This inspection was carried out on 30th June 2009.
CQC found this care home to be providing an Poor service.
The inspector found there to be outstanding requirements from the previous inspection
report. These are things the inspector asked to be changed, but found they had not done.
The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.
Random inspection report
Care homes for older people
Name: Address: Langdale Residential Home 6 Church Street Sapcote Leicestershire LE9 4FG zero star poor service 15/04/2009 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme 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 review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Debbie Williams Date: 0 2 0 7 2 0 0 9 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: Conditions of registration: Category(ies) : Miss Neemat Kassam,Mrs Yasmin Nazir Kassam care home 27 Number of places (if applicable): Under 65 Over 65 5 5 27 7 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Conditions of registration: 0 0 0 0 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 0 3 0 3 2 0 0 9 Care Homes for Older People Page 2 of 14 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, 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 3 of 14 What we found:
We visited the service on the 30th of June and the 2nd of July 2009 to carry out this random inspection. We case tracked two people living at the home and looked at their care records, spoke with staff about there care needs and observed care practises. We also looked at staff training records and spoke with staff about the training they had received. The registered provider was unavailable for the first day of this inspection, the home was being managed by two acting managers and the area manager was also present. We looked at staff recruitment files for five staff members and found that two references had been obtained for each staff member and that Criminal Records Bureau checks had been carried out, this is to ensure that staff are suitable to work at the service. We looked at the staffing rota and asked the provider for a copy of the rotas for 2008 but these were unavailable. We looked at staff training records and spoke with five staff members about the training they had received. One staff member told us they had completed training regarding caring for people with dementia, protection of vulnerable adults and moving and handling. This staff member was able to demonstrate a good understanding of vulnerable adults policies and procedures and said they would report any suspected abuse to a senior person. We found that an allegation of abuse that occurred earlier in 2009 was never reported by the provider to social services or to the CQC and therefore safeguarding polices and procedures had not been followed. During this inspection we witnessed care staff responding inappropriately to a resident who was clearly becoming distressed and this culminated in the resident lashing out at one staff member. One staff member we spoke with had training certificates in their file for dementia awareness and protection of vulnerable adults but had never received this training. This staff member was caring for people with challenging behaviour and exposed to verbal and physical aggression on a day to day basis but had not received training on how to respond to this or how to protect people from harm. We found that management arrangements at the home were not sufficient to meet the needs of people living at the home or to protect them from harm. At the time of this inspection the home was being managed by two acting managers but it was not clear whether they had the relevant skills or experience to run the service in the best interests of people living there. At the time of this inspection the service was also being closely monitored by the local authority and a voluntary suspension of placements was in place, this means that the providers had agreed not to accept any new admissions until improvements had been made. Care Homes for Older People Page 4 of 14 On the second day of this inspection we case tracked and looked at care records for two people living at the home. We observed one resident we case tracked shouting at another resident in the lounge. The second resident we case tracked was also shouting and appeared distressed. We could not find any information in care records for staff regarding how they should respond to these behaviours. We observed a care assistant serving a hot drink to one resident, although care records stated this person should have a thickening agent added to drinks to minimise the risk of choking, this had not been used and when we queried this we found that although this thickening agent had been prescribed by a GP, there was no stocks available at the home. The medication administration record for the day of this inspection was signed to say this had been given even though there was none in the home. The acting manager arranged for some thickening agent to be collected from the chemist once this omission had been pointed out. Later in the morning during this inspection we observed the two residents we case tracked asleep in the lounge. One resident was asleep in an upright armchair and was trying to lie down and was consequently slumped in their chair. The second resident was also asleep in their chair and was leaning froward resting their head on the wooden arm of the armchair. We spoke with two staff members about the care needs of the residents we case tracked. Staff spoken with told us about the care needs and these included frequent challenging verbal and physically aggressive behaviour. We looked at care records and found they did not contain clear instruction for staff on how to respond to these needs. Staff also told us about physical needs that were not addressed within care records. This means that there is a risk that the health and welfare and personal support needs of people living at the home may not be met by staff. What the care home does well: What they could do better:
Records specified within the Care Home Regulations 2001 should be kept in the care home for a minimum of three years, staff duty rotas are included in this regulation and must be kept securely in the care home and made available for inspection. All incidents of suspected abuse must be referred to social services as a safeguarding adults concern, this is to ensure the concern is investigated and measures are taken to protect people from harm. Staff must receive instruction and training regarding the safe management of challenging behaviour, staff must have an understanding of peoples individual needs and know how to respond to peoples individual needs. Care plans must be in place that address peoples individual needs, these must provide instruction for staff to follow on how to meet the health welfare and personal support needs of people living at the home. The home must be managed by a person with the relevant skills and experience to meet
