Inspection on 28/10/08 for Langdale View

This inspection was carried out on 28th October 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 5 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 10/12/09

Langdale View 10/07/09

Langdale View 01/04/09

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 20/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address:     Langdale View Leicester The quality rating for this care home is:   one star adequate service 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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Debbie Williams     Date: 3 0 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. the things that people have said are important to them: They reflect 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Telephone number: Fax number: Email address: Provider web address: Langdale View Leicester 01162762186 Name of registered provider(s): Type of registration: Number of places registered: Yasmin Kassam,Neemat Kassam 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 only - Code PC 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. 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. 34 0 Over 65 0 34 Care Homes for Older People Page 4 of 28 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: This key inspection included a visit to the service. We visited the home on the 28th and 30th of October 2008. The inspector was accompanied by an expert by experience during this inspection. An expert by experience is a person who, because of their shared experience of using services, and/or ways of communicating, visits a service with an inspector to help them get a picture of what it is like to live in or use the service. The expert by experience spoke with several residents. The main method of inspection was called case tracking which meant selecting three Care Homes for Older People Page 5 of 28 residents and tracking the quality of their care by checking records, discussion with them and with staff and observation of care practices. We also looked at the providers own assessment of the services they provide, which they sent to us, this is called the annual quality assurance assessment or AQAA. We checked all the standards which the Commission for Social Care Inspection 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. What the care home does well: What has improved since the last inspection? What they could do better: The arrangements for storage of controlled medicines must meet the requirements of the Misuse of Drugs Act (1971) and Safe Custody amendment (2007). Consideration should also be given to the recording of times when medicines are prescribed and given, this is to ensure that people living in the home are protected from harm. People living in the home must be treated with respect and dignity at all times, staff must be instructed and trained to deliver care in this manner. People living in the home must be given opportunities for stimulation through leisure and recreational activities. Meal times should be made flexible to meet the needs of people living in the home, a varied and nutritious diet should be on offer which also meets individual needs and preferences. The providers could take a more proactive approach by seeking the views of people living in the home and responding to them promptly and appropriately. The deployment of staff should be reviewed in order to ensure that people living in the home have their needs met and are attended to promptly by staff. Quality assurance systems in place should be improved to ensure that people living in the home have their views taken into account and receive a service that meets their needs. Care Homes for Older People Page 7 of 28 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 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 28 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 9 of 28 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. People are provided with the information they require before moving into the home but this did not always match experience of the service actually received. People have their needs assessed before they move into the home. Evidence: The providers have produced a service users guide which is given to all prospective residents. This sets out the aims and objectives, services and facilities and terms and conditions of the home. The service users guide states that people will not be discriminated against regarding their age, religion, disability, sexuality, race or gender. People spoken with said that they or their family had received this information. One relative spoken with felt the information provided did not always match their experience of the service provided and this was regarding activities, menus and the laundry service. Care Homes for Older People Page 10 of 28 Evidence: The care manager said they would carry out a needs assessment before people moved into the home and that prospective residents would be encouraged to spend some time at the home before deciding whether or not to move in. One person said they did have their needs assessed before they moved in. Care records for case tracked residents were inspected, assessment records were comprehensive and included risk assessments, however, some risk assessments were incomplete and had not been reviewed for some time. Copies of the providers contract of terms and conditions and where applicable social services assessment records and care plans were seen within care records. This means that staff have access to the information they need to meet the needs of people living in the home. Care Homes for Older People Page 11 of 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home do not always have their health and personal care needs met in the manner they would prefer. The management of medication could be improved to ensure people are protected form harm. Evidence: People living in the home have an individual care plan which is generated from a needs assessment. Care plans were comprehensive and mostly addressed all assessed needs, one instance was found where the advice given by a dietitian was not Incorporated into the persons care plan. People spoken with said they were not involved in the care planning process and did not know what was in their care plans. One staff member said they did not look at peoples care plans. The care manager was introducing new