Inspection on 10/10/07 for Langton House

This inspection was carried out on 10th October 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Langton House 03/11/09

Langton House 08/10/08

Langton House 12/07/06

Langton House 12/01/06

Langton House 29/06/05

Langton House 18/02/05

Langton House 20/07/04

Langton House 24/02/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Langton House Wharf Road Wroughton Swindon Wiltshire SN4 9LF Lead Inspector Pauline Lintern Key Unannounced Inspection 10th October 2007 9:30 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 Langton House DS0000035472.V345981.R01.S.doc Version 5.2 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. Langton House DS0000035472.V345981.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Langton House Address Wharf Road Wroughton Swindon Wiltshire SN4 9LF 01793 812661 01793 845439 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) Swindon Borough Council Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Langton House DS0000035472.V345981.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The Home may provide care and accommodation for up to 2 service users aged over 55 years and under 65 years at any one time, who are intermediate care, short term care or respite care. The Home may offer up to 2 places on a permanent basis at any one time if people receive intermediate care, short term or respite care. Intermediate care may only be provided for 11 people in the area known as the rehabilitation unit; 9 of which do not exceed 8 weeks and 2 of which do not exceed 16 weeks in any one episode. 12th July 2006 Date of last inspection Brief Description of the Service: Langton is a two storey purpose built care home that provides care and accommodation for up to 41 older people over 65 years. The home includes a rehabilitation unit that accommodates up to 12 people for a period of typically less than 3 months. Additionally there is a day care facility that is integrated within the home for those who live in the wider community. The home is situated in the village of Wroughton on the outskirts of Swindon town. It is owned and managed by Swindon Borough Council. Those living in the home have their own single bedrooms and there is a vertical passenger lift between the floors for easy access. The home has a large well maintained garden and includes a courtyard suitable for those who use wheel chairs. There is ample car parking. Typically the home is staffed by 3 care staff per shift covering the main house and 3 staff per shift in the rehabilitation unit. Additionally there are support staff who clean, house keep, administrate and garden. At night, 3 awake staff cover the whole of the service and they have to on-call staff if needed. The day centre is staffed separately. The aim of the home is to provide a high standard of care without taking away service users rights to choice, dignity and privacy. Langton House DS0000035472.V345981.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced key inspection was completed over a six and a half hour period. The pharmacy inspector was present during the morning and examined systems for the administration, storage and recording of medication. As part of the inspection process ‘Have your Say’ survey forms were sent out to service users and relatives. Eighteen service users responded and three relatives. Their comments will be included within this report. The inspector met seven service users in the communal areas and spoke to two people in private. Three staff members spoke to the inspector in private. The manager was present throughout the inspection and assisted the inspector. Various records were sampled during the inspection these included three care plans, assessments, complaints records, staff recruitment and training and health and safety records. The fees charged at Langton house range from £94.45p - £376.00 per week. What the service does well: What has improved since the last inspection? The statement of purpose and the service user guide has been recently updated to take into account recent changes within the home. The manager reports that the Council now have a ‘work party’ putting together protocols to improve end of life care. The drug store now has a small fridge for storage of medication that needs to be stored at low temperatures. Langton House DS0000035472.V345981.R01.S.doc Version 5.2 Page 6 Any complaints are now logged and timescales and outcomes are recorded. The home has developed a new format for the induction process of new staff. It was noted that all dining room chairs are in good order. Service users in the rehabilitation unit undergo a full multi disciplinary assessment before they are discharged. Monthly management audits specify which areas are satisfactory or not, as the case may be. 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. The summary of this inspection report can be made available in other formats on request. Langton House DS0000035472.V345981.R01.S.doc Version 5.2 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 Langton House DS0000035472.V345981.