Inspection on 10/12/09 for Langdale View

This inspection was carried out on 10th December 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 12 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Langdale View 30/12/09

Langdale View 10/07/09

Langdale View 01/04/09

Langdale View 28/10/08

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2010.

Key inspection report Care homes for older people Name: Address: Langdale View 590 Gypsy Lane Leicester Leicestershire LE5 0TB     The quality rating for this care home is:   zero star poor 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: 1 0 1 2 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 25 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 25 Information about the care home Name of care home: Address: Langdale View 590 Gypsy Lane Leicester Leicestershire LE5 0TB 01162762186 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Yasmin Kassam,Neemat Kassam Name of registered manager (if applicable) Ms Lucinda Nicholls Type of registration: Number of places registered: care home 34 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 34 The registered person may provide the following categories of service only: Care home with nursing -Code N. To service users of the following gender:either. Whose primary care needs on admission to the home fall within the following categories: Old Age not falling within any other category - Code OP . Dementia Code DE Date of last inspection Brief description of the care home Langdale View is registered to accomodate 34 older people and is also registered to accomodate people with dementia and who need nursing care. The home is a converted older building on the outskirts of Leicester City. Accomodation is on three floors which can be accessed by a passenger lift. There are two lounges and a seperate dining room on the ground floor. Care Homes for Older People Page 4 of 25 Over 65 0 34 34 0 1 0 0 7 2 0 0 9 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: zero star poor 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: This key inspection included a visit to the service. We visited the home on the 10th of December 2009. A pharmacy inspector visited the home on the 30th of December, a seperate report is available regarding this visit. The main method of inspection used was case tracking which meant selecting four residents and tracking the quality of their care by checking records, discussion with them and with staff and observation of care practices. We checked all the standards which the Care Quality Commission have decided are key standards during this inspection. In some sections we have also checked additional standards, these will be detailed in the main report. Since the last key inspection there have been concerns raised about care practice, medication procedures and staff recruitment and training procedures. As a result of Care Homes for Older People Page 5 of 25 this key inspection a referral was made to social services who are now conducting a safeguarding investigation. Since the last key inspection the service has been registered to accommodate people who need nursing care. Care Homes for Older People Page 6 of 25 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 25 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 25 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Some people who had moved into the home had not had their needs fully assessed and therefore did not have their needs fully met. Not all staff had the skills to meet the specialist needs of people living at Langdale View. Evidence: The provider has a service users guide which is given to all prospective residents, this provides the information that people need to make an informed decision before moving into Langdale View. The service is registered to accommodate people with dementia, mental health needs and people who require nursing care. A clinical lead nurse is employed to assist in the assessment and care planning of people who have nursing care needs. We looked at assessment records and found that assessments for some people were basic and lacked all the information required. The service was not able to fully meet Care Homes for Older People Page 9 of 25 Evidence: the needs of one person we case tracked. At the time of this inspection there was a management consultant in charge of the home as the registered manager had recently resigned. The management consultant felt that some people requiring nursing care had not been provided with the equipment they needed such as profiling beds and airwave mattresses that reduce the risk of pressure sores, this equipment has now been supplied. Only five staff working at the home had received training in caring for people with dementia. There were only three qualified nurses employed by the provider, many shifts were staffed with qualified nurses supplied by agencies. Care Homes for Older People Page 10 of 25 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Some people living at Langdale View did not have their health and personal care needs met and were at risk of harm because of unsafe medication management practices. Evidence: We looked at care records and care plans for four people we case tracked. Care plans were in place and some were detailed and included risk assessments and peoples personal preferences. For some people not all needs were addressed within their care plans and following observation of care practice for some people, it was evident that not all needs were being met or risks assessed. Care records seen confirmed that people had access and staff were making appropriate referrals to GPs, dietitians and community nurses. We looked at