care planning documentation, this was designed to be drawn up with the involvement of the residents and to be more accessible and more user friendly for staff. Care Homes for Older People Page 12 of 28 Evidence: People spoken with said they had access to health care services such as GPs and community nurses, evidence was also seen of this within care records. Care records included risk assessments although these were not always regularly reviewed or signed by staff completing them. Risk assessments included nutritional risk assessments and assessment of risk of developing pressure sores. The advice of community nurses was sought for the prevention and treatment of pressure sores and for the provision of any specialist equipment required. Medication management systems were inspected. Staff responsible for managing medication had received the appropriate training. People spoken with felt that staff managed their medication efficiently and effectively. The arrangements in place for storing controlled medicines did not comply with the Misuse of Drugs Regulations (1971) and Safe Custody Amendment 2007, a requirement was made regarding this. Medication administration records did not specify the time which medications must be administered, instead records stated morning, lunchtime, teatime and bedtime, this practice should be reviewed in order to ensure that the safe intervals required between the administration of medicines is adhered to and people are protected from harm. During this inspection some examples of positive interactions between staff and residents were observed. One interaction was observed between a staff member and resident where the staff member did not maintain dignity or treat the resident with respect. One person spoken with felt the staff did not have much time for them. One relative spoken with said that on some occasions staff spoke to residents in a patronizing way. The expert by experience spoke with three residents who said that staff were always helpful and caring and always assisted quickly. People spoken with said that staff did maintain privacy and dignity when providing personal care and support. Care Homes for Older People Page 13 of 28 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. Daily life and social activities did not meet peoples expectations and preferences. People living at the home were not helped to exercise choice and control over their lives. Evidence: People spoken with when asked about activities at the home said there was very little going on and people were left to their own devices. Another person said there was occasional games or bingo but this was not very often. People were not aware of any opportunities to take part in activities outside of the home unless they were taken out by their friends and relatives. During this inspection staff played a catching and throwing ball game with some of the residents in the main lounge. While some residents appeared to enjoy this and participated, others thought this was a game for children. People said they would like the opportunity to go out on trips or to go out shopping. There were no restrictions on visiting and people spoken with said they felt welcome at the home when they visited. Care Homes for Older People Page 14 of 28 Evidence: The lunchtime meal served during this inspection was scheduled to be served at 12:30 but did not arrive until 1:30. Residents were sitting at the table waiting for all of this time. People spoken with said that meals were frequently late and there was no choice of menu. One person said they thought you could ask for something different if you wanted to but had never tested this out. People said they would like a choice of menu. People spoken with generally liked the meals that were provided and felt they were given plenty to eat. One person living at the home was supposed to be provided with a special diet which had been devised by a dietitian. This person and their relatives said this special diet was not provided and the cook just cooked and served whatever she felt like. The cook was spoken to about this and confirmed she was not fully aware of this persons dietary needs. The cook said she did go and talk with residents to find out their likes and dislikes, she said there was no choice of menu but would make people an alternative meal if they requested one. Residents and staff were not aware of any residents meetings or any systems in place for people living at the home to become involved in decision making. The provider said they planned to introduce resident satisfaction questionnaires and the results of these would be published within a newsletter. Care Homes for Older People Page 15 of 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Policies and procedures in place protect people living in the home from harm. The providers could take a more proactive approach by seeking the views of people living in the home and responding to any concerns promptly. Evidence: A copy of the complaints procedure is provided to people living at the home as part of the service users guide. One relative spoken with said they had met with the providers on several occasions but were still not satisfied that their concerns had been addressed. A record of all complaints received is maintained. Staff receive protection of vulnerable adults and complaints training as part of their induction training when they first start working at the home. One staff member spoken with said they had also been given this training as part of their National Vocational Qualification in Care training. Staff spoken with demonstrated a good awareness of the correct policies and procedures to follow. Care Homes for Older People Page 16 of 28 Care Homes for Older People Page 17 of 28 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. People living at the home were provided with a clean, comfortable and homely environment. Evidence: People spoken with said the home was always clean and fresh. On the day of this inspection we found all areas of the home to be clean and fresh. There were two lounges on the ground floor and a separate dining room. One lounge was designated for activities. People were able to personalize their rooms with their own things such as photographs, pictures or pieces of furniture. An Environmental Health Officer visited the home earlier in the year as part of a routine visit and awarded the home