they had training that helped them to understand and meet the needs of people in the home. Approximately half of the care and nursing staff had received training about the care of people with dementia. The AQAA said the home had improved in the last 12 months by increasing care documentation and by introducing a “dynamic and robust” training programme for staff. Medication was stored securely and was administered by the registered nurses. The medication administration records (MARs) seen were correctly completed. Changes had been made to MARs and medication storage since the last inspection to comply with requirements made. Satisfactory records were seen of the receipt and disposal of medication. The temperature of the fridge used to store medication was recorded daily, though not the minimum and maximum temperatures as recommended by the Royal Pharmaceutical Society. Langdale Heights DS0000070079.V370594.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People were generally satisfied with the lifestyle offered in the home, although there was limited provision of activities. EVIDENCE: Two people who completed surveys said there were always activities arranged by the home that they could take part in. There were records kept of activities that people had taken part in, such as games, music, and manicures. One person living in the home said they had enjoyed a recent trip out into the Peak District. The acting manager said that local clergy visited people who wanted to see them. Activities were provided by the care staff as there was no separate activities coordinator employed at the home. Staff said there was little time during the morning to offer activities as they were usually busy, but they usually had some time in the afternoons. Staff who returned our surveys, and those spoken with, told us the range and frequency of activities could be improved, Langdale Heights DS0000070079.V370594.R01.S.doc Version 5.2 Page 14 particularly trips out. There were no activities observed on the day of the inspection visit. People we spoke to said they could follow the routines they preferred, such as getting up and going to bed when they wanted to. Staff spoken with were clear that people’s choice should be respected when giving care and support. Visitors said they were always made welcome and were always offered refreshments. They said they were able to see their relative in private if they wished. They said the nurses and the acting manager kept them informed about their relative’s general health. People were consulted about the lifestyle in the home through quality assurance questionnaires sent out every six months, and also at care reviews. We saw from the care records, from discussion with staff and visitors, and from observation that most people living in the home had communication difficulties due to dementia or other conditions. There was some evidence of consultation with the relatives of these people through the monthly care reviews. Most people spoken with and those who returned our surveys said they enjoyed the meals provided in the home. One person told us they did not enjoy the meals. One person said they were pleased that staff had listened and acted on their preferences regarding food. People said they were offered a choice and the menus seen showed that there was a choice at each mealtime. It was not clear how people with dementia or other communication difficulties made choices at mealtimes. There were no details of peoples likes and dislikes regarding food and drink in the care records seen. We observed that people were served with a meal at lunchtime without being offered a choice. The menus seen appeared varied and suitably balanced. Fresh vegetables were served each day. The dining room was pleasant and bright. Langdale Heights DS0000070079.V370594.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The complaints system was not sufficiently robust to ensure that appropriate action was always taken. There were gaps in recruitment practices that could put people at risk. EVIDENCE: The complaints procedure in the home included all the required information, except that the contact details for CSCI needed to be updated. The complaints procedure was available in the Service User Guide. People who responded to our surveys and those we spoke with knew how to make a complaint. One relative said they were pleased with the home’s response to a concern raised. They said that appropriate action was taken promptly. Staff who completed surveys and those spoken with all knew what to do if anyone had concerns about the home. We received one complaint about the home in August 2008. We referred this to the provider to investigate and we received a satisfactory response that addressed all the issues raised. We looked at complaints records. These included details of the action taken, though the outcome of the complaint was not always recorded. There were two complaints that included allegations of abuse. The acting manager and Langdale Heights DS0000070079.V370594.R01.S.doc Version 5.2 Page 16 area manager explained the action taken and the outcome, but this had not been documented. It was not clear that correct procedures had been followed. The staff training records showed that approximately half of the nursing and care staff had received training about safeguarding vulnerable adults issues and procedures. The acting manager said that training was booked for September 2008. The acting manager said that all staff had received some instruction during their induction about safeguarding issues and procedures, and that the relevant policies and procedures were included in the employee handbook issues to all staff. Most staff were aware of the correct procedures to follow if allegations of abuse were made to them. We found gaps in recruitment practices that could put people at risk. (See Staffing section of this report). Langdale Heights DS0000070079.V370594.