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Inspection on 09/08/06 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 9th August 2006.

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

The inspector found 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 has some care staff who have worked at the home for a long time and the residents said that they liked the staff and felt safe in the home. Comments such as "the staff are really nice to me, " and "I`m very happy here" were made to the Inspector. Meals and mealtimes were considered to be an important part of the residents` day. The dining room was a nice place to sit, eat and meet with other residents. The residents said that they really enjoyed their meals. They were satisfied with the choice of meals and the way they were cooked and served.

What has improved since the last inspection?

The manager and the cook are presently reviewing the food that is provided to residents. This will include the diets for people who have difficulty chewing or swallowing. The staff rotas are kept up to date to show which staff are working with the residents. The records kept of residents` monies are up to date and show how much money the home is holding for them.

What the care home could do better:

Most of the previous requirements and recommendations from the last inspection have not been complied with. The written information provided to residents and relatives needs updating. Serious concerns were expressed to the home in respect of the care of a resident, being nursed in bed, who was not being given sufficient fluids. The home was also failing to record how care staff were expected to manage one individual who was reluctant to co-operate with staff when asked not to go into other residents` rooms uninvited. More activities need to be provided and they must be activities that residents have said they would like to do. The home does not ensure that they receive 2 satisfactory references and that a CRB check is made to determine if the person is fit to work with older people, before offering them employment. Both of these failures put residents at risk. The grounds are unkempt and do not provide an attractive or safe environment for residents. There are parts of the home including bedrooms and communal areas that need decorating and new carpets providing. A strong smell of urine was evident in one part of the home. The home needs to provide a training programme for its entire staff and provide the opportunity for staff development.

