Inspection on 26/07/07 for Langley Court

This inspection was carried out on 26th July 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Langley Court 09/05/06

Langley Court 03/11/05

Langley Court 24/05/05

Langley Court 09/11/04

Langley Court 07/06/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Langley Court 9 Langley Avenue Surbiton Surrey KT6 6QH Lead Inspector Jon Fry Key Unannounced Inspection 10.00a 26th July & 9th August 2007 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 Langley Court DS0000013390.V343942.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. Langley Court DS0000013390.V343942.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Langley Court Address 9 Langley Avenue Surbiton Surrey KT6 6QH 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) 020 8399 6766 020 8399 2183 Mr Dinesh Ambalal Patel Mrs Gita Dinesh Patel Post Vacant Care Home 28 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (25) of places Langley Court DS0000013390.V343942.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th May 2006 Brief Description of the Service: Langley Court provides care for twenty-eight older people, three of whom may have dementia. The home is a large detached house situated in a quiet residential area of Surbiton. A copy of the home’s Service User Guide and Statement of Purpose can be obtained on request. Langley Court DS0000013390.V343942.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out by one inspector who spent twelve hours in the home over two separate visits. The inspector talked individually with eight people living there. Two relatives or friends of individuals were also spoken with during the inspection. A number of records were examined and discussions took place with the managers and three staff members. Completed surveys were received from nine people living at the service and seven relatives or friends of individuals. What the service does well: What has improved since the last inspection? Recruitment checks are now fully completed to make sure that people living there are protected. New carpets have been fitted which improves the look of the home. The management team is continuing to make improvements in areas such as care plans and activities. Langley Court DS0000013390.V343942.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Langley Court DS0000013390.V343942.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Langley Court DS0000013390.V343942.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 5. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Satisfactory information is available to prospective users of the service. Assessments are completed before people move in and are kept under review. EVIDENCE: “It’s very good”, “excellent”, “I like it” and “it suits me” were some typical comments from people living at the home. Relatives and friends comments included “very good” and “provides a warm homely atmosphere”. In surveys, all seven people who use the service said that they had received enough information to make a decision about moving in. Langley Court DS0000013390.V343942.R01.S.doc Version 5.2 Page 9 A Statement of Purpose is on display in the hallway of the home. This contains satisfactory information about the service provided but needs further development. Full information about the weekly fees charged needs to be included as well as any additional charges. The home should look at making this document available in large print and other formats such as tape or pictures. This will make sure that it can be used by as many people as possible. We saw that there is an admissions procedure and that assessments are completed prior to anybody moving in. Once an individual comes to live there, a care plan is written based on these assessments. It is important that the service looks at how good quality person centred information can be gathered within assessments. We looked at the assessments completed for three people and saw that some good information had been recorded. This could be improved by looking at the assessments in use and making sure that they capture the information needed to allow staff to provide personalised care and support. Five out of seven people who responded in surveys said that they had received a contract. We saw that the service has written contracts in place that are provided to people and / or their representatives on admission. We recommend that contracts be made available in large print and other formats as required. Langley Court DS0000013390.V343942.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Care plans address the health, personal and social care needs of individuals but could be improved to be even more person centred. Arrangements for the handling, storage and administration of medication are good. EVIDENCE: Three people who live at the home responded ‘always’ when asked if they received the care and support they needed. Five people said ‘usually’. Five out of the seven relatives or friends who sent in surveys said that the home ‘always’ met the needs of the individual. Two people said ‘usually’. One individual commented “the staff are always attentive”. Langley Court DS0000013390.V343942.R01.S.doc Version 5.2 Page 11 We looked at the care plans for three people. Each care plan sets out how their needs are to be met, this document is reviewed regularly. The plans could be improved to contain more individualised information to help staff deliver person centred care. We saw some very good detail recorded about the person’s background, likes and dislikes and individual interests. Individual care plans are written for areas such as mobility, personal care and social activities and some of these contained good specific information. Care staff need to make sure that this specific person centred information is recorded for everyone who lives there. For example when looking at personal care needs, does the person like a bath or a shower, which bathroom do they use, what day or time do they prefer and who do they like to help them? Care plans around ‘expressing sexuality’ were either blank or referred to individuals liking to dress smartly or look nice. It is recommended that