Key inspection report
Care homes for older people
Name: Address: Langdale Residential Home 6 Church Street Sapcote Leicestershire LE9 4FG The quality rating for this care home is:
one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Debbie Williams
Date: 2 7 1 0 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area.
Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection.
This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People
Page 2 of 22 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 22 Information about the care home
Name of care home: Address: Langdale Residential Home 6 Church Street Sapcote Leicestershire LE9 4FG 01455274544 F/P01455274544 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Miss Neemat Kassam,Mrs Yasmin Nazir Kassam care home 27 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Additional conditions: 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. Date of last inspection Brief description of the care home 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, Care Homes for Older People
Page 4 of 22 Over 65 5 5 27 7 0 0 0 0 0 4 0 8 2 0 0 9 Brief description of the care home 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 ensuite facilities, which consist of a wash hand basin and toilet. Bathroom and showering facilities are located on both floors. A copy of the last inspection report was available at the home. Care Homes for Older People Page 5 of 22 Summary
This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We visited the service on the 27th of October 2009 to carry out this key inspection. We case tracked six people living at the home and looked at their care records, spoke with staff about there care needs and observed care practices. We also looked at staff training records and spoke with staff about the training they had received. We looked at the providers Annual Quality Assurance Assessment (aqaa), this gave us information about what has happened at the service since the last key inspection. At the time of this inspection the provider had engaged a management consultant to run the home. Social services had suspended all placements at the service, this means that no new admissions could be made at the home until satisfactory improvements had been made. There were only ten residents living at the home at the time of this inspection. Care Homes for Older People Page 6 of 22 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 7 of 22 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 22 Choice of home
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents are provided with the information they require to make an informed decision before moving in to Langdale Residential Home. Evidence: The provider has a statement of purpose and service users guide which provides the information people need before moving into the home. At the time of this inspection there was a suspension of placements, this means that the providers were not able to admit anyone into the home while improvement work was being carried out. Therefore, it was difficult to assess standards regarding peoples experience of moving in, or the providers assessment procedures and records. The service is registered to accommodate people with dementia and staff had received training in this area. Care Homes for Older People Page 9 of 22 Evidence: The home does not provide intermediate care. Care Homes for Older People Page 10 of 22 Health and personal care
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Langdale Residential Home had their health and personal care needs met and were treated with respect. Evidence: We looked at care plans and care records for six people living at Langdale Residential Home. Care plans were person focused and where possible residents had been involved in their care plan reviews. Care plans addressed all assessed needs and included peoples individual preferences, likes and dislikes. A document known as all about me was included in peoples care records, this provides staff with details about peoples life history and individual preferences, this assists staff to meet peoples individual needs, particularly where people have communication difficulties. Assessment of risk was also included within care records, risk such as falls, nutrition and developing pressure sores were assessed and actions staff should take to minimize these risks were stated. Detailed daily records were maintained so that an account of daily event and wellbeing were recorded. People spoken with and care records seen confirmed that people had access to health care professionals such as
Care Homes for Older People Page 11 of 22 Evidence: GPs and community nurses. Care plans set out in detail, the actions staff needed to take to meet peoples needs. Staff spoken with were able to demonstrate a good understanding of peoples individual needs. People spoken with told us that staff managed their medication well, at the time of this inspection there were no residents managing their own medication. We looked at medication administration records and found these to be up to date and accurate. Medication polices and procedures in place minimized risk for people living at Langdale Residential Home. Staff responsible for managing medication had received the appropriate training. People spoken with praised the staff employed and said they were always treated with respect and their privacy and dignity maintained. We observed staff interacting with residents and found interactions to be positive and respectful. Care Homes for Older People Page 12 of 22 Daily life and social activities
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Langdale Residential Home are able to exercise choice and control over their daily lives and are provided with opportunities to participate in social and recreational activities that meet their needs and preferences. Evidence: We spoke with three people living at Langdale Residential Home. People spoken with told us they were given opportunities to participate in recreational activities and their expectations and preferences were met. Activities provided included going out to the local shop and public house, chatting with staff, TV, music and games. People were able to observe their chosen religious practices where applicable. People spoken with told us they could choose how to spend their day and that routines of daily living were made flexible to meet individual needs. People could choose when they got up in the morning, what time they went to bed at night and whether to spend time in their own room or in communal areas. There were no restriction on visitors coming to the home and people said their visitors were made very welcome. The lunch time meal served during this inspection appeared appetizing and nutritious. One person was asleep during the lunchtime and staff said they were saving a lunch
