Inspection on 09/01/09 for Langley House

This inspection was carried out on 9th January 2009.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Langley House 11/01/07

Langley House 10/11/05

Langley House 17/05/05

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 09/07/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Langley House Sunderland Road Horden Peterlee Durham SR8 4NL     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Stephen Ellis     Date: 0 9 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Langley House Sunderland Road Horden Peterlee Durham SR8 4NL 01915861342 01915864483 langley@damha.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Durham Aged Mineworkers` Homes Association Name of registered manager (if applicable) Mrs Joy Sheila Atkinson Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home Langley House is owned and run by Durham Aged Mineworkers Homes Association and provides personal care and accommodation for 29 older persons. The home may also accommodate 3 people with physical disabilities within this number. The home is located in the centre of the small town of Horden, close to the local shops and 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 Care Homes for Older People Page 4 of 25 care home 29 Over 65 29 0 0 3 Brief description of the care home bathing and toilet facilities are provided. There are two spacious lounges (one of which is a smoking area) and additionally a further small quiet sitting room where service users can relax with their visitors if they prefer more privacy. The spacious dining room has a pleasant outlook over the garden and patio area to which access is readily available through the french windows. There is a committed team of care and support staff. The current weekly fees are 417 pounds, although the actual amount payable depends on peoples individual circumstances. There are additional charges for hairdressing, newspapers, chiropody and dry cleaning, if these services are required. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This key unannounced inspection was carried out on 9th January 2009. The last key inspection was carried out on 11th January 2007. This current inspection benefited from information received prior to the fieldwork visit, including the homes annual quality assurance assessment (AQAA) completed on 31st November 2008 and 8 surveys completed by people who use the service and returned to the inspector in January 2009. The process of the inspection included discussions with 5 people who use the service, 4 visitors and 5 staff. There was also a tour of the building, sampling rooms and facilities, plus an examination of a selection of records, including plans of care, staff files and reports. The weekly fees charged are 417 pounds, but the actual amount payable depends on individual circumstances. Care Homes for Older People Page 6 of 25 Care Homes for Older People Page 7 of 25 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service have their needs assessed and their wishes and views are respected wherever possible. Intermediate care is not provided. Evidence: Plans of care examined showed that full assessments of need were carried out prior to admission. These covered all the activities of daily living and included inputs from health and social care professionals where appropriate. People who use the service said that they felt the home met their needs very well and that these were well understood by the staff team. Typical comments included: I always receive the care and support I need. I am very happy with the care provided. The deputy manager confirmed that full assessments were carried out prior to admission, unless it was an emergency (rarely), when assessments would be completed as quickly as possible within a few working days of the person being admitted. Care Homes for Older People Page 10 of 25 Care Homes for Older People Page 11 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people who use the service receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: Three plans of care were examined and these were comprehensive and detailed concerning health and personal care needs. They were also regularly reviewed at monthly intervals. The deputy manager said that plans of care would be reviewed more often if the needs of the person using the service required it. People who use the service said that their health and personal care needs were well met. Typical comments included: I always receive the medical support I need and I always receive the care and support I need. These observations were backed up by comments received from 3 relatives who were visiting. There were generally good arrangements observed for the storage, administration and disposal of medicines. People who use the service may self-administer and there were lockable drawers available in bedrooms for this to happen. However, in practice, most people who use the service prefer to leave this responsibility to the staff at the home. All staff Care Homes for Older People Page 12 of 25 Evidence: members responsible for medication have completed training in the safe handling of medicines and the manager and deputy have completed advanced courses in managing medicines, accredited with Teesside University. All senior staff members have achieved National Vocational Qualifications (NVQ) in Care at level 3. However, it was noted that some medicine profiles were hand written onto the medication administration record (MAR) sheets. Such entries must be signed and dated and countersigned, so that the risk of errors in entering information onto the MAR sheet is minimised. Staff practice in administration was observed and found to be good. People who use the service were very positive and complimentary in their comments about the