CARE HOMES FOR OLDER PEOPLE Langfield Nursing And Residential Home Wood Street Langley, Middleton Manchester Lancashire M24 5QH Lead Inspector Bernard Tracey Unannounced Inspection 9th August 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Langfield Nursing And Residential Home DS0000017327.V290398.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Langfield Nursing And Residential Home DS0000017327.V290398.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Langfield Nursing And Residential Home Address Wood Street Langley, Middleton Manchester Lancashire M24 5QH 0161 653 5319 0161 653 5393 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) Southern Cross Care Management Limited Vacant Care Home 50 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (1), Old age, not falling within any of places other category (50), Physical disability (2) Langfield Nursing And Residential Home DS0000017327.V290398.R01.S.doc Version 5.2 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 female service user in the category of (MD) Mental Disorder under 65 years of age; up to 2 male service users in the category of (PD) Physical Disabilities under 65 years of age. The service should employ a suitably qualified and experienced Manager who is registered with the Commission for Social Care Inspection. 12th September 2005 2. Date of last inspection 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 situated in its own grounds and has 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. The home makes the following charges over and above the weekly care and accommodation fees that are listed after this section: Chiropody Hairdressing Magazines and Newspapers Fees charged by the home provided in June 2006 are as follows: General Nursing range of £475.00 per week The following Nursing Care Enhancements need to be added to the above figure: High Dependency £133.00 per week Langfield Nursing And Residential Home DS0000017327.V290398.R01.S.doc Version 5.2 Page 5 Medium Dependency £83.00 per week Low Dependency £40.00 per week The above Dependency level is decided by a nurse not employed by the home but who works for the Health Authority Langfield Nursing And Residential Home DS0000017327.V290398.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The home was not made aware that this inspection was to take place. Several weeks before the inspection questionnaires were sent out to doctors, social workers and district nurses, as well as to the residents of the home and their relatives. The questionnaires asked what people thought of the care and services provided by the home. One reply was received from a relative and no concerns were expressed. The questionnaires sent to visiting professionals asked questions relating to communication, availability of senior staff when visiting, staff having a clear understanding of service users needs, management taking appropriate decisions, management of medication, complaints from service users they may be aware of, and if they are satisfied with the overall care provided by the home. Only one reply was received and though generally satisfied with the home did express concern about the availability of senior staff when she visited the home. The Inspector spent 7.5 hours at the home. During this time he looked at care and medicine records to ensure that health and care needs were met and also studied how information was given to people before they decided to move into the home. A full tour of the building was undertaken and time was spent looking at records regarding safety in the home. He also examined files that contained information about how the staff were recruited for their jobs, as well having a discussion about staff training. The Inspector spent time speaking to 5 residents as well as speaking to 2 relatives, 4 staff, and the newly appointed manager. All of the key National Minimum Standards were looked at on this visit to the home. What the service does well: The home has some care staff who have worked at the home for a long time and the residents said that they liked the staff and felt safe in the home. Comments such as “the staff are really nice to me, ” and “Im very happy here” were made to the Inspector. Meals and mealtimes were considered to be an important part of the residents’ day. The dining room was a nice place to sit, eat and meet with other residents. The residents said that they really enjoyed their meals. They were satisfied with the choice of meals and the way they were cooked and served. Langfield Nursing And Residential Home DS0000017327.V290398.R01.S.doc Version 5.2 Page 7 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 Nursing And Residential Home DS0000017327.V290398.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Langfield Nursing And Residential Home DS0000017327.V290398.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13 The quality outcome in this area was considered adequate. This judgement has been made using available evidence including a visit to this service. Information provided to residents before admission is in the process of being reviewed to include all of the information required to make an informed choice of where to live and include up to date information. The system for ensuring that all prospective residents had a detailed assessment undertaken prior to admission to the home, gave an assurance both to residents, relatives and staff that a resident was only admitted if the home could meet their needs. EVIDENCE: The newly appointed manager was in the process of reviewing the home’s Statement of Purpose and Service User Guide to include details of the recent changes that had occurred at the home. When this is completed a copy of the documents is to be forwarded to the Commission for Social Care Inspection. Individual records were kept for each resident. Three files were inspected and all had assessments completed by the manager or Senior Carer prior to Langfield Nursing And Residential Home DS0000017327.V290398.R01.S.doc Version 5.2 Page 10 admission. If residents were funded by the Social Services Department a care management assessment was also completed and a copy was retained in the individual’s file. The manager visited people in their home or hospital setting in order to assess them. Records showed that the assessment covered not only assessment of need but other important areas such as culture and religion, with a note made of people’s wishes in these and other personal choice areas. Langfield Nursing And Residential Home DS0000017327.V290398.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The care plans did not always reflect the support needs of the residents. Care practices at times did not ensure that the residents health care needs were met. EVIDENCE: Individual care plans were in place for all residents that clearly set out the health, personal and social care needs identified for each resident. The plans had been evaluated on a monthly basis and any changes to the care being given is documented and implemented by the staff. The care plans had been signed by a relative. The care plans were, on the whole, well written and included detailed information about the needs and expectations of the residents and the care being given on a daily basis. Detailed risk assessments were in place in each of the files inspected. They covered areas such as nutrition, pressure areas, moving and handling and the risk of falls. Other risk areas were identified in connection with daily living activities and it was evident that responsible risk Langfield Nursing And Residential Home DS0000017327.V290398.R01.S.doc Version 5.2 Page 12 taking was regarded as part of the normal expression of peoples’ independence by the staff team. One care plan described a resident as ‘displaying challenging behavior’. Although separate records described several incidents where the staff had needed to care for the individual during such