CARE HOMES FOR OLDER PEOPLE
Langley House Langley House Sunderland Road Horden Peterlee Durham SR8 4NL Lead Inspector
Mrs Pat English Announced Inspection 10th November 2005 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 Langley House DS0000007485.V248966.R01.S.doc Version 5.0 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 House DS0000007485.V248966.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Langley House Address Langley House Sunderland Road Horden Peterlee Durham SR8 4NL 0191 5861342 0191 5864483 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) Durham Aged Mineworkers Association Mrs Joy Sheila Atkinson Care Home 29 Category(ies) of Old age, not falling within any other category registration, with number (29), Physical disability (3) of places Langley House DS0000007485.V248966.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 17/05/05 Brief Description of the Service: Langley House is owned and run by Durham Aged Mineworkers Association and provides personal care and accommodation for 29 older persons; included in this number, the home may also accommodate 3 people with physical disabilities. The home is located in the centre of the small town of Horden and is close to the local shops and local amenities and within easy travelling distance of surrounding towns and villages. It was first registered as a care home in 1989 and consists of a single storey building which was purpose built to meet the needs of older people with physical disabilities. The accommodation consists of 26 bedrooms all of which have en-suite toilets, three of the bedrooms were built for shared use but are currently used as single rooms. Adequate bathing and toilet facilities are provided. There are two spacious lounges (one of which is a smoking area) and a spacious dining room which overlooks a patio and garden area which are well maintained and easily accessible. In addition there is a small quiet lounge which can also be used by visitors. Langley House DS0000007485.V248966.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This announced inspection took place over approximately seven hours and the manager, deputy manager, three care staff, six visitors and six residents were spoken to and gave their views. Four comment cards were received, two from residents and two from relatives. On this occasion the inspector looked at a total of 13 standards under Health and Personal Care, Daily life and Social Activities, Environment and Management and Administration. What the service does well: What has improved since the last inspection?
Positive action has been taken to improve residents’ care plans. New documentation has been introduced which gives more detailed information on each resident’s individual needs and how these needs will be met, particularly regarding their health and personal care. Langley House DS0000007485.V248966.R01.S.doc Version 5.0 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. Langley House DS0000007485.V248966.R01.S.doc Version 5.0 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 House DS0000007485.V248966.R01.S.doc Version 5.0 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 the following standard(s): Standards not assessed on this inspection EVIDENCE: Langley House DS0000007485.V248966.R01.S.doc Version 5.0 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9 and 10 Policies and procedures for dealing with medicines have not been strictly followed resulting in some unsafe practices. Care practices in the home promote and protect residents privacy, dignity and independence. EVIDENCE: Medicines including Controlled Drugs were being stored appropriately. All staff who administer medication have completed a satisfactory training course in the safe handling of medicines. A few discrepancies were noted in a sample of residents’ medication administration records inspected. Records of each resident’s prescribed medication were not consistently kept updated where changes occur and the medication administration records did not clearly identify who had administered the medication or the time it was administered. Some short courses of medication were not recorded in the prescribed medication record. It was acknowledged that the current system of keeping several records relating to each person’s medication may have contributed to the errors and the manager agreed to review the procedures and address the issues.
Langley House DS0000007485.V248966.R01.S.doc Version 5.0 Page 10 All comments from residents and relatives confirmed that they were very satisfied with care practices within the home staff were highly regarded for their respectful and caring attitude. They said that “their views were taken into consideration” and that staff were “caring and friendly” and “very polite and helpful”. It was also clear from talking to a number of residents that a high proportion of them chose to spend most of their time in their rooms and that they appreciated the privacy this gave them. Langley House DS0000007485.V248966.R01.S.doc Version 5.0 Page 11 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 and 15 Residents’ individual abilities, expectations and preferences are taken into account when planning activities and social events both inside and outside of the home. Social activities are creative and provide stimulation and interest for residents in the home. Meals are nutritious and balanced and offer a healthy and varied diet for residents. EVIDENCE: The home has an activities organiser who plans a programme of activities on a weekly basis which is based on residents’ social, religious and recreational interests. This programme includes a variety of indoor and outdoor recreational and social activities such as board games, indoor bowls, musical instruments, singing, videos and learning the computer. There is a strong emphasis on organising social events where relatives are invited to join in such as coffee mornings, fetes, parties for birthdays and special occasions and entertainment provided by outside entertainers such as magicians and singers. There have been trips out to the theatre, park and local pubs. Each resident has an activities plan which includes a record of what they have done and numerous photographs of them engaging in activities.