quality of care experienced and how they were treated with respect. They also felt that their privacy was respected. Typical comments included: The staff are very helpful and friendly. The staff always listen and act on what I say. Care Homes for Older People Page 13 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to choose their lifestyle, social activity and keep in contact with family and friends. Social, cultural and recreational activities meet peoples expectations in a positive way. People receive a healthy, varied diet according to their assessed requirement and choice. Evidence: People who use the service said they were very satisfied with the range of activities on offer. There is a dedicated, full time activities coordinator (25 hours) which is commendable. People who use the service commented very positively about the atmosphere in the home that supported their needs for social and recreational activities, whilst respecting peoples individuality and personal choices. Visitors to the home said they were always made welcome and there was a strong impression that the home valued their involvement and the contact with the wider community. The interests of people who use the service are recorded in an assessment document. These include interests concerning sensory and cognitive preferences as well as physical exercise. The home takes a holistic view of the people who use the service and encourages them to pursue their individual interests, such as contact with friends and family, social and cultural involvement and religious activities where desired. Care Homes for Older People Page 14 of 25 Evidence: Typical comments received included: There are always activities arranged by the home that I can take part in. Recent activities included seasonal events such as Firework display, Christmas celebrations, snakes and ladders, bingo, skittles, cake decorating, raffle and jewelry party, shopping outing to Sunderland, music and movement and weekly visits from a therapy dog. People said that they did not have to take part in anything if they did not want to and they could choose how they spent their day, including when they got up and went to bed. People who use the service were also very satisfied with the quality of the meals, saying that the catering was good and there was always a good choice of menu. As one person said: Everything is lovely. Another person who visted the home regularly said that the meals on Sundays were particularly enjoyable. The meals at Christmas and New Year were also very well regarded. People were able to take their meals in the dining room or, if they preferred, in their own room. Dining areas were observed to be pleasantly decorated and well equipped with dining furniture. A relaxed atmosphere was evident. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service have access to a robust, effective complaints procedure and are protected from abuse. Evidence: People who use the service said that they were confident about raising any concern or complaint with members of staff. These views were reflected in comments received from relatives and friends who were visiting. Typical comments included: I know how to make a complaint. I know who to speak to if I am unhappy. People said that staff members were approachable and friendly and knew that any complaint would be taken seriously. Staff members confirmed that they listened carefully to any concern or complaint and would always try to resolve matters speedily and effectively, in line with the homes complaints procedure, available in the service users guide. Any complaint is recorded by the service, along with all actions taken to resolve matters to the satisfaction of the complainant. All staff members are carefully recruited after full preemployment checks have been completed, including enhanced criminal record bureau checks and the taking up of two references. All staff members undergo training in safeguarding adults procedures, whereby any suspected abuse or neglect is reported and investigated, in line with the local multi-agency safeguarding procedures, led by the Local Authority for Adult Social Care. Staff files confirmed that staff had undergone rigorous recruitment procedures and staff comments confirmed awareness of local safeguarding procedures, plus whistleblowing about suspected abuse. Care plans Care Homes for Older People Page 16 of 25 Evidence: showed that risk assessments were carried out to minimise the risk of harm befalling people who use the service, by offering clear guidance to staff about how best to act to protect and promote the safety and welfare of people who use the service. Individual bank accounts are used by the majority of people who use the service which, along with the provision of receipts for expenditure, show clear audit trails for financial transactions, thereby helping to minimise the risk of financial abuse. Care Homes for Older People Page 17 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical design and layout of the home enables people who use the service to live in a safe, well-maintained and comfortable environment, which encourages independence. Evidence: People who use the service said that they liked the premises and felt that they were well-equipped, safe and hygienic. Typical comments included: The home is always beautifully clean. All members of staff have completed training in infection control and hygienic practices were observed throughout the home, such as the use of paper towels and liquid soap in communal toilets. All bedrooms are well-equipped singles with en suite facilities. These were observed to be personalised. People who use the service expressed satisfaction with the homes facilities, aids and adaptations, such as assisted bathrooms with hoists. There are a number of spacious communal areas, including lounge and dining areas, plus a designated smokers room. Accommodation is provided on the ground floor and there is good access around the building for people with mobility problems. Maintenance records were sampled and confirmed that proper procedures are in place to ensure the home is safe and maintained to an acceptable standard. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to fulfil the aims of the home and meet the changing needs of people who use the service. Evidence: People who use the service said that they were well satisfied with the care and support provided by members of staff. Typical comments included: All staff are excellent. I always receive the care and support I need. 90 of care staff members have achieved National Vocational Qualifications (NVQ) in Care at level 2 or above and all senior staff have completed NVQ in Care at level 3. On the day of inspection there were 25 people being accommodated. Typically, there are at least 3 members of care staff on duty during the day from 07:00 to 22:00, one of which will be a senior. In addition, there are 2 house-keeping staff deployed between 08:00 and 14:00, plus a cook and kitchen assistant 7 days per week from 08:00 to 15:00 and 13:30 respectively. There is a full time, dedicated activities coordinator (25 hours), which is commendable. At night, there are 2 awake members of care staff on duty. The hours of the registered manager are not included in the care hours available. The registered manager was on sick leave at the time of inspection, but her duties are being covered by the deputy managers. Staff members confirmed the good induction and training they had received, including all manadatory training plus NVQ in Care. Staff files provided evidence of training and qualifications obtained. Training needs analysis is Care Homes for Older People Page 19 of 25 Evidence: carried out at regular intervals and monitored by the homes human resource adviser at Head Office. A full staff training and development programme is in operation. Staff files also confirmed the good recruitment practices, whereby new staff are only taken on after thorough pre-employment checks, including enhanced criminal records bureau checks, protection of vulnerable adult checks and the taking up of 2 references, including one from the last employer. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and administration of the home is based on openness and respect, with effective quality assurance systems, developed by a registered, qualified manager and wider management team. Evidence: People who use the service said that they had full confidence in the management of the home. They described management and staff as being approachable, willing to listen and help wherever possible. Typical comments included: The staff are always available when I need them and are always willing to help. The registered manager is qualified and experienced but, at the time of inspection, on sick leave. In her absence, two deputies assist in the daily management of the home. They are both experienced with appropriate qualifications for their role, including National Vocational Qualification (NVQ) in Care at level 4 and level 4 Award in Occupational Health and Safety. The service is well supported by visiting officers from the provider who carry out monthly checks under regulation 26 of the care homes regulations and provide a report. Care Homes for Older People Page 21 of 25 Evidence: Feedback from people who use the service and their representatives is actively sought through face to face consultations and written surveys. The provider publishes a quarterly newsletter for the people who use its service, which is focused on their interests. The home has the Investor in People Award, which is an important indicator of quality assurance. Staff files confirmed comments received from members of the care team that staff felt appropriatel supervised and supported. However, the frequency of one to one supervisions has fallen to about 4 per year and it is recommended that this increase to 6 per year (one of which may be the annual appraisal). Health and Safety matters are taken seriously by the home, as evidenced in records of staff meetings, training and maintenance. Staff confirmed that they had undergone mandatory training in Health and Safety issues, including infection control, fire safety, control of substances hazardous to health and first aid. The home follows the safer food better business approach to catering standards and complies with the requirements of the Environmental Health Authority. A sample of maintenance records showed that the services and eqipment in the home are subject to regular testing, audit, repair and replacement, including laundry and kitchen items. The majority of people who use the service either manage their own personal monies or receive assistance from their families. A minority receive help from the Local Authority financial protection teams or independent power of attorney. Where the home does assist people with looking after their personal monies for essential purchases, such as hairdressing or toiletries, individual accounts are kept, along with receipts, and transactions are witnessed by 2 signatures. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 Hand-written entries of medicine profiles into peoples medicine administration records must be signed, dated and countersigned. This will minimise the risk of errors being made when information is hand-written onto the medication record. 31/05/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 36 It is recommended that staff one to one supervisions increase to 6 per year (but one of these can be the annual appraisal). Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!