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Inspection on 08/05/08 for Langwith Lodge Care Home

Also see our care home review for Langwith Lodge Care Home for more information

This inspection was carried out on 8th May 2008.

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

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

The staff team provide a friendly and caring environment for the people that live at Langwith Lodge. Staff had a good understanding of the needs of the people they care for and in general the care records seen were accurate and kept up to date to ensure any changing needs are met. The staff team were supportive of each other and demonstrated a positive and enthusiastic approach to their work. The registered manager worked hard to maintain the management of the home and provided good leadership skills to the staff.

What has improved since the last inspection?

No requirements were left at the last inspection. Out of the 13 recommendations left 8 have now been met. Parts of the home have been refurbished and this included a new computer room for the use of the people living at the home. Improvements to the activities have been provided and innovative ideas were in place to ensure there were activities that could benefit and meet everyone`s needs. An additional activities coordinator was now employed which increased the time that activities were undertaken.

CARE HOMES FOR OLDER PEOPLE Langwith Lodge Care Home The Park Nether Langwith Mansfield Nottinghamshire NG20 9ES Lead Inspector Angela Kennedy Unannounced Inspection 8th May 2008 10:30 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 Langwith Lodge Care Home DS0000008742.V364109.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. Langwith Lodge Care Home DS0000008742.V364109.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Langwith Lodge Care Home Address The Park Nether Langwith Mansfield Nottinghamshire NG20 9ES 01623 742 204 01623 744 611 awlangwithlodge@btconnect.com www.yourhealth.ltd.uk Your Health Ltd 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) Lynn Gedling Care Home 54 Category(ies) of Dementia (12), Old age, not falling within any registration, with number other category (42) of places Langwith Lodge Care Home DS0000008742.V364109.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: The registered person may provide the following category of service only: Care home only code P.C To service users of the following gender – either whose primary care needs on admission are within the following categories. Code O.P Dementia – Code DE. The maximum number of service user who can be accommodated is 54. Date of last inspection 17th May 2007 Brief Description of the Service: Langwith Lodge is an adapted large country house, set in its own private grounds overlooking a lake within a scenic rural setting. The home is owned by Your Health Ltd. There are two units, the main house and the Horton Suite, which adjoins the main house. Lift Access is provided to the first and second floors, for those who cannot manage the stairs. The home provides 24-hour care and support for 54 older people and service users with dementia. Information was provided on the range of fees charged; these are between £293 and £400. This includes 1 visit to the hairdresser each month, basic toiletries and access to newspapers ordered by the home. Additional to the fees are specific newspapers our magazines required, additional hairdressing services (other than the 1 visit per month included in fee and chiropody treatment. A copy of the last inspection report was displayed in the home. Langwith Lodge Care Home DS0000008742.V364109.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This key inspection was unannounced and took place over approximately eight hours. Key inspections take into account a wide range of information and commence before the site visit by examining previous reports and information such as any reported incidents. The site visit is used to see how the service is performing in practice and to meet with the people using the service. The focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for service users and their views on the service provided. This process considers the provider’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. An Annual Quality Assurance Assessment (AQAA) had been completed by the service. This is a self-assessment for providers that is a legal requirement. This assessment gives the provider an opportunity to let us know about their service and how well they think they are performing. The information provided in the AQAA is reflected within this report. At this inspection visit three people were case tracked. Case tracking is a method used to track the care of individuals from the assessments undertaken before they are admitted to a service through to the care and support they receive on a daily basis. This includes looking at care plans and other documents relating to that persons care, talking to staff regarding the care they provide and if possible talking to the individual. Two of the people case tracked were able to discuss their opinion of the service and support provided to them. Three surveys were returned from people living at the home and the comments received in the surveys and on the day of the inspection visit are included within this report. One visitor was spoken with on the day of this inspection and six surveys were returned from relatives or friends of the people living at the home. The information provided in discussions and from the surveys are included in this report. Four members of the staff team were spoken with on the day of the inspection visit and two staff surveys were returned. The comments from discussions and within the surveys are reflected within this report. Langwith Lodge Care Home DS0000008742.V364109.