Inspection on 07/06/05 for Langdown House

This inspection was carried out on 7th June 2005.

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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Langdown House 17/02/09

Langdown House 20/02/08

Langdown House 07/09/06

Langdown House 08/11/05

Langdown House 07/10/04

Langdown House 22/07/04

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

CARE HOME ADULTS 18-65 Langdown House 1-4 Yeend Close West Molesey Surrey KT8 2NY Lead Inspector Kenneth Dunn Unannounced 7 June 2005 10:00 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 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 Stationary 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. Langdown House Version 1.10 Page 3 SERVICE INFORMATION Name of service Langdown House Address 1-4 Yeend Close, Off High Street, West Molesey, Surrey, KT8 2NY Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0208 9794561 Kingston YMCA Care in the Community Ltd CRH 28 Category(ies) of LD Learning Disability - 24 registration, with number LD(E) Learning Disability - over 65 - 4 of places MD Mental Disorder - 2 MD(E) Mental Disorder - over 65 - 1 Langdown House Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: 1) Of the 24 service users within the category LD (Learning Disabilities), 2 may also fall within the category MD (Mental Disorder). 2) Of the 4 service users within the category LD(E) (Learning Disabilities - over 65), 1 may also fall within the category MD(E) (Mental Disorder - over 65). 3) The age/ age range of those to be accommodated will be: 24 residents aged 32-64 years, 4 residents currently over the age of 65 years. Date of last inspection 7 October 2004 Brief Description of the Service: Langdown is located in the centre of the local Molesey community and benefits from good access to transport, shops, banks and other local facilities. Langdown House consists of four, seven bed roomed detached houses, purposely built and designed with specific attention to the service users. In addition all 4 house benefits from individual private gardens. Service users have single bedroom accommodation and each room is linked to an emergency call system. Specialist equipment can be made available if required. Langdown is owned and managed by Kingston YMCA, with staff under contract to Surrey County Council Langdown House Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 5.5 hours and was the first inspection to be undertaken in the Commission for Social Care Inspection year April 2005 to March 2006. Mr Kenneth Dunn, Lead Inspector for the service, carried out this inspection Mrs. Jane Gupta the newly appointed and registered home Manager was present as a representative for the establishment. A tour of the premises took place policies and procedures were discussed with the manager who explained that she was undertaking a full evaluation of all documents and procedures at Langdown House. Service users who spoke to the inspector talked at length about the home and what they liked and disliked about living at this service. The service users from house 2 were not present during this inspection they were on their annual holidays the choice this year was Hastings. The inspector would like to thank the staff and students for their time, assistance and hospitality during this inspection. What the service does well: What has improved since the last inspection? The previous inspection was a positive one, and there no concerns raised as a result. Langdown House Version 1.10 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Langdown House Version 1.10 Page 7 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 Standards Statutory Requirements Identified During the Inspection Langdown House Version 1.10 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 4 &5 Residents have the information they need to make an informed choice about where to live. The home has an admission procedure in place that includes a basic needs assessment for an individual and offers the person an opportunity to visit the home. Contracts were in place for residents whose files were looked at. However all of the documents are under review to ensure that they accurately depict the true nature of the service and the service users. EVIDENCE: The statement of purpose and service users guide complies with the National minimum Standards. In discussions with the manager it was felt that both documents should be reviewed and changed to reflect fully the service and the service users. The format must be in an appropriate format to allow the service users to access the information they contain. The admission procedure talks about pre-admission assessments that must be carried out and offers trial visits to the home on numerous occasions. The manager must ensure that any potential new admission into the home fully complies with their policies. Therefore the manager must review the policies of admission to ensure that they are fully based upon the National Minimum Standards for Younger Adults specifically standards 2, 3, 4 & 5. Langdown House Version 1.10 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8, 9 & 10 Staff have a good understanding of the residents support needs. This is evident from the positive relationships, which have been formed between the staff, residents and their representatives. The systems for service user consultation were good, with a variety of evidence that indicated that their views are sought in relation to their needs and aspects of their lives in the home. There was clear care planning and risk assessing in place. EVIDENCE: Care plans were found to be good, giving an insight into the personal and social history of each resident together with a comprehensive risk assessment. One of the residents spoken to during the inspection said that she had a cold and had not attended the day centre morning. She was unsure as to whether she should do anything in the afternoon and the member of staff reassured her that whatever decision she made would be alright. Staff were observed sitting with one of the residents listening to her express her feelings, thoughts and memories about a family member. The manager plans to introduce person centred plans (PCP)and evidence of the work done was available. The manager felt that PCP offer a more accurate all round picture of the service users and there introduction would enhance the service for both service users and staff. Langdown House Version 1.10 Page 10 Residents informed the inspectors that they were involved in the running of the home, they helped decide the menus, helped choose new staff, kitchen duties and one service users was very busy cleaning. Residents stated that they were aware of risks to themselves inside and outside the home and that was why the staff were there, to help them. Langdown House Version 1.10 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 15, 16 & 17. Links with the local community are good and through this the residents are well supported in their social and educational needs. The menus are chosen by the residents with the support of staff to ensure a good balance and they offer variety and take into account any preferences or dietary needs EVIDENCE: The care plans detail each service users known preferences for leisure activities. The manager stated that she would like to gradually introduce new activities and experiences, both inside and outside the home in an effort to offer a challenge to the service users. The home has their own mini-bus for outside activities. The inspector was advised that the service user in general enjoy helping with domestic chores. In one house a service user showed the inspector the kitchen rota and explained her role and in another house one service user was very busy keeping the home clean and doing the vacuuming. Service users were very busy and active preparing to go out to their work or day centres. Two residents are in