Inspection on 01/11/05 for Langdon House

This inspection was carried out on 1st November 2005.

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 but made no statutory requirements on the home.

Other inspections for this house

Langdon House 16/10/07

Langdon House 26/07/06

Langdon House 01/06/05

Langdon House 17/11/04

Langdon House 27/07/04

Langdon House 18/02/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Langdon House 1 Scotland Road Cambridge CB4 1QE Lead Inspector Janie Buchanan Unannounced Inspection 1st November 2005 09:00 X10015.doc Version 1.40 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 House DS0000015202.V260155.R01.S.doc Version 5.0 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 Older People. 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 House DS0000015202.V260155.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Langdon House Address 1 Scotland Road Cambridge CB4 1QE 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) 01223 578601 01223 578629 Cambridge Housing Society Ltd Mrs Susan Jill Gooch Care Home 47 Category(ies) of Dementia - over 65 years of age (11), Old age, registration, with number not falling within any other category (47) of places Langdon House DS0000015202.V260155.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st June 2005 Brief Description of the Service: Langdon House is a purpose built home owned and run by Cambridge Housing Society. It provides accommodation and personal care for 47 older people. This includes a specialist unit for the care of 11 people with one of the dementias. The home is in walking distance of local amenities and is a short drive away from Cambridge City Centre. All bedrooms are spacious and have ensuite facilities. The residents have a choice of bright airy communal rooms and also access to a newly landscaped garden. Accommodation is on two floors with the upper floor being accessed by a passenger lift. Langdon House DS0000015202.V260155.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the home’s second inspection for the year 2005/6 and was unannounced. The inspector interviewed five residents, one visiting relative, three members of staff and the assistant manager. Medication storage was checked, as was a sample of residents’ monies. A range of documents was also viewed. Six requirements and three recommendations have been made as a result of this inspection. What the service does well: What has improved since the last inspection? What they could do better: A number of residents who appeared very confused have been placed on the home’s residential units, rather than its dementia care unit. This is of concern as the home is actually only registered for 11 residents with a diagnosis of dementia and it may, therefore, be operating outside its categories of registration. These residents were also adversely affecting the daily life of the other residents on this unit. Information about residents in their care plans remains basic, is not up to date and has not been reviewed. These plans must be reviewed regularly to ensure that staff pick up any changes in residents’ needs quickly. These issues have been raised at previous inspections and failure to comply with the regulations may result in enforcement action being taken by the commission. As before, the continued use of agency staff should be reduced so that residents receive consistent care from staff who know them well. Supervision and training for domestic staff must improve to ensure they have proper guidance and skills to do their job. A manager must be appointed to ensure Langdon House DS0000015202.V260155.R01.S.doc Version 5.0 Page 6 that the requirements and recommendations of this report are actioned within the given timescales. 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. Langdon House DS0000015202.V260155.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Langdon House DS0000015202.V260155.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3,4,5 Prospective residents are encouraged to visit the home to assess its suitability. However, some residents have been inappropriately placed in units where their needs cannot be met. EVIDENCE: Three residents’ files were viewed and each contained pre-admission assessments completed by a senior member of staff at the home. Of the four residents interviewed by the inspector, two reported that they had visited the home prior to their admission and the other two stated that their family had visited on their behalf. Information packs about the home are given out when prospective residents and their families visit. Each resident is provided with a ‘Licence Agreement’ that states the terms and conditions of their residency: these agreements were viewed on the residents’ files checked by the inspector. The inspector spoke with a number of residents on the grey unit (a residential unit rather that a dementia care unit) who appeared to show considerable signs of confusion or dementia. This is of concern as the unit is not staffed Langdon House DS0000015202.V260155.R01.S.doc Version 5.0 Page 9 adequately to offer additional supervision for these residents and also these residents were adversely affecting the quality of life of the other residents living there. Two residents complained that they were frequently interrupted by confused residents wandering into their bedrooms. These confused residents must be assessed to determine if they have one of the dementias, and if so, be suitably placed elsewhere. Langdon House DS0000015202.V260155.