Inspection on 02/08/05 for Long Lea

This inspection was carried out on 2nd August 2005.

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

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

Other inspections for this house

Long Lea 02/03/09

Long Lea 16/01/07

Long Lea 16/02/06

Long Lea 24/02/05

Long Lea 23/06/04

Similar services:

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

Maple Lodge

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

CARE HOMES FOR OLDER PEOPLE Long Lea 113 The Long Shoot Nuneaton Warwickshire CV11 6JG Lead Inspector Louise Thompson Unannounced 2 August 2005 09:20 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 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. Long Lea E53 S4230 Long Lea V242985 020805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Long Lea Address 113 The Long Shoot Nuneaton Warwickshire CV11 6JG 02476 370553 02476 370553 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Dwell Limited Tracey Harris Care Home 25 Category(ies) of OP Old age (25) registration, with number of places Long Lea E53 S4230 Long Lea V242985 020805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24 February 2005 Brief Description of the Service: Long Lea is a care home providing personal care and accommodation for 25 older people aged 65 years and over. It does not offer any specialist services. The home is located on the outskirts of Nuneaton, and is close to shops, pubs, the post office and other amenities. The accommodation is provided in an extended bungalow with suitable access to service users. The home has 23 bedrooms, 22 of these are single with en-suite facilities. One room is shared. There are currently three assisted bathroom areas and four WCs situated around the home. Communal areas include two large lounges, a small lounge and a dining room. The home has extensive gardens that are well maintained and easily accessible.Future proposals for the home include the provision of additional beds and the extension of kitchen and laundry facilities. Long Lea E53 S4230 Long Lea V242985 020805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over one day. This was the first visit for this inspection year. Staff co operated fully with the inspection. The registered manager was present throughout the inspection. The inspection process involved a tour of the home, talking with the manager, examining records and care plans, observation of care practices along with discussions with residents, staff and relatives visiting on the day of the inspection. What the service does well: What has improved since the last inspection? 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. Long Lea E53 S4230 Long Lea V242985 020805 Stage 4.doc Version 1.40 Page 6 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 Standards Statutory Requirements Identified During the Inspection Long Lea E53 S4230 Long Lea V242985 020805 Stage 4.doc Version 1.40 Page 7 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 standard(s) 3 and 5 Systems for the assessment of prospective residents needs are good. Residents and their relatives are encouraged to visit and assess the suitability of the home prior to a decision to stay. EVIDENCE: The records of three residents were observed each file contained evidence of suitable pre admission assessments by the manager and other health and social professionals. The manager completed an assessment visit at the home of one prospective resident at the time of this visit. During this inspection a prospective resident and family came to visit the home. The manager provided them with a copy of the service user guide and other information senior staff showed them around the home introducing them to other residents. The prospective resident stayed for lunch and spent time chatting with residents about the service and care provided by the home. Long Lea E53 S4230 Long Lea V242985 020805 Stage 4.doc Version 1.40 Page 8 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 standard(s) 7, 8, 9 and 10 Care plans require further development to provide the staff with the necessary information to meet individual residents needs. Health needs of residents are met with evidence of liaison with health and social care professionals on a regular basis. Some progress has been made with arrangements for management and administration of medication. Personal support is offered in such a way as to maintain residents’ privacy and dignity. EVIDENCE: Since the last inspection a new care planning system has been implemented within the home. The records of three residents were observed during this inspection. Individual care plans are available but they do not adequately identify and plan for all aspects of health, personal and social care. Plans observed lacked specific detail. Keyworkers complete monthly reviews but those observed did not adequately review the care plans. Risk assessments have been partially implemented. On two of the files these and the dependency profiles had been partially completed. The manager said that staff were now becoming more familiar with the new care documentation. Long Lea E53 S4230 Long Lea V242985 020805 Stage 4.doc Version 1.40 Page 9 Daily entries are not maintained but significant information is recorded in resident files. Records observed of one resident demonstrated that the resident displayed fluctuating behaviours. There was no care plan for this aspect of need. Discussions with the manager, residents and staff suggested that residents care needs were being addressed, even though there was a lack of clear plans. This approach is dependent upon staff memory and good verbal communication systems. Access is available to health professionals outside of the home, which includes the Chiropodist, GP, District nurses and the Dentist. Care files viewed showed involvement of members of the multidisciplinary team in assessing and meeting residents’ care needs. Systems for the management and administration of medications were observed and were satisfactory apart from the following issues, which were discussed with the manager. • • Inaccuracies with MAR transcribed by hand Criteria for as required medication not always clearly defined and recorded. Staff were observed treating the residents with dignity and respect during the inspection. Without exception residents said that the staff were very kind and caring and that they enjoyed living in the home. One resident said “that nothing was too much trouble for the manager and staff. It was like home from home.” Long Lea E53 S4230 Long Lea V242985 020805 Stage 4.doc Version 1.40 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 standard(s) 15 Dietary needs of residents are well catered for with a balanced and varied selection of food available that meets residents’ tastes and choices. EVIDENCE: The inspector ate lunch with the residents. The meal was tasty and nicely presented. The dining room tables were attractively laid and staff were readily available to assist residents where necessary. Residents said that the meals were very good and suitable choices were available at mealtimes. A recent quality review with residents identified areas for improvement as a result of this the menus have been reviewed. Residents said that they could have snacks and drinks any time they wanted them. Long Lea E53 S4230 Long Lea V242985 020805 Stage 4.doc Version 1.40 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 standard(s) 18 Robust policies and staff practices are maintained by the home to ensure that residents are safeguarded from abuse. EVIDENCE: The inspector observed the homes policies for the management