the staff team discuss this area further and decide what information should be recorded. Daily notes kept by staff should be looked at to make sure that good quality useful information is recorded. We saw that some notes tended to be repetitive and made general statements – ‘was fine this morning’ and ‘attended to personal care’. We did see one example where some very good detailed information had been recorded for one person that could then be used to inform the care being provided. This is important to make sure that changing needs are being met. Risk assessments are completed around areas such as falls, pressure areas and nutrition. We saw that these were generally well completed and kept under review. All eight people who completed a survey said that they ‘always’ received the medical support they needed. Comments included “I can see the Dr if I wish” and “I had a fall and was immediately taken to hospital”. Good records are kept of any contact with healthcare professionals for each person. We saw that medication is stored securely and that accurate administration records are kept by staff. Langley Court DS0000013390.V343942.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home offers a good range of activities in and out of the home. People living there enjoy the food provided and mealtimes are a pleasant social occasion. EVIDENCE: People spoken with said that they enjoyed the food offered with comments including “very nice”, “the food is good”, “excellent”, “pretty good” and “it varies but a good stable diet”. In completed surveys, four of the eight people said they ‘usually’ liked the meals served. Three individuals said ‘always’ and one person said ‘sometimes’. We saw lunch being served on both days we visited. People were given a choice and were able to serve themselves where possible. The day’s menu is Langley Court DS0000013390.V343942.R01.S.doc Version 5.2 Page 13 displayed in the dining room and condiments and napkins are provided on each table. One of the managers said that they were hoping to get new dining tables and chairs in the near future. We have recommended that space be provided for staff to be able to sit down with the people living there to eat meals. This would make the mealtimes even more of a social occasion. Six out of the eight people who completed a survey said that there were ‘usually’ activities that they could take part in. Two people said ‘always’. Comments included “they are good but not everyday”, “you can have your hair done”, “I like to go on the trips” and “I’d like to go for exercise a bit more”. An activities officer works at the home for two days a week and care staff take responsibility for providing activities at other times. Entertainers also come in once a week. Activities provided include art and craft, quizzes and bingo. Monthly trips out are also provided and an afternoon out to a local vineyard was taking place on the second day we visited. The home was looking at developing the activities it provides and was compiling a list of ‘simple pleasures’ that each person living there liked to do. Requests from individuals had included ‘more Italian food’ and ‘a few more walks’. We have recommended that the home continue to develop its activities programme and look at training it could access to help with this. Additional hours for the activities officer should also be considered. Langley Court DS0000013390.V343942.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service feel able to voice any concerns they have. A policy is in place for Safeguarding Adults and staff have training in this important area. EVIDENCE: Records are kept of any concerns or complaints received and we saw that the last complaint received was in November 2006. This had been looked into by the home with records kept to show what had been done. The complaints policy and procedure is displayed in the home and is part of the information for the people living there. All the people who completed surveys said that they knew how to make a complaint. All seven relatives or friends who completed surveys said they knew how to make a complaint. Care staff at the home have training that teaches them how to recognise and report abuse. There is a procedure available for staff to follow in the event of any allegations being made. Langley Court DS0000013390.V343942.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living at the home enjoy a comfortable and safe living environment. The home is generally kept clean and well maintained but would benefit from redecoration in some areas. EVIDENCE: People spoken to were happy with the environment. Comments from individuals included “my bedroom is very nice”, “the new carpets are nice”, “ok”, “my room is a bit small” and “a super room – I love it up there”. We saw that the home generally provides a pleasant and well maintained place for people to live. Some bathrooms are in need of updating and we saw that Langley Court DS0000013390.V343942.R01.S.doc Version 5.2 Page 16 work had begun on doing this. We have strongly recommended that the owner put a programme in place to update all the bathrooms. This will really help to enhance the environment provided for the people living there. A number of chairs in the conservatory need replacement and a bathroom on the ground floor needs a new lock. One of the managers said that they were awaiting a grant to get new dining room and garden furniture The home was clean and hygienic at the time of this inspection. All the people who returned surveys responded ‘usually’ when asked if the home is fresh and clean. Langley Court DS0000013390.V343942.