Inspection on 04/12/06 for Langdon Foundation Clore House, 11 Norwood

This inspection was carried out on 4th December 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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 15 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Langdon Foundation Clore House,... 23/10/08

Langdon Foundation Clore House,... 11/10/07

Langdon Foundation Clore House,... 25/01/06

Langdon Foundation Clore House,... 07/09/05

Langdon Foundation Clore House,... 03/02/05

Langdon Foundation Clore House,... 06/09/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Langdon Foundation Clore House, 11 Norwood Langdon Community Clore House 11 Norwood Prestwich Manchester M25 9WA Lead Inspector Julie Bodell Unannounced Inspection 4th & 11 December 2006 09:30 th Langdon Foundation Clore House, 11 Norwood DS0000008478.V297745.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Langdon Foundation Clore House, 11 Norwood DS0000008478.V297745.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Langdon Foundation Clore House, 11 Norwood DS0000008478.V297745.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Langdon Foundation Clore House, 11 Norwood Address Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Langdon Community Clore House 11 Norwood Prestwich Manchester M25 9WA 0161 773 3015 Langdon Foundation Lisa Jayne Abrahams Care Home 5 Category(ies) of Learning disability (6) registration, with number of places Langdon Foundation Clore House, 11 Norwood DS0000008478.V297745.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The Home is registered for a maximum of 5 service users to include: Up to 5 service users in the category of LD (Learning Disabilities under 65 years of age). The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 25th January 2006 Date of last inspection Brief Description of the Service: Clore House is part of The Langdon Foundation, a charitable organisation that was established to promote opportunities for young Jewish adults with learning disabilities. The home provides 24 hour support for up to 5 young Jewish female service users, most of whom eventually move on to a more independent setting. The house is situated in a quiet residential area of Prestwich, approximately three quarters of a mile from the village centre. It is within walking distance of bus routes, shops, and other local amenities. As the Prestwich area houses a large Jewish community, there is easy access to synagogues and kosher food shops. Clore House is a large detached home, similar to other properties in the area and it is not distinguishable as a care home. All the bedrooms are single. One resident is accommodated in a self contained flatlet within the building. Facilities in the home are domestic in style and provide a homely living environment. Residents have use of a lounge, dining room, and kitchen. Outside there are gardens at the front and side of the house. Langdon Foundation Clore House, 11 Norwood DS0000008478.V297745.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took 10 hours over two visits. The inspector spent time watching what went on in the home, talking to four residents, the acting manager and a staff member. The inspector also looked round some parts of the house, and looked at some key records. The acting manager has only been in post for a short time. She has an application in place to register with the Commission for Social Care Inspection. The acting manager has been registered previously. The inspector is confident that the acting manager is aware of the shortfalls within the service and is doing her best to rectify them. A further inspection visit will be made to the service to check that this has been done. What the service does well: What has improved since the last inspection? Plans are in place to improve the assessment and transitional arrangements between Langdon College and Clore House. The service has listened to the views of residents who have said, that although they liked living at Clore House, they would like to live closer to their family homes. Langdon Foundation Clore House, 11 Norwood DS0000008478.V297745.R01.S.doc Version 5.2 Page 6 Improvements have been made to the house recently and further improvements are planned to take place in the future with a new bathroom and kitchen to be fitted. The service has a new and experienced manager in place who has quickly identified shortfalls in the service provided and is addressing them. What they could do better: Improvements need to continue to be made to initial assessments, care plans and risk assessments to ensure that they give clear direction and guidance to support workers including healthcare arrangements in how they are to support residents’. The arrangements for recording information about residents and support workers must be reviewed to ensure that individual and private records are kept and securely held. In order to protect the health and welfare of residents’, improvements in the medication system must be made. A skills audit of the staff team needs to be carried out to ensure that the staff team has completed all mandatory training, LDAF and NVQ training and training in the specific needs of individual residents’. Although all the legally required information is in place on recruitment files, there needs to be greater care taken when examining the information supplied by prospective employees to ensure that it is valid and that a full employment history is given. Verification is also required for outside agency workers being employed in the home. The acting manager must complete the registration process. A review of the present management hours must be undertaken. This review must evidence that the present arrangements are satisfactory to ensure that the service is appropriately managed and monitored. A development plan to show residents, and others, how the standards in the home are being reviewed and improved upon needs to be carried out. The responsible person for the service must visit on a monthly basis to ensure that the needs and wishes of service users are being met. A copy of a valid NEICEIC certificate must be obtained to ensure that the health and safety of the residents. Langdon Foundation Clore House, 11 Norwood DS0000008478.V297745.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Langdon Foundation Clore House, 11 Norwood DS0000008478.V297745.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Langdon Foundation Clore House, 11 Norwood DS0000008478.V297745.