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Inspection on 12/09/05 for Langfield Nursing And Residential Home

Also see our care home review for Langfield Nursing And Residential Home for more information

This inspection was carried out on 12th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

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 home had a group of staff who had worked at the home a long time and residents and relatives spoken with liked the present staff team. They felt they cared for them well. Staff were described as "great", "excellent", "brilliant" and "fabulous". Other comments included "ten out of ten for caring", "the staff are really good to me" and "I`m so well looked after". The home was good at making sure residents health was well taken care of by sending for health care workers whenever they felt they were needed. Residents said they felt happy and really well cared for. The records kept on residents, to make sure staff were looking after them properly (care plans), were detailed, up to date and gave the reader a very clear picture of what each person needed help with. The manager was now holding meetings for each resident, every year to which the resident, relative and key worker were invited in order to see if the person was satisfied with the care they were receiving. There was a relaxed, welcoming and friendly feel within the home and the relatives said they were able to come and go as they pleased. The home was very clean and the staff were good at making sure they did not spread germs by washing their hands regularly and using "throwaway" gloves and aprons.

What has improved since the last inspection?

The care plans on the nursing unit were up to date and the records about care needed to look after wounds had much improved. Teamwork had also improved and the staff were passing on information to each other to make sure residents were receiving the right care. A new administrator had taken over who was part way through sorting out files and other records to make the whole system easier to use and up to date. The shower had been repaired, the fire doors throughout the building had been re-fitted and extra nurse call points fitted in the residential unit.

What the care home could do better:

The staff rotas must be kept up to date to show which staff are working with the residents. Staff who start work before their Police checks come through, must always work alongside another member of staff to make sure residents are kept safe. Not all of the staff had received 3 days training over the past year. The records kept of residents` monies must be brought up to date to show how much money the home is holding for them. All staff must receive one to one meetings with their managers to make sure they are doing their jobs properly and to check what training they may need to do in the future.

CARE HOMES FOR OLDER PEOPLE Langfield Residential Home Wood Street, Langley, Middleton, M24 5QH. Lead Inspector Jenny Andrew Unannounced 12 September 2005 th 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 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. Langfield Residential Home F06 F56 S17327 Langfield V247208 12.09.05 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Langfield Residenital Home Address Wood Street, Langley, Middleton, M24 5QH 0161 653 5319 0161 653 5393 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) Southern Cross Care Management Limited Simon Emsley Care Home With Nursing 50 Category(ies) of Old Age 50, Physical Disbaility 1 & Mental registration, with number Disorder 1. of places Langfield Residential Home F06 F56 S17327 Langfield V247208 12.09.05 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 50 service users to include: up to 50 service users in the category of (OP) Older People; up to 1 femaleservice user in the category of (MD) Mental Disorder under 65 years of age; up to 1 male service user in the category of (PD) Physical Disabilities under 65 years of age. 2. The service should employ a suitably qualified and experienced Manager who is registered with the Commission for Social Care Inspection. Date of last inspection 27th April 2005 Brief Description of the Service: Langfield Residential Home F06 F56 S17327 Langfield V247208 12.09.05 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over one day with 2 inspectors. Two extra visits had been made to the home in June and August to make sure the manager had completed all the things he needed to do from the last inspection. Letters sent to the home, following those visits, can be obtained from the Commission for Social Care Inspection (CSCI) office on request. The inspectors looked around parts of the building, checked care plans and other records and watched how staff spoke to and cared for the residents. In order to obtain information about the home, the operational manager, 9 residents, 4 relatives, 3 staff, a speech therapist, the cook, administrator, activity worker, handyman and 2 domestics were spoken with. Not all the National Minimum Standards were looked at on this visit as many had been checked at the last inspection. What the service does well: The home had a group of staff who had worked at the home a long time and residents and relatives spoken with liked the present staff team. They felt they cared for them well. Staff were described as “great”, “excellent”, “brilliant” and “fabulous”. Other comments included “ten out of ten for caring”, “the staff are really good to me” and “I’m so well looked after”. The home was good at making sure residents health was well taken care of by sending for health care workers whenever they felt they were needed. Residents said they felt happy and really well cared for. The records kept on residents, to make sure staff were looking after them properly (care plans), were detailed, up to date and gave the reader a very clear picture of what each person needed help with. The manager was now holding meetings for each resident, every year to which the resident, relative and key worker were invited in order to see if the person was satisfied with the care they were receiving. There was a relaxed, welcoming and friendly feel within the home and the relatives said they were able to come and go as they pleased. The home was very clean and the staff were good at making sure they did not spread germs by washing their hands regularly and using “throwaway” gloves and aprons. Langfield Residential Home F06 F56 S17327 Langfield V247208 12.09.05 Stage 4.doc Version 1.40 Page 6 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. Langfield Residential Home F06 F56 S17327 Langfield V247208 12.09.05 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Langfield Residential Home F06 F56 S17327 Langfield V247208 12.09.05 Stage 4.doc Version 1.40 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 standard(s) EVIDENCE: Standards 2, 3 and 4 were inspected and met, at the last inspection, which took place on 27/28 April 2005. The home does not offer intermediate care and therefore standard 6 is not applicable. Langfield Residential Home F06 F56 S17327 Langfield V247208 12.09.05 Stage 4.doc Version 1.40 Page 9 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 standard(s) 7 & 8 The home had an effective care planning and reviewing system in place, which ensured the needs of the residents were being identified and met. The health care needs of the residents were well met with external health care professionals being consulted as needed. EVIDENCE: Care plans were generated from the care management or home’s preadmission assessment. The 6 care plans looked at on the residential and nursing units were detailed, clearly setting out action to be taken to address all aspects of the health and personal care of residents. Such detailed plans ensured the staff received the information they needed to satisfactorily meet the needs of the residents. Good practice was noted in relation to the promotion of residents’ privacy, dignity and independence in care plan recordings. Although care plans indicated that residents or their families had been involved in developing the plans of care, there was only 1 signature recorded to confirm this. Relatives interviewed said they were aware of the care the person they visited needed. Risk assessments for skin, dependency, moving/handling, nutrition and falls were in place and had been reviewed monthly. One care plan on the nursing unit did not contain a continence assessment but the operational manager said Langfield Residential Home F06 F56 S17327 Langfield V247208 12.09.05 Stage 4.doc Version 1.40 Page 10 this would be addressed. Other risk areas for individuals had been completed where risks had been identified i.e. smoking, going out unaccompanied, making a hot drink etc. It was clear that responsible risk taking was regarded as part of the normal expression of people’s independence and was encouraged as far as possible. Records showed that residents were encouraged to value their self-worth and were helped to maintain their selfimage. Minor shortfalls were identified as follows. Two residential care plans did not contain a photograph although the team leader said the photographs had been taken but not yet developed and there were no social profiles on 2 of the nursing care plans. The list of clothes brought into the home had not been completed in 3 instances and this must be addressed. The reviewing system was good with staff undertaking reviews of care plans and risk assessments on a monthly basis. In addition, the manager had introduced an annual review meeting, whereby the resident, their relative, key worker and himself would meet to discuss the resident’s satisfaction with the service and give them an opportunity to say what changes, if any, they wanted with their care. Care plans contained details of all nursing needs and the identified needs were being well met either by the nursing staff employed at the home or by visiting district nurses for the residential unit. Care plans on the nursing unit had improved, especially in relation to wound care with recordings showing care and progress made. A body map, initial assessment and a progress record were included in the care plan. Good daily recordings were seen on both units where staff had identified any areas of concern together with what action was needed to address the problem. Where risk areas had been identified in relation to skin or weight, staff were implementing the care plans i.e. weighing residents weekly and recording gains/losses, using charts to record when pressure relief had been given. In one instance however, on the residential unit, night staff had not recorded in detail the 2 hourly required turns and this should be addressed. Adequate equipment was available for the treatment and prevention of pressure sores. Records showed that residents had good access to health care professionals, for example, chiropodists, opticians, district nurse (for residential unit), as well as to specialist health care i.e. stoma care and speech therapy. A speech therapist was visiting at the time of the inspection and she said the staff were always co-operative and implemented any instructions given. Langfield Residential Home F06 F56 S17327 Langfield V247208 12.09.05 Stage 4.doc Version 1.40 Page 11 Residents were encouraged to keep as active as possible and gentle chair exercises were part of the activity programme. Residents interviewed were very positive about the care they received and said they felt happy and cared for. The staff had a good understanding of the residents’ support needs and this was evident