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Information about the service is current and has been updated to reflect the recent changes. Potential new service users have their needs assessed prior to being offered a place at the home although case files do not contain written confirmation assuring that their needs will be able to be met. Service users assessed for intermediate care are helped to maximise their independence and return home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Examination of the statement of purpose and the service user guide shows that it was updated in September 2007 to reflect the changes within the service. The manager confirmed that she plans to ensure that all service users and their representatives have a copy of the service user guide and these will be distributed when she completes her initial assessment. Case files show that an assessment has been completed by the Council however files do not show written confirmation that the home will be able to meet the person’s needs. The manager explained that there is now a letter Langton House DS0000035472.V345981.R01.S.doc Version 5.2 Page 9 detailing whether or not needs could be met; however a copy should be kept on each case file. A copy of the letter was shown to the inspector. The manager confirmed that the home are only admitting people within the categories of their registration and that although some people may experience some confusion due to increased frailty their primary needs are those of old age. Discussion with senior staff from the rehabilitation unit demonstrated that people are assessed prior to admission. She added that before a person is discharged and returns home a full multi disciplinary assessment is completed with input from the physiotherapist, doctor, community nurse and dietician. Several service users report that the home is good at meeting their needs. No service user made any significant adverse comment about the home or the care they receive. Comments about the home by service user’s include; 1. My doctor and social services gave me the information; it was nearer for my daughter for visiting. I also knew people as I had come to the day centre once a week. 2. After a few enquiries I decided this place was friendly and I liked the atmosphere. 3. I am quite happy here. 4. I was involved in the assessment, they asked me what I wanted and gave me enough information to decide. 5. It is going really well: I was on the rehab unit before. 6. They are very good to us it is all going ok. 7. I have everything I need. 8. My son and daughter were involved in my assessment. 9. Sometimes I wish I wasn’t here but they are good. Three relatives returned comment cards. Comments included: 1. The care home looks after them very well for their everyday needs. 2. I think all the staff are doing their best and overall an excellent job. One relative made a negative comment, i.e. 1. More funding should be provided, better maintenance of the gardens and sitting out area. Langton House DS0000035472.V345981.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. The current care planning system remains outdated and does not fully reflect people’s assessed needs. People tell us that their healthcare needs are being met. Residents are supported to self medicate and are protected by the homes procedures for medication handling, however the home must keep full records of these processes. Service users confirm that staff members treat them with respect and in a dignified way. Action is being taken to ensure end of life care is appropriately managed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: As part of the inspection process three care plans were examined and showed that they do not fully reflect peoples’ assessed needs. The plans are not person centred and do not demonstrate any involvement by the service user or their representative. The manager agreed that this is an area for improvement. Discussion with the manager demonstrated that she has a good understanding of person centred planning and that she is planning to update all care plans and individual risk assessments in the near future. Either the service user should sign plans themselves or their representative to confirm Langton House DS0000035472.V345981.R01.S.doc Version 5.2 Page 11 that they agree to the contents. Some people have a daily living plan, which breaks down how certain tasks are to be carried out, however this information also needs to be clearly detailed within the person’s care plan. One case file sampled did not contain a care plan. Current care plans fail to provide the reader with sufficient information on desired outcomes for people, what is important and what is not and any potential associated risk. The manager confirmed that she would discuss this with staff members in their team meetings and during 1-1 supervisions. Service users told us that they feel that their health care needs are addressed. There is evidence to show that the district nurse attends daily and during the inspection the doctor was completing their visit to the home. The manager confirmed that there is a risk assessment for pressure care and any concerns are raised with the district nurse on her daily visit. Any service users who are classed as ‘frequent fallers’ are audited monthly. If required they are then referred to the ‘falls’ clinic. One service user reported that the physiotherapist was visiting them on the day of the inspection. Another person said, “my medical and healthcare needs are being met”. They added that they like to remain as independent as possible and that they prefer to make their own bed and keep their bedroom tidy. The Pharmacist Inspector looked at arrangements for the handling of medicines and observed a medication round. Two staff checked all administrations and assisted residents with their medicines carefully. Some residents prefer to be left to take their medication unaided after being issued with it, staff were able to identify these people but their wishes were not recorded in the care plan or risk assessment. Residents who tool complete responsibility for self medication did have appropriate risk