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Inspection on 08/11/05 for Langdown House

Also see our care home review for Langdown House for more information

This inspection was carried out on 8th 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The atmosphere in the home was warm and friendly. Service users are supported in a positive way to make choices. One service user informed the inspector that she is fully supported by staff and that she had a very good relationship with them. Each service user is allocated a named key worker and care plans are kept up to date with review of care as necessary. The staff has enabled and supported service users to participate in a wide variety of social activities such as going to the pubs, restaurants, the cinema day centres and keeping in touch with families and friends.

What has improved since the last inspection?

The manager has conducted a series of reviews on all of the home policies, procedures, staff recruitment and training practices. The policies that have been developed now ensure that as is reasonably practicable, the service users health, safety and welfare will be protected.

What the care home could do better:

The home consistently offers a good standard of care and support to the service users. Two requirements were made during this inspection one on security of the homes and the second on continual review of conditions of registrations.

CARE HOME ADULTS 18-65 Langdown House Langdown House 1-4 Yeend Close Off High Street West Molesey Surrey KT8 2NY Lead Inspector Kenneth Dunn Unannounced Inspection 8th November 2005 10:00 Langdown House DS0000060463.V261351.R01.S.doc Version 5.0 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 Langdown House DS0000060463.V261351.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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Langdown House DS0000060463.V261351.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Langdown House Address Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Langdown House 1-4 Yeend Close Off High Street West Molesey Surrey KT8 2NY 020 8979 4561 020 8979 8901 Kingston & Wimbledon YMCA Ms Jane Susan Gupta Care Home 28 Category(ies) of Learning disability (24), Learning disability over registration, with number 65 years of age (4), Mental disorder, excluding of places learning disability or dementia (2), Mental Disorder, excluding learning disability or dementia - over 65 years of age (1) Langdown House DS0000060463.V261351.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Of the 24 service users within the category LD (Learning Disabilities), 2 may also fall within the category MD (Mental Disorder) 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 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) 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 7th June 2005 3. Date of last inspection 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 DS0000060463.V261351.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the second inspection to be undertaken in the Commission for Social Care Inspection year April 2005 to march 2006. This unannounced inspection took place on the 8th November 2005. To gain a full picture of this service please also refers to the previous inspection report dated the 7th of May 2005. The inspection spent the first part of the inspection with the service manager and home manager this was then followed with time being spent with the service users. A tour of the home and grounds was conducted. The service users help in maintaining their home, which is, clean and tidy; it was evident that the service users identified the service as their home. What the service does well: What has improved since the last inspection? 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. Langdown House DS0000060463.V261351.R01.S.doc Version 5.0 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Langdown House DS0000060463.V261351.R01.S.doc Version 5.0 Page 7 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 the following standard(s): 1, 2 & 3 There is sufficient information available to allow potential residents or there representatives to make an informed choice about the home. 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. EVIDENCE: The statement of purpose and service users guide complies with the National minimum Standards. The admission procedure offers pre-admission assessments on all potential service users. The manager must ensure that any potential new admission into the home fully complies with the homes policies. A recent admission into the home did not follow the homes procedures and potentially could have had an adverse effect of the dynamics of the existing service users within the home. The new resident was moved in before the other residents were not afforded the opportunity of meeting and developing a connection or relationship with the new resident prior to her moving into the home. The resident have the right to be fully informed and included in the process of any new service user who could potentially become a resident, it is essential that there are fully included in any future moves into the home. The manager must also review the current conditions of registration to ensure that all service users are covered within the categories in place for the home. This is essential to ensure that any possible changes or diagnoses are covered within the homes registration. Langdown House DS0000060463.V261351.R01.S.doc Version 5.0 Page 8 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 the following standard(s): Standards 6, 7, 8, 9 & 10were assessed on the last