Inspection on 27/04/05 for Langfield Nursing And Residential Home

This inspection was carried out on 27th April 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.

Other inspections for this house

Langfield Nursing And... 07/10/08

Langfield Nursing And... 25/10/07

Langfield Nursing And... 20/12/06

Langfield Nursing And... 09/08/06

Langfield Nursing And... 12/09/05

Langfield Nursing And... 20/10/04

Langfield Nursing And... 02/06/04

Langfield Nursing And... 16/02/04

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Bushell House

Langrigg House

Parkside

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Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Langfield Nursing and Residential Home Wood Street, Langley, Middleton, Manchester, M24 5QH. Lead Inspector Jenny Andrew Unannounced 27 & 28th April 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 Nursing and Residential Home F56 F06 S17327 Langfield V222252 270405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Langfield Nursing & Residential Home Address Wood Street, Langley, Middleton, Manchester, M24 5QH. 0161 6535319 0161 6535393 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) Highfield Care Homes Limited Simon Emsley Care Home 50 Category(ies) of Old Age 49 Physical Disability 1 registration, with number of places Langfield Nursing and Residential Home F56 F06 S17327 Langfield V222252 270405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 50 service users to include: Up to 49 service users in the category of Older People (OP),(19 nursing and 30 residential) male and female 60 years of age and over; up to 1 service user in the category of PD (Physical disability 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 20th October 2004 Brief Description of the Service: Langfield Care Home is a purpose built home with 2 units, which caters for 50 residents with a variety of needs. There is a residential unit on the first floor and nursing unit on the ground floor. The home is situated in a residential area in Middleton and is on the main bus route. A local shop, post office and public house are close to the home. It is pleasantly situated in its own grounds and has attractive gardens to the side and rear with ample parking at the front of the home. Accommodation is provided on two floors in 50 single bedrooms. All but one has en-suite facilities. Level access to the home is provided and a passenger lift ensures access is provided to both floors. Five lounges and three dining rooms are available and the communal rooms on the ground floor allow access to the garden and patio area. Langfield Nursing and Residential Home F56 F06 S17327 Langfield V222252 270405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over one and a half days. The first day 2 inspectors and a pharmacist inspector were present and on the second day there was one inspector. An extra visit had been made to the home in March to make sure they had completed all the things they needed to do from the last inspection. Inspectors looked around parts of the building, checked care plans and some records as well as looking at how the medication was given out. In order to obtain information about the home, the manager, 12 residents, 8 relatives, 6 staff, a social worker, the cook, activity worker, laundry assistant and a domestic were spoken with. In addition 2 comment cards were returned by relatives to say in writing what they thought about the home. What the service does well: What has improved since the last inspection? The home had almost finished being re-decorated and a lot of new furniture had been bought. These improvements had made a big difference to the residents living there and residents and relatives said how pleased they were with the completed bedrooms. Good progress had been made by the manager to make sure that the things which needed improving from the last inspection had been done. Relatives spoken to were pleased that a new manager was now running the home and said they felt he was willing to listen to them and to put things right when necessary. They felt the home had suffered in the past from different managers coming and going and hoped that the new person would stay. Langfield Nursing and Residential Home F56 F06 S17327 Langfield V222252 270405 Stage 4.doc Version 1.30 Page 6 Residents spoken with said the activities provided were now much better and the person who organised them chatted to all those who did not wish to take part in the activities. More trips out had taken place and residents were pleased about this. Several of the staff spoken to felt the new manager was giving them good support and things in the home were gradually improving. 