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The acting manager is looking at ways to improve the assessment and transitional arrangements for prospective residents’ moving from the College to Clore House to ensure that their needs can be fully met and that the move is what the resident wants and is in their best interests. EVIDENCE: The residents originally moved to the area to attend Langdon College and initially lived in student accommodation. Once their time at College is completed they moved to Clore House under Langdon Community. Both services fall with in the organisation known as Langdon Foundation. Residents had a good understanding of their own support needs. Residents spoke positively about the Home and they liked being close to the friends that they had made in the area. However, many residents come from the London area and some said that they missed being close to their families and would be prefer to live near to them. The inspector was informed that this was being explored by the organisation. Langdon Foundation Clore House, 11 Norwood DS0000008478.V297745.R01.S.doc Version 5.2 Page 10 Documentation relating to the residents is transferred from one service to another. The acting manager is aware that more work is needed so improve the assessment process from the College to the Community to ensure that Clore House is able to meet the needs of prospective residents and that that the move was in the prospective residents best interests and what they wanted. The acting manager said that she will be working closely with the registered manager of the College in future to ensure that this happens. Langdon Foundation Clore House, 11 Norwood DS0000008478.V297745.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6 7 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Further improvements are needed to care plans and risk assessments to ensure that support workers are clear as to how to support the residents safely and in line with their wishes, which are regularly reviewed by the acting manager. Residents are able to make choices about their lifestyles, with help from support workers if necessary to exercise their right to autonomy and individuality EVIDENCE: Residents’ records have been re-organised and some improvements have been made to care plans and risk assessments. However following examination of a service users file and discussion with the acting manager it was agreed that they could be improved further to ensure that support workers had the most up to date and relevant information and guidelines. Langdon Foundation Clore House, 11 Norwood DS0000008478.V297745.R01.S.doc Version 5.2 Page 12 This is particularly important for agency support workers, which the home sometimes uses. It will also ensure that the support workers adopt a consistent approach from clear written direction from the acting manager that links to their job descriptions. It was discussed that it may be beneficial to look at recently updated formats within Langdon College and consider whether they are transferable to Clore House as a way of introducing standardised recording formats throughout the organisation, where possible and that also link to developing IT systems within the organisation. When considering new formats it will also be important to take into account the new seven quality of life outcomes for residents that the service will be inspected against in the near future. Discussions with the acting manager show that she has good knowledge and understanding of residents’ likes, dislikes, wishes, and goals. Residents have a key worker. There is evidence that formal review meetings take place and the resident, relatives and social workers were invited to attend to discuss their support needs and goals. The inspector met with four residents as a group and spoke to two independently over the two days. It was clear that residents’ felt that it was their home and they had a lot of say about what happened in the home and in their day-to-day lives. They enjoyed the fact that they had their independence and freedom. The residents appear to get on well as a group and could be open and honest with each other. Observation showed that the support workers were attentive whilst supporting them discreetly. The inspector had some concerns about confidentiality around written information. The message book, which holds some personal information about people was left on the dining table and was accessible to everyone. In the office/sleep in room group held information was also found. Individual records must be maintained in respect of personal information. Some information introduced by the previous manager appears to be missing. The acting manager is currently reviewing these systems. Langdon Foundation Clore House, 11 Norwood DS0000008478.V297745.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11 12 13 14 15 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are encouraged and supported to take part in meaningful activities. They participate in the community and in the main lead fulfilling lifestyles. Contact with families and friends is encouraged and supported. Practices in the home respect residents’ rights to privacy, independence and choice. Cultural needs are both respected and supported. EVIDENCE: It was clear from discussions, observations, and records that residents were encouraged to participate in fulfilling activities, with support workers as necessary. On the first day of the inspection one resident was out at college, another resident was being supported to go to work experience, one resident was in London and two residents were at Clore House. One was getting up at a leisurely pace, with the support of a staff member and the other was Langdon Foundation Clore House, 11 Norwood DS0000008478.V297745.R01.S.doc Version 5.2 Page 14 emailing friends on the homes computer. Support is available within the organisation to help service users access education and work opportunities. Residents have regular contact with family and friends and make frequent trips home to London, with support where necessary. This is done by making and receiving visits, and by telephone and email. Residents have lots of friends locally through their connections with Langdon College. Many of the group had long-standing friendships or personal relationships. Arrangements had been made to hold the Hanukah celebration at Clore House. The inspector’s return visit was the day after the party. It was