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Inspection on 22/04/05 for Langdale Nursing Home

Also see our care home review for Langdale Nursing Home for more information

This inspection was carried out on 22nd April 2005.

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

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Review of care for all residents is undertaken regularly and involves both the resident, their key worker and where possible family members. The manager and her deputy are undertaking their NVQ 4, Managers Award, and are using the knowledge gained from this to implement changes in care practices ensuring that all standards of care and staff management in the home are maintained to a high level. Staff and residents stated that communication between the manager and her deputy is very good and that the "open door" policy is always in place. The home operates a "key worker" system that provides both staff and residents with continuity in the provision of care.

What has improved since the last inspection?

The personal documentation for the residents has been reviewed and reappraised. The files provide very comprehensive documentation of all aspects of care. Information is easily accessed with the introduction of a colour coding system that highlights documents covering such areas as risk assessments, personal details, special needs for safe moving and handling and care plans that are generated from these assessments. The plans of care are regularly reviewed and updated with the involvement and consent of the resident and their family.

What the care home could do better:

The home is constantly reviewing standards in the home and will look to maintain these standards. Spare call bell lead should be available at all times to replace those that develop a fault to ensure that residents are never left without the means to summon assistance.

CARE HOMES FOR OLDER PEOPLE Langdale Nursing Home 11 The Avenue Alverstoke Gosport Hampshire PO12 2JS Lead Inspector Sue Maynard Unannounced 22 April 2005, 09:30 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 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 Nursing Home H54 S11503 Langdale V221655 220405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Langdale Nursing Home Address 11 The Avenue Alverstoke Gosport Hampshire PO12 2JS 023 92 581754 023 92 503854 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Ruby Evelyn Kelly Mrs Bethney-Jane Kelly, Mrs Rebecca Evelyn McBride Rebecca Evelyn McBride Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35), Physical disability (7), Physical disability of places over 65 years of age (35), Terminally ill (7), Terminally ill over 65 years of age (35) Langdale Nursing Home H54 S11503 Langdale V221655 220405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 No more than 7 service usres between the ages of 55-65 can be accommodated at any one time within the categories of PD and TI 2 Staffing levels apply 3 Dispensation has been granted for 4 service users under the age of 55 whose dates of birth are 08/3/57, 16/09/52, 28/04/52, 19/02/52 Date of last inspection 18/11/2004 Brief Description of the Service: Langdale nursing home has been converted from a large old house and is situated in a quiet residential area of Gosport, close to all local amenities. The home is registered to accommodate 35 service users over the age of 65 years who are in need of nursing care and who have physical disabilities. The home is also registered to care for those service users who are terminally ill. There is a condition to the registration that 7 service users may be accommodated at any one time between the ages of 55-65 years who are within the stated categories. Langdale Nursing Home H54 S11503 Langdale V221655 220405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and was the first of two statutory inspections for the year 2005/2006. The inspection was conducted by one inspector and lasted five hours. Both the registered manager and her deputy were on duty throughout the inspection. A tour of the premises took place and records were examined. Four staff members were spoken with. Seven of the thirty-three residents and one visitor were spoken with. No requirements were made. One recommendation has been made. What the service does well: What has improved since the last inspection? The personal documentation for the residents has been reviewed and reappraised. The files provide very comprehensive documentation of all aspects of care. Information is easily accessed with the introduction of a colour coding system that highlights documents covering such areas as risk assessments, personal details, special needs for safe moving and handling and care plans that are generated from these assessments. The plans of care are regularly reviewed and updated with the involvement and consent of the resident and their family. Langdale Nursing Home H54 S11503 Langdale V221655 220405 Stage 4.doc Version 1.30 Page 6 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. Langdale Nursing Home H54 S11503 Langdale V221655 220405 Stage 4.doc Version 1.30 Page 7 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 Standards Statutory Requirements Identified During the Inspection Langdale Nursing Home H54 S11503 Langdale V221655 220405 Stage 4.doc Version 1.30 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Standard 3 was not assessed at this inspection. Standard 6 is not applicable to this home. EVIDENCE: Langdale Nursing Home H54 S11503 Langdale V221655 220405 Stage 4.doc Version 1.30 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9 and 10 The care planning and communication systems in the home ensure that the health and care needs of the residents are met in a way that respects their privacy and dignity. EVIDENCE: The manager for the home has recently undertaken a recent review of all documentation for the residents. The individual plans of care are very concise and comprehensive. All significant events in the daily lives of the residents are well documented. The various aspects of care are entered on colour coded sheets which enable staff to access with ease, risk assessments, coded RED and night care plan, coded GREEN and general plans of care, coded PINK. All the documents are in the same order in all files with the Pre-admission assessment at the front providing all the residents personal details such as date of birth and contact details for next of kin. A key worker system is in place in the home and staff spoken to confirm that new documentation is very easy to access and they are able to ensure that all assessments are kept up to date. Two residents spoken to confirmed that they are involved with regular reviews of their care plans. Medication records were seen and were found to be accurate and up to date. Residents spoken to confirmed that the staff in the home always treated them with respect and that their right to privacy was always upheld. Langdale Nursing Home H54 S11503 Langdale V221655 220405 Stage 4.doc Version 1.30 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13 and 14 The management of the social activities creates a positive, varied and interesting life for the residents, which