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 Nursing and Residential Home F56 F06 S17327 Langfield V222252 270405 Stage 4.doc Version 1.30 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 Nursing and Residential Home F56 F06 S17327 Langfield V222252 270405 Stage 4.doc Version 1.30 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) 2, 3 and 4 A good assessment process was in place in order to ensure that those admitted were able to be adequately cared for and the manager and staff demonstrated a high level of commitment to ensuring the needs of the residents were being met. EVIDENCE: A detailed Terms & Conditions of Residence document was contained in the service user guide, a copy of which was given to each new resident which ensured they were clear about their rights. Service users paid for by local authorities had a service delivery agreement. In addition the local authority contract contained the broader terms and conditions. Some residents and/or relatives said they had received a copy but others could not remember having done so. The manager said each person had been issued with a service user guide containing the terms and conditions. There was a good assessment system in place. The manager or deputy visited each person either at home or in hospital whether they were paying for themselves or being paid for by the local authority. The assessment document was detailed and included all necessary areas. One visiting relative confirmed the manager had conducted an assessment of needs prior to admission. One Langfield Nursing and Residential Home F56 F06 S17327 Langfield V222252 270405 Stage 4.doc Version 1.30 Page 9 resident had a trial day visit at the home and his assessment was done during this time. For those residents admitted on an emergency basis, all the necessary details were obtained as soon after admission as possible. On all the files inspected, detailed assessments were in place. All residents spoken to felt their needs were being met by the staff. Relatives also said they were satisfied with the care given. The manager had been doing short training sessions with staff on different aspects of care. Staff knew what care the service users needed and were reporting any changes to the right people. During the inspection, staff were seen to be attentive and spent time talking to service users. Where it was found that residents had specialist needs, health care professionals were involved, as necessary. Since the last inspection, 6 residents had been reassessed and transferred to homes where their specialist needs could be better met. Whilst the home did not specialise in looking after people with dementia, the manager agreed that staff would benefit from attending training in dementia care and said he would arrange this. Langfield Nursing and Residential Home F56 F06 S17327 Langfield V222252 270405 Stage 4.doc Version 1.30 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 standard(s) 7, 8, 9 & 10 In the main, care plans were detailed, up to date and reflected the care needed, but staff were not always following the plans, which meant residents personal care needs were not being fully met. Some medication records were not well maintained and did not accurately record the handling of medication in the home. EVIDENCE: Progress had been made in the development of care plans which included monitoring and reviewing arrangements. The plans were initially drawn up from the assessment information with more details being added later. Signatures of relatives/residents to the care plans were in place. Residents had not, however, received a copy of their care plan. Whilst the care plans on the residential unit had been audited and accurately recorded, the care needed for the residents who were spoken to, one care plan on the nursing unit had not been reviewed to reflect the changing needs of a service user. All care plans must be accurate and kept updated. From checking bathing records and speaking to residents and staff, it was identified that due to staffing shortages, residents had, on occasions, missed having their baths. Staff feedback also indicated that as they were very busy Langfield Nursing and Residential Home F56 F06 S17327 Langfield V222252 270405 Stage 4.doc Version 1.30 Page 11 in a morning, baths were generally done at weekends when it was quieter and the personal care records in place confirmed this. Personal hygiene needs must be met by the residents assessed needs and choice not at staff’s convenience. The manager stated he had already identified this as a problem and was currently addressing the matter. Detailed risk assessments were in place in each of the files inspected. They covered areas such as nutrition, pressure areas, moving/handling and falls. Other risk areas were identified in connection with daily living activities and it was evident that responsible risk taking was regarded as part of the normal expression of peoples’ independence by the staff team. The health care needs of residents were, in the main, being well met with evidence of good multi-disciplinary working taking place on a regular basis. Feedback from two care managers indicated they had seen a big improvement in the care now being given to residents they had placed at the home. The residents and relatives spoken to all said they were satisfied with the care provided, when enough staff were on duty. Adequate equipment was available for the treatment and prevention of pressure sores. The home had recently purchased 6 new Profile nursing beds to make a total of 8 beds. Improvements were evident on the residential unit, with regard to staff monitoring