assessments. Medication is stored securely and appropriately. A procedure is available to all staff. A homely remedy policy has been agreed but has not been reviewed for two years. Staff administering medication are trained in the process. All records of receipt and returns or disposal were kept. Printed medication administration records are used, however written additions were not signed and checked by two members of staff. Records of some administrations are not kept on the medication administration record for example controlled drugs and doses of insulin that the district nurse gives. A complete record of these doses should be kept. All feedback received from service users confirm that they are treated with respect and in a dignified manner. Staff were observed interacting with service users in a friendly and sensitive way. One service use asked a staff member to assist them with an article of clothing, it was noted how the staff member ensured the persons privacy before helping them. People told us that when they are supported with personal care they are treated gently and encouraged to be as independent as possible. One person commented that they need help with bathing but can wash their own face. The home has a hair salon where people can make appointments to have their hair done. Staff impress as being committed to providing good outcomes for the people who live there. Langton House DS0000035472.V345981.R01.S.doc Version 5.2 Page 12 The manager reported that the Council are currently developing a work party, looking at ways of managing ‘end of life’ care. She explained how they are looking at ways of ensuring people get the support they need immediately and all healthcare professionals are ’signed up’ to these protocols. Langton House DS0000035472.V345981.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. People told us that the home generally meets their social, cultural, religious and recreational needs. Links with family, friends and the local community are encouraged. Service users are encouraged to make choices. People appear to be satisfied with the meals provided at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Feedback from service users indicates that they are satisfied with the social, cultural, religious and recreational opportunities provided to them. It was noted that a large number of people chose to sit in the communal areas rather than stay alone in their rooms. One person commented that they prefer to be in the lounge where they can chat to others. Service users were observed ‘looking out’ for each other. One person said that staff place the call bell near to them in the lounge so they were able to summon help for others if they were unable to use the bell themselves. This is not considered good practice and the home must ensure staff are available to ensure the health, safety and welfare of the people who live at the home. One person told the inspector that their religion was important to them and they used to be an active church member. They confirmed that since being at the home they were able to continue attending church services, which are Langton House DS0000035472.V345981.R01.S.doc Version 5.2 Page 14 regularly held within the home. She added that they sing hymns and even have an organ. Hymn books and prayer books are provided by the home. The home’s statement of purpose states that visitors are welcome at all times to the home. One person reported that when their husband visits they are left in private in their bedroom to chat. The manager reported that she is planning to develop a newsletter to be distributed to families and representatives to ensure they are kept informed of any events or changes that take place within the home. The home offers daily activities, which people can to choose to participate in or not. Most people who spoke to the inspector confirmed that they enjoyed the activities. It was noted that during the inspection fourteen people were taking part in a game of ‘hangman’. Links with the local community are encouraged and events such as Christmas bazaars and summer fetes help to build good relationships. The home benefits from having a shop within the dining room where people can purchase sweets and crisps etc. During the visit to the service plenty of drinks were offered and jugs of orange and water were available at the dining tables. Service users spoke highly of the meals provided stating that they are always ‘fresh and hot’. One person remarked that they would prefer to have more rice pudding as a dessert and another that sometimes the portions can be a little on the small side. One person told us that as they no longer use dentures chewing food could be difficult for them. They added that staff members ensure that food is soft, mashed up or chopped up small to enable them to eat it. On the day of the inspection the main meal was a roast dinner and service users commented that it was ‘lovely’. The mealtime was unrushed and relaxed with staff supporting the people who needed it. The meal appeared to be a social event, which people look forward to. People are offered a choice of food. One person said that although most people liked to have porridge for breakfast she preferred cornflakes and a piece of toast with marmalade. Langton House DS0000035472.V345981.