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Inspection on 08/01/06 for Langrigg House

Also see our care home review for Langrigg House for more information

This inspection was carried out on 8th January 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

All prospective residents have an in-depth assessment before moving into the home to ensure all individual needs can be met. The care planning documentation is excellent with those residents who wish to be, involved in the process. The staff are given all the information they need to deliver a high level of care and meet the assessed needs. All healthcare needs are met and there is an up to date record of professional healthcare visits and appointments documented on the daily record sheets. There is a programme of organised activities and religious services are held on a regular basis. Catering staff make every effort to ensure that a nutritious and varied menu is provided, with a choice at each meal.

What has improved since the last inspection?

Seven residents` rooms have been redecorated and the day care centre has been redecorated and new curtains purchased. There is also new carpeting on the ground floor corridor. One of the kitchen areas is being refurbished.

What the care home could do better:

There were no requirements or recommendations made at this inspection and the home should continue to give the high standard of care and support to those living in the home.

CARE HOMES FOR OLDER PEOPLE Langrigg House Langrigg Road Morton Carlisle Cumbria CA2 6DX Lead Inspector Mrs Margaret Drury Unannounced Inspection 8th January 2006 01:00 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 Langrigg House DS0000035210.V271325.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 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. Langrigg House DS0000035210.V271325.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Langrigg House Address Langrigg Road Morton Carlisle Cumbria CA2 6DX 01228 606391 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) www.cumbriacare.org.uk Cumbria Care Mrs Eileen Joy Muir Care Home 40 Category(ies) of Dementia (13), Old age, not falling within any registration, with number other category (40), Physical disability (1) of places Langrigg House DS0000035210.V271325.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service must at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. The home is registered for a maximum of 40 service users to include: - up to 40 service users in the category of OP (older people, not falling within any other category. - up to 13 service users in the category of DE(E). The staffing levels for the home must meet the Residential Forum Care Staffing Formula for Older Adults. When single rooms of less than 12 sqm usable floor space become available they must not be used to accommodate wheelchair users, and where existing wheelchair users are in bedrooms of less than 12 sqm they must be given the opportunity to move to a large room when one becomes available. One named service user in the category of PD (physical disability) may be accommodated within the overall numbers of registered places. 25th July 2005 3. 4. 5. Date of last inspection Brief Description of the Service: Langrigg House is located in a suburb of SW Carlisle and is close to local amenities such as health centre, shops, Post Office and public transport. The home is owned by Cumbria Care, an internal business unit of Cumbria County Council, and operated on a daily basis by Mrs Eileen Muir. The internal layout had been redesigned to offer accommodation in four smaller units, each having a sitting/dining room, and kitchenette. There is a separate 10 bedded EMI unit and dedicated respite accommodation. These are both on the ground floor, each with its own separate lounge. The EMI unit has a lounge and conservatory area, which can be used for private visits. The home has ample toilet and washing facilities, all of which are suitable for people with a disability. Thirteen bedrooms have en-suite facilities. Residents are able to move around the home independently with the help of passenger lifts, ramps, handrails and grab rails. There is also a day service for older people situated within the home. Langrigg House DS0000035210.V271325.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection of the home that took place over one Sunday afternoon. It was the second inspection of the year and those standards not assessed on this occasion were inspected and met during the previous inspection that took place in July 2005. Time was spent talking with the manager, care supervisors, residents and visitors to the home. Records to do with the running of the home were examined and some parts of the home were looked at. What the service does well: What has improved since the last inspection? Seven residents’ rooms have been redecorated and the day care centre has been redecorated and new curtains purchased. There is also new carpeting on the ground floor corridor. One of the kitchen areas is being refurbished. Langrigg House DS0000035210.V271325.R01.S.doc Version 5.1 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. Langrigg House DS0000035210.V271325.R01.S.doc Version 5.1 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 Langrigg House DS0000035210.V271325.R01.S.doc Version 5.1 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): 1&4 The home’s statement of purpose is very informative, providing residents and prospective residents with details of the services the home provides. This information enables an informed decision to be made about admission to the home. Residents and their families benefit from the opportunity to visit the home to view the facilities on offer. EVIDENCE: The home has a detailed statement of purpose, a copy of which was on display in the front hall. This includes copies of the resident’s guide, complaints procedure and charter of rights. All prospective residents and/or their families are invited and encouraged to visit the home prior to admission. This gives opportunity to view the facilities on offer and meet with the staff and other people living in the