Inspection on 10/02/06 for Langley House

This inspection was carried out on 10th February 2006.

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 found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Langley House 22/12/08

Langley House 29/06/07

Langley House 30/05/06

Langley House 29/07/05

Langley House 30/11/04

Langley House 11/05/04

Langley House 04/04/03

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

CARE HOME ADULTS 18-65 Langley House 47 Collington Avenue Bexhill-on-Sea East Sussex TN39 3NB Lead Inspector Christopher Stanley Unannounced Inspection 10th February 2006 09:30 Langley House DS0000021152.V283091.R01.S.doc Version 5.1 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 House DS0000021152.V283091.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Langley House DS0000021152.V283091.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Langley House Address 47 Collington Avenue Bexhill-on-Sea East Sussex TN39 3NB 01424 212934 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) Mrs Rajeswaree Jeeawon Mrs Rajeswaree Jeeawon Care Home 19 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (19) of places Langley House DS0000021152.V283091.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of people to be accommodated is nineteen (19) People admitted will have suffered or be suffering from a mental illness People accommodated will be between the ages of nineteen (19) and sixty five (65) years on admission 29th July 2005 Date of last inspection Brief Description of the Service: Langley House is a care home providing personal care and accommodation to nineteen (19) people with mental health needs. It is owned and managed by Mrs Rajeswaree Jeeawon. The home is located approximately one mile from the centre of Bexhill, with access to shops, pubs, churches and the post office. The accommodation comprises of three floors, and includes communal space, plus thirteen (13) single bedrooms, and three (3) shared bedrooms. Five (5) of the bedrooms provide en-suite facilities. At the time of the inspection, the home was accommodating fifteen (15) service users. Langley House DS0000021152.V283091.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out by two Inspectors on 10 February 2006, between the hours of 10.00 to 12.30, and involved discussion with the home’s manager and staff, six service users, the inspection of care documentation relating to four service users, and inspection of communal areas, and by invitation the opportunity to see three service users’ bedrooms. Following the last inspection, CSCI met with the home’s owners, the Community Mental Health Team, and the Contracts Department of East Sussex County Council, to consider the findings of the inspection, particularly in respect of the home accommodating adults with a complexity of mental health needs, beyond the skill of the staff team, and with adverse effects on the needs of other service users. This inspection therefore was particularly focused on the needs of the service users being accommodated, and the home’s ability to meet these needs. What the service does well: What has improved since the last inspection? All service users have been reviewed, to ensure that Langley House can meet the mental health needs of those being accommodated. This review has resulted in alternative placements being arranged for two service users. Following this review, the home has revised the Statement of Purpose to reflect its aim of providing care for those with less complex mental health needs, and its decision not to provide Respite Care. The quality of care documentation and risk assessment was noted to be much improved, and service users state that they are now being consulted more fully Langley House DS0000021152.V283091.R01.S.doc Version 5.1 Page 6 about the choice of food served, and the range of leisure activities they would like. A number of communal bathrooms and toilet areas have been upgraded, and satisfactory arrangements have been put in place for the storage and administration of controlled medications, in line with the requirements of the last inspection report. 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. Langley House DS0000021152.V283091.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Langley House DS0000021152.V283091.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4 Following the requirements of the last inspection report, the home is now accommodating service users, on the basis of a thorough assessment, and evidence that they can meet each individual service user’s needs. EVIDENCE: All service users have been reassessed since the last inspection, to ensure that the home can meet their needs. Following these reassessments, alternative placements have been obtained for two service users. The home’s Statement of Purpose has been revised to reflect that Langley House cannot accommodate adults with complex care needs, and the care assessment documentation, and care planning has been revised to ensure that service users are only being accommodated on the basis of a thorough assessment, and evidence that the home can meet their needs. Langley House DS0000021152.V283091.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, The newly devised system for the recording of service users’ care needs is comprehensive, and those inspected were comprehensive, and reflected the requirements of the last inspection EVIDENCE: A new electronic format for the assessment and recording of service users’ care needs has been devised, and the inspection of the new records for a number of service users showed that these were comprehensive, in their identification of need, assessed risk, and guidance to staff about the management of care needs and assessed risk. However, the process of transferring these from written documents had not been completed at the time of the inspection. The Inspectors stressed the importance of ensuring that this task is completed without delay, and that all care staff have access to service users’ care documentation at all times. Service users should be encouraged to participate in the preparation of meals in the home where this is supported by a risk assessment and the individual preference of service users. Langley House DS0000021152.V283091.R01.S.doc Version 5.1 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12 , 13, 14, 16, 17 The home is taking appropriate action to ensure that the varying cultural and social needs of service users are being met, and that service users have genuine opportunities to participate in the day-to-day life of the home, and local community. EVIDENCE: The challenge of involving service users in the day to day life of the home is considerable, with a number clearly wishing to enjoy their own company, and not being required to interact too closely with their colleagues. However, many service users require to be supported and enabled to enjoy a range of social and leisure activities that have the potential to enhance their self worth and self esteem. In this regard, in response to the requirement of the last inspection report, the home has consulted with service users, and devised a programme of activities and pursuits to reflect their expressed wishes. This is based around group activities both inside and outside the home, and the Inspectors have Langley House DS0000021152.V283091.R01.S.doc Version 5.1 Page 11 highlighted the importance of working in addition, on an individual basis with service users, to enhance their life skills and quality of