times, no written care plans were available to assist staff by describing how these incidents were best dealt with, apart from assistance with bathing. Evidence of poor monitoring of fluid intake of one resident who was being cared for in bed, was found. From observations made during the inspection and examination of the fluid intake chart there was clear evidence that the individual was not receiving adequate fluids. The need for urgent action was related to the manager at the time of the visit and subsequently a letter of serious concern was sent to the Responsible Individual requiring immediate action to address the issues identified and to ensure the safety of all persons in the service. A discussion with the residents identified that they had access to other health care services including hearing, sight tests and a visiting chiropodist. Evidence of these visits was kept in the residents’ individual files. Equipment necessary for the prevention and treatment of pressure sores was available. Continence aids were in use and the staff were aware of how to contact the continence advisor if deemed necessary. Following the previous inspection an additional inspection was carried by the Pharmacist Inspector, the outcome of which was that several requirements and recommendations were made. As part of this current inspection the manager was able to confirm that all of these matter had been dealt with. Langfield Nursing And Residential Home DS0000017327.V290398.R01.S.doc Version 5.2 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 the following standard(s): 12 13 14 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Provision of social activities and integration into community life did not fully satisfy each resident’s social and recreational interests. A nutritious, varied and balanced diet was provided and enjoyed by residents. EVIDENCE: The activity co-ordinator had recently returned following a period of leave and was hoping to review the provision of activities provided both in and out of the home. From interviews with staff, residents and relatives it was established that inhouse activities had taken place and included jigsaws and bingo. On resident said she used to enjoy the trips out to places such as Blackpool and the Coronation St. set but said these have not been happening recently. Another resident said there was “not enough variety and if you did not like the bingo then there was little else” Residents wishing to maintain their religious links were encouraged and enabled to do so. Special occasions were celebrated to which relatives and Langfield Nursing And Residential Home DS0000017327.V290398.R01.S.doc Version 5.2 Page 14 friends were invited. celebrated. Religious festivals and occasions were observed and Observation and discussion with residents and staff showed that residents were able to make day to day decisions regarding rising/retiring times, what clothing to wear, where to sit, what to eat, whether or not to be involved in activities. Residents’ wishes regarding involvement in their financial affairs were established on admission. None had chosen to control their own monies. The majority had asked relatives or friends to be responsible for finances. Advice regarding financial advocacy was held at the home if needed. Residents were able to bring personal possessions, including furniture with them, and evidence of this practice was seen in bedrooms. Menus inspected were seen to provide a varied diet over a 4 week period. Fresh fruit was served 2 or 3 times each week and residents said it was also offered as a snack and served as an alternative dessert most days. Two hot choices of lunchtime meals and a salad were offered each day and a hot and cold choice offered at teatime. Residents described the food as ‘very good’, one resident said ‘it’s well cooked and plenty of it”. Observation and inspection of records showed that the cook offered alternatives to residents if they didn’t want what was on the menu or were not eating well. She had also amended the menus during the recent hot weather to offer foods, which she thought residents would prefer whilst it was very hot. Daily choice sheets recorded these changes. The manager is planning to meet with the cook to discuss the menus and nutritional issues. Both had recently attended training provided by the NHS Dietician on nutrition, which they said would inform their menu review. The cook was trying out new dishes prior to rewriting menus with the manager. It was clear from talking to her that she knew the residents’ likes and dislikes well and did her utmost to provide nutritious food that they enjoyed. Diabetic and soft diets were provided for those who required them. The consistency and presentation of the ‘soft’ diets was under review. Staff were observed giving appropriate assistance to those needing it and were both supportive and encouraging. Plate guards and adapted cutlery were available and in use by some residents. Langfield Nursing And Residential Home DS0000017327.V290398.R01.S.doc Version 5.2 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 the following standard(s): 16 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Systems were in place with regard to the investigation of complaints and adult protection issues, ensuring that residents were listened to and protected. EVIDENCE: There is a written complaints policy and copies of this are posted in prominent positions throughout the home. There have been two recent complaints made to the home, one of which is still under investigation. Residents and relatives said they would not hesitate to tell the Manager if they had any concerns. No members of staff had undertaken training in the protection of vulnerable adults. The manager said that it was her intention to send staff on the course that Rochdale Social Services were providing and was actively pursuing places for all members of 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 Nursing And Residential Home DS0000017327.V290398.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A homely environment was provided but cleanliness was not always maintained throughout, which on occasions adversely affected residents’ comfort. EVIDENCE: Whilst most of the accommodation was satisfactory, not all areas were well maintained, clean or safe for residents. The home has a variety of communal spaces – lounges, small sitting area on the first floor, and two dining rooms, including one that has additional sitting space. Furnishings in communal areas were domestic in character, generally of good quality and suitable for their purpose. The home has failed to ensure that the gardens and outside walkways have been adequately maintained. The paved areas have grass growing through Langfield Nursing And Residential Home DS0000017327.V290398.R01.S.doc Version 5.2 Page 17 that could present as a trip hazard for the residents or visitors. The lawns require cutting and the hedge to the side of the home needs trimming. There are several double glazed units, which are ‘popped’ and require replacing. The showerhead in the bathroom is broken and needs replacing. There was a strong smell of urine in one of the corridors. The source was the carpet in room 16, a vacant room, and the Inspector was informed that this had been a long standing issue, causing discomfort to residents and visitors who were in the vicinity of this area, and which the home has failed to address adequately. The carpet in this room must be taken up and disposed of and a replacement laid once the floor area has been thoroughly cleaned. Room 6 requires urgent redecoration and the provision of a new carpet. The Hairdressing salon requires decorating and the provision of suitable chairs and flooring. The mirror must be re positioned so that the residents are able to see themselves during their time in the salon. There has been no attempt to personalise this area and consideration should be given to this when the room has been refurbished. The window did not have blinds or curtains. Suitable window blinds must be provided in the hairdressing salon. Other bedrooms were looked at and were bright, airy and personalised with residents personal belongings bringing a homely touch to their rooms. 