CARE HOMES FOR OLDER PEOPLE
Langdale Residential Home 6 Church Street Sapcote Leicestershire LE9 4FG Lead Inspector
Keith Williamson Unannounced 14 July 2005 at 9.00am 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 Residential Home C51 C01 S61086 Langdale V237765 140705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Langdale Residential Home Address 6 Church Street Sapcote Leicestershire 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) 01455 274544 01455 274544 None Mrs Y Kassam Vacant Care Home 25 Category(ies) of OP - Older People - 25 registration, with number DE(E) - Dementia over 65 - 5 of places PD(E) - Physical disability over 65 - 5 MD(E) - Mental disability over 65 - 5 Langdale Residential Home C51 C01 S61086 Langdale V237765 140705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: No person in category PD(E) to be admitted to the home when there are 5 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 are already accommodated in the home. Date of last inspection 04-02-2005 Brief Description of the Service: Langdale Residential Home offers accommodation for 25 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. Landgale 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 have two chair lifts 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. Langdale Residential Home C51 C01 S61086 Langdale V237765 140705 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over one day, commenced at 9.15 am and was completed in four hours by one Inspector. An opportunity was taken to view the care plans and other records in detail. Three residents were spoken with on this visit; comments made by those individuals and the comment cards returned to the inspector prior to the inspection are enclosed in this report. Three staff were also interviewed. Fifteen residents’ or their relatives’ questionnaires were returned to the inspector prior to the day, all comments were very positive, though no additional comments or information was noted on the returned cards. The registered person and acting manager assisted with the inspection, spending time with the inspector discussing the management of the home. This is the inspectors’ first visit to this home and overall the inspector recognised the home, continues to function very well and provides a homely and secure environment for residents’ and staff. What the service does well:
A homely and comfortable atmosphere is provided for residents. Clear guidance is given to staff members regarding keeping residents’ care records up to date. The residents spoken with indicated that they feel safe in the home and that they are well taken care of. A tour of the premises took place, which indicated that the premises are maintained to a very high standard creating a homely environment for residents. The registered providers are committed to raising and maintaining good standards of care for this service based on the outcome of the inspection. Residents and staff spoke positively about the approach to managing the home indicating that it creates an open and inclusive atmosphere. The fixtures and fittings are maintained to a very high standard creating a homely environment. A number of resident choices are evident pastimes, hobbies and meals are varied and well presented. All comments about meals were very positive. All residents spoken with indicated that they are satisfied with the overall care given in the home.
Langdale Residential Home C51 C01 S61086 Langdale V237765 140705 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Langdale Residential Home C51 C01 S61086 Langdale V237765 140705 Stage 4.doc Version 1.40 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 Residential Home C51 C01 S61086 Langdale V237765 140705 Stage 4.doc Version 1.40 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) 1, 2, 3 & 6. The admission process is good; there is detailed information about the type of services provided in the home, which is given to prospective residents and their relatives to enable decision-making. The assessment process is detailed and effective. The entire staff team are very committed to delivering good quality care. EVIDENCE: The Statement of Purpose and Service User Guide were viewed; resident’s relatives confirmed to the Inspector that these documents were supplied prior to the resident moving into the home. Resident assessments are completed prior to residents’ admission, and care plans compiled for the information supplied. Contracts between the resident and the home are in place, and were placed appropriately in files. The home does not provide accommodation under Standard 6. Langdale Residential Home C51 C01 S61086 Langdale V237765 140705 Stage 4.doc Version 1.40 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, 10 & 11. Residents’ care plans are written in detail to give staff members clear instructions about the tasks they must carry out to meet residents’ care needs. The medication procedure is not effective in areas, which have the potential of placing a resident at risk. EVIDENCE: The inspection of three residents’ care plans indicated that all aspects of personal and health care needs are being met. None of the residents passed comment on knowledge of their care plan. Evidence is in place to confirm that contact with psychiatric community care professionals is maintained. The daily care records were inspected and confirm that other related health care professionals located in the community visit the home. The medication system was seen to be administered appropriately, however not all medications are currently receipted and the home should commence this immediately.
