CARE HOMES FOR OLDER PEOPLE
Langdale Residential Home 6 Church Street Sapcote Leicestershire LE9 4FG Lead Inspector
Debbie Williams Key Unannounced Inspection 10th October 2007 10:00 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 Residential Home DS0000061086.V347534.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 Residential Home DS0000061086.V347534.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Langdale Residential Home Address 6 Church Street Sapcote Leicestershire LE9 4FG 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) 01455 274544 F/P 01455 274544 Mrs Yasmin Nazir Kassam Miss Neemat Kassam vacant Care Home 27 Category(ies) of Dementia - over 65 years of age (5), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (5), Old age, not falling within any other category (27), Physical disability over 65 years of age (7) Langdale Residential Home DS0000061086.V347534.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. No person in category PD(E) to be admitted to the home when there are 7 persons of that category already accommodated within the home. No person to be admitted to the home in categories MD(E) or DE(E) when 5 persons in total of these categories/combined categories are already accommodated in the home. 5th March 2007 Date of last inspection Brief Description of the Service: Langdale Residential Home offers accommodation for 27 Older Persons, and is situated close to the centre of Sapcote, which offers local shops including a Post Office and local supermarket. Views from part of the home overlook the local Church and countryside. Langdale Residential Home offers two lounges and one dining area to the ground floor, with bedrooms being sited on the ground and first floor. Access to the first floor is via stairs, which has a chair lift and a passenger lift. The majority of bedrooms have en-suite facilities, which consist of a wash hand basin and toilet. Bathroom and showering facilities are located on both floors. An extension has nearly been complete so as to increase numbers by two residents, with a change of lounge set up, to make the lounge by the office much bigger. At the time of this inspection the weekly fees ranged from £375 to £420 per week - this information was provided on the inspection day. There are additional costs for expenditure such as hairdressing, private chiropody, toiletries, newspapers, etc. A copy of the last inspection report was available at the home. Langdale Residential Home DS0000061086.V347534.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The focus of the inspections undertaken by the Commission for Social Care Inspection is upon outcomes for service users and their views of the service provided. The primary method of inspection used was ‘case tracking’ which involved selecting three service users and tracking the care they received through looking at their records, discussion, where possible, with them and care staff and observation of care practices. Evidence from the providers Annual Quality Assurance assessment was also used. This was a positive inspection with good outcomes for residents achieved in all areas. Residents and relatives spoken with were satisfied with the service provided. The inspection was unannounced and was facilitated by the homes acting manager and the registered provider/owner. Six recommendations were made. What the service does well: What has improved since the last inspection? Langdale Residential Home DS0000061086.V347534.R01.S.doc Version 5.2 Page 6 Since the last inspection recruitment procedures have been improved and all staff are checked with the Criminal records Bureau and two written references are obtained before employment is commenced. Care plans had improved; these were reviewed at least monthly and addressed all assessed needs. The fire risk assessment had been reviewed. 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 Residential Home DS0000061086.V347534.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Langdale Residential Home DS0000061086.V347534.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1, 2 and 3 (standard 6 not applicable to this service) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People moving into the home have their needs assessed and information needed to make an informed choice is provided. EVIDENCE: The service has a comprehensive Statement of Purpose and service user guide. The acting manager said that these were given to the relatives of all prospective residents, a recommendation was made that the providers ensure that current and prospective residents are provided with these documents and that they are provided in formats that are accessible to them. The acting manager said that a full needs assessment is carried out prior to residents moving into the home, this was confirmed within the providers annual quality assurance assessment. One relative spoken with also confirmed
Langdale Residential Home DS0000061086.V347534.R01.S.doc Version 5.2 Page 9 that a needs assessment had been undertaken prior to their relative moving into the home, they also confirmed that a contract had been provided. Assessment records for three case tracked residents were inspected and found to be comprehensive, social worker assessments were also seen where applicable. There was no nutritional risk assessment being used, a recommendation was made that these be introduced in order to minimise the risk of malnutrition and identify those at risk. The acting manager said that care records and documentation were being upgraded and replaced. Langdale Residential Home DS0000061086.V347534.R01.S.doc Version 5.2 Page 10 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): Standards 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. The health, personal and social care needs of residents are met. EVIDENCE: Care plans for three case tracked residents were inspected. Care plans appeared to meet all assessed needs including spiritual and cultural needs. Risk assessments were in place for moving and handling and pressure sores. Some moving and handling risk assessments had not been reviewed since august 2006, a recommendation was made regarding this. Medication care plans were in place and these detailed the uses and potential side effects of the medication prescribed. The service had a contract with a pharmacist. Senior care staff administer medications. All senior care staff have completed safe handling of medication training, certificates for this were seen. Langdale Residential Home DS0000061086.V347534.R01.S.doc Version 5.2 Page 11 Medication administration records were seen and appeared to be accurate and in good order. Residents spoken with were satisfied with the way staff administered their medication. Residents and relatives spoken with felt that staff were always friendly and respectful. Interactions observed between staff and residents appeared positive and respectful. The providers set out a charter of resident’s rights within their annual quality assurance assessment and described these as fundamental to the home’s philosophy. Langdale Residential Home DS0000061086.V347534.R01.S.doc Version 5.2 Page 12 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): Standards 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. Routines of daily living are made flexible in order to meet the individual needs and preferences of people who live in the home. EVIDENCE: A range of activities was on offer and these included trips outside of the home. One resident spoken with chose to spend their time in their own room but was also able to visit local shops independently. Another resident went out to visit their relative on a regular basis. The social, religious and cultural needs of residents were recorded within their care plans. Residents and relatives spoken with confirmed that visitors were made welcome in the home and could visit at anytime and be seen in private. Menu records were seen; a nutritious and wholesome menu was on offer with a choice always available.