residents fluid intake. There were however, still instances where charts had not been accurately completed. Residents were encouraged to exercise and good practice was seen, during the inspection, of gentle chair exercises being done by some of the residents. Progress had been made on improving the management of medication throughout the home. The self-administration of medication had been assessed in accordance with the homes self-administration policy but one resident’s assessment (residential respite care) had not been updated for their current stay and self-administration was not supported as described in the initial assessment; this must be reviewed to confirm that the required support is provided. Qualified nurses or trained carers (residential floor) administer other medication. Current guidance states that records are signed immediately after medicines had been given but on the residential floor, records were completed at the end of the medicines round. Medication storage was orderly and secure with no evidence of over-stocking. Contrary to the home’s policy, eye drops were not dated on first opening (residential floor) to help ensure they were not used for extended periods. Langfield Nursing and Residential Home F56 F06 S17327 Langfield V222252 270405 Stage 4.doc Version 1.30 Page 12 Residents said that staff respected their privacy and dignity and relatives, in Some feedback did the main, also expressed satisfaction in this area. however, indicate that on occasions, loss of clothes and other items caused distress to residents and dressings were on display in bedrooms. The manager said he would address these areas of concern. Throughout the inspection, staff were observed interacting with residents in a natural and respectful way. During the inspection, the G.P. was seen examining a resident in the lounge, rather than in their own bedroom. The care assistant had suggested to the doctor she take the person to their room but the doctor had over-ruled this. The manager was to follow up on this incident. Langfield Nursing and Residential Home F56 F06 S17327 Langfield V222252 270405 Stage 4.doc Version 1.30 Page 13 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) 12 & 15 Social activities and meals were both well managed, providing daily variation and interest for people living in the home. EVIDENCE: A new activities co-ordinator had been employed and the provision of leisure activities had much improved. They were appropriate to the resident group and catered for individual tastes and capacities. Several residents commented upon how they enjoyed chatting to the worker, who would spend individual time with them. They had particularly enjoyed the trips out which had recently been arranged and it was planned these regular trips out would be continued throughout the year. The home had the use of a mini-bus. Residents wishing to maintain their religious links were encouraged and enabled to do so. Special occasions were celebrated to which relatives and friends were invited. Religious festivals and occasions were observed and celebrated. The dietary needs of residents were well catered for with a balanced and varied selection of food available. Comments with regard to meals was generally good although 3 residents did state they would like more boiled eggs, omelettes, egg/cress sandwiches and chicken legs. The Cook said she would accommodate these requests. Langfield Nursing and Residential Home F56 F06 S17327 Langfield V222252 270405 Stage 4.doc Version 1.30 Page 14 The menus were displayed on both floors and they were being adhered to. The manager had not yet had the opportunity to review them but did intend to include residents when making changes. During lunch on the first day of the inspection, it was noted that those residents requiring assistance, were being helped by staff who were standing up. They said this was because there was no room for extra chairs. The manager should ensure that suitable seating is provided in order that this practice ceases. The inspector sampled the food served at lunch time, on the first day of the inspection. There was a choice of lamb hot pot or liver and onions, served with green beans and mashed potatoes. Both the lamb and liver were tender and the meals appeared to be enjoyed by the residents. Langfield Nursing and Residential Home F56 F06 S17327 Langfield V222252 270405 Stage 4.doc Version 1.30 Page 15 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 resident had a copy of. The home’s complaints book showed 6 complaints had been logged in 2005 but the outcomes of only 3 of the investigations had been recorded. The manager must ensure that the outcome of all investigations are logged. 