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: The service could better demonstrate that they have an open and transparent approach to safeguarding, by amending their policy in line with the Local Authority procedure. This will ensure the protection of the people living at the home is further enhanced. Vegetarian options should be included on the menu to demonstrate that they are available to anyone who may prefer or require them. Consideration should be given to how feedback from quality assurance systems can be provided to people living at the home, their friends and family and other interested parties. Langwith Lodge Care Home DS0000008742.V364109.R01.S.doc Version 5.2 Page 7 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. Langwith Lodge Care Home DS0000008742.V364109.R01.S.doc Version 5.2 Page 8 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 Langwith Lodge Care Home DS0000008742.V364109.R01.S.doc Version 5.2 Page 9 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): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Accurate assessments of needs means that that people living at the home can be confident that the service is able to meet their needs. EVIDENCE: As stated in the AQAA a copy of the last inspection report was displayed within the home. Information was also displayed on how individuals could access copies of reports. This means that people are provided with up to date reports about the home. People can be confident that the staff at Langwith Lodge can support them. This is because there was an accurate assessment of needs in place for the three people case tracked. The three needs assessments seen were dated and signed and showed the date of admission for each person. The detailed information within the needs Langwith Lodge Care Home DS0000008742.V364109.R01.S.doc Version 5.2 Page 10 assessments informed staff of the support each person needed to ensure their needs were met. There was evidence within one person’s needs assessment that demonstrated their consent with the assessment documentation. This means that this person had been involved in the reviewing of their needs and the support they required to ensure their needs were met. A recommendation made at the last inspection was to include capacity to consent within assessment documentation. This was not seen within the assessments of the people case tracked. Discussions with the manager confirmed that this information was being included in all new admissions and would then be cascaded through everyone’s assessment information. A review of one person’s initial needs assessment was seen. This demonstrated that individual’s needs are reviewed to ensure they can still be met by the service. The records seen demonstrated that this individual’s representative was given the opportunity to be involved in the assessment of needs, as they were unable to. This enabled them to discuss how the support provided could be given in a way preferable to the individual. Langwith Lodge Care Home DS0000008742.V364109.R01.S.doc Version 5.2 Page 11 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): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s health and personal needs are met by the service and the service supports people to take their medicines in a safe way. EVIDENCE: People’s health, personal and social care needs were being met. Plans of care and risk assessments were in place for each person case tracked. Although the care plans seen had been signed to say that they had been reviewed each month, some information within two of the care records seen was not accurate. This meant that it did not reflect the level of capacity each person had and the level of support each person required. Discussions with staff regarding the needs of these people, demonstrated a good understanding of each persons needs and the support they required for their needs to be met. Langwith Lodge Care Home DS0000008742.V364109.R01.S.doc Version 5.2 Page 12 Staff demonstrated a good understanding of each persons level of dependency and of their capacity to make decisions. Therefore the outcomes for the people being case tracked had not been affected by the inaccurate information seen. However it is important that information within care records is accurate and reflects the strengths and support needs of each person. This will ensure that any new members of staff will have accurate information regarding each individual and will ensure needs are met appropriately. Risk assessments within care files seen included; mobility and moving and handling assessments, falls assessments and assessments on skin integrity. Weights were recorded regularly, although as recommended at the last inspection there were no action plans in place within the weight record chart to enable staff to evaluate and monitor each person’s nutritional needs. Nutritional care plans were in place within the records seen but as recommended at the last inspection a nutritional screening tool had not been undertaken. Once this in place it will ensure that each person’s nutritional needs are appropriately assessed. As stated in the AQAA, records were seen of health care appointments. This demonstrated that each person’s health care needs were being met. They showed that eye care needs were addressed appropriately, such as eye tests and optical prescriptions. Chiropody visits were provided in house and records showed these were undertaken regularly, this ensured foot care was provided. G.P visits and visits to consultants and hospital appointments were recorded. Relatives, friends or representatives generally felt the home was good at informing them of any changes in health that affected their relative or friend living at the home. Comments included, “ on both occasions we were informed straight away”. Another relative also confirmed that they were always informed of any accidents or changes in health to their mothers care. This person did state that they weren’t given enough notice to arrange time off work to attend care reviews. Comments from people living at the home and their representatives included, “ the staff are lovely, they’re very caring, nothing is too much trouble for them” and “the staff are very nice, most obliging”. The medication practices were looked at for the people case tracked and demonstrated that the home supported them to take their medication in a safe