from the positive relationships that had been formed between the staff and residents. Langfield Residential Home F06 F56 S17327 Langfield V247208 12.09.05 Stage 4.doc Version 1.40 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 standard(s) 13 & 14 The home valued the role, which relatives and friends could play in the lives of the residents. Staff gave residents the opportunity to make choices about their chosen life styles and routines, enabling them to feel in control of their lives as far as possible. EVIDENCE: Four relatives were spoken to during the inspection. Feedback was very positive with regard to the care being given to the person they visited. They all felt they were made welcome by the staff, kept informed of any changes in the person’s health and said they could visit whenever they wanted. One relative chose to visit at meal times so that she could be involved in assisting the person she visited to have their meals. Another relative said the staff had been marvellous in caring for her mother and she had requested that she continue to be cared for at the home rather than going into hospital. Residents interviewed gave examples of choices they made in their every day routines. They said they chose their own clothes, could choose whether or not to join in social activities, what to eat and the more independent residents could go out into the community to visit shops or other facilities. Observations made during the inspection also confirmed this. One resident had requested an early lunch so he would be free to watch the cricket which started early afternoon, one resident was seen to go out to the shops, residents were offered a choice of activities and not pressured to join in unless they wanted, Langfield Residential Home F06 F56 S17327 Langfield V247208 12.09.05 Stage 4.doc Version 1.40 Page 13 one resident was assisting in the setting of dining tables, a religious visitor was at the home seeing people who wanted to be part of a bible reading. One carer spoken to said that in her last job she had not been able to offer choices to the residents but that “you can do it here”. Residents said they could bring personal possessions into the home and this was observed in some of the bedrooms seen. Langfield Residential Home F06 F56 S17327 Langfield V247208 12.09.05 Stage 4.doc Version 1.40 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 standard(s) 16 & 18 Systems were in place with regard to the investigation of complaints and adult protection issues, ensuring that residents were listened to and protected. EVIDENCE: A complaints procedure was in place, which was displayed on both levels of the home. In addition the procedure was contained in the service user guide, which each new resident received a copy of. At the time of the inspection, the registered manager was on annual leave and the complaints book could not be located. The operational manager said that in future she would ensure the book was kept in an easily accessible place so it was available when the manager was absent. She did state however, that as far as she was aware, there was only one ongoing complaint, which was presently being investigated. Since the appointment of the new manager, the Commission for Social Care Inspection (CSCI) had not received any direct complaints about the home. Communication with relatives/friends had continued to improve and the manager was holding relative/friend evening “surgeries” once a week when people could call in to see him without prior appointment. All relatives and residents interviewed said they would feel able to discuss any problems with a member of the staff. One POVA (Protection of Vulnerable Adult) investigation was ongoing at the time of the inspection. The investigation was being conducted in line with the local authority’s protection of vulnerable adults procedure All relevant agencies had been involved and the Commission for Social Care Inspection had been kept updated and would ultimately be notified of the outcome. Langfield Residential Home F06 F56 S17327 Langfield V247208 12.09.05 Stage 4.doc Version 1.40 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 standard(s) 21 and 26 The home was well decorated and furnished, providing residents with a safe, clean, pleasant and comfortable environment. Good hygienic care practices ensured that as far as possible, residents were safeguarded from infection. EVIDENCE: From walking around the home, it was evident that it was in good decorative order throughout. The home employs a handyman who ensures that any repairs reported to him are addressed speedily. Only the toilet, shower and bathing facilities were inspected on this visit. Since the last inspection, the ground floor shower had been repaired and was now being used by residents who preferred a shower to a bath. All facilities were well equipped with a good range of aids and adaptations to ensure the needs of the present resident group were met. Langfield Residential Home F06 F56 S17327 Langfield V247208 12.09.05 Stage 4.doc Version 1.40 Page 16 Policies and procedures were in place with regard to control of infection and handling of laundry and, throughout the inspection, staff were seen adhering to good hygienic practices. Laundry staff and care assistants were provided with protective disposable aprons and gloves to prevent the spread of infection and staff hand washing facilities were available in bedrooms, bathrooms and toilets. All areas were clean and odour free. Residents and their relatives also commented positively about the cleanliness and the fact that whenever they visited, there were never any odours present. Two relatives said this had initially, influenced their choice of home. Since the last inspection, the numerous unmarked items of clothing had mainly been claimed and appropriately