Care Homes for Older People Page 13 of 22 Evidence: for them for later. People spoken with said that they were satisfied with the quality and quantity of meals provided. One person told us they could have a cup of tea or a snack at anytime day or night and that staff would go out of there way to get you anything you wanted even if it wasnt on the menu. We looked at the kitchen and the procedures in place to promote food hygiene and found these to be in good order. The kitchen was well stocked and staff had 24 hour access to all food stores. A weekly menu was in place and there was usually a hot option at tea time. The management consultant in charge of the home at the time of this inspection was in the process of looking at nutritional values in order to ensure that a varied and healthy menu was on offer that met peoples individual needs and preferences. A record had been made of each residents individual nutritional needs, likes and dislikes, a copy of this was available to care and catering staff. Nutritional risk was assessed on a monthly basis and a monthly body weight recorded, this ensures that people identified at risk of malnutrition are referred to the appropriate health care professional and the risk is minimized. Care Homes for Older People Page 14 of 22 Complaints and protection
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Langdale Residential Home are protected by safeguarding and complaints policies and procedures. Evidence: The provider has a complaints procedure which outlines the ways in which people can make a complaint and the actions the providers and management team will take. People spoken with told us they would feel confident making a complaint and that staff and the providers would listen to them and take appropriate action. We spoke with staff about complaints and safeguarding policies and procedures. Staff were able to demonstrate a good awareness of these policies and procedures and were able to describe the actions they would take in the event of suspected abuse. Staff had recently attended training in safeguarding policies and procedures. Since the last inspection, procedures for handling peoples personal money had been changed and improved, this minimizes the risk of financial abuse for people living at Langdale Residential Home. Care Homes for Older People Page 15 of 22 Environment
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The environment was well maintained, homely and comfortable. Evidence: We looked at communal areas and at the private rooms of people we case tracked. At the time of this inspection there were only ten residents living at Langdale Residential Home and communal areas were sufficient to meet peoples needs. Private rooms were personalized with people own possessions. People told us they were happy with their rooms, one person who had lived at the home for many years told us they would like some new furniture, we spoke with the provider, who agreed to provide this. Care Homes for Older People Page 16 of 22 Staffing
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff numbers and skill mix were sufficient to meet the needs of people living at Langdale House. Evidence: At the time of this inspection there were ten people living at the home, staffing numbers and skill mix were sufficient to meet peoples needs. A staff training and development programme was ongoing, staff had recently received updated training in moving and handling, caring for people with dementia and safeguarding people from abuse. Some care staff were working towards a National Vocational Qualification in care. People spoken with said that staff were competent to do their jobs and that there were sufficient numbers of staff on each shift. Staff spoken with said they had received the training they required and that this helped them to do their job. We looked at staff files and recruitment procedures. All appropriate checks and references were obtained before staff commenced working at the home, this ensures that staff are suitable to work at the home and that people living there are protected from abuse. Care Homes for Older People Page 17 of 22 Management and administration
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There was not a suitable manager in place to provide a longterm and consistent management approach so as to ensure the home is run in the best interests of people living there. Evidence: At the time of this inspection a management consultant was in charge of the day to day running of the home. The providers were in the process of recruiting a suitable manager. People spoken with told us that the management team were approachable. Staff spoken with told us that meeting were regularly held and that they felt supported to do their job. Since the last inspection, procedures for handling peoples personal money had been changed and improved, this minimizes the risk of financial abuse for people living at Langdale Residential Home. The management consultant had carried out detailed staff assessments and
Care Homes for Older People Page 18 of 22 Evidence: supervision of all staff working at the home. This ensures that staff are adhering to the providers policies and procedures and that the home was being run in the best interests of people living there. A quality assurance programme was ongoing and this included seeking the views of people using the service and their relatives. All mandatory health and safety training had been provided to staff working at the home, this promotes safety for people living and working at Langdale Residential Home. The providers annual quality assurance assessment told us that all routine maintenance and safety testing had been carried out. Care Homes for Older People Page 19 of 22 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 20 of 22 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 31 8 A suitable person must be appointed to manage the service. This is to ensure the service is run in the best interests of people living there. 24/12/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations 1 16 The whistle blowing policy should make reference to the Public Interest Disclosure Act and to the Charity Public Concern at Work which supports staff who make disclosures of bad practice in good faith. Care Homes for Older People Page 21 of 22 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 22 of 22 - 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!