paid employment and require very minimal assistance to get ready and go to work by themselves. Langdown House Version 1.10 Page 12 The service users from house 3 were not present during this inspection they were on their annual holidays away from the home. This year they picked Hastings as their holiday destination. All 4 houses have annual holidays away from the service each selecting the appropriate destination for their individual house. There is evidence to indicate that the service users are fully involved in the selection of their holidays. Langdown House Version 1.10 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19, & 21 The staff have a good understanding of the residents support needs and have good interpersonal relationships with the residents. The health needs were being met with evidence of multi disciplinary working taking place. Some very good training has been made available for staff in relation to ageing, illness or death of residents. EVIDENCE: Residents stated that staff help them when needed. Where appropriate residents are assisted when they are in the bathroom although the amount of support needed varies from resident to resident and some service users are fully independent. On the day of this inspection the service was being audited by their local pharmacy to ensure good working practices were being adhered to, no errors have been reported. Staff stated and this was backed up in the individual residents records that residents visit the GP when required and that other health needs are met. On the day of the visit one service user attended a doctors appointment with staff and another told the inspector that she had seen the doctor the day before and that the staff are making another appointment for her because she still was unwell. Langdown House Version 1.10 Page 14 Langdown House Version 1.10 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 There is a clear and effective complaints and compliments procedure in place. Complaints information is available to residents. Complaints are responded to appropriately and staff are aware of that residents must be protected from abuse, neglect and self-harm. EVIDENCE: Policies and procedures are in place to ensure that service users are safeguarded from harm or abuse. The home has a copy of the Surrey Multiagency Protection of Vulnerable Adults procedure, which is available to all staff in the office of the home. Regular residents meetings are held so that views are listened to and acted upon. Residents were aware that if they are unhappy they could complain to a number of people. Residents are very vocal and were heard to be talking to staff about what they like and anything that they do not like. A log is kept of all complaints and compliments received into the home. There had been an anonymous complaint made to the CSCI about the service which was in the process of investigation by the service. The manager must ensure that the CSCI local office is fully updated on the outcome of the investigation. Langdown House Version 1.10 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27, 28, 29 and 30 The general standard of the environment within this home is good providing residents with an attractive and homely place to live. EVIDENCE: Residents stated that they like their home and that they were involved in choosing the colours used to paint during the last redecoration. Residents bedrooms were individually decorated and reflected the individual person’s tastes and needs. There were photos of family and friends in most of the bedroom there was one exception but the service users explained that she did not like fuss and hated things on the walls. One resident said she had her own key to her bedroom however the lock had jammed and she was worried about not being able to lock it. Langdown House Version 1.10 Page 17 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 34, 35 & 36 All interactions observed between staff and service users evidenced a high degree of respect and skill in working with the individual service users at the home. Staffing is kept under review and provided to meet the needs of the service users at all times. EVIDENCE: All staff access regular training updates and are conversant with the needs of residents with physical and learning disabilities. Members of staff spoken to during the inspection confirmed that they can access training and development through the home or NVQ training organised by the Surrey Social Services. There is a key worker system in place. The manager stated that all new staff receive full induction training prior working independently with the service users. Langdown House Version 1.10 Page 18 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 39, 41, 42 & 43 A new manager has been registered who was able to show that further improvements had been made to the care plans and in the revision and development of policies and procedures. The home is managed in an open and inclusive atmosphere, creating a homely place to live for residents. The manager is fully aware of the needs of the Service Users in the home and as such is able to communicate this to staff through regular staff meetings and individual supervision sessions. EVIDENCE: Langdown House Version 1.10 Page 19 The manager has been in post for only a short period of time and has recently been approved by the CSCI as the registered manager. The manager holds the Registered Manager’s Award (RMA) and an NVQ level 4 in management she is currently undertaking an NVQ level 4 in care, in addition to her she has worked for over 15 years in care 10 of which in management. In discussions with the manager she was able to fully illustrates her commitment to the home and its Service Users. The frequency of staff meetings and informal and formal supervision was indicative of an open and supportive atmosphere. Regulation 26 (Monthly visits by the proprietor) are undertaken and evidence was seen of their occurrence. Relevant policies and procedures were in place. Systems existed to demonstrate these had been communicated to staff. Also those of relevance to service users had been shared with them. The manger is undertaking a full review of all policies and procedures to ensure that they accurately reflect the service and will continue to meet them in the future. The manager assured the inspector that this process would be completed over the next 4 months. 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. Where there is no score against a standard it has not been looked at during this inspection. 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 CONCERNS AND COMPLAINTS Standard No 1 2 Langdown House Score 3 2 Standard No 22 23 Version 1.10 Score 2 2 Page 20 3 4 5 2 2 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 x 3 Standard No 37 38 39 40 41 42 43 Score 3 3 3 x 3 3 3 Langdown House Version 1.10 Page 21 no Are there any outstanding requirements from the last inspection? 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, 3, 4 & 5 Regulation 5(1)(b & c), 12(2 & 3), 14 (1)(d), 18(1 & 3), 19(5)(b) Schedules 3.1 & 4.1 22 (1, 3 & 4) Schedule 4.11 Requirement The manager must complete the review of policies, procedures and all service documentation to ensure that they accurately reflect the service and the services provided by Langdown House. The manager must ensure that the CSCI local office is fully updated on the outcome of the complaint investigation being conducted. Timescale for action 01/10/05 2 YA 22 & 23 01/09/05 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. Refer to Standard Good Practice Recommendations Langdown House Version 1.10 Page 22 Commission for Social Care Inspection The Wharf Abbey Mills Business Park Eashing Surrey GU7 2QN 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 Langdown House Version 1.10 Page 23 - 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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