Inspection on 26/07/06 for Langdon House

This inspection was carried out on 26th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 16/10/07

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 26th July 2006 09:30 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.V306310.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.V306310.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 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.V306310.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st November 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 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 £425 and £523 per week. A copy of the latest CSCI report is available in the entrance hall to the home. Langdon House DS0000015202.V306310.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the home’s key inspection for the year 2006/7. It was unannounced. The inspector spoke with four residents, five members of staff and the manager. A brief tour of the home was undertaken and a range of documents was viewed. The inspector received a total of 35 comment cards requesting feedback about the home, completed by residents and their relatives. This was an excellent response. The majority of respondents were very pleased with the overall service provided at Langdon House, although several raised concerns about the quality of the food, the cleanliness of some areas of the home and the time it took to locate staff in the building. Two 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: All staff, including bank staff, should receive regular supervision so that they have the opportunity to discuss their working practices and training needs. More frequent and meaningful activities should be provided for all residents and in particular those with hearing and sight loss. Medication recording needs to improve to ensure that there is no mishandling. The manager must continue Langdon House DS0000015202.V306310.R01.S.doc Version 5.2 Page 6 to address residents’ very mixed opinions concerning the quality of food at the home. The long and dark corridor on the dementia care unit should be made a more interesting and stimulating place for residents who wander up and down it. 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.V306310.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.V306310.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,5 Outcomes in this group of standards are 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. Admission procedures are also good, ensuring that staff can fully meet residents’ needs. 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 and 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 their needs are fully discussed with the management team as a whole. Additional information about them is requested when necessary. Prospective residents are actively encouraged to visit the home as part of their admission procedure. The files of three recently admitted residents were checked and all contained comprehensive pre-admission information. Langdon House DS0000015202.V306310.R01.S.doc Version 5.2 Page 9 Each resident is issued with a ‘Licence Agreement’ that clearly sets out the terms and conditions of their stay at the home. Langdon House DS0000015202.V306310.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Outcomes in this group of standards are good. Residents’ health is monitored closely and there is access to a range of health care services. However medication recording must be improved to ensure that residents receive medication safely. EVIDENCE: The inspector viewed three care plans and each contained satisfactory information about residents, and their personal and social care needs. There was evidence that the plans were updated monthly to reflect residents’ changing needs. Specific ‘person centred’ care plans for those on the home’s dementia care unit are currently being implemented and these include detailed behaviour management guidelines for residents. Residents’ weights, nutrition, pressure sore risk and dependency levels are assessed monthly. A GP visits the home every Thursday; a chiropodist every 6 weeks, and an optical health care company visit every year to test residents’ sight. The home has a good relationship with the local community mental health team who visit monthly to give discuss the needs of residents on the dementia care unit. Four residents are currently seeing a physiotherapist to help them improve their mobility. Residents interviewed confirmed that they Langdon House DS0000015202.V306310.R01.S.doc Version 5.2 Page 11 receive the medical support they need. One commented: ‘ nothing seems to pass them by, they notice every small mark on my body’. On the day of inspection itself staff were actively encouraging residents have more drinks to keep help keep them hydrated in the hot weather. A sample of residents’ medication administration records were checked and a number of problems were identified in the receipt and recording of medications: the number of tablets recorded on the MAR sheets did not correspond with the actual number held; there were a number of gaps where staff had failed to sign that they had given medication to residents; dates on the MAR sheets did not correspond with actual calendar dates and hand written additions to the MAR sheets had not been signed or dated. A requirement has been made in relation to this. Residents spoken to confirmed that staff help them in a way they like. One commented ‘I never feel rushed’. Staff gave many good practical examples how they maintain residents’ privacy and dignity when assisting them with their personal care. Langdon House DS0000015202.V306310.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13, 14, 15 Outcomes in this group of standards are adequate. Family and friends are made to feel welcome and community groups are encouraged to visit the home. The quality of the food is variable. EVIDENCE: The home does provide some activities including discussion groups led by the University of the 3rd Age, regular Holy Communion and PAT (pets as therapy) dogs. The mobile library van visits and a number of residents attend day centres outside the home. Despite this a number of residents remarked on the lack of activities. Comments included: ‘there have been no activities since I’ve been her, would like to do some’ ‘there are activities but I rarely take part because I have problems with my sight and hearing’ and ‘I haven’t done any activity’. The manager is aware of this shortfall and is working closely with other homes to promote more activities. Residents confirmed that their family and friends visit them regularly and visitors who completed the comment cards stated that they were made to feel welcome in the home, and could visit their relative in private. Residents told the inspector that their daily routines were flexible and they could choose how they spend their time. Langdon House DS0000015202.V306310.R01.S.doc Version 5.2 Page 13 Six residents and relatives raised concerns about the quality of the meals provided at the home. Comments included: ‘Not enough variation on meals, would like more individual choice; and ‘too many hot meals on hot days! and ‘I believe the food could be improved- especially suppers- watery soup, sausage, hot dogs. As I imagine good nutritious food is of great import to the elderly and I’ve been surprised at some of it.’ However, some positive comments were also received and one resident, a vegetarian, was pleased with the variety of food he received. Food is also a regular topic raised by residents in their meetings. Langdon House DS0000015202.V306310.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Outcomes in this group of standards are good. 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. Cambridge Housing Society is currently updating its complaints procedure and had recently written to all residents informing them of this. Most residents stated on their comment cards that they knew who to speak to if they were unhappy and were aware of a complaints procedure. A recent complaint from a relative concerned at the high temperature of the home was being dealt with appropriately. Staff receive regular training in the protection of vulnerable adults. Langdon House DS0000015202.V306310.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,22,25,26 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. Residents make good use of outdoor areas. 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. All bedrooms are in excess of the national minimum size requirements and have Langdon House DS0000015202.V306310.R01.S.doc Version 5.2 Page 16 ensuite facilities. There are a number of aids in place to help residents find their way around the dementia care unit 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. More could be done to make this area varied and stimulating so that residents who spend their time wandering up and down it have places to stop and sit, and objects to see, touch and fiddle with. The grounds around the home are attractive and offer residents access to fresh air, light, seating, a green house and a pagoda. One resident told the inspector she enjoys eating her lunch in the garden. The inspector observed the home to be generally well maintained, clean and in good decorative order, although one boiler had broken down causing temporary problems with the hot water supply. Langdon House DS0000015202.V306310.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Outcomes in this group of standards are good. Residents are looked after by well-trained staff in sufficient numbers to meet their needs. The home’s recruitment procedures ensure that residents are protected. 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. There was some evidence that the use of agency staff has reduced since the last inspection, although two agency staff were on duty on the day of inspection itself. Most residents stated that staff were available when they needed them. The home runs a key worker system which enables closer residents/ staff relationships. One resident commented ‘I have a very good key worker who sewed my buttons on’. Staff training is good and 80 of them hold an NVQ level 2 in care: well above the minimum number required. 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. Langdon House DS0000015202.V306310.R01.S.doc Version 5.2 Page 18 Langdon House DS0000015202.V306310.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,36,38 Outcomes in this group of standards are adequate. Records are of a good standard and are routinely completed. However, all staff must receive regular supervision and fire doors must be kept closed so that residents can be protected in the event of a fire. EVIDENCE: A new manager was appointed to the home in January 2006 and she is currently applying for registration with the CSCI. Staff and residents made many positive comments about her approachability and management style. One staff member stated ‘She’s made a lot of good changes’. One resident was particularly appreciative that the new manager met weekly with residents when she was first appointed. Langdon House DS0000015202.V306310.R01.S.doc Version 5.2 Page 20 Some staff told the inspector they do receive regular supervision and they find it a useful forum to discuss their working practices and training needs. However, one member of bank staff reported that she had never received supervision and other staff reported they did receive it, but not as often as recommended by the standards. The home maintains very clear records of residents’ monies. These are routinely kept up to date and checked, and can be used to easily track individual residents’ finances. A number of records in relation to health and safety (fire, gas, lift and hoist servicing and emergency lighting tests) were checked by and found to be in good order. It was of concern to note, however, that a fire door outside the kitchen had been wedged open, thereby preventing it from closing in the event of a fire. Langdon House DS0000015202.V306310.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 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 x 3 x x 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 x 2 x 2 Langdon House DS0000015202.V306310.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. 2. Standard OP9 OP38 Regulation 13 (2) 23 (4)(c) Requirement Accurate records must be kept of all medicines received, administered and disposed of. All fire doors must be kept shut. Timescale for action 26/07/06 26/07/06 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 OP12 OP20 OP36 Good Practice Recommendations Activities suitable for residents with sight and hearing loss must be provided The corridor in the dementia care unit should be made more stimulating and interesting for residents. All staff should receive formal supervision at least six times a year. Langdon House DS0000015202.V306310.R01.S.doc Version 5.2 Page 23 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.V306310.R01.S.doc Version 5.2 Page 24 - 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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