Care Homes for Older People Page 5 of 14 the needs of people living at the home and the ability to provide a clear sense of leadership and direction. People living at the home must be provided with the medicines prescribed to them by their GP and must receive the care and treatment they require. 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 set out on page 2. Care Homes for Older People Page 6 of 14 Are there any outstanding requirements from the last inspection? Yes R No £ 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, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action 1 3 14 People moving into the home 29/05/2009 must have their needs assessed and this assessment must be kept under review and revised at any time that this is necessary This is to ensure that people living at Langdale House have their needs met. 2 4 18 Staff must individually and collectively have the skills and experience to meet the specialist needs of people living at the home. This is to ensure that people with dementia or mental health have their specialist needs met. 26/06/2009 3 7 14 People living at Langdale House must have a plan of care based on a comprehensive needs assessment. The care plan must set out in detail the action which needs to be taken by staff to meet all aspects of health, personal and social care needs. This will ensure that people living at Langdale House 30/05/2009 Care Homes for Older People Page 7 of 14 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, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action have their needs met. 4 7 15 Care records must be reflective of peoples changing needs. A record must be kept of the wellbeing or otherwise, events of the day and care provided for people living at the home. This is to keep people living at the home safe from harm. 5 8 12 People living at Langdale House must have access to all required health care services. This is to ensure people have access to the health care services they require and receive the treatment they need. 6 9 13 Staff must follow safe policies and procedures for the management of medicines. This is to ensure people living at the home receive the treatment prescribed to them by healthcare professionals and are kept safe from harm 7 9 13 Accurate records of the receipt, administration and disposal of medicines must be kept. This is necassary in order to demonstrate that medicines
Care Homes for Older People Page 8 of 14 20/03/2009 29/05/2009 30/03/2009 29/05/2009 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, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action are administered as prescribed. 8 12 12 People must be given the opportunity for stimulation through recreational and social activities. Staff must receive the training they require to provide meaningful activity for people with dementia. This is to ensure people living at Langdale House have a fulfilled lifestyle. 9 12 12 Routines of daily living must be made flexible in order to meet individual needs and preferences. This is to ensure that are able to make decisions about the care they receive. 10 12 12 People living at langdale House must be given opportunities to excersise choice. This is to ensure that choice and autonmy are promoted. 11 18 13 National and local 29/05/2009 safeguarding policies and procedures must be adhered to and staff must receive training in this area. This is to protect people living at Langdale House from harm. 12 18 13 Staff must receive training in 29/05/2009 caring for people with
Page 9 of 14 05/06/2009 22/05/2009 15/05/2009 Care Homes for Older People 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, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action dementia and safe management of challenging behaviour. This is to ensure that people living at Langdale House are protected form harm. 13 18 13 Staff must respond 20/03/2009 appropriately to any incident of suspected abuse and must follow safeguarding adults policies and procedures. This is to protect people living at the home from harm. 14 22 13 Specialist equipment must be 22/05/2009 fit for use and properly risk assessed. This is to promote safety for people living at Langdale House 15 27 18 Staff must be trained and 31/03/2009 competent in order to meet peoples needs. In particular, caring for people with dementia and challenging behaviour. Moving and handling and safeguarding vulnerable adults. This is to ensure that people living at the home have their needs met and are kept safe from harm. 16 31 18 People working at the home 20/03/2009 must be appropriately supervised to ensure that care practice adheres to safe
Page 10 of 14 Care Homes for Older People 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, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action policies and procedures This is to ensure that people living at the home receive the care that meets their needs and are kept safe from harm. 17 31 8 A manager must be appointed to manage the home effectively. Langdale House must be managed in the best interests of people living there. 18 38 13 People living at the home 20/03/2009 must have their moving and handling needs risk assessed by a person trained to do so. Staff must use appropriate and safe moving and handling techniques. This is to keep people living at the home safe from harm. 26/06/2009 Care Homes for Older People Page 11 of 14 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, 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 7 15 The provider is required to 07/09/2009 prepare a written plan for each service user setting out how their needs in respect of health and welfare are to be met. A statutory requirment notice has been issued. This is so that people living at the care home have their health and welfare needs met. 2 7 15 The provider is required to 07/09/2009 put in effective systems to ensure that as service users needs change, the service users plan is updated so that the plan is an accurate record of the persons current needs and how they should be met. A statutory requirement notice has been issued. This is so that people living at the care home have their health and welfare needs Care Homes for Older People Page 12 of 14 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 met. 3 18 13 The provider must make arrangements to prevent service users being harmed or being placed at risk of harm or abuse. A statutory requirement notice has been issued. This is to protect people living at the home from harm or suffering abuse. 4 37 17 Records required for the 13/08/2009 effective and efficient running of the home must be securley stored at the care home for a minimum of three years. This is for the protection of people living at Langdale House 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 07/09/2009 Care Homes for Older People Page 13 of 14 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 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 14 of 14 - 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!