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. There are generally enough staff on duty to meet the needs of people using the service and individuals are happy with the care they receive. People living at the home are protected by the recruitment procedures. There is a good staff training and development programme in place. EVIDENCE: Feedback about the way the staff carried out their duties was very positive. Comments included “very good”, “the staff are lovely”, “quite nice”, “excellent” and “they could not do any more”. Relatives or friends of individuals said “I have found Langley Court staff to be very helpful” and “staff are always kind and friendly”. Six people who filled in surveys said that staff were ‘usually’ available when needed. One person responded ’always’ and another person said ‘sometimes’. Five relatives or friends of individuals said that staff ‘always’ had the right skills and experience to look after people properly. Two people said ‘sometimes’. Langley Court DS0000013390.V343942.R01.S.doc Version 5.2 Page 18 We saw that staff spoke to individuals in a polite and respectful manner. Staff are offered training in a number of topics such as manual handling, medication, fire safety, First Aid, and Protection of Vulnerable Adults. The home also has a programme of NVQ training and all members of care staff have either completed, or are in the process of studying for, this award. We have recommended that the home looks at developing further training for care staff around dementia care, activities and person centred approaches. We looked at the recruitment records for three members of staff. These were well maintained and contained all the necessary checks including Criminal Records Bureau (CRB) checks. Langley Court DS0000013390.V343942.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People live in a home that is well run. There are generally good arrangements to make sure that the health and welfare of people using the service is protected. EVIDENCE: There are two individuals sharing the management duties for the home. We thought that this was working well and both managers were clearly committed in providing a high quality service to the people living there. Langley Court DS0000013390.V343942.R01.S.doc Version 5.2 Page 20 Comments from staff about the management of the home included “nice to work for”, “it’s run really well” and “lovely”. People who live at the home said “the manager is very nice”, “nice” and “cares about everybody”. A system for regular individual staff supervision is in place. It is recommended that manager’s sign and date the notes kept of these sessions. Staff meetings are currently held every six months and we think that the service should look at holding these at least quarterly. Meetings for people who live at the home are held every three months and things talked about included food and activities. Questionnaires had also been given out to individuals in May 2007 to formally ask for their views about the service. Health and Safety checks take place to make sure people are kept safe and good records are kept of these. One issue was highlighted where the hot water temperatures of a bath were very high. The manager stated that additional measures have been put in place to make sure that people using this bath are kept safe at all times. We have made a Requirement about this issue. Langley Court DS0000013390.V343942.R01.S.doc Version 5.2 Page 21 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 3 3 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 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 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 2 Langley Court DS0000013390.V343942.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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 5 (1) (bc) Requirement In order to make sure that people living at the home or their representatives know how much they are paying for services, the user guide must include details of fees payable by individuals. Timescale for action 01/11/07 2. OP19 23 (2) (c) 3. OP38 13 (4) To make sure that people live in 01/11/07 a pleasant and well maintained environment, the worn chairs in the conservatory must be replaced. A working lock must also be fitted in the ground floor bathroom. Effective control measures must 01/10/07 be put in place to make sure that people living at the home are protected from scalding when using baths or showers. This will make sure that the environment is safe for the people living there. Langley Court DS0000013390.V343942.R01.S.doc Version 5.2 Page 23 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. Refer to Standard OP1 OP2 OP3 Good Practice Recommendations The guide to the home should be made available in a variety of formats such as large print, audiotape or pictures. It is recommended that the home makes sure that contracts are in plain English and in alternative formats as required. The assessment format should be reviewed to make sure that good quality person centred information is recorded. This can then be used to inform the care plan from when the individual moves in. The home should look at ways to make the care plans more person centred and better reflect the individual’s life and preferences. The plan in place should direct the care to be person orientated and not task based. Care plans need to give specific information about how the person likes the care and support to be delivered. Care staff should start to discuss issues regarding care planning around sexuality. Daily notes should be reviewed to make sure that good quality useful information is being recorded. The organisation should seriously consider allocating additional hours for the activities officer for the home. It is strongly recommended that further training courses be made available to the activities officer and/or other responsible care staff. Dining space should be made available to allow care staff to be able to eat with the people living at the home as appropriate. It is strongly recommended that all bathrooms in the home be updated. It is recommended that all staff receive training in caring for people with dementia. This should cover person centred approaches, effective communication and the use of activities. The managers should sign and date records of supervision with care staff. It is recommended that staff meetings be held at least DS0000013390.V343942.R01.S.doc Version 5.2 Page 24 4. OP7 5. 6. 7. OP7 OP7 OP12 8. 9. 10. OP15 OP19 OP30 11. 12. OP36 OP36 Langley Court quarterly. Langley Court DS0000013390.V343942.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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. 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