marked. Relatives were now being asked to ensure all new clothing purchased was marked before being put into residents’ bedrooms. One relative interviewed said she was really pleased with the standard of the laundry service. She remarked upon how well ironed the clothes of the person she visited were and that provided the clothes were marked, they were not misplaced. Langfield Residential Home F06 F56 S17327 Langfield V247208 12.09.05 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 Staffing levels and skill match of staff was adequate to meet the needs of the present resident group. EVIDENCE: Whilst there continued to be some turnover of staff, several staff had worked at the home for many years and others, who had previously worked there, were returning, providing the residents with consistent care. Staff interviewed felt they worked well together as a team and the residents interviewed said they liked the staff. Following the last inspection in April 2005, two additional visits to the home were made in June and August 2005 to follow up on the requirements made. On both visits, staffing levels were unsatisfactory on the residential unit and Immediate Requirement Notices, to address the staffing shortfalls, were left. Rotas for the week of the inspection were checked and staffing levels on the residential unit were sufficient to meet the needs of the current resident group. It was difficult to determine whether staffing levels on the nursing unit were being adhered to, as the rota had not been updated to reflect the present staffing position. Staff rotas are part of the legal records which are required to be kept within the home, and must be an up to date accurate account of hours worked. From the pay roll, it was determined that staffing levels were just about adequate to meet the needs of the current nursing residents. The manager should closely monitor staffing levels on the nursing unit to ensure that the changing needs of the frail and vulnerable residents are being met. Langfield Residential Home F06 F56 S17327 Langfield V247208 12.09.05 Stage 4.doc Version 1.40 Page 18 Staff spoken to said they had opportunities to express their views on how changes could be made to benefit residents. Staffing had been a big issue, and at the most recent meeting, it had been agreed that the permanent staff would pick up extra hours thus reducing the use of agency staff, in order to provide more continuity of care for residents. Staff felt they worked well together as a team and one person said “I love it here”. Three staff files were examined to ensure that the necessary checks were being made before staff commenced working at the home, as this was a shortfall identified at the last inspection. The files inspected showed that POVA First (Protection of Vulnerable Adult) checks had been obtained for all 3 people and Criminal Record Bureau (CRB) checks submitted in all instances, with one having been returned after a period of 6 weeks. It was stressed to the operations manager that only in emergency situations, should staff be started with a POVA First check and that normal practice would be to wait until full CRB clearance had been received. Should staff commence with only a POVA First check, they must work under supervision at all times. This was not the case for the two most recently recruited staff who were now working unsupervised and the manager must address this. Whilst residents said that staff were looking after them well, staff training was an area which still needed prioritising. One care assistant interviewed had worked at the home for over 3 years and had only attended moving and handling training. All staff must receive a minimum of 3 days training (prorata), annually and this shortfall has been highlighted in the last 2 inspection reports. In order to review staff training needs, the manager should ensure that staff appraisals are undertaken for all staff. Contracts were said to contain clauses about mandatory training and if staff refuse or are reluctant to attend, then the manager should go down the company’s disciplinary procedure. Langfield Residential Home F06 F56 S17327 Langfield V247208 12.09.05 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35, 36 & 38 Satisfactory quality assurance & monitoring systems were in place, which ensured residents had a say in how the home was run. Financial systems in place were unsatisfactory and did not safeguard residents’ interests. There was no formal staff supervision system in place, which could impact negatively on the quality of care given to residents. Maintenance of equipment was up to date but not all staff had received relevant health and safety training, which could result in some practices that do not promote and safeguard the health, safety and welfare of the people using the service. EVIDENCE: The home had achieved a quality assurance award, which was due for renewal later this year. Effective quality assurance and monitoring systems were in place such as regular staff meetings, residents questionnaires and meetings, weekly evening “surgeries” giving relatives the opportunity of seeing the manager and the home’s internal quality audit which was undertaken on a regular basis. Other ways of improving the monitoring system, as identified at the previous inspection, would be via questionnaires to other stakeholders i.e. Langfield Residential Home F06 F56 S17327 Langfield V247208 12.09.05 Stage 4.doc Version 1.40 Page 20 district nurses, care managers etc and the results of any service user surveys should be published in the service user guide. Resident reviews were continuing to be held on an annual basis, with relatives also being invited to attend. Regular staff meetings were taking place and the staff spoken to said they felt able to speak their minds and put