life. Service users were complimentary in discussion with Inspectors, and in the comment cards they filled out following the inspection, about the quality of food service in the home. Langley House DS0000021152.V283091.R01.S.doc Version 5.1 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 There is evidence that the manager and staff have begun to focus more closely on ensuring that service users’ assessed needs can be, and are being met, and that appropriate levels of support are being provided. EVIDENCE: The manager and staff have been active since the last inspection in putting in place clear care plans, with the cooperation of service users, that reflect their individual needs and aspirations. The challenge for the staff team now is to ensure that service users are receiving personal support in the way they prefer and require, and that service users emotional health needs are being met. It will be important in future inspections that the home can evidence that they are engaging with service users in a manner that reflects their identified goals and aspirations, and that the care documentation maintained is underpinning, informing, and guiding staff in their work with individual service users. The arrangements for the storage and handling of medication were found to be satisfactory. Langley House DS0000021152.V283091.R01.S.doc Version 5.1 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 The home has a complaint procedure which service users are aware of. EVIDENCE: In discussion with service users, and from the comment cards received, it is clear that service users are aware of the home’s complaint procedure. Prior to and following the last inspection, complaints were received from a neighbour of Langley House, on behalf of a number of local residents, in respect of the anti-social behaviour of one particular service user, and the noise emanating from the home. This complaint was partially upheld, in that the home was accommodating one service user, in particular, whose needs they were not meeting, and whose behaviour was impacting adversely on the local community. This hopefully has been resolved, with the reaccommodation of this service user, and the home’s decision that in future it will not be accommodating people with complex mental health needs. It is also hoped that this will address the concerns expressed by a number of service users, during the last inspection, regarding fellow service users with challenging behaviour. Langley House DS0000021152.V283091.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 29 The home is providing a high level of comfort, within a safe environment. EVIDENCE: The on-going programme of refurbishment and redecoration is creating a homely and comfortable environment. Since the last inspection, work has been carried out to upgrade communal toilet and washing facilities. The Inspectors were pleased to note that all service users have access to the Internet, and their own e-mail address, and that three service users are routinely using a laptop, as a means of communication, and accessing information. The home is to be commended for its use of information technology, to broaden the lives of service users, and to enhance their contact with a wider community. In this regard, one service user has commented that they would welcome the opportunity to develop their skills by way of evening classes, and support. Langley House DS0000021152.V283091.R01.S.doc Version 5.1 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36 Following the recent reassessment of service users, and the revision to the home’s Statement of Purpose, to say that they are not accommodating adults with complex mental health needs, and providing respite care, there is evidence that service users’ individual and joint needs can be met by appropriately trained staff. EVIDENCE: Since the reassessment of service users, and the move of two service users to alternative accommodation, there is evidence that staff are now focussing on working more individually with service users, in respect of the quality of their lives, both within and outside the home. Staff appeared more relaxed, and positive about the work they were doing, and enthusiastic about recent initiatives, in respect of leisure and recreational pursuits for service users. The success of these initiatives is totally dependent on the home adhering to its recently adopted policy of not accommodating service users with complex mental health needs, and the owner and manager continuing to recognise that staff and service users function best where the day to day life of the home is not being disrupted by the levels of challenging behaviours, arising from inappropriate placements. Langley House DS0000021152.V283091.R01.S.doc Version 5.1 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 41; Recent initiatives, particularly in respect of the home’s admissions policy, and service user involvement in the day to day life of the home, suggest that the Registered Manager is seeking to address the concerns about the adequacy of the home’s management, highlighted in the last inspection report. EVIDENCE: The home is embarking on a period of change, following concerns about the adequacy of its management, staff skills, and the appropriateness of some of the service users being accommodated. These changes centre on the home’s admissions policy, and initiatives taken to enhance the quality of life for service users. It will be important that the home’s manager ensures that periodic reviews are carried out to ensure that the home is working within the term of its Statement of Purpose, and the National Minimum Standards for Adults with Mental Health needs. Langley House DS0000021152.V283091.R01.S.doc Version 5.1 Page 17 In view of past concerns, the home will continue to be monitored to ensure that it is maintaining and consolidating the work it has carried out to address these concerns. Langley House DS0000021152.V283091.R01.S.doc Version 5.1 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 3 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 x ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 x 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 x x LIFESTYLES Standard No Score 11 2 12 3 13 3 14 3 15 x 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 2 2 3 3 3 x x Langley House DS0000021152.V283091.R01.S.doc Version 5.1 Page 19 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 YA6 Regulation 15(1)(2)(a)(b)(c)(d) Requirement Timescale for action 30/04/06 2 YA11 16(2)(m) 3 YA38 24(1)(2)(3) Ensure that a completed care plan, inclusive of a risk assessment, is in place for each service user, and available to staff at all times. Evidence how service 30/04/06 users are being enabled to maintain and develop social, emotional, communication and independent living skills. That the Registered 10/02/06 Manager communicates a clear sense of direction and leadership which staff and service users understand and are able to relate to the aims and purpose of the home. Langley House DS0000021152.V283091.R01.S.doc Version 5.1 Page 20 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 YA16 Good Practice Recommendations That service users within the risk assessment framework are enabled to share in the day to day running of the home eg preparation of meals. Langley House DS0000021152.V283091.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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. 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