Inspection on 17/05/05 for Langley House

This inspection was carried out on 17th May 2005.

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 House 09/01/09

Langley House 11/01/07

Langley House 10/11/05

Langley House 06/12/04

Langley House 24/05/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Langley House Sunderland Road Horden, Peterlee Durham SR8 4NL Lead Inspector Patricia English Unannounced 17th May 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Langley House B54 S7485 Langley House V219108 170505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Langley House Address Sunderland Road Horden Peterlee Durham SR8 4NL 0191 5861342 0191 5864483 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Durham Aged Mineworkers Association Mrs Joy Sheila Atkinson CRH 29 Category(ies) of PD Physical disability (3) registration, with number OP Old age (29) of places Langley House B54 S7485 Langley House V219108 170505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 04/12/2004 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 B54 S7485 Langley House V219108 170505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over approximately six hours and the manager, two care staff, three visitors and three residents were spoken to. Previous to this inspection the inspector was invited to attend a coffee morning which is a popular event held periodically by the home for residents’ relatives and friends to meet socially with staff and residents in the home. The inspector took this visit as an opportunity to speak to staff as well as seven residents, nine relatives and two directors of the organisation. Evidence obtained from the coffee morning visit has been included in with the evidence from this inspection when assessing standards. On this occasion the inspector looked at standards under Choice of Home, Health and Personal Care, Complaints and Protection and Staffing. What the service does well: What has improved since the last inspection? What they could do better: It is clear from the numerous positive views expressed by residents and relatives that the home is meeting residents’ assessed needs. However, Langley House B54 S7485 Langley House V219108 170505 Stage 4.doc Version 1.30 Page 6 residents records and care plans do not always show clearly what these needs are or what tasks staff must do to meet these needs particularly when these needs change and this practice must be improved. The manager must ensure that new staff provide a full employment history on their application form with dates and explanations of any gaps in employment. 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 B54 S7485 Langley House V219108 170505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Langley House B54 S7485 Langley House V219108 170505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 The home’s admission procedures are generally satisfactory and prospective residents have their needs assessed by a qualified person prior to entering the home to ensure that the home can adequately meet their needs. However, the effectiveness of this process is undermined in some cases by the lack of detailed recorded evidence of these assessments which would ensure that staff in the home have all the relevant information they need. EVIDENCE: Individual records are kept of each resident and inspection of three of these records showed that all had been appropriately assessed by a qualified person prior to their admission to the home. All new residents are admitted through the Care Management process (Social Care and Health) and have had a full assessment of their needs carried out by a Care Manager. However, there were notable differences in the amount and detail of the written information provided to the home from the Care Manager and in some cases this resulted in the manager having to rely on verbal information and notes. The manager stated that some of the information is often faxed through to the home following a telephone call from the Care Manager and that Langley House B54 S7485 Langley House V219108 170505 Stage 4.doc Version 1.30 Page 9 sometimes the full assessment is not received until after the resident is admitted. There were no formal records kept by the home of the information received from Care Managers via telephone calls. The lack of detailed recorded evidence of a new resident’s care needs assessment could potentially undermine the effectiveness of the admission process and result in important information being overlooked. However, staff receive satisfactory instructions and support from the manager and deputy manager whenever a new resident is admitted and there have been no issues raised over the process. It was evident that the manager exercises good judgement during the admission process and sometimes has the opportunity to meet prospective residents in hospital and also involve family members in the pre-assessment process which is good practice. Langley House B54 S7485 Langley House V219108 170505 Stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7 and 8 The residents’ individual care plans do not clearly or consistently identify all their assessed needs, the action that needs to be taken to meet these needs or the outcomes to be achieved. The review process does not provide sufficient information to reflect any changing needs or current objectives. Despite these shortfalls, the overwhelming view of residents and relatives was one of satisfaction with the service where residents benefit from being cared for by a well managed and supervised team of caring staff. EVIDENCE: Each of the three resident’s records inspected contained a care plan but there were some discrepancies between the needs identified in the assessment and the needs identified in the care plans, such as health care needs, special needs, mobility and mental health needs. Also individual personal care needs were not identified. Overall, there was insufficient information recorded in the care plans to inform staff what action needs to be taken to meet each resident’s individual needs. Some of the entries were not signed or dated. Records of risk assessments, manual handling risk assessments, weight charts and records of falls were being recorded appropriately but were not always being linked with the care plan to identify how risks will be managed. Langley House B54 S7485 Langley House V219108 170505 Stage 4.doc Version 1.30 Page 11 A good system of monthly “evaluations”, which also included a monthly review summary, was in place but records of the monthly evaluations did not provide sufficient information to reflect any changing needs or current objectives. However, the monthly summary was more informative. The manager and staff stated that reviews were being carried out by Care Managers but records of these reviews were not always supplied to the home. Although residents’ health care needs were not clearly identified in their care plans, there were a number of other records which showed that their health care needs were being met appropriately, these