Langdale Residential Home DS0000061086.V347534.R01.S.doc Version 5.2 Page 13 The cook was spoken with and confirmed that enough resources were available to provide a wholesome and nutritious diet to all residents. A three-week menu was in place and this was about to be changed for the wintertime. One resident spoken with said that snacks and drinks were available at all times. Langdale Residential Home DS0000061086.V347534.R01.S.doc Version 5.2 Page 14 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): Standards 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s protection was promoted by policies and procedures in place. EVIDENCE: Information provided within the providers annual quality assurance questionnaire indicated that only one complaint had been received by the providers in the last twelve months. Complaints policies and procedures were in place and these stated that complaints would be responded to with seven days and investigated within twenty-eight days. Residents, relatives and staff spoken with said they would feel happy to make a complaint to the management team and that they would be taken seriously. Staff spoken with were aware of the correct protection of vulnerable adults training. Safeguarding adults policies were available in the office. The acting manager said that further staff training in this area was to be arranged. Langdale Residential Home DS0000061086.V347534.R01.S.doc Version 5.2 Page 15 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): Standards 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a safe, comfortable and homely environment. EVIDENCE: A partial tour of the premises was undertaken. The private rooms belonging to case tracked residents rooms seen, these were personalised and appeared homely. The home appeared clean, hygienic, homely and well maintained. Residents and relatives spoken with felt that the home was always clean and fresh. Staff are provided with infection control training, records of this were seen. Langdale Residential Home DS0000061086.V347534.R01.S.doc Version 5.2 Page 16 Information provided within the annual quality assurance questionnaire stated that the environment is well maintained and conforms to all relevant regulatory requirements. Langdale Residential Home DS0000061086.V347534.R01.S.doc Version 5.2 Page 17 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): Standards 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. People who live in the home are cared for by staff that are competent to do their jobs. Recruitment procedures promote protection. EVIDENCE: Residents and relatives spoken with felt that staff were deployed in sufficient numbers to meet residents needs. Recruitment procedures were robust, Criminal record Bureau checks and written references are obtained prior to staff commencing employment. Information provided within the annual quality assurance assessment stated that over fifty percent of care staff had achieved a National Vocational Qualification in care and a further twenty four percent of care staff were working towards this qualification. At the time of this inspection staff induction training was not being formally recorded but the acting manager said that a national training organisation (skills for care) induction training was to be introduced.
Langdale Residential Home DS0000061086.V347534.R01.S.doc Version 5.2 Page 18 One staff member spoken with said they had received the following training – dementia awareness, first aid, moving and handling and infection control. Training records were seen. All but two staff had undertaken dementia awareness training. Staff had access to policies and procedures. The providers were in the process of developing a staff handbook that would contain all essential policies and procedures needed by staff. Langdale Residential Home DS0000061086.V347534.R01.S.doc Version 5.2 Page 19 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): Standards 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 is run in the best interests of residents and health, safety and welfare are promoted. EVIDENCE: At the time of this inspection the Registered Managers post was vacant and had been for some time. The service had an acting manager in place. A recommendation was made regarding this. Residents, relatives and staff spoken with felt they could approach the management team with any concerns and would be listened to.
Langdale Residential Home DS0000061086.V347534.R01.S.doc Version 5.2 Page 20 The area manager carried out a weekly quality assurance audit. The providers were developing a quality assurance programme and this included sending out customer satisfaction surveys to residents and relatives. Residents and relatives spoken with confirmed that the home did not become involved in their financial affairs. Facilities were available for secure storage of small amounts of money. All transaction details are recorded and signed by two people. Risk assessments were seen within individual care records, a recommendation was made that these be updated more frequently. Staff received all relevant health and safety training. Information provided within the annual quality assurance audit confirmed that risk assessments were carried out and that all relevant health and safety and maintenance work had been carried out. The home’s fire risk assessment had recently been reviewed. Fire records were seen. Fire alarms were tested weekly and fire drills held every two months. Langdale Residential Home DS0000061086.V347534.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 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 3 3 x x x 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 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Langdale Residential Home DS0000061086.V347534.R01.S.doc Version 5.2 Page 22 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. 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 OP1 Good Practice Recommendations The providers should ensure that all current and prospective residents are provided with a copy of the service users guide and this should be made available in a format which is accessible to each resident. Moving and handling risk assessments should be reviewed at least monthly in order to meet residents changing needs. Nutritional risk assessments should be undertaken as people move into the home and thereafter regularly reviewed, this will ensure that the risk of malnutrition is minimised.
DS0000061086.V347534.R01.S.doc Version 5.2 Page 23 2 3 OP38 OP3 Langdale Residential Home 4 5 6 OP30 OP31 OP36 Formal induction training which meets national training organisation standards should be provided to all staff and written records of this training should be maintained. The home should be working towards registering the manager with the Commission for Social Care Inspection. All care staff should receive formal supervision and records of this should be maintained. Langdale Residential Home DS0000061086.V347534.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
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