Inspection on 16/10/07 for Langdon House

This inspection was carried out on 16th October 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Langdon House 26/07/06

Langdon House 01/11/05

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 20 Union Lane Cambridge CB4 1QE Lead Inspector Janie Buchanan Key Unannounced Inspection 16th October 2007 11:00 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.V352802.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 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.V352802.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Langdon House Address 20 Union Lane 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 Kathryn McGuirk Care Home 48 Category(ies) of Dementia - over 65 years of age (11), Old age, registration, with number not falling within any other category (48) of places Langdon House DS0000015202.V352802.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th July 2006 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 48 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. Charges vary between £453 and £557 per week. A copy of the latest CSCI report is available in the entrance hall to the home. Langdon House DS0000015202.V352802.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. For this key inspection we (CSCI) looked at all the information that we have received, or asked for, since the last key inspection. This included: • The annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. Surveys returned to us by people using the service and from other people with an interest in the service. Eight surveys were received. What the service has told us about things that have happened in the home, these are called ‘notifications’ and are a legal requirement. • • We also visited the home and talked with eight people living there and five members of staff. A tour of the premises was undertaken and a range of policies and documents were viewed. We also observed a lunchtime meal at the home. An expert by experience (ex by ex) was part of our inspection: an ex by ex is someone who has direct experience of using social care services. During this inspection the ex by ex looked at the quality of activties,and food and mealtimes for residents. His feedback is included in this report. One requirement and four recommnedations have been made as a reault of this report. What the service does well: What has improved since the last inspection? Langdon House DS0000015202.V352802.R01.S.doc Version 5.2 Page 6 The use of agency staff has reduced considerably and means residents will get better consistency of care from staff who know them well. Support for staff has improved and they now receive regular supervision and an annual appraisal of their working practices and training needs What they could do better: 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 House DS0000015202.V352802.R01.S.doc Version 5.2 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.V352802.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,5 Quality in this outcome area is good. Information available about the home is detailed, allowing prospective residents to make a fully informed choice about whether or not the home is suitable for them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a detailed statement of purpose and service user guide that are widely available to residents. A brochure about the home is also issued to prospective residents when they request an initial application form. A copy of the latest inspection report is available in the entrance to the home. Senior staff at the home assess all prospective residents and additional information about them is requested when necessary. There is also information about the home on the internet at www.cambridgehs.org.uk. Residents are issued with a licence agreement that clearly states the terms and conditions of their stay. Prospective residents are actively encouraged to visit the home as part of their admission procedure. One resident told us: ‘I was shown around, with my daughter, by a nice senior carer, who covered all our questions’. Langdon House DS0000015202.V352802.R01.S.doc Version 5.2 Page 9 The file of the most recently admitted resident was checked and contained comprehensive pre-admission information. Langdon House DS0000015202.V352802.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. Residents’ health is monitored closely and they have access to a range of health care services This judgement has been made using available evidence including a visit to this service. EVIDENCE: All residents have a care plan that clearly states the help they need. The home ensures that these plans are reviewed regularly so they can be kept up to date and reflect residents’ changing needs and residents who are able are involved in planning and reviewing their care. The plans also showed us that residents see a range of health care professionals and have their weights, nutrition, dependency levels and risk of pressure sores monitored closely. A sample of residents’ medication records and storage was checked and the following was noted: • Medicines are now stored on each unit at the home, secured to a corridor handrail by a bike lock. In addition to obstructing residents’ access to the handrails, these trolleys do not create a very homely environment and should be stored somewhere more appropriate. Also residents’ DS0000015202.V352802.R01.S.doc Version 5.2 Page 11 Langdon House • • • • confidential medical administration records were left on top of the trolleys for anyone to look at. There were a number of gaps in the MAR sheet where staff had not signed that they had administered medication There was no risk assessment available for one resident who administers her own medication A risk assessment for another resident stated that she couldn’t manage any medications but her MAR sheet stated that she was managing GTN and Beclomatasone herself. There were a number of handwritten additions to the MAR sheets that had not been signed or dated We observed staff interacting with residents in a mature and considerate manner, actively seeking their preferences and not hurrying them. Residents spoken to confirmed that staff treated them in a respectful and dignified way. Langdon House DS0000015202.V352802.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. Activities are well managed and provide stimulation and entertainment for residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Activities are well advertised: each resident is given their own copy of forthcoming events and laminated posters are on display around the home. One resident reported that she enjoyed the Monday exercise group and U3A (university of the third age) visits. Another resident stated that there were lots of activities but added there was the option not to participate. Recent developments have included a Saturday film club, art classes for residents on the dementia care unit and a gardening group. Despite this however, one resident commented that afternoons could ‘feel a bit long’ and perhaps the timings of activities could be reviewed. Some staff at the home are about to undertake reminiscence training and the home is currently creating a ‘reminiscence’ room for residents to enjoy. Family members told us that they were kept up to date with issues affecting their relative and one daughter stated that staff informed her quickly when her mum had a fall. Langdon House DS0000015202.V352802.R01.S.doc Version 5.2 Page 13 Once again we received very mixed opinions from residents about the food. The teatime meal in particular caused the most concern with residents telling us there was too much frozen food and chicken nuggets being served, and little choice offered. However both the staff and cook at the home were fully aware of these concerns and were working hard with residents to improve the menu. Lunch on the day of inspection consisted of chicken in mushroom sauce or cauliflower and broccoli bake, followed by crème caramel. Tea consisted of beans on toast. Langdon House DS0000015202.V352802.