way. Langwith Lodge Care Home DS0000008742.V364109.R01.S.doc Version 5.2 Page 13 People’s right to privacy was respected and the support they received from the staff team was given in a way that maintained their dignity. Examples of this include, one of the people case tracked who enjoyed spending time alone in their room. This person confirmed that staff respected their wishes. Staff were observed knocking and waiting for a reply before entering this person’s room. Within the care records seen each person had been asked if they had a preference of staff gender to support them in their personal care needs. Each person’s preferences had been recorded and two of these people were able to confirm that their wishes were followed regarding this. People living at the home appeared to be clean and appropriately dressed. The majority of comments from relatives confirmed this, “ mum is very settled and happy and always looks presentable”. Comments from one relative stated that there had been occasions when they had visited their relative when they had not been fully dressed and they said they had not been clean. This person did not confirm if they had brought this to the attention of the staff. Langwith Lodge Care Home DS0000008742.V364109.R01.S.doc Version 5.2 Page 14 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): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service supports people to follow their social interests and is responsive to individual’s religious and faith needs. EVIDENCE: The service supported people to follow personal interests and activities. Activities were provided and the records demonstrated that activities had been organised through consultation with the people living at the home. Two activities coordinators were employed and records were kept of the activities provided and of who had chosen to participate in them. As stated in the AQAA a wider choice of activities was now available and included; music to movement, bingo, dominoes, quiz hour, hymns and praise, karaoke, ball games, nostalgia hour and arts and crafts. Following a request from one of the people living at the home a greenhouse was being purchased. This demonstrates that the home supports people to maintain their interests and hobbies. Langwith Lodge Care Home DS0000008742.V364109.R01.S.doc Version 5.2 Page 15 External entertainment was provided on a Friday for the people living at the home and this entertainment varied. Visits from the local brownies group and school choir was also provided. Community activities were provided such as day trips to local farms, garden centres and meals out. Activities within the grounds of the home included, walks and chair skittles. Seating areas was also provided. A summer fayre was being organised for the 28th June. Religious and faith needs were met through Holy Communion that was provided at the home by the local vicar and comments from one relative demonstrated that the home was responsive to peoples differing religious and faith needs. Hymns and praise were provided regularly and this was observed on the day of this inspection visit. This appeared to be enjoyed by many of the people living at the home. People were able to keep in touch with family ad friends. From observation it was noted that visitors were made welcome by the staff team. Comments from visitors included, “nothing is too much trouble, I get a nice cup of tea and biscuits” and “you visit when you want, the staff are always pleased to see you and very good at their job”. People are encouraged to be as independent as they can be, through promoting choice and being given the opportunity to make the most of their abilities and independence. The people spoken with confirmed that they were able to choose when they went to bed and the time they got up each morning. As already stated people were able to choose their preferred gender of staff to support them in their personal care needs. The menus were looked at. It was noted that menus were written in small print. This means that for people with failing eyesight they would be difficult to read. This was confirmed by one person spoken with who said, “ I can’t see what’s on the menu, the writing is too small”. The menus demonstrated that two choices were available at the main meal, however it was noted that there was not always a vegetarian option available. The manager discussed plans to provide photographs of meal options for people with dementia. This would support them in making choices regarding their preferred meals. Comments regarding meals included, “ …., enjoys her food. Kitchen staff are very obliging if. …wants anything different at meal times.” Langwith Lodge Care Home DS0000008742.V364109.R01.S.doc Version 5.2 Page 16 The comments regarding the quality of the meals were general positive. One person spoken with, who was relatively new to the home, said they had complained as their hot meal was served on a cold plate. This meant that the meal was not hot on arrival. This person said they had made the complaint the previous day and as they had been out at lunchtime on the day of this inspection visit they had not taken lunch at the home since. They were therefore unable to confirm if their complaint had been addressed. Discussions with the manager indicated that this had been addressed to ensure this did not happen again. Langwith Lodge Care Home DS0000008742.V364109.R01.S.doc Version 5.2 Page 17 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): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Concerns are looked into and actions are taken to put things right. The home safeguards people from abuse but the policy in place did not clearly reflect this. EVIDENCE: Five complaints have been received by the home in the last twelve months. As stated in the AQAA records were kept to demonstrate that they had been addressed appropriately. Complaints were recorded in a diary and letters received and written responses were attached to this diary. Although no specific format for recording complaints is required, discussions with the manager took place regarding the types of recording forms that