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. Langfield Nursing And Residential Home DS0000017327.V290398.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The homes recruitment procedures do not provide safeguards for the protection of residents. Staff training must be planned, so that residents can be assured that staff will be trained and competent to do their jobs. EVIDENCE: The Inspector examined three staff files and found that two of them did not contain all of the information required to provide safeguards for the protection of residents, confirming that the correct recruitment procedures had not been followed. One file examined did not contain any references whilst a declaration regarding any criminal convictions, on the same individual’s application form, had not been signed and she was subsequently found to have a criminal conviction. This disclosure was referred to the Operational Manager but no evidence of a follow up was included in the file. The file did not contain a check with the POVA First list prior to her commencing he employment. The appointment of the manager was made without obtaining a reference from her last employer and before the Registered Person had received the CRB Disclosure, neither was a POVA First obtained prior to appointing the manager to her post. Langfield Nursing And Residential Home DS0000017327.V290398.R01.S.doc Version 5.2 Page 19 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 adequate as residents were seen to require assistance but no staff were available in the vicinity. A visitor on the nursing unit confirmed the view that at the busier times there was insufficient staff to meet the needs of the residents on this unit. 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. Staffing numbers should be increased to meet the assessed needs of residents. The manager is aware that staff training is not up to date and is presently planning to assess staff training needs. Updates are needed for Food Hygiene, Moving and Handling and various other areas of statutory staff training. The manager should also complete a training overview record, to ensure all staff have appropriate training in place. Staff had a limited knowledge and understanding of adult protection procedures thereby increasing the possible risk of harm or abuse to residents. No record of members of staff who have undertaken training in the protection of vulnerable adults was available. The home must provide access to training in the Protection of Vulnerable Adults for all care staff in the home. The manager said that it was her intention to obtain places for all staff on the course that Rochdale Social Services provide. Langfield Nursing And Residential Home DS0000017327.V290398.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 33 34 35 36 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The recently appointed manager was working hard to maintain nursing and personal care standards. Residents’ finances were efficiently managed. A satisfactory accounting system was in place, which protected residents interests. EVIDENCE: Since the last inspection the Manager had resigned his position. A new Manager had been recruited and commenced employment at the home on 18th June 2006. The manager has yet to apply to be registered with the Commission and should do so without further delay. Langfield Nursing And Residential Home DS0000017327.V290398.R01.S.doc Version 5.2 Page 21 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. The manager has plans set up a structured supervision system for staff, to provide the opportunity to identify a person’s limitations or knowledge gaps, and to support staff in their own development and implementing the home’s philosophy of care. One nurse spoke of her wish to further her knowledge and skills in relation to Tissue Viability and is approaching the manager with a request for support in obtaining a qualification in this area of resident care. Written records of all transactions were available and of those examined, appeared to be accurately maintained. Personal allowances are not pooled and receipts are kept for any purchases made on behalf the individual. A safe is available for storage of valuables. The company audits personal accounts independently. Health and safety issues were satisfactory with regular maintenance checks of equipment being undertaken. All essential equipment had been appropriately maintained with records kept. The five yearly electrical certificate was due to be renewed and following a satisfactory inspection should be forwarded to the Commission for Social Care Inspection. Requirements made from the Greater Manchester Fire Service inspection in August 2006, had been implemented. The handyman was responsible for inducting new staff in fire safety and security of the building. Langfield Nursing And Residential Home DS0000017327.V290398.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X x 2 STAFFING Standard No Score 27 2 28 2 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 3 3 x 2 x 3 Langfield Nursing And Residential Home DS0000017327.V290398.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? YES 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 OP1 Regulation 4 Requirement An up to date Statement of Purpose and Service User Guide is to be produced and made available to service users. Care plans for service users must set out in detail the action to be taken by care staff to ensure that all their care needs are met. When monitoring a service user’s fluid intake an accurate record must be maintained. Residents’ interests must be recorded and used to give opportunity for stimulation at the home. Grounds are to be kept tidy, safe, accessible to service users and attractive. The damaged double glazed units throughout the home are to be replaced. The broken shower head is to be replaced The hairdresser room is to be refurbished Room 6 requires decorating and a new carpet. Room 16 requires a new carpet DS0000017327.V290398.R01.S.doc Timescale for action 30/09/06 2. OP7 15 30/09/06 3. 4. OP8 OP12 12 14 30/09/06 30/09/06 5. 6. 7. 8 9. OP19 OP19 OP19 OP19 OP19 23 23 23 23 23 30/09/06 30/10/06 30/09/06 30/10/06 30/09/06 Langfield Nursing And Residential Home Version 5.2 Page 24 10 11. OP26 OP29 16 19 12. OP29 19 The home must be kept clean 30/09/06 hygienic and free from offensive odours. Two written references, one from 30/09/06 last employer, are obtained before appointing a member of staff. New staff must not commence in 30/09/06 post without a satisfactory Criminal Record Bureau disclosure. All staff must receive a minimum of 3 days paid training (pro rata) per year and should include all mandatory training. The Registered Person must ensure there is a staff training and development programme. A copy of the programme to be sent to the Commission for Social Care Inspection All staff must receive training in the Protection of Vulnerable Adults. The new Manager must apply for registration with CSCI. All staff must receive formal supervision 30/03/07 13. OP30 18 14. OP30 12 30/10/06 15. 14. 15. OP30 OP31 OP36 12 8. 18 30/03/07 30/09/06 31/12/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP30 Good Practice Recommendations Staffing numbers should reflect the assessed needs of the residents. Langfield Nursing And Residential Home DS0000017327.V290398.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office 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 DS0000017327.V290398.R01.S.doc Version 5.2 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. 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