of abuse; whistle blowing, management of residents’ finances and the management of physical and verbal aggression. These were observed to be satisfactory and had recently been reviewed by the manager. Additional POVA guidance is kept in the office for staff to access should they need this. Training records observed demonstrated that staff have attended training in the management and recognition of abuse. Staff were able to tell the inspector of the action to be taken should abuse be witnessed or suspected confirming that they were aware of the procedure. There have been no reported allegations/incidents of abuse at Long Lea. Long Lea E53 S4230 Long Lea V242985 020805 Stage 4.doc Version 1.40 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 standard(s) 19 and 26 The standard of décor and furnishings is good with evidence of ongoing planned improvement and maintenance. The home presents as very comfortable and homely for residents. EVIDENCE: Long Lea is a care home providing personal care and accommodation for older people and is located close to shops, pubs, the post office and other amenities. The accommodation is provided in an extended bungalow which has 23 bedrooms, 22 of these are single with en-suite facilities. One room is shared. There are currently three assisted bathroom areas and four WCs situated around the home. Communal areas include two large lounges, a small lounge and a dining room. At the time of this visit work had commenced to extend the number of bedrooms and extend kitchen and laundry facilities. Residents told the inspector that the manager and staff were keeping them fully informed of the plans and progress of the building. During a tour of the building the home was observed to be extremely clean and tidy. The décor and furniture and furnishings are of a good quality and is suitable for current residents needs. Since the last inspection radiator covers Long Lea E53 S4230 Long Lea V242985 020805 Stage 4.doc Version 1.40 Page 13 have been fitted, the hairdressing room, two bathrooms and several residents’ bedrooms have been refurbished. Sluicing and laundry facilities are being improved as part of the current building programme. Long Lea E53 S4230 Long Lea V242985 020805 Stage 4.doc Version 1.40 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 , 29 and 30 There is a complement of staff that have worked at the home for many years and staffing levels offer a good consistency of care within the home. The procedures for the recruitment of staff are satisfactory and protect the residents. Training is well planned and good opportunities are available for all staff. EVIDENCE: The retention of staff at Long Lea is good with many of the current staff having worked at the home since it opened. Duty rotas seen for the period of a month demonstrate that staffing is maintained within previously agreed levels. Staff do additional shifts to cover for sickness and annual leave. Staff and residents told the inspector that the staffing levels were suitable to meet current care needs of residents. The inspector examined the records of three staff members, which included those who had recently been appointed. Each file contained evidence of suitable CRB checks, references and all other information as required by the standard. Since the last inspection the manager has completed a training needs analysis and has used this to develop the training plan for 2005/6. There is an active NVQ training programme with nine of the care assistants having achieved NVQ level 2 and one staff member due to commence NVQ level 3. Long Lea E53 S4230 Long Lea V242985 020805 Stage 4.doc Version 1.40 Page 15 Certificated evidence of courses attended were observed on a number of staff files throughout the inspection. Recently staff have completed a distance learning course on dementia care and foot care awareness. Staff said that good opportunities were made available for them to attend training. Staff spoken to appeared knowledgeable on the care needs of the older person. Long Lea E53 S4230 Long Lea V242985 020805 Stage 4.doc Version 1.40 Page 16 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 and 38. The quality management systems in this home are developing, with evidence that residents’ views are sought and acted upon. The health and safety of residents and staff are promoted and protected. EVIDENCE: Since the last inspection the manager has developed an annual business plan for 2005/6. Systems for the monitoring of quality continue to develop and include the views of residents. The results of recent satisfaction surveys of residents and relatives were available and displayed in reception. The majority of responses rated the service as excellent and were very complimentary. Issues raised by these and a recent resident meeting have been actioned and include: the review of menus, a review of laundry services and the provision of additional external entertainers. Long Lea E53 S4230 Long Lea V242985 020805 Stage 4.doc Version 1.40 Page 17 Residents told the inspector that they were informed of and included in any changes within the home. The manager said that she is currently developing a newsletter for residents and relatives. The manager completed a quality audit in June 2005 and as a result has developed an action plan to address issues from this. Policies and procedures are reviewed on a regular basis with evidence of this seen during the inspection. Certificates for the service and maintenance for most major systems were available the manager said that these were done by appropriately qualified personnel. The certification for the fire alarm service and portable appliance testing was awaited by the home. Reports of visits by the Fire Officer, Environmental Health Officer and Health and Safety Officer were observed during the inspection. Long Lea E53 S4230 Long Lea V242985 020805 Stage 4.doc Version 1.40 Page 18 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 2 STAFFING Standard No Score 27 3 28 x 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 x x 3 x x x x 3 Long Lea E53 S4230 Long Lea V242985 020805 Stage 4.doc Version 1.40 Page 19 Yes Are there any outstanding requirements from the last inspection? 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 OP 7 Regulation 15 Requirement Timescale for action 30.09.05 2. OP 9 13 3. OP 21 23 , 16 The registered manager must ensure that the care plans are current and accurately record each residents, health, social and personal care needs. A system for involving residents or their representatives in determining care should be implemented with records kept. (OLD TIMESCALE OF 31.07.05 PART MET. New care documentation being implemented.) The registered manager must 31.08.05 ensure that MAR sheets are accurately transcibed by hand. Medications prescribed to be given as required should specify the criteria for their administration. The registered person must 31.10.05 ensure that suitable sluicing facilities are provided. (Old timescale 30.06.05 part met, work has commenced on new build which includes the provision of suitable sluicing facilities) Long Lea E53 S4230 Long Lea V242985 020805 Stage 4.doc Version 1.40 Page 20 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 OP 8 Good Practice Recommendations The inspector recommends that a suitable pressure area risk assessment is implemented and care planned accordingly. Long Lea E53 S4230 Long Lea V242985 020805 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection Imperial Court Holly Walk Leamington Spa CV32 4YB 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. 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