home. Langrigg House DS0000035210.V271325.R01.S.doc Version 5.1 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): 7, 9 & 11 Residents benefit from a care planning system that is detailed and gives the care staff the information required to meet the assessed needs. Healthcare needs are met through close working relationships with the healthcare professionals. EVIDENCE: The care plans contain information about residents’ care needs, including moving and handling assessments. They are reviewed and updated every month with the involvement of the resident where possible. The plans provide the care staff with the information they need to meet resident’s needs. Records are kept about GP appointments and when district nurses visit, and residents said that they are able to see the doctor or nurse when they request. Medication records were checked and all found to be correctly and neatly completed. Those residents who spoke with the inspector confirmed that their medication was given at the right time and in a sympathetic manner. Langrigg House DS0000035210.V271325.R01.S.doc Version 5.1 Page 10 Information about residents’ preferences after death is held on the care plans and residents and their families know their wishes will be followed. Langrigg House DS0000035210.V271325.R01.S.doc Version 5.1 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): EVIDENCE: All the standards in this section were inspected and met at the last inspection. Langrigg House DS0000035210.V271325.R01.S.doc Version 5.1 Page 12 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): 16 & 17 The home has a satisfactory complaints system with some evidence that residents and their families feel that their views are listened to and acted upon. EVIDENCE: Residents are given information about how to complain when moving into the home, with details also contained in the statement of purpose. The family members who spoke with the inspector said that if they had any issues to raise they would bring them to the attention of the manager knowing they would be dealt with promptly. Any resident who wished to take part in the local elections were given a postal vote. Although the advocacy service is not currently being used details of the service are available to those who wish to access it. Langrigg House DS0000035210.V271325.R01.S.doc Version 5.1 Page 13 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): 21, 23 & 24 The standard of the environment is reasonably good, providing the residents with a warm and homely place in which to live. EVIDENCE: The home has sufficient communal toilet and bathing facilities throughout to meet residents’ needs. All the baths are suitable to assist any who may have a physical disability. The inspector was able to examine some of the bedrooms that have recently been redecorated. They were found to be bright and clean and personalised with items brought from the resident’s own home. Langrigg House DS0000035210.V271325.R01.S.doc Version 5.1 Page 14 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): 27 & 30 Residents benefit from a well-organised, trained and experienced staff group that is able to meet the assessed needs. EVIDENCE: The home has a good mixture of trained and experienced care staff. Three of the four supervisors are qualified to NVQ level 4 in management and half of the care staff have gained their NVQ level 2 in care. Staffing levels were checked against the off duty rota and although one member of staff had not returned from sick leave on the day of the inspection, the home was adequately staffed. The manager does bring in another member of night staff as extra to cover in unusual situations when they arise but the inspector did feel that the residents would benefit from there being 3 members of waking night staff on a permanent basis. This is mainly due to the increased level of care required in the EMI unit. All mandatory training is up to date and this includes, first aid, manual handling and food hygiene. Staff are also trained in medication, infection control, fire awareness, dementia care and protection of vulnerable adults. Langrigg House DS0000035210.V271325.R01.S.doc Version 5.1 Page 15 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): 34, 35, 37 & 38 Residents benefit from policies and procedures put in place to safeguard the financial viability of the home as well as their own personal finances. EVIDENCE: Cumbria Care is responsible for the viability of the home and all the finances are dealt with at head office. Annual budgets are provided to the manager who, together with her line manager, is responsible for the allocation of that budget. The home does hold personal monies and behalf of some residents and the inspector checked the records held on their behalf. All transactions were recorded and signed by two members of staff. Any receipts obtained were held on file with the cash balance. The home has a full set of corporate policies and procedures that are made available for the staff team to reference whenever they wish. Langrigg House DS0000035210.V271325.R01.S.doc Version 5.1 Page 16 Annual health and safety audits take place to ensure the safety of the residents and staff. Langrigg House DS0000035210.V271325.R01.S.doc Version 5.1 Page 17 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 3 X X 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 X 9 3 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 x X X 3 X 3 3 X x STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X 3 3 X 3 3 Langrigg House DS0000035210.V271325.R01.S.doc Version 5.1 Page 18 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 27 Good Practice Recommendations It is recommended that consideration be given to employing 3 members of waking night staff throughout the week. Langrigg House DS0000035210.V271325.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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. Extracts may not be used or reproduced without the express permission of CSCI Langrigg House DS0000035210.V271325.R01.S.doc Version 5.1 Page 20 - 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. 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