clear that everyone had had a great time though thoroughly exhausted and were “chilling out” watching television. During the group discussion, residents said that they had choices about their daily routines, for example what time they went to bed, what they ate, or what they did throughout the day. Some residents are going on holiday abroad together early in the New Year. There is an expectation that residents work towards gaining more independence and involve themselves in tasks around the house. Cultural and religious needs are respected. For example kosher meals were prepared, and Shabbas, and Jewish festivals were observed and celebrated as identified above. Residents have different levels of observance and this has been the source of some tension between residents. There have been issues around Shabbos. These have been discussed and the group are now in agreement that Shabbos should be respected as a time for rest and contemplation. Residents said that they liked the new manager and the permanent support workers. They said that staff members were polite and respectful. A good rapport was observed between the residents and the staff team and a happy and relaxed and friendly atmosphere prevailed throughout the inspection. Residents were satisfied that their privacy was respected, for example staff knocked on their bedroom doors. Locks were fitted to bedroom doors. Mail was given to them unopened. Meals are planned to meet the cultural needs, and preferences of the group. The residents were seen to access the kitchen freely to make small snacks or were provided with food on request. The present layout of the kitchen does not meet Kosher requirements for food preparation. Arrangements are in place to have a new kitchen fitted. Residents said that they were satisfied with the meals that were provided. Langdon Foundation Clore House, 11 Norwood DS0000008478.V297745.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18 19 and 20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Most residents attend to their own personal needs, with prompt and encouragement if needed. Any changes in health needs are dealt with in liaison with the appropriate specialist health services. There are concerns about the safety of the present medication system. EVIDENCE: Most residents are fully able to express their wishes about the way they were supported and in away that ensures that they remain as independent as possible. Support workers prompt and encouragement residents to maintain their personal needs as necessary. Discussions with residents and the acting manager as well as the examination of records indicated that residents used community healthcare services such as dentists and GPs. Residents said that a staff member usually accompanied them to appointments. Three service users have specific healthcare needs. Records showed that the home requested assistance from specialist health Langdon Foundation Clore House, 11 Norwood DS0000008478.V297745.R01.S.doc Version 5.2 Page 16 workers where needed. The home has experienced some difficulties in getting access to healthcare support because of crossing boundaries but in the main and after a lot of effort this has been resolved. Improvements had been noted in the health of one resident who has recently moved into the home. The acting manager has good knowledge and understanding of the residents needs and is conscious of the balance that needs to be maintained between her duty of care, keeping the residents safe and well and also taking the residents wishes into account. One resident said that following a number of incidents that she was not confident that new or agency staff would support her appropriately and safely when she was ill and very vulnerable. This needs to be addressed by clear direction and guidance on care plans and risk assessments. The pharmacist inspector visited the home on 26th September 2005 to look at medication procedures. The inspector examined the medication procedures and still has some concerns. The inspector has asked the pharmacist inspector to visit the home again to look at the overall system with particularly reference to the emergency stock of medication that does not seem to be accounted for on the MAR sheet. Medication that has been supplied from a pharmacist whilst the resident has been at home, also does not appear on the MAR sheet. Three service users have specific issues around medication and the arrangements for administration need to be looked at in more detail with clear written procedures for support workers to follow to ensure the residents safety. There are also concerns about the regular use of homely remedies. Again it would be useful to look at the systems put in place within the Langdon College service to see if they would be beneficial to Clore House. Langdon Foundation Clore House, 11 Norwood DS0000008478.V297745.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents were confident that if they had any problems or concerns they could approach the manager who would listen to them and take action. Evidence needs to be produced to show that all the staff team have received adult protection training that makes clear links local authority adult protection procedures. EVIDENCE: The home has a written complaints procedure. A record of complaints is maintained. Two complaints are recorded and have been dealt with. Residents said that they would speak with the manager if they had any concerns. They were confident that the manager would listen and sort out any problems they had. A residents meeting was held on 27.11.06, which also gives the residents an opportunity to raise any issues that they have. There have been no complaints about the service to CSCI. There are written procedures covering adult protection. There have been no reported allegations of abuse. Evidence needs to be gathered as part of the skills audit currently being undertaken by the manager to ensure that all the staff team have received training in adult protection that makes clear links to local authority procedures. This will area will be looked at again at the next inspection visit. Langdon Foundation Clore House, 11 Norwood DS0000008478.V297745.