medication management procedures and records. An error had occurred in the management of one persons medication, staff had not followed safe procedures in response to this and had not reported it or sought medical advice. Care staff were Care Homes for Older People Page 11 of 25 Evidence: supplying the second signature required when controlled drugs are administered but were unclear of the correct procedure or what they were signing for. Other medication records seen appeared accurate and medication was being stored correctly. A second visit to the home was made by a specialist CQC pharmacy inspector, a seperate report is available for this visit. Interactions observed between staff and residents appeared positive and carers and staff on duty were respectful when speaking with residents. Since this inspection a concern was raised regarding the manner in which one staff member was speaking to residents, this was reported to social services who are conduction a safeguarding investigation. Care Homes for Older People Page 12 of 25 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples lifestyle choices and expectations were not always met. Evidence: Staff spoken with told us that they were extremely busy and had little time to offer people opportunities to participate in leisure or social activities. We observed people in the lounge during the morning of this inspection, people were unsupervised and unoccupied, some people appeared anxious and confused and did not receive the reassurance they required. One person was socially isolated due to communication difficulties and this person was withdrawn or asleep for the entire morning and there was minimal interaction with staff members. Staff told us that people could choose how to spend their day and that routines of daily living were flexible, however, due to the high dependency needs of some people and the numbers of staff on duty it was unclear whether this allowed staff enough time to offer choice or promote autonomy. We looked at menu records and observed the lunch time meal. There was a choice of meal available and the meal appeared appetizing and nutritious. A pureed diet was provided to two people and this was not presented in an appetizing manner or in line Care Homes for Older People Page 13 of 25 Evidence: with best practice. Nutritional risk assessments had been carried out and records of peoples weight, weight gain or loss were maintained and referrals where made to a dietitian where required. We saw evidence within care records that people were assisted to observe their chosen religious practices. Staff told us that special cultural diets were supplied where required but another staff member told us that there were no people living at the home who required such a diet. Some care records provided detail about peoples individual preferences and needs but other records we saw were very basic and did not contain enough information. This is of particular importance to people who may have difficulties with communication, staff must have as much information about them as possible if they are to meet peoples needs. There were no restrictions on visitors coming into the home Care Homes for Older People Page 14 of 25 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 poor 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 View were at risk of harm as safeguarding adults policies and procedures were not always followed by staff. Evidence: The provider has a complaints and safeguarding adults policy. At the time of this inspection, some people were at risk of harm due to lack of staff supervision. We looked at care records and accident records and found that staff had not always taken appropriate action such as seeking medical attention or making a safeguarding referral following accidents or incidents. Not all staff employed had received training in safeguarding adults and prevention of abuse. Not all staff had received training in caring for people with dementia and management of challenging behaviour, this training is required in order to keep people safe. Care Homes for Older People Page 15 of 25 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. A safe, comfortable and well maintained environment was provided. Evidence: All areas of the home seen appeared homely, comfortable and well maintained. Peoples private rooms were personalized with their own possessions. A fire risk assessment had recently been carried out and weekly fire alarm tests were being carried out. Staff were due to receive further fire safety training shortly after this inspection. There were two lounges and a separate dining room. The lounges and dining room were congenial and suitable to meet the needs of people living at Langdale View. Staff had received training in infection control which minimized the risk of cross infection. The management consultant had recently purchased equipment for prevention of pressure sores such as air-wave mattress and profiling beds. Care Homes for Older People Page 16 of 25 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing numbers and skills mix were not sufficient to meet peoples needs or to keep them safe. Evidence: We looked at staffing numbers and staff training records. We found that staffing numbers were not sufficient to meet peoples needs or to keep people safe. This is because people were left unsupervised who were at risk of falling and staff did not have any time to assist people with recreational or social activities. Staff training records were seen, not all staff had received training in safeguarding adults or in caring for people with dementia. New staff employed had not been provided with induction training. We