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. The management of complaints appears to have improved. This appears to be a service that is rarely complained about. Staff impress as being aware of the procedure to follow in the event of suspected abuse This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the period from 29/09/06 to 20/09/07 four complaints have been recorded. The complaints log shows that complaints have been addressed within the given timescales, identifies who will investigate the complaints and records the outcome. One service user had fedback during their review that they felt unsupported by staff to rise at their preferred time. Evidence shows that staff discussed this later with the person to obtain their preferred time for getting up and this was recorded and passed on the night staff. The person was also provided with information on how to make a complaint if they wished to do so. Surveys returned to us showed that thirteen out of eighteen service users knew how to make a complaint if they needed. Two people reported not to know how to make a complaint and two did not answer. All three relatives who responded to the survey confirmed that they knew how to make a complaint. When asked ‘Do you know who to speak to if you are not happy?’ comments included: 1. My daughter or key worker. 2. There’s always someone you can talk to. 3. Staff are always available to listen and sort out my queries. Langton House DS0000035472.V345981.R01.S.doc Version 5.2 Page 16 4. Usually someone is in charge. All three staff members who met with the inspector were able to explain the procedure for alerting if they suspected any form of abuse. They had all received some form of training in safeguarding people, were aware of the home’s ‘whistle blowing’ policy and the local ‘No Secrets’ guidance. One member of staff reported that she felt confident that all of the care staff were experienced and aware of policies and procedures. Another staff member added that they covered safeguarding people when they completed their National Vocational Qualification (NVQ). Langton House DS0000035472.V345981.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. The standard of accommodation is very good, being clean and comfortable and in a good location. Systems are in place to ensure the safety of staff and services users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home continues to provide a very good standard of accommodation. Each service user has their own bedroom and five rooms have ensuite facilities. The home is located in a village on the outskirts of Swindon. It was noted at the time of the inspection that all areas of the home were clean and tidy with no offensive odours. The home employs staff to clean and carry out laundry functions as well as housekeepers to assist with meals and bed making. There is a large laundry, well away from food preparation areas. Throughout the home there was protective clothing available such as gloves and aprons. Anti-bacterial hand wash is available in all hand washing areas. Staff reported that they have attended training in infection control. Langton House DS0000035472.V345981.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. People who use this service benefit from a well-trained staff group. Staffing levels are adequate, though sometimes dependent on agency and bank staff. Recruitment is managed well. A new induction format has now been introduced. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager explained that they have eight staff on duty in the morning, seven in the afternoon and four waking night staff. The home currently has staff vacancies and bank/ agency staff are covering these posts until they are filled. The manager reported that they try to be consistent with the agency workers that they use and she provides feedback to the agency used on the carers work practices. Staff members who spoke to the inspector reported ‘some agency workers are good and some not so good’. Staff members who met with the inspectors appeared knowledgeable and well trained. There is now a staff training log in place, which shows that staff are provided with training in stoma care, dementia care, abuse awareness, person centred planning, catheter care, report writing, health and safety, infection control, basic food hygiene, equalities and the principles of care. The manager reported that there were some equality issues surrounding training, such as refresher training for manual handling and safeguarding people for the waking night staff. To assist the staff the Council are reportedly arranging for training sessions to take place during the night, which will be easier for the waking night staff to attend. Langton House DS0000035472.V345981.R01.S.doc Version 5.2 Page 19 The home has now developed a new format for the induction of new staff. This includes all mandatory training such as manual handling, fire safety, principles of care and medication procedure. One staff member reported that they had been given a ‘buddy’ to work alongside when they were completing their induction. The manager confirmed that 26.6 of permanent staff is working towards their National Vocational Qualification (NVQ) Level 2 or above. Nineteen staff have already achieved their NVQ level 2 or above. One senior carer told us that she had completed her NVQ level 4 and would like to progress to achieving the Registered Managers Award. She explained that the Council are offering some staff the opportunity to obtain a Diploma in Management Skills, which is new and also and will be an introduction to management progression. Recruitment procedures appear satisfactory with evidence of a relevant CRB/Protection of Vulnerable Adults (POVA) checks and the taking up of references. The three recruitment records sampled showed that three references had been sought prior to employment. Staff receive a three month probationary report and another one at five months to monitor their progress. Staff members confirmed that they receive regular formal 1-1 supervision with their line manager. One person commented ‘I have no problems or concerns, the team are open and able to express themselves’. Other comments included: ‘the service is developing well’, and ‘I treat people as I would wish to be treated myself’. Minutes from staff meetings show that they take place on a regular basis. Staff confirm that they attend the meetings. Langton House DS0000035472.V345981.