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was well equipped and generally well maintained so that people lived in a safe, clean, comfortable and pleasant environment. EVIDENCE: People told us they were pleased with the work that had been carried out since the providers took over the home in May 2007. People said that the décor and cleanliness of the home had improved. Staff said that they could ask the providers for equipment or improvements in the environment and appropriate action was usually taken promptly. Examples of this were the provision of height adjustable beds to ensure safer manual handling of people, and the Langdale Heights DS0000070079.V370594.R01.S.doc Version 5.2 Page 18 provision of laminate style floors in bedrooms where problems with continence had previously caused odours and stains to the carpet. The home was an older, converted building with accommodation on three floors. There was a parking area to the front of the home, a courtyard area for people living in the home to sit out, and gardens. The gardens were overgrown and were not accessible for people living in the home. The courtyard area was accessible from the lounge and was furnished with benches to sit on and plants in tubs. At the previous inspection it was noted that this area was not safe for use by people with dementia because it was adjacent to the car park. In the response to the improvement plan, the acting manager said that the area would be fenced and a lockable gate fitted “when the weather improves”. This work had not been carried out. The main entrance led straight into an open area used as the office of the home. The acting manager used this area to work in and frequently had to open the front door to visitors as it was kept locked for security. There was no privacy in this area and it was possible for people in adjacent bedrooms and visitors to overhear anyone talking to the acting manager, or her telephone conversations. The area manager said they were considering either relocating the office or using a partition to provide a separate office space. The lounge and dining room were pleasant and comfortable with suitable furniture for people living in the home. Since the last inspection the home had been provided with six new height adjustable beds with integral bed rails. The home appeared suitably equipped with hoists to aid manual handling, wheelchairs, ramps, and hand rails. Several bedrooms had been fitted with laminate style flooring instead of carpets. The main entrance area had also been fitted with the same style of floor. The acting manager said that no-one was currently sharing a bedroom and that rooms would only be shared if people chose to. Privacy curtains were available in shared bedrooms if needed. One of the first floor bathrooms had recently been converted to a shower room that was fully accessible for a wheeled shower chair. As at the previous inspection, there was a bathroom with an outdated, ‘medi-bath’ that was not used. There was a bathroom on the ground floor with a mobile hoist. The toilet cistern in this bathroom was leaking and the bathroom needed Langdale Heights DS0000070079.V370594.R01.S.doc Version 5.2 Page 19 refurbishment and redecorating. The provider said they planned to refurbish all the bathrooms in time. At the previous inspection it was noted that several of the toilets were placed on small steps and that this may make them difficult for some people to use. A requirement was made for the steps to be removed. In the response to the improvement plan the acting manager said that this work had not been done as a risk assessment had been carried out and the situation was kept under review. The décor in the toilets was dull and ‘tired’ looking. There was an area of bare and damaged plaster to a corridor wall in the lower ground floor. The acting manager said this was due to water damage and was awaiting repair. The laundry was suitable equipped with a commercial type washer and dryer. The washing machine had a sluice facility. There were three sluice rooms in the home, one on each floor. One was equipped with a mechanical sluice machine. The home appeared clean throughout and was free from offensive odours on the day of the inspection visit. People who completed our surveys and those we spoke to said the home was always clean. One person said, “My room is cleaned every day”. The provider had recently increased the number of hours for cleaning in response to a request from the domestic staff. Most of the staff had received training about the control of infection. Staff spoken with were clear about procedures to follow to reduce the risk of spread of infection. Langdale Heights DS0000070079.V370594.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There were sufficient staff available and a good staff training programme so that people were supported by a well motivated staff team. EVIDENCE: People we spoke with, and those who returned our surveys, said there were always staff available when needed. People said, “As soon as I press my buzzer the staff soon come to answer it”, “There is always someone available”, and, “The staff come straightaway when we ask them to help Mum”. Most of the staff spoken with and those who responded to our surveys said there were always enough staff to meet people’s individual needs. They said, “we have the right amount of staff”, and, “It can be very busy in the mornings and we could sometimes do with another care assistant”. Some staff told us that they did not always have time to carry out social and therapeutic activities with people. The staff rotas showed that there was always a registered nurse on duty, plus three care assistants during the morning and afternoon, and two care Langdale Heights DS0000070079.V370594.R01.S.doc Version 5.2 Page 21 assistants during the night. In addition there was a cook, kitchen assistant, domestic assistant and laundry assistant during the day. The acting manager’s hours were all supernumerary. Staff meeting records showed that staff had asked for additional staffing at night to ensure the specific needs of one person could be met, and also additional hours for the domestic staff. The providers had agreed to this and had provided an extra care assistant at night and an additional five hours for domestic staff. The AQAA said that more than 50 of care staff had achieved National Vocational Qualification (NVQ) Level 2 or above and this was confirmed by the training records seen. We looked at the records for three members of staff. Two of them included all the required documents and information, such as a Criminal Records Bureau (CRB) disclosure, and two written references. The third staff record did not include a CRB disclosure, although there was evidence that this had been applied for, or a POVA First check. The acting manager said that a POVA First check had been received but there was no evidence of this available at the home on the day of the inspection visit. The member of staff was not always working under supervision as required for new staff employed before a satisfactory CRB disclosure is in place. An Immediate Requirement was made for the providers to ensure a satisfactory system was in place so that new staff were appropriately supervised whilst awaiting CRB disclosures, and so that people living in the home were protected. The provider took appropriate action to comply with the Immediate Requirement: evidence of the POVA First check was provided to us within the allowed timescale and showed that the check was already in place before the person started employment; the provider put measures in place to ensure that all new staff were appropriately supervised if they were starting employment before their CRB disclosure had been received. We looked at staff induction and training records. The provider sent information after the inspection visit to show that staff had received an induction that met Skills For Care standards. The staff training records showed that most of the care staff had received training in first aid, infection control, manual handling, and food hygiene. Approximately half of the care staff had received training about the care of people with dementia. Three of Langdale Heights DS0000070079.V370594.R01.S.doc Version 5.2 Page 22 the four qualified nurses, and the acting manager, had received training about the Mental Capacity Act 2005. The acting manager said it was planned that this training would be arranged for care assistants. Staff told us they had training that helped them to understand and meet people’s individual needs. Staff told us, “training keeps me up to date on how to do things more effectively”, and, “we have excellent and up to date training”. Langdale Heights DS0000070079.V370594.