forward any ideas and suggestions they had. A residents’ financial policy/procedure was in place and care plans also addressed residents’ finances. The Administrator had only been at the home for 5 weeks and prior to this, the post had been vacant for approximately 3 months. His induction had been somewhat difficult due to the manager having been off sick and then on leave but he stressed he had been given as much support as possible in the circumstances. The home’s administration systems were therefore not up to date and the residents financial accounts were not up to date and did not reflect how much money the home was holding for individuals. The Administrator was aware of this shortfall and was working hard to try and get all accounts up to date. This must now be prioritised and up to date resident accounts be available for inspection within one month. Whilst the accounts were not up to date, administration systems and files had been set up and the office was far more organised than previously. When visits to the home were made by the hairdresser or chiropodist, the administrator would pay collectively for their services but retain a receipt, identifying which residents had been seen, so that the home could invoice the resident or their relative, dependent upon the arrangements in place. Secure facilities were provided for the safekeeping of money/valuables. None of the staff spoken to had received any formal supervision. As the manager was on leave, it could not be determined at what stage he was at in relation to the implementation of supervision. As the lack of supervision has been highlighted over the last 2 years, this must now be addressed without further delay. Informal networks were in place and the team leader on the residential unit said she monitored staff practices whilst working alongside them. Health and safety issues were satisfactory with regular maintenance checks of equipment being undertaken. The company were in the process of changing contractors and the servicing of the fire extinguishers would be a month overdue due to the changes taking place. In the circumstances, requirements regarding this will not be made. Requirements made from the Greater Manchester Fire Service inspection, had been implemented. The handyman was responsible for inducting new staff in fire safety and security of the building. Langfield Residential Home F06 F56 S17327 Langfield V247208 12.09.05 Stage 4.doc Version 1.40 Page 21 Since the last inspection, it was evident that the manager had prioritised health and safety training with courses in food hygiene, moving/handling and fire having taken place. The majority of staff had also undertaken a distance learning course in infection control. It was apparent, through discussions with staff, that they had not all attended the mandatory courses and this should be addressed within the previous timescale set of 30 April 2006. Langfield Residential Home F06 F56 S17327 Langfield V247208 12.09.05 Stage 4.doc Version 1.40 Page 22 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 x COMPLAINTS AND PROTECTION x x 3 x x x x 3 STAFFING Standard No Score 27 2 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x 1 1 x 3 Langfield Residential Home F06 F56 S17327 Langfield V247208 12.09.05 Stage 4.doc Version 1.40 Page 23 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 1 Regulation 4 Requirement A copy of the reviewed statement of purpose must be sent to the CSCI Bolton office. (original timescale of 18.02.05 not met) All care plans must contain a photograph of the resident. All care plans must include social profiles and continence assessments. The complaints file/book must be available at all times. Accurate staffing rotas must be maintained at all times. Copies of the off duty rotas for both units must be faxed to the CSCI Bolton Office on a weekly basis in order that staffing levels may be monitored. Staff employed in an emergency, following a POVA first check, must not work unsupervised until a satisfactory CRB check has been undertaken. All staff must receive a minimum of 3 days paid training (pro rata) each year. (Previous timescale of 30.04.06 not met). Accurate and up to date records must be in place in relation to each residents personal finances. F06 F56 S17327 Langfield V247208 12.09.05 Stage 4.doc Timescale for action 31.10.05 2. 3. 4. 5. 6. 7 7 16 27 27 17 15 22 17 18 31.10.05 31.10.05 30.09.05 30.09.05 30.09.05 7. 27 19 30.09.05 8. 30 18 31.03.06 9. 35 17 14.10.05 Langfield Residential Home Version 1.40 Page 24 10. 36 18 All staff must receive formal supervision. 31.10.05 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. 2. 3. 4. 5. 6. Refer to Standard 7 7 7 7 27 33 Good Practice Recommendations All residents should receive a copy of their care plan which is easily understandable unless there are clear reasons recorded why not (previously made recommendation) Care plans should be agreed and signed by the resident and/or their representative. A record of residents clothing should be undertaken upon admission. All specific care given to residents, should be recorded i.e. 2 hourly turns for pressure relief. The manager should ensure that annual appraisals are undertaken to identify individuals training needs. The current quality assurance system should be expanded in order to obtain feedback from a wider variety of stakeholders. (This has been recommended previously). Langfield Residential Home F06 F56 S17327 Langfield V247208 12.09.05 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Turton Suite, Paragon Business Park, Chorley New Road, Horwich, Bolton, BL6 6HG. 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 Langfield Residential Home F06 F56 S17327 Langfield V247208 12.09.05 Stage 4.doc Version 1.40 Page 26 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!