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. An experienced and qualified person with a ‘hands on’ approach runs the home. Monthly management audits are carried out and identify areas that are satisfactory or not. Health and safety is well managed. Quality assurance is improving. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has been working in the position of registered manager for just over one month now. She has completed her Registered Managers Award (RMA) and the NVQ level 4 in care management. Staff spoke highly of the manager and said they felt well-supported and received clear direction and leadership. One person told us ‘she will roll up her sleeves and work alongside us, which enables her to know what is going on the shop floor’. Discussion with the manager showed that she has a good understanding of how some areas Langton House DS0000035472.V345981.R01.S.doc Version 5.2 Page 21 can be improved and she has plans to implement these as soon as possible. She commented that the staff’s work practices are very good but there may be some room for improving recording and documenting. Overall the comments feedback to us was positive from both staff and service users. Staff told us that morale is better and that they feel things are improving. The manager explained that when the required monthly management audits take place, this now includes using the SOFI approach (Short Observational Framework for Inspection). This involves the senior manager allowing time to sit and observe the activities and interactions between staff and service users. Swindon Borough Council carry out an internal audit approximately every two years. The manager confirmed that the administration officer and herself also complete random checks and monthly audits. Questionnaires were sent out by Swindon Borough Council to capture the views of service users, relatives and health care professionals. Feedback was generally very positive. Service user’s finances were not sampled as part of this inspection, however from previous inspections there is no reason to suggest that service users financial interests are not being safeguarded. There is evidence which shows that service user meetings do take place although the frequency that this happens could be improved. Minutes showed that there has only been one meeting in the last year. The manager confirmed that she would ensure that they take place more frequently to enable people to share their views and ideas about the service provided to them. She also added that she is hoping to introduce a regular news letter as previously stated, which can be sent out to service users and relatives to keep them up to date on what is happening in the home. Examination of the fire safety book demonstrates that staff are receiving fire safety training, in addition there has been regular fire drills. Safety records are kept such as hot water temperatures, fridge/freezer temperatures, portable appliance tests, (PAT). Environmental risk assessments are completed and updated. Accidents and incidents are well managed. Langton House DS0000035472.V345981.R01.S.doc Version 5.2 Page 22 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 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 3 Langton House DS0000035472.V345981.R01.S.doc Version 5.2 Page 23 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 OP7 Regulation 14(1)© Requirement Each service user must have a care plan, which has been signed by either the service user or their representative to confirm that they agree its contents. Assessment details and care plans should cover nutritional needs, history of falls, continence care, where these are factors in the person circumstances. (This requirement has been partially met) Care plans must be developed where possible with the service user to include their desired outcomes in a person centred format. These plans must be kept under review to reflect any changes. Medication risk assessments must include all details of individual administration methods, including residents who wish to have medicines left with them to take unaided A complete and easily referenced DS0000035472.V345981.R01.S.doc Timescale for action 10/12/07 2. OP3 12(1)(a) 10/12/07 3. OP7 14(1)© 10/12/07 4. OP9 13(2) 10/12/07 5. OP13 13(2) 10/12/07 Page 24 Langton House Version 5.2 record must be kept of all medication administered to residents 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. 3. Refer to Standard OP33 OP9 OP9 Good Practice Recommendations It is recommended that resident’s meetings take place at least three monthly to ensure their views are captured. Written medication administration records should be signed, dated and checked by a second member of staff. The homely remedy list should be reviewed to ensure that it is still relevant. Langton House DS0000035472.V345981.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection South West regional Office 4th Floor, Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Langton House DS0000035472.V345981.R01.S.doc Version 5.2 Page 26 - 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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