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. Residents have access to a complaints procedure and their concerns are taken seriously. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Details of how to complain are included in the Service User Guide, the home’s Statement of Purpose and the complaints procedure is displayed on the notice board in the main entrance. Residents who completed the surveys told us that they knew how to make a complaint, and those spoken to stated they would feel able to raise their concerns. There is evidence that concerns are taken responded to by staff: one resident told us ‘any problems that arise are normally sorted between staff and ourselves’: one relative commented ‘my sister and I have expressed concerns and they have been sorted out to the best of their (the home’s) ability’ Staff receive training in protecting vulnerable adults so that they are aware of the different types of abuse and reporting procedures. There have been two incidents at the home in the last year concerning the protection of vulnerable adults. Each time the home responded swiftly and professionally, informing all the relevant agencies and taken appropriate action. Langdon House DS0000015202.V352802.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,22,23,26 Outcomes in this group of standards are good. Residents live in a pleasant, comfortable, safe and well-maintained environment with sufficient aids and adaptations in place to maximise their independence. This judgement has been made using available evidence including a visit to this service. 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 also additional office space that can be made available to residents if required. All areas within the home are accessible to wheelchairs users. All bedrooms are in excess of the national minimum size requirements and have ensuite facilities. There are a number of aids in place to help residents find their way around the dementia care unit Langdon House DS0000015202.V352802.R01.S.doc Version 5.2 Page 16 such as pictorial representations of toilets on bathroom doors and a picture of each resident on their bedroom door. However the main corridor is long, dark and uninteresting for residents who spend a lot of time wandering along it. Two relatives who completed the surveys commented that the cleaning could be better. One stated ‘the level of dusting in my mum’s room is poor and clothes are not put away tidily in the wardrobe’. CSCI also received a written complaint about cleanliness in the home. However, on the day of the visit the home was clean, hygienic and free form strong smells. Carpet has been replaced in all the main lounges; giving them a brighter, cleaner feel. A mural displaying scenes around Cambridge has been painted on the upstairs corridor by students form a local college. The grounds around the home are attractive and offer residents access to fresh air, light, seating, a green house and a pagoda. Langdon House DS0000015202.V352802.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. Staff have the right skills and experience to look after residents properly. This judgement has been made using available evidence including a visit to this service. 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. The home still relies on agency staff to cover shifts, although this has reduced significantly in the last few months. Most residents and relatives told us that staff are available when needed and respond quickly to calls for help. However one relative commented: ‘it is sometimes hard to find someone to talk to at the week-end’. A resident told us ‘ at the week-ends there seems to be fewer people around and I know that residents have to wait a long time before their call is answered’. Staff training is excellent, over 50 of staff hold an NVQ level 2 in care and 6 hold an NVQ level 3. In addition to all the mandatory training required, staff also attend equalities and diversity training to ensure they can meet the varying needs of residents. The home’s recruitment procedures are good and all staff interviewed confirmed that they had received an application form and job description; had been thoroughly interviewed and had had two references and a CRB taken up before starting work. Staff personnel files are kept at Cambridge Housing Society’s head office and previous checks of these files have shown that all Langdon House DS0000015202.V352802.R01.S.doc Version 5.2 Page 18 necessary pre-employment checks are undertaken before someone starts work at the home. Langdon House DS0000015202.V352802.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36,37,38 Quality in this outcome area is good. Residents benefit from a well run home, where their views are taken seriously. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is currently operating without a registered manager, as the previous manager resigned in July 2007. However, there are good interim management arrangements in place that seem to be working well, with little impact on the overall quality of service to residents. Staff told us they felt supported, that they enjoyed their work and had access to good training. In addition to regular supervision, they receive an annual appraisal from their line manager to review their performance and identify their training needs. Langdon House DS0000015202.V352802.R01.S.doc Version 5.2 Page 20 Feedback about the service is regularly sought via residents and visitors’ questionnaires. Residents can also express their views at monthly meetings, minutes of which were viewed: these showed that residents actively discussed a range of issues including menu planning, problems with the home’s hot water system and activities. The home maintains very clear records of residents’ monies and fee payments. These are routinely kept up to date and checked, and could be used to easily track individual residents’ finances. A number of records in relation to health and safety (lift and hoist servicing, gas, portable appliance testing and emergency lighting tests) were checked by and found to be in good order. However a number of the home’s health and safety policies were dated 2004, and it was not clear if they had been reviewed and updated to comply with any changes in legislation. Langdon House DS0000015202.V352802.R01.S.doc Version 5.2 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 3 3 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 x 3 3 x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 3 x 3 3 3 3 Langdon House DS0000015202.V352802.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? no 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 OP9 Regulation 17 (1) (a) schedule 3 Requirement Accurate records must be kept of all medicines administered and risk assessments for those residents wishing to self medicate must be kept up to date Timescale for action 01/12/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2. 3. 4. Refer to Standard OP9 OP15 OP20 OP38 Good Practice Recommendations Medication trolleys should not be stored in corridors. The teatime menu should be reviewed to ensure it offers varied and tasty food for residents. The corridor in the dementia care unit should be made more stimulating and interesting for residents. The home’s health and safety policies and procedures should reviewed and updated regularly to ensure they still meet the needs of people living there, and comply with legislation. Langdon House DS0000015202.V352802.R01.S.doc Version 5.2 Page 23 Langdon House DS0000015202.V352802.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 House DS0000015202.V352802.R01.S.doc Version 5.2 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. 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