could be used, which would enable complaints records to be recorded, audited and reviewed in an easier way. Comments from people living at the home or their representatives indicated that they knew how to make a complaint if they needed to. All confirmed that any concerns or complaints were addressed promptly and satisfactorily. The home safeguards people from abuse and neglect and takes action to follow up any allegations. Langwith Lodge Care Home DS0000008742.V364109.R01.S.doc Version 5.2 Page 18 Records demonstrated that a policy on Safeguarding Adults (Adult protection) was in place. This policy was detailed in the different types of abuse and in the initial procedure care staff should follow if they suspected or witnessed any abuse, or if abuse was reported to them. However the policy did not clearly follow the local authority guidelines, who are the lead investigators in Safeguarding Adults. This was discussed with the manager and managing director on the day of this visit. An amendment to this policy will ensure that no misinterpretation to the policy can be construed. It will also ensure that all staff are aware of the protocol that should be followed. The manager was aware of the Local Authority procedure and of the named safeguarding officer. The staff spoken with had a good understanding of abuse. They demonstrated a clear understanding of the need to report any concerns or allegations promptly and said they would report to the manager or if this was not possible the managing director. However as stated above the staff team should be made aware that if they do not feel this is appropriate they can report any concerns to the safeguarding officer at the Local Authority. The contact details of the Safeguarding officer should be available on the Safeguarding Policy to ensure everyone has this information. Once this is in place it will further demonstrate that an open and transparent approach to safeguarding the people at the home is provided. Langwith Lodge Care Home DS0000008742.V364109.R01.S.doc Version 5.2 Page 19 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): 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in an attractive home that is well maintained with good standards of hygiene kept. This ensures they are kept safe and are able to enjoy their surroundings. EVIDENCE: People stay in a safe well maintained home that is clean, pleasant and hygienic, As stated in the AQAA an attractive computer room is available for the people living at the home. This room was not observed to be in use during a tour of the building, however the manager stated that some of the people living at the home did use these facilities. Langwith Lodge Care Home DS0000008742.V364109.R01.S.doc Version 5.2 Page 20 Bedrooms seen were personalised to reflect individual taste. Some bedrooms had ensuite facilities. Some bathrooms seen were spacious and provided the appropriate equipment to safely support people’s mobility needs. However one bathroom seen was very low to the floor and was not used, as it was unsuitable for use. Therefore this bathroom served no purpose in the home and consideration should be given as to the alternatives that this room could be used for. All areas of the home seen were attractively decorated and well maintained. Views from within the home and the grounds were attractive and the front of the home overlooked a lake. Discussions took place with staff, the manager and managing director regarding plans to provide a safe seating and walkway nearer to the lake. Comments regarding the environment included, “ it’s a very beautiful building, clean and pleasant” and “they keep the place clean and tidy” Comments within one survey said that the home “smells”, however no unpleasant odours were noted on the day of this inspection visit. The laundry area was seen and provided appropriate equipment to ensure individual’s laundry was maintained to a good standard. People spoken with confirmed that they were happy with the laundry services provided. Langwith Lodge Care Home DS0000008742.V364109.R01.S.doc Version 5.2 Page 21 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): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People have safe and appropriate support from a competent and trained staff team. EVIDENCE: People have safe and appropriate support as there are enough competent staff on duty at all times. Comments within surveys received and from discussions with the people living at the home and staff, indicated that sufficient numbers of staff were available to meet individual’s needs. The rotas seen reflected this. Discussions with the manager confirmed that supernumery hours for her had not increased since the last inspection. The manager confirmed she was allocated ten hours a week to undertake management duties. It was agreed with the manager that this is not sufficient to enable her to fulfil all of her management responsibilities. As stated in the AQAA the manager confirmed that all of the care staff team, except one had achieved an NVQ in care at level 2. The person who had not achieved this stated that they were hoping to commence training soon. Two senior care staff had achieved an NVQ at level 3 and five staff were waiting to commence this training. Records were seen to demonstrate this. Langwith Lodge Care Home DS0000008742.V364109.R01.S.doc Version 5.2 Page 22 People at the home can be confident in the staff supporting them. This is because checks have been done on all staff, to make sure they are suitable to care for the people living at the home. The recruitment records of three members of staff were looked at. All had the required checks in place that were satisfactory. The training records were seen, and as stated in the AQAA training certificates were seen within the staff files looked at. The records demonstrated that mandatory training was kept up to date. As recommended at the last inspection, training in equality and diversity had been undertaken by all of the staff. This means that staff’s awareness of the diverse needs of the people living at the home are enhanced, which will enable them to