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 improved and the manager was holding relative/friend evening “surgeries” once a week when people could call in to see him without prior appointment. Since the last inspection, three allegations regarding abuse, had been made against staff by one resident. The investigations had been 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 notified of the outcomes. The care manager involved, who was visiting the home at the time of the inspection, was spoken to. She confirmed that the home had fully co-operated in the investigation process and that none of the allegations had been upheld. Langfield Nursing and Residential Home F56 F06 S17327 Langfield V222252 270405 Stage 4.doc Version 1.30 Page 16 Whilst some staff had received protection of vulnerable adult training, many had not and the manager should address this. Langfield Nursing and Residential Home F56 F06 S17327 Langfield V222252 270405 Stage 4.doc Version 1.30 Page 17 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) 19 & 26 A recent programme of decoration and refurbishment had resulted in significant improvements, providing residents with a safe, clean, pleasant and comfortable environment. EVIDENCE: Residents were delighted with the improvements to the home, especially their bedrooms, which had been totally refurbished. Unoccupied bedrooms were also being done and were not being re-let until they were completed. The ground floor shower, was however, in need of repair and this must be addressed without delay as several residents preferred to have a shower rather than a bath. 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 were provided with protective aprons and gloves to prevent the spread of infection and staff hand washing facilities were available around the home. Langfield Nursing and Residential Home F56 F06 S17327 Langfield V222252 270405 Stage 4.doc Version 1.30 Page 18 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. As previously stated, problems were being experienced with missing laundry, due to garments not being name marked. The manager said he was aware of this and was currently putting new systems in place to ensure the problem was satisfactorily addressed. Langfield Nursing and Residential Home F56 F06 S17327 Langfield V222252 270405 Stage 4.doc Version 1.30 Page 19 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, 29 & 30 On occasions, the home were operating under the required staffing levels which meant the needs of residents were not being fully met. The recruitment and selection policies/procedures were robust but were not always being adhered to and staff were not always receiving appropriate training, placing residents at potential risk. EVIDENCE: Whilst there continued to be a turnover of staff, there were several staff who had worked at the home for many years, who were providing the residents with consistent care. Rotas on both the nursing and residential units, identified under-staffing on a regular basis. Residents, relatives and staff spoken to also confirmed that staff shortages occurred regularly, with staff ringing in sick at the last minute, preventing cover being obtained. Examples were given when the nursing unit was short staffed, of staff being transferred from the residential unit, consequently leaving them short of staff. Two residents said that “staff were always busy because someone was off sick”. The manager must ensure that steps are taken to address the problems in order that adequate staffing levels are maintained at all times on each of the units. When checking staff files, it was noted that in one instance, a member of staff did not have a Criminal Records Bureau check in place. The manager was adamant that the home had received a satisfactory response but it could not be found during the inspection. Staff personnel files were in need of reviewing and this was a area which the manager said he had already prioritised. Langfield Nursing and Residential Home F56 F06 S17327 Langfield V222252 270405 Stage 4.doc Version 1.30 Page 20 Whilst residents said that staff were looking after them well, staff training was an area which needed prioritising. There was no evidence to show that any staff had undertaken induction training although blank induction packs were seen. The manager must ensure that all staff undertake induction training which meets the National Training Organisation (NTO) specification within 6 weeks of appointment to their posts and foundation training within 6 months of appointment. At the time of the inspection the manager was in the process of arranging a days basic induction training for all staff. From the training records seen, it was evident that not all staff had received 3 days training over the past 12 months and this should be addressed as highlighted in the last inspection report. Langfield Nursing and Residential Home F56 F06 S17327 Langfield V222252 270405 Stage 4.doc Version 1.30 Page 21 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 The home was being well managed resulting in a consistent and reliable service for people using it. A satisfactory accounting system was in place which protected residents interests. Not all staff had received relevant health and safety training, which could put residents at potential risk. EVIDENCE: The manager had a good understanding of the areas in which the home still needed to improve. He had made good progress in implementing many of the requirements made at the last inspection and had drawn up a list of priority areas to address which he was working through in a planned way. The home had a satisfactory