Langdale Residential Home C51 C01 S61086 Langdale V237765 140705 Stage 4.doc Version 1.40 Page 10 Observations made indicated that residents’ privacy are maintained for example knocking on residents’ bedroom doors before entering their rooms, which was confirmed by verbal statements made by a resident. On viewing individual files, no mention of the residents final wishes were noted in the plans of care, it is recommended this be amended and information be entered accordingly for new residents entering the service. Langdale Residential Home C51 C01 S61086 Langdale V237765 140705 Stage 4.doc Version 1.40 Page 11 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, 14 & 15. Giving residents’ choices over their daily lifestyles and providing a wellbalanced meal is managed very well. EVIDENCE: A varied programme of activities is offered to residents, a sample programme being viewed by the inspector, one resident did comment that he was not taken out regularly enough, this was an isolated comment as the weight of evidence suggests a varied and interesting programme of visits and time away from the home. Personal choice is offered throughout the home, and evidence is in place to suggest that practices are flexible, promoting resident’s individuality and independence. Comments passed by residents indicated that staff are very accommodating to visitors, the residents’ knowing of no restrictions placed on visiting. The menu system offers a well-balanced dietary choice. Comments from the residents indicated that the breakfast (when served on trays in the bedroom) “was served slowly”, other comments from the Service User comment cards indicated the food was of a good quality and was well liked. An alternative personal menu for a resident with specific dietary needs is in place; this is seen as very good practice and is congratulated as a positive step in the individual attention residents receive in the home.
Langdale Residential Home C51 C01 S61086 Langdale V237765 140705 Stage 4.doc Version 1.40 Page 12 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 & 18. Complaints and adult protection procedures are in place for the protection of residents in the home in the event of a complaint or suspicion of abuse. EVIDENCE: The complaints procedure is publicly displayed in the foyer of the home, as well as in the Statement of Purpose and Service User Guide, which makes clear the process of making a complaint. Detailed examination of the adult protection policy indicated that sufficient information is contained in the document for staff members’ guidance on how to prevent elder abuse in the home. The majority of the staff have undertaken an extended instruction course on dealing with abuse in the home. Two staff members spoken to displayed good verbal knowledge concerning the protection of vulnerable adults in their care. Evidence of advocates and advocacy information is publicly displayed on a notice board in the foyer of the home. Langdale Residential Home C51 C01 S61086 Langdale V237765 140705 Stage 4.doc Version 1.40 Page 13 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, 21 & 26. The premises are maintained to a very high standard with strong emphasis on residents’ comfort. There is sufficient communal space including adequate numbers of toilet and bathing facilities. The home is clean and pleasant in appearance. EVIDENCE: An inspection of the flooring, fixtures and fittings in the home indicated that the registered provider make good effort in maintaining the home to a good standard. One resident spoke positively about the upkeep of the home commenting, they had their room cleaned regularly, evidence of which was in place with the staff on duty. The bathroom and toilet facilities were inspected and found to be sufficient in numbers based on the number of residents residing in the home. An inspection of the premises found it to be very clean and hygienic in appearance. Langdale Residential Home C51 C01 S61086 Langdale V237765 140705 Stage 4.doc Version 1.40 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, 29 & 30. The number of staff employed to work in the home is sufficient in meeting residents’ assessed care needs; and the recruitment process ensures resident’s safety. EVIDENCE: The staffing rota was examined and a physical count indicated that there was adequate numbers of care staff on duty. The staffing rota was viewed and discussion held with the acting manager indicated that there is appropriate skill mix of staff employed to work in the home. The residents’ spoken with indicated that there are staff members available when needed. Of the staff files viewed all had the appropriate pre-employment checks in place prior to staff commencing in their post. Evidence of staff training and an organised training programme is in place. Langdale Residential Home C51 C01 S61086 Langdale V237765 140705 Stage 4.doc Version 1.40 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) 36, 37 & 38. The management approach promotes effective care practice in the home for residents’ care and protection. EVIDENCE: Staff are appropriately supervised with the content of the sessions being targeted toward individual resident discussion and staff knowledge of the policies and procedures of the home. Three residents’ care records were inspected. All care records seen are kept up to date and in order in accordance with the Data Protection Act 1998 and the Care Homes Regulations 2001. Observations made indicated that periodic tests were performed to the water gas and electrical services on a regular basis. Two staff members spoken with indicated that they were adhering to safe work practices for example the practice of safe moving and handling techniques.
Langdale Residential Home C51 C01 S61086 Langdale V237765 140705 Stage 4.doc Version 1.40 Page 16 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 3 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 3 x 3 x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 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 x x x 3 3 3 Langdale Residential Home C51 C01 S61086 Langdale V237765 140705 Stage 4.doc Version 1.40 Page 17 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 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. 2. 3. 4. Refer to Standard 9 11 19 29 Good Practice Recommendations It is recommended that bulk medications be accounted for periodically through the administration period. It is recommended that the final wishes of residents be entered into the plan of care. It is recommended that the carpet in the smaller of the two lounges has appropriate attention to the joint in the carpet. It is recommended that for new staff commencing in post, no to whom it may concern references be accepted within the recruitment process. Langdale Residential Home C51 C01 S61086 Langdale V237765 140705 Stage 4.doc Version 1.40 Page 18 Commission for Social Care Inspection The Pavilions, 5 Smith Way Grove Park Enderby Leicestershire LE19 1SX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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