meets their expectations for living in the home. EVIDENCE: The inspector spoke to a number of people living in the home. They confirmed that they had freedom of choice as to how they lived their daily lives within the limitation of their disabilities. One resident reported “ I can do exactly what I like when I want to. I go to bed and get up at the time I choose. The food is very good and I am always given the option of going to the dining room or eating my meal in the privacy of my own room”. The home employs a full time activities co-ordinator who plans a varied programme of activities with the residents to ensure that their wishes are always considered. The residents confirmed that they are always given the choice of whether or not they wish to take part in the activity that has been arranged. Langdale Nursing Home H54 S11503 Langdale V221655 220405 Stage 4.doc Version 1.30 Page 11 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 Residents are confident their concerns will be acted upon appropriately. The vulnerable adults procedure ensures that any allegation of abuse will be addressed appropriately. EVIDENCE: The home has a detailed complaints procedure that is available in the home’s Statement of Purpose. No complaints against the home have been received by CSCI since the last inspection. Residents spoken to confirmed that their concerns are always taken seriously and acted upon. Robust policies and procedures for the reporting of allegations of abuse within the home are in place. Staff members spoken to confirmed that they are aware of the procedure and that they receive regular training for the awareness and reporting of abuse within the care home setting. Langdale Nursing Home H54 S11503 Langdale V221655 220405 Stage 4.doc Version 1.30 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 22,24 and 26 The ongoing review of services provided in the home ensures that all residents are enabled to live in a clean, safe and comfortable environment. EVIDENCE: Last year the home completed a programme of refurbishment and redecoration, including new flooring throughout the home and redecoration of all the corridors and hallway. The fabric of the building is constantly under review and the programme of redecoration and refurbishment is ongoing. Residents were seen to have many of their own possessions in their rooms, including small items of furniture, pictures and family photographs. One resident told the inspector that she has her own bed linen, which “makes her feel really at home.” Langdale Nursing Home H54 S11503 Langdale V221655 220405 Stage 4.doc Version 1.30 Page 13 Risk assessments are undertaken to ensure that small items of furniture in residents’ rooms do not compromise their safety and the maintaining of their independence. Domestic staff ensure that standards of cleanliness are maintained throughout the home at all times. In some bedrooms the inspector noted that call alarms were not available to the residents. This was discussed with the manager who explained that replacement leads had been ordered and should be available within a few days. In the interim period until the leads arrive staff were being extra vigilant with the residents whose alarms were unavailable. Langdale Nursing Home H54 S11503 Langdale V221655 220405 Stage 4.doc Version 1.30 Page 14 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 30 The numbers of staff on duty at any one time appear to be sufficient to meet the needs of the residents. Staff undertake training that enables them to be competent to do their jobs. EVIDENCE: Residents spoken to stated that the staff was always attentive to their needs and that they responded to the call alarm promptly. When asked the residents stated that staffing numbers always seemed to be adequate. Staffing rotas seen, confirmed that the correct number of staff were on duty throughout a twenty-four hour period. Staff spoken to confirmed that there is a comprehensive programme of training available to all the staff. Staff are supported to undertake relevant training that provides staff with additional knowledge to provide the continuing high standard of care in the home. The training programme for this year was seen by the inspector, which confirmed that all staff undertakes statutory training for fire safety, moving and handling, together with NVQ level 2 and 3. Additional training is also provided for topics such as infection control and continence care. Langdale Nursing Home H54 S11503 Langdale V221655 220405 Stage 4.doc Version 1.30 Page 15 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 and 38 The manager and her deputy provide strong leadership in the home providing guidance and direction to the staff to ensure that standards within the home are maintained at all times. Close monitoring of practices within the home safeguard the health, safety and welfare of both residents, staff and visitors to the home. EVIDENCE: Staff and residents were very positive about the way the home is run. Staff stated that they received a very comprehensive induction programme and were very aware of their roles with the staffing structure of the home. The residents and a visitor to the home stated that they were able to approach the staff at any time and they were free to discuss any concerns they had. Prior to the introduction of the new documentation system the manager for the home invited both residents and their families to attend an informal meeting at the home in order to explain how the new documents would be implemented Langdale Nursing Home H54 S11503 Langdale V221655 220405 Stage 4.doc Version 1.30 Page 16 and used. The meeting was well attended by the residents who took great interest what the manager explained to them. The manager was very disappointed that the families of the residents showed very little interest. Not deterred by this, further meetings are to be arranged in order that both residents and their families are kept up to date with all that is happening in the home. Inspection of records indicated that regular tests are undertaken of fire safety equipment, including emergency lighting and extinguishers. The records also demonstrated that fire drills and instructions take place regularly. Staff members spoken to confirmed this. Langdale Nursing Home H54 S11503 Langdale V221655 220405 Stage 4.doc Version 1.30 Page 17 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x 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 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION 3 x x 3 3 x x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x x x x 3 Langdale Nursing Home H54 S11503 Langdale V221655 220405 Stage 4.doc Version 1.30 Page 18 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 Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Langdale Nursing Home H54 S11503 Langdale V221655 220405 Stage 4.doc Version 1.30 Page 19 Commission for Social Care Inspection Hampshire Area Office 4th Floor, Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 0845 015 0120 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 Nursing Home H54 S11503 Langdale V221655 220405 Stage 4.doc Version 1.30 Page 20 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!