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Clore House provides a clean, homely, well-maintained environment for residents, suited to their lifestyles. A number of improvements have been made to the house recently with more to be carried out in the near future. EVIDENCE: The house is a large detached home, similar to other properties in the area. It is not identifiable as a care home. All bedrooms are single. One resident lives in a self contained flat within the building. The home is situated in a residential area of Prestwich, about three quarters of a mile from the village centre. It is close to bus routes, kosher shops, synagogues, and other local amenities. Since the acting manager took up post there have been many improvements made to the house including new carpets and redecorating, a new central Langdon Foundation Clore House, 11 Norwood DS0000008478.V297745.R01.S.doc Version 5.2 Page 19 heating system, new beds and bedding to some rooms. Plans are in place to have a new kitchen and bathroom fitted in the spring. The communal areas of the home and two bedrooms were looked. These areas were comfortable, homely, and well maintained. The home was furnished with domestic style furnishings and equipment. Bedrooms were individually decorated and furnished, and highly personalised with residents’ own possessions. One bedroom has recently been refurbished with new bedroom furniture and curtains. The home was clean and tidy throughout at the time of the inspection. Langdon Foundation Clore House, 11 Norwood DS0000008478.V297745.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32 34 and 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Langdon Community provides training to equip staff with the knowledge and skills that they need to meet the needs of the residents. However, there are a few gaps that need to be addressed and the manager is undertaking a skills audit of the staff team to identify the shortfalls and make arrangements for the training to be carried out. The recruitment documentation of current employees is to be scrutinised by the acting manager who will verify and validate information if and where necessary. EVIDENCE: Residents were happy with the support they received from permanent staff members. It was observed that residents had no hesitation in approaching staff members if they needed them. Residents felt that the staff team were approachable, and that they listened to them. They did however express that they did not like support workers that they have got to know leaving and having to get to know new people. They also said that they were not also happy about having agency support workers in the house and were not always confident that they could support them safely with specific healthcare needs. Langdon Foundation Clore House, 11 Norwood DS0000008478.V297745.R01.S.doc Version 5.2 Page 21 There are induction-training books in place for permanent members of the staff team. The staff member spoken with said that she had received induction training and that the manager and staff had been very welcoming and helpful. The acting manager is checking for any gaps in mandatory training and is currently undertaking a skills audit. This should also identify gaps in training in the specific needs of individual residents, particularly around healthcare. Also to be included is the present position at Clore House regarding NVQ training to ensure that 50 of the staff team hold a relevant NVQ qualification. The inspector discussed with the acting manager the possibility of contacting Bury Adult Care Partnership to check out whether it is a suitable option for the staff team to attend Skills for Care training through the partnership arrangements. This would also be a means of keeping the acting manager updated in new training initiatives and an opportunity to network. It also might be beneficial to discuss the appropriateness of the partnership with the registered manager for Langdon College who may already have had contact with this organisation. Staff recruitment records were looked at and they contained most of the necessary records required by the law. However, on closer examination of the information received by the organisation did not appear to stand up to scrutiny particularly around the authenticity of references and training certificates. It was discussed that it may be useful for the manager to receive training specifically in recruitment and selection of prospective workers from oversees. It was agreed that the acting manager would take a close look at the recruitment files for all support workers currently employed at Clore House. The inspector also discussed with the manager her need to ensure that agency workers also met legal recruitment requirements through written confirmation from the registered manager of the agency supplying the support worker. Again it would be helpful to speak with Langdon College to check what systems they have adopted. Clore House also use support workers from other houses within Langdon Community. It is noted that this part of the organisation remains un-registered and there is no guarantee that these workers meet the legal requirements. The acting manager is reminded that once registered she will be responsible for the support workers operating within Clore House and the recruitment process, which is the first basic safeguard to protect vulnerable service users. The acting manager plans to hold a staff meeting in the near future. Evidence of staff supervision will be looked at during the next visit. Langdon Foundation Clore House, 11 Norwood DS0000008478.V297745.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37 39 and 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents benefit from the open management approach of the home and they are comfortable about expressing their wishes and opinions. A written plan to show residents and others how their views are being used to improve the service needs to be produced. The health and safety of residents and staff is generally well promoted. EVIDENCE: Clore House has not had a settled manager for sometime. in post. She has worked for the organisation for sometime organiser and at Clore House for approximately 4 months. application to register with the CSCI. The acting manager Langdon Foundation Clore House, 11 Norwood DS0000008478.V297745.R01.S.doc A new manager is as an activities She has sent in an has many years Version 5.2 Page 23 experience working in residential care settings. She has been registered previously and holds the Registered Managers Award. Following discussion with the acting manager it is clear that the home would benefit from a capable and competent manager, who will give support workers clear direction and expectations and ensure that the residents receive