accounting system in place. The administrator could determine exactly how much money the home were holding for each person and how the money was being spent. Receipts were retained for all financial transactions. Langfield Nursing and Residential Home F56 F06 S17327 Langfield V222252 270405 Stage 4.doc Version 1.30 Page 22 Effective quality assurance and monitoring systems were in place such as regular monthly 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 monitoring the service would be via questionnaires to other stakeholders i.e. district nurses, care managers etc and the results of any service user surveys should be published in the service user guide. Whilst the manager had set up a structured supervision system for staff, he had not delegated other senior staff to assist in this process and consequently was finding it impossible to remain on target. In the main, health and safety issues were satisfactory with regular maintenance checks of equipment being undertaken. Not all the Greater Manchester Fire Service requirements had been implemented and this must now be prioritised. All accidents and incidents were being correctly recorded and reported, although it was noted that the home needed to purchase a new accident record book. From checking the staff training records, it was clear that the requirement previously made, with regard to all staff receiving mandatory health and safety training had not been implemented. The manager said this was an area he was prioritising. He demonstrated his competency in this area, having recently completed a 3 day health and safety training course. Langfield Nursing and Residential Home F56 F06 S17327 Langfield V222252 270405 Stage 4.doc Version 1.30 Page 23 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 3 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x x STAFFING Standard No Score 27 1 28 x 29 2 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 3 x 3 x 3 2 x 2 Langfield Nursing and Residential Home F56 F06 S17327 Langfield V222252 270405 Stage 4.doc Version 1.30 Page 24 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 The statement of purpose was in need of further review in order to meet the required standard. (Timescale of 18.02.05 not met) Care plans must be accurate and regularly updated to reflect residents changing needs and current objectives. Bathing arrangements for each resident must e reviewed in order to ensure they receive baths on the days and at a time, convenient to them. Fluid charts must be completed for residents assessed at risk. All requirements in relation to medication issues, as set out in the letter sent under separate cover, must be implemented. The outcome of all complaint investigations must be logged. The shower must be repaired. Timescale for action 30.06.05 2. 7 17 31.05.05 3. 8 12 31.05.05 4. 5. 8 9 12 13 31.05.05 30.06.05 6. 7. 8. 9. 16 19 21 26 22 23 23 12 30.06.05 31.05.05 10. 27 18 Call bells must be fitted and 30.06.05 accessible in all communal areas. (Timescale of 30.09.04 not met). Residents clothes must be 30.06.05 properly marked in order to ensure people get their own clothes returned. Adequate staffing levels must be 31.05.05 maintained at all times, on both F56 F06 S17327 Langfield V222252 270405 Stage 4.doc Version 1.30 Page 25 Langfield Nursing and Residential Home levels of the home. 11. 29 19 Criminal Record Bureau/Pova First checks must be undertaken prior to new staff commencing work. All staff must receive a minimum of 3 days training per year. All staff must complete induction training which meets the TOPSS specification. (Timescale of 31.03.05 not met). All staff must complete all mandatory training i.e. moving/handling, fire, infection control etc. (Timescale of 31.03.05 not met). All the requirements from the Greater Manchester Fire report must be actioned. (Timescale of 31.12.04 not met). 31.05.05 12. 13. 30 30 18 18 30.04.06 31.07.05 14. 30 18 31.08.05 15. 38 30.06.05 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. 7. Refer to Standard 4 7 10 15 29 33 36 Good Practice Recommendations Staff should receive training in dementia care. All residents should receive a copy of their care plan which is easily understandable unless there are clear reasons recorded why not. Staff should ensure that dressings are discreetly stored away in residents bedrooms. Appropriate seating should be provided in the dining room for staff who are assisting residents. Staff personnel files should be reviewed in order to ensure all necessary information is in place for each person. The current quality assurance system should be expanded in order to obtain feedback from a wider variety of stakeholders. The supervision system should be reviewed in order to ensure that all staff receive a minimum of 6 supervision sessions each year. F56 F06 S17327 Langfield V222252 270405 Stage 4.doc Version 1.30 Page 26 Langfield Nursing and Residential Home 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 Nursing and Residential Home F56 F06 S17327 Langfield V222252 270405 Stage 4.doc Version 1.30 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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