This inspection was carried out on 17th February 2006.
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 made no statutory requirements on the home as a result of this inspection
and there were no outstanding actions from the previous inspection report.
CARE HOMES FOR OLDER PEOPLE
Littledene House 54 Bushey Grove Road Bushey Watford Hertfordshire WD2 2JJ Lead Inspector
Sheila Knopp Unannounced Inspection 17th February 2006 09:50 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 Littledene House DS0000019451.V282974.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. Littledene House DS0000019451.V282974.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Littledene House Address 54 Bushey Grove Road Bushey Watford Hertfordshire WD2 2JJ 01923 245 864 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) m.ang@btopenworld.com Ms Margaret Ang Ms Margaret Ang Care Home 12 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (12), Old age, not falling within any other of places category (12) Littledene House DS0000019451.V282974.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. The home may accommodate one named service user under the age of 65 with Dementia. If the names service user ceases to be accommodated at the home then the variation to the category shall cease. The manager must inform CSCI if the service user permanently leaves the home for any reason. 8th August 2005 Date of last inspection Brief Description of the Service: Littledene House is a care home providing personal care and accommodation to twelve elderly people, in single rooms. The home is registered for Dementia Care (Elderly). Littledene is privately owned and managed by a provider with nursing qualifications and management in care award. The large, converted, property is located in a quiet residential street in Bushey, Hertfordshire. The home is close to the attractive village of Bushey and also not far from Watford Town Centre; both places are about two miles each away, so large selections of amenities are reasonably close. There is also a row of shops just a couple of minutes walk away which offer fish and chip shop, oriental takeaway, newsagent and essential groceries and provisions store. Relatively small, Littledene radiates a very homely and friendly atmosphere. The house is well presented and comfortable; a lift offers access to all parts of the home for people who are not fully ambulant. The frontage of the property is attractively paved and allows for the parking of several cars. The rear garden is mainly laid to lawn with an extended patio and is neatly kept. Littledene House DS0000019451.V282974.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This is the second planned unannounced inspection for the year April 2005 – March 2006. A full assessment of all the key standards can be found in the inspection report dated 8.8.05. The inspector spent time talking with residents and a visitor while observing the morning routine and staff interaction had with residents. Four residents were spoken with in detail. This was a positive inspection. The home was warm and welcoming. Staff were observed to have a sensitive and calm approach to residents as they supported and encouraged them. The response from residents to conversations started by the inspector indicated those with a limited ability to respond were used to being included and encouraged to express themselves. No complaints have been received by the Commission between inspections. What the service does well: What has improved since the last inspection?
A risk assessment in relation to a resident with swallowing problems has been put in place to address an issue identified at the last inspection. Littledene House DS0000019451.V282974.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. Littledene House DS0000019451.V282974.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 Littledene House DS0000019451.V282974.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): Not inspected as the outcomes for standards 1 – 5 were met when the home was inspected on 8.8.05. Standard 6 does not apply to this service. EVIDENCE: Littledene House DS0000019451.V282974.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): Not inspected as the outcomes for standards 7 – 11 were met when the home was inspected on 8.8.05. Under standard 7 the manager has been required to review the seating and moving and handling arrangements for one resident to ensure that they are comfortable and appropriate equipment is being used. EVIDENCE: A resident is regularly sitting in a chair, which is not designed to provide permanent seating. Discussions with the manager identified that an occupational therapist should be consulted to provide advice on the most appropriate equipment to use. Littledene House DS0000019451.V282974.R01.S.doc Version 5.1 Page 10 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): Not inspected as the outcomes for standards 12 – 15 were met when the home was inspected on 8.8.05. EVIDENCE: Littledene House DS0000019451.V282974.R01.S.doc Version 5.1 Page 11 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): Not inspected as the outcomes for standards 16 – 16 were met when the home was inspected on 8.8.05. EVIDENCE: Littledene House DS0000019451.V282974.R01.S.doc Version 5.1 Page 12 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): 26 Not inspected as the outcomes for standards 9, 20, 21, and 23 were met when the home was inspected on 8.8.05. Residents are provided with a fresh clean home in which to live. EVIDENCE: A high standard of housekeeping and provision of freshly laundered linen and clothing were observed. Littledene House DS0000019451.V282974.R01.S.doc Version 5.1 Page 13 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): 28 The outcomes for standards 27 – 30 were assessed as being met when the home was inspected on 8.8.05. However from the end of 2005, to meet Standard 28, 50 of the care staff, excluding the manager, should have qualifications in care at NVQ level 2. There were no indications from the observations made by the inspector that staff had not been trained to carry out their jobs. However only 1 out of 6 care staff had achieved the required qualifications. EVIDENCE: One of the care staff has an NVQ 3 and the manager is a registered nurse. Other staff have worked in the home for a number of years and gained experience over time. The core staff team is supplemented by two exchange student from Denmark who work under six month contracts before returning home. This may have implications for achieving the 50 ratio required. Littledene House DS0000019451.V282974.R01.S.doc Version 5.1 Page 14 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): Not inspected as the outcomes for standards 31, 33, 34, and 35 were met when the home was inspected on 8.8.05. A requirement made under standard 38 to put risk assessment in place for a service user with swallowing problems was followed up. EVIDENCE: Littledene House DS0000019451.V282974.R01.S.doc Version 5.1 Page 15 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 x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x x x x x x x x x STAFFING Standard No Score 27 x 28 2 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x x x x x Littledene House DS0000019451.V282974.R01.S.doc Version 5.1 Page 16 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 13(4) 13(5) Requirement Obtain advice from an occupational therapist on the seating and moving and handling requirements for an identified resident. Timescale for action 31/05/06 Littledene House DS0000019451.V282974.R01.S.doc Version 5.1 Page 17 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 OP28 Good Practice Recommendations Review the current induction programme against the new Skills for Care guidance available to managers, particularly in relation to meeting the level of competence and accreditation required. Review the arrangements for training to provide 50 of staff with qualifications in care at NVQ level 2. 2. OP28 Littledene House DS0000019451.V282974.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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 Littledene House DS0000019451.V282974.R01.S.doc Version 5.1 Page 19 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