support each person in meeting their individual needs. The manager confirmed that training on nutrition had been booked for staff. Staff spoken with said that the training provided was very good. All of the staff spoken with demonstrated an enthusiastic and caring approach to their work and the people living at the home. They appeared to have a good understanding of the needs of the people they cared for. Two of the staff spoken with had undertaken dementia care training and they said this had been very interesting and useful in providing them with the skills required to support people’s needs. This demonstrates that people’s needs are met and that they are for cared for by staff that receive the relevant training. Staff confirmed that the team worked well together and were supportive of each other. Comments from one relative regarding the staff team were, “ people’s different requirements always seem to be catered for, they provide a happy and safe environment and genuinely care for these people” and “ I have witnessed staff popping in on their days off, just to see some one or bringing their baby in to show them and have a chat with them”. Langwith Lodge Care Home DS0000008742.V364109.R01.S.doc Version 5.2 Page 23 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): 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The well-led management of the home ensures both the people living at the home and staff team are kept safe. People’s finances are safeguarded and their views influence the running of their home. EVIDENCE: The manager achieved registration with us in July 2007 and is now the Registered Manager for the service. Staff spoken with were extremely complimentary regarding the managers ability to run the service and support them in their duties. Comments included, “the boss is superb, she has an open door for us all, she’s really easy Langwith Lodge Care Home DS0000008742.V364109.R01.S.doc Version 5.2 Page 24 to talk to and very supportive”. Comments on the day of the inspection and from the surveys completed all indicated that the home is well managed. The quality assurance practices in place demonstrated that the home is run in the best interests of those living there. Examples of this include, minutes of meetings and satisfaction questionnaires, where people had made suggestions for improvements to the home. These suggestions had been acted upon. Such as water coolers had been purchased for the people living at the home. A greenhouse was being purchased following a request from someone living at the home. Although evidence was seen to show that people’s opinions and ideas were listened to and acted upon, the service did not publish this. Discussions took place with the manager as to how this could be achieved. This will ensure feedback is given to the people living at the home, their representatives and other interested parties, such as people looking for residential care and stakeholders. Suitable accounting procedures were in place for the safe keeping of monies held by the home for individuals. The records of the people case tracked and the monies held were checked and were satisfactory. As recommended at the last inspection visit a process was now in place for auditing individual’s accounts. This protects both the people living at the home and the staff team. This demonstrates that for people who cannot manage their own money, it is managed by the home in their best interests. A sample of service certificates such as gas safety, electrical installation, portable electrical appliances and lifts and hoists was seen. As stated in the AQAA all service certificates were up to date. Records relating to fire safety were looked at and demonstrated that the correct checks and services had been undertaken as required. This means that the environment is safe for people because appropriate health and safety practices are carried out. Langwith Lodge Care Home DS0000008742.V364109.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 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 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Langwith Lodge Care Home DS0000008742.V364109.R01.S.doc Version 5.2 Page 26 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. 1 Standard OP7 Regulation 15 Requirement Information within care records must be accurate to reflect the individual’s dependency level and their capacity to make decisions. Timescale for action 08/08/08 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 OP3 Good Practice Recommendations Include capacity to consent within the assessment documentation. Ensure weight records have an action section and are used in the evaluation and monitoring of service users nutritional needs. It is recommended that a nutritional screening tool be included within the system and that the dietician be consulted about how best to record the dietary intake of individuals to ensure appropriate nutritional values of food DS0000008742.V364109.R01.S.doc Version 5.2 Page 27 2. OP8 3. OP8 Langwith Lodge Care Home are monitored. 4. 5. 6. 7. OP15 OP15 OP18 OP27 Menus should be provided in larger print to ensure they can be read easily. Vegetarian options should be available on menus for each mealtime. Amendment to the Safeguarding policy should be made to ensure it is in line with the Local Authority procedure The manager does not work supernumery full time. In order for the manager to undertake and fulfil her responsibilities under the Care Standards Act 2000 it is strongly recommended that she work full time supernumery Provide training for care staff in challenging behaviour, and other specific needs of service users. Results of quality audits and the actions taken should be published. This will feed back to people living at the home, their friends and family, stakeholders and other interested parties how the home is run in the best interests of the people living there. 8. 9. OP30 OP33 Langwith Lodge Care Home DS0000008742.V364109.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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. 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