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,9,10 Residents’ care plans are poor and do not provide staff with the information they need to satisfactorily meet residents’ needs. EVIDENCE: Individual plans of care are available but the quality of information they contain is poor. Residents’ daily routines are not recorded and there is no specific detail about what residents can, and cannot do, for themselves. It was often unclear when information had been recorded, and who had recorded it. None of the plans viewed had been reviewed monthly as required by the standards and therefore it was unclear how residents’ needs were being monitored. These issues have been raised at the two previous inspections and little progress has been made to improve these plans. Most residents stated that staff maintain their privacy well and deliver care to them in a way they like. However, one resident stated that another resident frequently wanders into his room, much to his annoyance. Staff are trying to deal with this but it was obviously a source of distress for this resident. Medication records and storage was checked. Some entries on the controlled drug register had not been double signed as required; bottles of Temazepam Langdon House DS0000015202.V260155.R01.S.doc Version 5.0 Page 11 were so sticky that their instruction labels had become obscured and in one instance what was recorded on the MAR sheet did not correspond with the number of tablets contained in the blister pack. One resident at the home currently self-medicates and the inspector viewed an appropriate risk assessment for this. Langdon House DS0000015202.V260155.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 Residents have opportunity for stimulation and recreation both in and outside the home. Routines of daily living are flexible and varied to meet residents’ needs. EVIDENCE: There are regular activities at the home, including discussion groups led by the University of the 3rd Age and trips out to local pubs and shops. On the day of inspection itself a volunteer was helping residents choose books from a visiting mobile library and residents told the inspector about a successful Halloween Party that had taken place the night before. There are no visiting restrictions and all residents reported that their visitors are made to feel welcome by staff at the home. There are no specific meetings organised with relatives and the inspector suggested that some be held as a means to consult them and involve them in the running of the home. Residents have choice over their routines of daily living. One resident commented: ‘I do what I like, there are no restrictions at all’ another ‘some residents like to stay up and watch TV but I like getting to bed early’ and another ‘I choose when I get up and go to bed, but I’m very glad to get to bed early most days’. Langdon House DS0000015202.V260155.R01.S.doc Version 5.0 Page 13 Langdon House DS0000015202.V260155.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Complaints are taken seriously by the home and residents feel able to raise concerns. EVIDENCE: Details of how to complain are included in the Service User Guide, the home’s Statement of Purpose and the complaints procedure. This is also displayed on the notice board in the main entrance. The inspector viewed the home’s complaints log and recent complaints concerned staffing levels and the cleanliness of a bedroom. Both these complaints had been addressed appropriately by the home. There was also a letter from a relative praising staff for their excellent care of her mother before she died. One relative told the inspector that she had complained once about the cleanliness of her mother’s bedroom. She stated that staff were very apologetic and the room had been cleaned immediately. Most residents interviewed by the inspector stated that they would report any concerns they had to one of the home’s management team. Staff receive regular training in the protection of vulnerable adults. Langdon House DS0000015202.V260155.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22, Residents live in a pleasant, comfortable, safe and well-maintained environment with sufficient aids and adaptations in place to maximise their independence. EVIDENCE: Langdon House is a purpose built home for older people. It provides a range of aids and adaptations to meet the needs of disabled people such as grab rails, mobile hoists, bath chairs, raised toilet seats, widened doors and a loop system (for the hearing impaired). The home is divided into four separate units and each has its own sizeable sitting room and dining area. In addition to this, there is a large seating area that overlooks the garden and smaller seating areas dotted around the home. There is no separate smoking area but residents are allowed to smoke in their own bedrooms or in the garden. There is also additional office space that can be made available to residents if required. All areas within the home are accessible to wheelchairs users. The grounds surrounding the home were tidy, safe and attractive. All bedrooms are in excess of the national minimum size requirements and have ensuite facilities. The inspector observed the home to be well maintained, clean and in Langdon House DS0000015202.V260155.R01.S.doc Version 5.0 Page 16 good decorative order, although some stained carpet was viewed in the lounge area of the grey unit. Langdon House DS0000015202.V260155.