the continuity and consistency that they need. At this time there is still only 18.30 management hours available to the acting manager. Although the manager felt this was adequate. The inspector was less confident given the shortfalls identified at this inspection that this is ample time to effectively monitor the performance of staff. It is a requirement of the regulations that the manager is “intended to be in full-time day-to-day charge of the care home” and therefore management hours should be available to her. This situation needs to be reviewed by the organisation giving clear reasons and evidence as to why the organisation believes that this is not necessary in this case. The acting manager said that she is supported well by her line managers. The inspector is very confident after discussion with the acting manager that she is aware of the shortfalls and issues that need to be addressed within the service and that this will take time to action. It was agreed that it would be more productive to give the acting manager time to work on the identified areas and return to carry out a second inspection visit at a later date, but before the end of March 2007. A resident said that she felt that the manager was “very efficient.” As discussed at previous inspections a quality review of the service needs to be undertaken and a written report produced. A copy of the report needs to be made available to residents, and others, so that they know that their views have been noted and, where applicable, acted upon. A copy also needs to be sent to the CSCI. This matter has been discussed at previous inspections. The acting manager was not aware of the availability of a report and would check out what progress had been made. The identified responsible individual must undertake visits as specified in Regulation 26 and a copy of the written report produced in relation to this visit must be forwarded to CSCI. The importance of both these reports as self-assessment tools as part of inspecting for better life processed was discussed with the acting manager. Several safety records were checked. These included the gas safety report, servicing of the fire alarm and extinguishers. A valid NEICEIC certificate could not be located. The acting manager has produced a house file, which will help support workers to locate meters etc and contact numbers for maintenance contractors. Langdon Foundation Clore House, 11 Norwood DS0000008478.V297745.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 2 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 2 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 2 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 X 2 X 2 X X 2 X Langdon Foundation Clore House, 11 Norwood DS0000008478.V297745.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA2 Regulation 14 Requirement That a review of the assessment process for the transition of service users from the College to Clore House is undertaken to ensure that the process and the arrangements made are in the best interests of the service users. That the adequacy of current care/support plans are reviewed to ensure that they clearly identify all the needs of each individual service user and give clear direction to support staff as to what action they are to take. That the adequacy of current risk assessments are reviewed to ensure that they clearly identify all the needs of each individual service user and give clear direction to support staff as to what action they are to take. That the service users’ right to confidentiality is maintained by ensuring that information about them is held individually and securely held. That the specific healthcare needs of service users’ are clearly identified on the service DS0000008478.V297745.R01.S.doc Timescale for action 28/02/07 2. YA6 15 28/02/07 3. YA9 13 28/02/07 4. YA10 17 28/02/07 5. YA19 13 28/02/07 Langdon Foundation Clore House, 11 Norwood Version 5.2 Page 26 6. YA20 13 7. YA23 13 8. YA32 YA35 18 9. YA34 19 10. YA37 9 11. YA37 8 user plans and risk assessments and give clear direction to support staff as to what action they are to take in a medical emergency. That improvement is made to the medication system to ensure the health and safety of service users. That as part of the skills and training audit the manager ensures that all the staff team have received training in adult protection procedures that makes clear links to local authority procedures. That as part of the skills and training audit the manager ensures that the staff team have received all the necessary mandatory training and training to meet the specific needs of individual service users needs. Evidence of who has completed NVQ training is also needed to ensure the competence of the staff team to meet the needs of the service users. That the recruitment documentation supplied by current employees is scrutinised and validated where appropriate to ensure that it is authentic. The reasons for any gaps in employment should be sought and recorded. Verification that the legal requirements of outside agency workers are in place is sought and that this is recorded. This is to ensure that service users are protected from potential abuse. That the acting manager completes the registration process with CSCI to ensure fitness to carry out the role. That a review of the present management hours is carried out DS0000008478.V297745.R01.S.doc 28/02/07 28/02/07 28/02/07 28/02/07 28/02/07 28/02/07 Langdon Foundation Clore House, 11 Norwood Version 5.2 Page 27 12. YA39 24 13. YA39 26 14. YA42 13 to ensure that it is adequate to meet the regulations and ensure that the service is appropriately managed and monitored to ensure consistency for the service users. A quality review of the service must be undertaken and a copy of the report produced must be forwarded to CSCI. That the responsible individual undertakes visits as outlined in this regulation. A copy of the written report produced must be forwarded to CSCI That a valid NEICEIC certificate is forwarded to CSCI to ensure that the electrical fittings and fitments at the home are safe. 28/02/07 31/01/07 31/01/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Langdon Foundation Clore House, 11 Norwood DS0000008478.V297745.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Langdon Foundation Clore House, 11 Norwood DS0000008478.V297745.R01.S.doc Version 5.2 Page 29 - 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. 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