included nutritional needs, records of falls, weight charts and visits from Community Nurses, Doctors, Chiropodist etc. A lot of the detail of how residents’ needs were being met was recorded by staff in the daily records but this was not consistent as some staff were recording in more detail than others. There has been an on-going issue which has been raised on previous inspections regarding the recording of care plans and staff have commented on how this is a time consuming activity which some find difficult. This is being addressed through training initiatives. Despite the fact that care plans and record keeping needs to be improved, there is good leadership and a strong element of team working in the home and good communication between residents, staff and management. Staff felt well supported by the manager and deputy manager and “enjoyed working in the home”. Views expressed by both residents and their relatives confirmed that they were very satisfied with the standard of care provided and that the “care was good” and that they are kept well informed of any issues or changes relating to residents health and social care needs. Several family members stated “how well their relatives had improved since being in the home” and that the manager was very supportive and attended to any issues or concerns they might have. One resident said how much he enjoyed being in the home and that he “had everything he needs and could not fault the service”. Langley House B54 S7485 Langley House V219108 170505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None EVIDENCE: Langley House B54 S7485 Langley House V219108 170505 Stage 4.doc Version 1.30 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 standard(s) 16, 17 and 18 Residents and relatives are confident that their concerns will be listened to, taken seriously and acted upon. The home’s policies and practices ensure that residents’ legal rights are protected and that they are safeguarded from abuse or harm. EVIDENCE: The complaints record showed that very few complaints have been made but that all complaints, including concerns and minor complaints are taken seriously and acted upon. Appropriate records were being kept and these included details of any action taken and the outcome. Comments from residents and relatives confirmed that they felt able to express their views freely and that the manager would listen to them and was always approachable. Residents had been given the opportunity to vote in the recent local and general elections and this was mainly through the postal voting system. The manager stated that in the even of advocacy services being needed, these can normally be accessed through Age Concern or through the organisation’s own advocacy service. Satisfactory procedures for protecting residents from abuse are in place and a new programme of training courses on abuse and protection of vulnerable adults has recently been introduced. Langley House B54 S7485 Langley House V219108 170505 Stage 4.doc Version 1.30 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 standard(s) None EVIDENCE: Langley House B54 S7485 Langley House V219108 170505 Stage 4.doc Version 1.30 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 and 30 The home benefits from a competent, well trained and well managed workforce who work positively with residents to improve their quality of life. EVIDENCE: There are a number of staff who have worked in the home for a long time and the staffing turnover is low. Comments from staff indicate that there is good morale and team work and that they are well supported by the manager and deputy manager. Comments from relatives and residents confirmed that there has been no cause to complain about staffing levels although some felt that staff were sometimes very busy and that they think there could be more staff on at times. Catering and domestic staffing arrangements are good. Recruitment procedures were being followed apart from the checks on new staffs’ employment history where a full employment history was not being sought and some gaps in employment were not being clearly dated or explained. This is an outstanding issue from the previous inspection. The home’s staff training and development programme including induction training is excellent particularly regarding NVQ training. The deputy manager has almost completed her NVQ level 4 management training and four senior staff have achieved their NVQ level 3 and another is still to complete the course. All care staff (apart from two newly recruited staff) have their NVQ level 2. Domestic and catering staff are also training for a NVQ in Langley House B54 S7485 Langley House V219108 170505 Stage 4.doc Version 1.30 Page 16 Housekeeping. Mandatory training is updated and other courses includes a number of subjects relevant to the needs of residents e.g. Continence, Deaf Awareness, Eye Care, Abuse. Positive comments received from staff indicated that they were encouraged to attend training courses and develop their skills, even those who would have considered themselves “too old” have enrolled on NVQ courses and enjoyed the experience. Langley House B54 S7485 Langley House V219108 170505 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None EVIDENCE: Langley House B54 S7485 Langley House V219108 170505 Stage 4.doc Version 1.30 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 3 28 4 29 2 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 x x x x x x x x Langley House B54 S7485 Langley House V219108 170505 Stage 4.doc Version 1.30 Page 19 no 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 7 Regulation 12-15/18 Requirement The details on how each residents assessed needs are to be met must be in sufficient detail in their individual care plans to provide clear guidance to staff on the action to be taken to meet their specific needs and choices (particularly regarding health and personal care); the care plan must include how risks are being managed A full employment history must be obtained together with a satisfactory written explanation of any gaps in employment before making an appointment Timescale for action 31 July 2005 2. 29 7/9/19 Schedule2 30 June 2005 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 7 Good Practice Recommendations All information recorded in residents care plans should be signed and dated Records of monthly reviews of residents care plans should be consistent and clearly identify how current objectives for health and personal care needs are being met including B54 S7485 Langley House V219108 170505 Stage 4.doc Version 1.30 Page 20 Langley House 2. 3 any changes, and any action taken to meet these needs The effectiveness of the admission process could be improved by the introduction of a more structured and formal system for recording information on a persons assessed care needs received prior to admission Langley House B54 S7485 Langley House V219108 170505 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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