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,30 Residents’ needs are met by the number of staff, however not all staff have received appropriate training for their specific job role. EVIDENCE: Staffing levels are satisfactory. There are nine members of staff on duty between 7.30am and 2.30 pm, and eight members of staff between 2.30pm and 9.30pm to support 47 residents. There are three waking night staff. Scrutiny of the duty rota showed these staffing levels to be maintained. However, the home continues to rely heavily on agency staff and, of the nine staff on duty on the day of inspection, four of these were from an agency. Most residents were happy with the quality of the staff and comments included: ‘staff work very hard, everything is prompt and on time’; ‘the majority are good’ and ‘I can’t fault them’. However comments also included: ‘there seem to be a lot of staff changes at the moment’; ‘some staff are a little brusque with me’; ‘some staff are a little hoity-toity’ and ‘we sometimes have to wait a long time for our breakfast as staff are so busy’. The inspector interviewed one of the home’s domestic assistants who reported that the only training she had received since starting her post in July was first aid. This staff member should also receive training in infection control, COSSH requirements, and health and safety. Langdon House DS0000015202.V260155.R01.S.doc Version 5.0 Page 18 Langdon House DS0000015202.V260155.R01.S.doc Version 5.0 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,34 Residents’ monies are well looked after by the home. EVIDENCE: There is no registered manager presently in place and a manager from a sister home is overseeing the day-to-day running of Langdon House, supported by two of its assistant managers. The post is currently being advertised. An application to register a manager must be submitted to the Commission for Social Care Inspection. The home’s practices regarding residents’ monies are good. Written records of all transactions are maintained and audited regularly, receipts are kept and secure facilities are provided for the safekeeping of money and valuables. Langdon House DS0000015202.V260155.R01.S.doc Version 5.0 Page 20 Staff do receive support from their line manager, however one member of staff stated she had not been supervised in the last 5 months and another that she had not received any formal supervision since starting her post in July 2005. Langdon House DS0000015202.V260155.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x 3 3 2 3 x HEALTH AND PERSONAL CARE Standard No Score 7 1 8 x 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 3 3 3 x x x STAFFING Standard No Score 27 3 28 x 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x x 3 x 3 x x Langdon House DS0000015202.V260155.R01.S.doc Version 5.0 Page 22 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 OP4 Regulation 12 Requirement Residents must not be admitted out with the home’s current service user categories. In particular no resident with dementia must be admitted to the home’s residential care units. Those residents currently on residential units and who appear to have dementia must have their needs re-assessed and accommodated elsewhere if necessary. Residents’ care plans must set out in detail the action which needs to be taken by staff to ensure that all aspects of their health, personal and social care needs are met. Residents’ care plans must be reviewed monthly. This is outstanding from the last inspection. Two members of staff must sign the controlled drug register. A manager must be appointed Timescale for action 01/11/05 2 OP4 12 01/02/06 3 OP7 15(1) 01/01/06 4. OP7 15(2) 01/01/06 5. 6 OP9 OP31 13(2) 8(1) 01/11/04 01/02/06 Langdon House DS0000015202.V260155.R01.S.doc Version 5.0 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard OP27 OP30 OP36 Good Practice Recommendations The use of agency staff should be reduced. All domestic staff should receive training in infection control, health and safety and COSHH. All staff, including domestic staff, should receive regular supervision. Langdon House DS0000015202.V260155.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB1 5XE National Enquiry Line: 0845 015 0120 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 House DS0000015202.V260155.R01.S.doc Version 5.0 Page 25 - 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. 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