looked at staff recruitment records, a number of staff had been employed at the home without criminal records bureau checks or without references. These checks are required to ensure that people working at the home are suitable to do so and this protects residents. At the time of this inspection the management consultant in charge of the home had taken the appropriate action and ensured that all staff working at the home had undergone the appropriate checks. Care Homes for Older People Page 17 of 25 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health, safety and welfare of people living at Langdale View was not always protected. Evidence: The registered manager had recently resigned. At the time of this inspection the home was being run by a management consultant employed by the provider. It appeared that the registered manager had failed to follow procedures required to keep people safe, such as following safe recruitment procedures, reporting incidents or accidents to social services and the CQC, and providing appropriate staff training. Quality assurance systems used were not sufficient to ensure that people were receiving the care they required or were being kept safe. Staff had received health and safety training such as moving and handling, food hygiene and infection control. Care Homes for Older People Page 18 of 25 Evidence: Information received form the provider in their annual quality assessment told us that the required maintenance work and safety checks such as electrical and heating systems had been carried out. At the time of this inspection a fire risk assessment had recently been carried out. Care Homes for Older People Page 19 of 25 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, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 4 18 Staff must receive training in 30/10/2009 caring for people with dementia and the safe management of challenging behaviour. This is to ensure people have their needs met and are protected from harm. 2 18 13 Staff must receive training regarding safeguarding policies and procedures. This is to protect people living at the home from harm. 12/10/2009 Care Homes for Older People Page 20 of 25 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 3 14 People must not move into the home unless their needs have been fully assessed by a suitable trained person and the service is able to meet their needs. This is to ensure that people moving into the home have their needs met. 31/12/2009 2 4 12 Staff individually and collectively must have the skills and experience to meet the specialist needs of people living at Langdale View. Staff must receive training in caring for people with dementia and mental health problems. Suitably qualified and experienced nurses must be on duty at all times. This is to ensure that people have their specialist needs met. 22/01/2010 Care Homes for Older People Page 21 of 25 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 3 7 14 Care plans must be in place that address peoples individual needs. Care plans must provide clear instruction to staff about how to meet people needs and keep them safe from harm. This is to ensure that people have their health and personal care needs met and are protected from harm. 13/01/2010 4 9 13 Staff must adhere to safe policies and procedures for the management of medication. This is to protect people from harm. 06/01/2010 5 12 12 People living at langdale 29/01/2010 View must be given opportunities for occupation and engagement in recreational and social activities and be encouraged to exercise choice and autonomy over their lives. This is so that people have their needs and expectations met and live fulfilling lives. 6 18 13 People at risk of falling or 05/01/2010 who may become anxious or distressed if left alone must not be left unsupervised in the lounges. Care Homes for Older People Page 22 of 25 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 This is so that people are protected from harm. 7 18 13 Staff must receive training in caring for people with dementia and the safe management of challenging behaviour. This is so that people have their specialist needs met and are kept safe from harm. 8 18 13 Staff must receive training in safeguarding vulnerable adults. This is to minimize risk for people living at the home and ensure that appropriate referrals are made where necessary. 9 27 18 Staffing numbers must be sufficient to meet peoples needs. This is so that people have their individual needs met. 10 30 18 Staff must receive the 22/01/2010 training they needs to meet peoples needs and to keep them safe. Induction training must be provided on the commencement of employment. 29/01/2010 29/01/2010 30/01/2010 Care Homes for Older People Page 23 of 25 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 This is so that people have their needs met and are kept safe. 11 31 8 A suitable manager must be appointed with the necessary skills and experience to manage the service. This is so the service is run in the best interests of people living there and people are protected from harm. 12 33 12 A programme of quality assurance must be introduced. This is to ensure that the service provided meets the needs and expectations of people living at Langdale View and that safe practice policies and procedures are adhered to. 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 26/02/2010 29/01/2010 1 15 Advice should be sought from an appropriate organization about best practice in the provision of meals for people with dementia. Care Homes for Older People Page 24 of 25 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). 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