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was well organised so that people received a consistent service that generally met their needs. EVIDENCE: The registered manager for the home, Mrs Connie Hudson, had retired at the end of October 2007. The deputy manager, Mrs Celine Joseph, had been acting manager since then. She had not applied for registration with CSCI. The area manager said the application process would be started in September 2008. Langdale Heights DS0000070079.V370594.R01.S.doc Version 5.2 Page 24 People told us they found the acting manager approachable and were confident that she would take appropriate action on any concerns raised. The AQAA was completed by the provider. All sections were completed and the information gave a reasonable picture of the current situation within the home. There were some inconsistencies in the information provided. The quality assurance system included internal audits and surveys sent out every six months to people living in the home and / or their relatives. The results of the surveys were analysed and action taken to address any issues raised. For example, people said they were not always offered supper during the evening so action was taken to ensure that all staff were aware to do this. There was no report of the results of surveys, but the area manager said it was planned that this would go into a newsletter for people living in the home and their relatives. The provider carried out monthly visits to comply with regulation 26 of the Care Standards Act 2000. The reports of these visits were detailed and showed where action was taken to meet any issues raised. The home had recently started working towards the Investors in People award. Personal money held for people living in the home was kept securely with access restricted to the acting manager. There were satisfactory records of all transactions. The AQAA said that maintenance of equipment and systems in the home was up to date. We looked at the fire safety records and these were up to date. Accident records were satisfactory and there was a monthly audit of accidents by the acting manager. Staff had recently been issued with a health and safety handbook. Most of the staff had received training related to health and safety, including training about Control of Substances Hazardous to Health (COSHH), food hygiene, first aid, fire safety, manual handling, and the control of infection. Langdale Heights DS0000070079.V370594.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 2 Langdale Heights DS0000070079.V370594.R01.S.doc Version 5.2 Page 26 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. 1 Standard OP16 Regulation 17(2) Requirement Timescale for action 30/09/08 2 OP18 13(6) 3 OP19 23(2)(o) 4 OP19 23(2)(b) There must be a record of all complaints made by people living in the home, or their representatives, or by staff working in the home. The records must include the action taken to address the complaint and the outcome of the complaint. This will ensure that people are confident their concerns are taken seriously and appropriate action taken. All staff must have training 31/10/08 about safeguarding vulnerable adults. This will help to ensure that people are protected from abuse. The outdoor area used by people 31/12/08 living in the home must be made safe, specifically for people with dementia who may have limited understanding of the risks of walking into the car park. (This was part of a requirement made at the previous inspection. As the rest of the requirement has been met, it has not been repeated in full in this report) To help ensure a safe, well 31/10/08 DS0000070079.V370594.R01.S.doc Version 5.2 Langdale Heights Page 27 maintained and pleasant environment for people: • The leaking toilet cistern in the identified ground floor bathroom must be repaired. The corridor wall in the lower ground floor must be repaired and redecorated. There must be a system in place to ensure people living in the home are protected and that new staff are appropriately supervised whilst awaiting CRB disclosures. Immediate Requirement All care staff must have training about safe manual handling to ensure that risks to people are minimised by correct and appropriate handling. • 5 OP29 19(9)(10) (11) 29/08/08 6 OP38 13(4)(b) (c) 31/10/08 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 OP9 Good Practice Recommendations The daily maximum and minimum temperatures of the fridge used to store medication should be recorded. This will ensure medication is stored at the correct temperature and minimise the risk of medication losing effectiveness. The range and frequency of activities should be increased to ensure that all people in the home, including those with dementia, are offered enjoyable and stimulating activities to meet their needs and preferences. People should be actively encouraged and supported to access and use advocacy services so that their rights and choices are promoted. The office should be relocated or adapted to ensure that there is sufficient privacy and so that confidentiality of information can be more easily maintained. DS0000070079.V370594.R01.S.doc Version 5.2 Page 28 2 OP12 3 4 OP14 OP19 Langdale Heights 5 OP30 6 OP31 All staff should have training about the care of people with dementia and about the Mental Capacity Act 2005. This will help to ensure that people’s needs are fully met, and their rights promoted. The acting manager should apply for registration with CSCI as soon as possible. This will ensure that she is a fit person to run the home. Langdale Heights DS0000070079.V370594.R01.S.doc Version 5.2 Page 29 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 Heights DS0000070079.V370594.R01.S.doc Version 5.2 Page 30 - 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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