Langley House DS0000007485.V248966.R01.S.doc Version 5.0 Page 12 There are good links with the local community and numerous visitors came in during the inspection. They commented on how “they are always made welcome and are offered a cup of tea and biscuits”. One visitor said how she enjoyed having a meal with her relative on some visits. The manager stated that the local parish council invites residents to attend functions held in aid of the village such as charity events and coffee mornings. The home is currently planning for their usual Christmas events such as singers from the church and the Salvation Army. Menus show that a balanced and nutritious diet is provided with plenty of choice. Residents are consulted every day about their choice on the menu. Several residents and relatives commented that the food was “very good” and that there was “plenty of choice”. The home is well known for providing good buffets of home cooked food at the coffee mornings and other functions. Langley House DS0000007485.V248966.R01.S.doc Version 5.0 Page 13 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): Standards not assessed on this inspection EVIDENCE: Langley House DS0000007485.V248966.R01.S.doc Version 5.0 Page 14 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 and 26 Although some refurbishment is required, the standard of the environment within this home is good providing service users with an attractive, comfortable and homely place to live. EVIDENCE: The home is tastefully furnished and decorated in an attractive domestic style. Residents’ bedrooms were equipped to meet their individual needs and many had brought personal items with them to make their rooms homely and comfortable. Both residents and relatives remarked on how the rooms were kept “very clean and tidy” and that it was like “home from home”. There is an ongoing maintenance and refurbishment programme in place and the grounds are kept safe and tidy. It was noted that several of the bedrooms have been refurbished with good quality furniture, carpets and soft furnishings and more bedrooms were planned for refurbishment.
Langley House DS0000007485.V248966.R01.S.doc Version 5.0 Page 15 A brief tour of the premises was made and the home was found to be clean and tidy and generally well maintained. The laundry facilities were in good working order and satisfactory procedures were in place for control of infection and the safe handling and disposal of clinical waste. However, an outstanding matter relating to the refurbishment of a corridor in one area of the building had still not been resolved satisfactorily. It was agreed that this would be addressed as a matter of priority. Langley House DS0000007485.V248966.R01.S.doc Version 5.0 Page 16 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): Standard not assessed on this inspection EVIDENCE: Langley House DS0000007485.V248966.R01.S.doc Version 5.0 Page 17 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, 35, 36 and 38 There is effective leadership, guidance and direction of staff to ensure that the home is run in the best interests of residents. Overall, practices within the home promote and safeguard the health, safety and welfare of residents and staff. EVIDENCE: The registered manager is well qualified and has achieved a number of management qualifications including a National Vocation Qualification (NVQ) level 4 in management. It was commendable to note that the deputy manager was also training to achieve her NVQ level 4 in management. Langley House DS0000007485.V248966.R01.S.doc Version 5.0 Page 18 Comments from both staff and residents confirmed that relationships within the home are friendly and supportive. They said that the manager has “an open door policy” and “is always ready to listen”. Relatives who gave their views remarked, “I am always kept in touch about any changes” and “I can relax knowing my father is well cared for”. There are good communication systems within the home such as very informative notice boards and regular newsletters. A yearly quality assurance questionnaire has resulted in a number of service users and relatives responding with positive views of the home. There is a programme of staff meetings and a staff supervision and appraisal programme. Staff who gave their views confirmed that the manager encouraged them to go on numerous training courses to improve their knowledge and skills. Records of all transactions concerned with residents’ personal finances were being kept and clearly showed where deposits and withdrawals had been made. The records were being regularly audited. There is an ongoing maintenance programme in place for the servicing of equipment and maintenance of heating and electrical systems etc. and there was evidence from the maintenance contracts and service certificates that that the programme was kept up to date. It was noted that water temperature checks were being carried out but they were not consistent, as the number of checks carried out on a monthly basis varied. It was recommended that the procedure for checking water temperatures be reviewed. The home has had satisfactory inspections carried out by out by the Fire Safety Officer and Environmental Health Officer and there are no outstanding issues. Langley House DS0000007485.V248966.R01.S.doc Version 5.0 Page 19 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 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 2 X X X X X X 3 STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 3 X 3 Langley House DS0000007485.V248966.R01.S.doc Version 5.0 Page 20 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 OP9 Regulation 13/17 Schedule3 Requirement Records of each resident’s current medication must be accurate and kept up to date; the records must include all prescribed medication including short courses Medication administration records must clearly identify who administered the medication and the time it was administered The corridor leading from the dining room area must be redecorated and the carpet replaced A full employment history must be obtained together with a satisfactory written explanation of any gaps in employment before employing staff (Time scale of 30/06/05 from previous inspection not met) Timescale for action 30/11/05 2. OP19 23 31/01/06 3 OP29 7/9/19 Schedule2 30/11/05 Langley House DS0000007485.V248966.R01.S.doc Version 5.0 Page 21 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 Refer to Standard OP9 OP38 Good Practice Recommendations The current record keeping procedures for the receipt and administration of medication should be reviewed to ensure that there is less margin for error The procedure for checking water temperatures should be reviewed to ensure that the checks are carried out consistently Langley House DS0000007485.V248966.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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