inspection. EVIDENCE: For information on these standards please refer to the report of 7th May 2005. Langdown House DS0000060463.V261351.R01.S.doc Version 5.0 Page 9 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 the following standard(s): Standards 11, 12, 13, 14, 15, 16 & 17 were assessed on the last inspection. EVIDENCE: For information on these standards please refer to the report of 7th May 2005. Langdown House DS0000060463.V261351.R01.S.doc Version 5.0 Page 10 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 the following standard(s): 20 The personal and healthcare needs of service users are well met with evidence of excellent teamwork between service users and staffs. EVIDENCE: All service user are assessed to establish their suitability to self manage their own medication, where the service users has been assessed as suitable to self mange risk assessment and documentation is completed and regularly updated. All staffs are fully trained to do so administer medication. All medications are administered within the homes policy and guidelines. Langdown House DS0000060463.V261351.R01.S.doc Version 5.0 Page 11 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 the following standard(s): Standards 22 & 23 were assessed on the last inspection. EVIDENCE: For information on these standards please refer to the report of 7th May 2005. Langdown House DS0000060463.V261351.R01.S.doc Version 5.0 Page 12 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 the following standard(s): 24 On the whole the home provides a good level of accommodation in a homely environment, suitable for the needs of the service users. EVIDENCE: The home was generally operated to a good standard. Service users bedrooms are furnished to the individual’s taste, are clean and tidy, and are personalised with their personal belongings. One service user displayed great pride about her room and how she decorated it; during the inspection she was very busy keeping her room tidy. There are adequate bathrooms and toileting facilities for the use of service users. Generally, the home was clean and tidy and free of odour. There is a question regarding the overall security of the 4 individual houses. The service is very open to the community and there is no measure in place to restrict any one from gaining access to the home if they wanted. During the inspection the doors were kept unlocked and people could simply walk into the home without effort. It is essential that the manager assess this practices to ensure that the service users remain safe within their own homes. Langdown House DS0000060463.V261351.R01.S.doc Version 5.0 Page 13 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 Staff appeared to be enthusiastic and committed to supporting the service users, there was a strong indication that training and development is given a high priority. EVIDENCE: There are appropriate training opportunities in place for staff. There are arrangements in place for all staff to have regular access to training and a commitment from the organisation to provide staff with NVQ training. Four members of staff have NVQ Level 2. There are currently sufficient staff employed to meet the needs of the service user group. Langdown House DS0000060463.V261351.R01.S.doc Version 5.0 Page 14 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 40 The manager has a good staff team and works well with meeting her responsibilities. The home has relevant health and safety procedures and staff are given training in all aspects of health and safety to protect the service users and themselves. The manager had completed a review of all policies and procedures in line with a requirement from the previous inspection report. EVIDENCE: All 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 has undertaken a full review of all policies and procedures to ensure that they accurately reflect the service. These have been reviewed by the inspector and they were comprehensive and fully comply with current legislative requirements. However the policies should be the date of introduction and the date of review clearly marked on each individual page for clarity and for eases of future reviews. Langdown House DS0000060463.V261351.R01.S.doc Version 5.0 Page 15 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 2 2 X X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 1 X X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 X X X X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Langdown House Score X X 3 X Standard No 37 38 39 40 41 42 43 Score X X X 3 X X X DS0000060463.V261351.R01.S.doc Version 5.0 Page 16 YES 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 Regulation 14 Schedule 3.1 (a) 14, 18 & 19 Requirement The manager must ensure that new admission into the home complies with the homes policies. The manager must also review the current conditions of registration to ensure that all service users are covered within the categories. The manager must review the security of the site. Timescale for action 30/11/05 2 YA3 30/11/05 3 YA24 16(1) 23(2)(elf) 08/11/05 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 YA40 Good Practice Recommendations The manger should ensure that all introductory and review dates are clearly indicated on all policies and procedures. Langdown House DS0000060463.V261351.R01.S.doc Version 5.0 Page 17 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill 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 DS0000060463.V261351.R01.S.doc Version 5.0 Page 18 - 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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