with 3 stars. All routine tests and maintenance required by the local Fire Authority were being carried out in order to protect people living in the home. Staff had received infection control training and were aware of the procedures to follow Care Homes for Older People Page 18 of 28 Evidence: to minimize the risk of cross infection. Care Homes for Older People Page 19 of 28 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. The numbers and skill mix of staff met the needs of people living in the home. More effective deployment of staff would ensure that people are attended to as required. Recruitment procedures promote protection for people living in the home. Evidence: Two people spoken with said there were not always enough staff on duty and that the day before this inspection they had had to wait some time for staff to attend to them. Two people said that staff were very helpful and usually responded to them very quickly. Staff files for three people working at the home were seen and these were found to contain all necessary checks and references required, this promotes safety and protection for people living in the home. Records of staff training were also seen, a training programme was in place which ensures that staff get the training they require to meet the needs of people living in the home. All staff are provided with induction training when they first commence employment at the home and this was in line with national training organization standards. Staff Care Homes for Older People Page 20 of 28 Evidence: responsible for managing medication had undertaken training in this area. All care staff were working towards a National Vocational Qualification in care. Care Homes for Older People Page 21 of 28 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. The health and safety of people living in the home is promoted. Quality assurance procedures and staff management could be improved to ensure that the service is run in the best interests of people living in the home Evidence: An acting manager had recently taken over management responsibilities at the home. the acting manager had the relevant qualifications and experience to manage this service. People living at the home, relatives and staff said they had confidence in the acting manager and found her approachable. Residents and staff were not aware of any residents meetings or any systems in place for people living at the home to become involved in decision making. It was evident that some people living in the home were not satisfied with the way home was being run and did not feel their individual needs and expectations were always met. Following the feedback given to the provider and acting manager on the first day of Care Homes for Older People Page 22 of 28 Evidence: this inspection, action to address these issues was put into place. On the second day of this inspection the providers had already commenced individual meetings with people living in the home to find out their needs, preferences and any concerns they may have. The provider said they planned to introduce resident satisfaction questionnaires and the results of these would be published within a newsletter. A key worker system was also being set up. A quality assurance system was in place but the providers were working towards improving this to ensure that people living in the home did receive a service which meets their needs. Procedures in place to manage residents money where this was requested, promoted protection by minimizing the risk of financial abuse. Staff working a the home had received all necessary health and safety and fire safety training to promote protection and safety for people living and working at the home. Care Homes for Older People Page 23 of 28 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 24 of 28 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 9 13 The storage of controlled medicines must comply with the Misuse of drugs regulation (1971) and Safe Custody amendment (2007) This is to protect people who live in the home from harm. 30/04/2009 2 10 12 All staff must be instructed to treat people living in the home in a professional and respectful manner. People living in the home must be treated with respect and dignity. 20/11/2008 3 12 12 Routines of daily living must be made flexible and varied to meet peoples expectations and preferences. People must be given the opportunities for stimulation through leisure and recreational activities which are meaningful to the individual. People living in the home 23/12/2008 Care Homes for Older People Page 25 of 28 must be given opportunities for stimulation through leisure and recreational activities. Routines of daily living must be made flexible in order to meet peoples needs. 4 14 12 People living in the home must be helped to exercise choice and autonomy over their lives. In particular chice should be provided for meals and meal times. People living in the home must be enabled to control have control over their lives. 5 15 12 People living in the home 10/12/2008 must be offered a choice at meal times and be provided with a varied and nutritious diet at suitable times as may reasonably be required. People living in the home must be offered a choice at mealtimes and must be provided with a nutritious diet that meets their individual needs. 23/12/2008 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 7 People living in the home should be given the opportunity to be involved in the care planning process. This is to promote choice and autonomy. The actual time that medicines are prescribed to be administered and actually administered should be made clear to all staff responsible for managing medicines. This is to ensure that people living in the home are protected form harm. Page 26 of 28 2 9 Care Homes for Older People 3 16 The providers could take a more proactive approach by seeking the views of people living in the home and responding to them promptly and appropriately. The deployment of staff should be reviewed in order to ensure that people living in the home have their needs attended to promptly. Quality assurance systems in place should be improved to ensure that people living in the home have their views taken into account and receive a service that meets their needs. 4 27 5 33 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - 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!