Inspection on 02/03/09 for Long Lea

This inspection was carried out on 2nd March 2009.

CSCI found this care home to be providing an Excellent 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.

Other inspections for this house

Long Lea 16/01/07

Long Lea 16/02/06

Long Lea 02/08/05

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 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Long Lea 113 The Long Shoot Nuneaton Warwickshire CV11 6JG     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Patricia Flanaghan     Date: 0 2 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Long Lea 113 The Long Shoot Nuneaton Warwickshire CV11 6JG 02476370553 02476370553 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Dwell Limited care home 27 Number of places (if applicable): Under 65 Over 65 27 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 0 Long Lea is a care home providing personal care and accommodation for 27 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 and other amenities. The accommodation is provided in an extended bungalow with suitable access to service users. The home has converted a double bedroom into a single room and currently provides accommodation for 26 people. All 26 bedrooms are now single and 24 have en-suite facilities. There are currently four 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. The manager stated that the current fees are £415 per week. The people at the home pay for additional personal items, such as hairdressing, private chiropody, newspapers and leisure costs. Care Homes for Older People Page 4 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 3 star. This means the people who use the service experience excellent quality outcomes. This was an unannounced inspection visit which took place on Monday 2nd March 2009 between 10:30am and 3:30pm. The previous key inspection to Long Lea was on 4th October 2007. An Annual Service Review (ASR) was undertaken on 1st February 2008. An ASR involves reviewing all the information received by us since the last key inspection. The people living at the home were also sent satisfaction surveys to complete. After reviewing this evidence we judged the home as continuing to provide a good service. Care Homes for Older People Page 5 of 27 Before the inspection, we looked at all the information we have about this service, such as information about concerns, complaints or allegations, incidents and previous inspection reports. We do this to see how well the service has performed in the past and how it has improved. We looked at the Annual Quality Assurance Audit (AQAA) which the manager completed and returned to us before our visit. This is the managers review of the service and gives us information about how the service has progressed in the last 12 months. We used a range of methods to gather evidence about how well the service meets the needs of people who use it. We asked people who use the service, visitors and staff to complete satisfaction surveys. We received 15 completed surveys in total. Their comments about the service provided are included within this report. Three people using the service were identified for case tracking. This is a way of inspecting that helps us to look at services from the point of view of some of the people who use them. We looked at the environment and facilities provided and checked records such as care plans and risk assessments. We talked to people who use the service, the manager, two care staff andt he cook. We also spoke with two visitors to the home. At the end of the visit we discussed our preliminary findings with the manager. What the care home does well: What has improved since the last inspection? What they could do better: The findings of this inspection indicated that the service is currently performing well. We have not made any requirements as a result of this visit. We have made good practice recommendations which the home should consider implementing to improve outcomes for people living at Long Lea. The system for formally reviewing the quality of service provided should be further developed in order to continually improve the service for people who live there. The manager has indicated on the AQAA that she aims to develop a development plan based on the quality outcome areas, indicated in this inspection report, for people living at the home. Care Homes for Older People Page 7 of 27 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who are considering moving into Long Lea benefit from having their care needs assessed so that they can be sure the home can meet their needs. Evidence: We looked at the files of two people who had recently been admitted to the home to assess the admission process. The manager had undertaken pre-admission assessments before the people moved into the home. This gives the home the chance to look at peoples needs and decide whether they can offer a service to people that will meet their assessed needs. The pre-admission assessments were comprehensive and provided information that allowed staff to start planning for the persons care before they were admitted into the home. People using the service confirmed that the homes management had visited Care Homes for Older People Page 10 of 27 Evidence: them before they moved into the home and talked to them about their needs and expectations. The manager told us in the Annual Quality Assurance Assessment that Each resident has a pre-admission assessment to ensure we can meet their needs and a raft of information regarding the home and the services we can provide. We meet with potential residents and family or representatives and try to answer their questions and provide reassurance. We suggest a number of pre-admission visits to the home spending a longer time and enjoying meals with the residents to get a feel of whether they would enjoy the home. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Long Lea are treated respectfully. Each person has a plan of care and access to health care services so that their health and personal care needs are met. Evidence: We looked at the care files for three people as part of our case tracking process. This process enables us to make decisions about how the home is meeting the needs of the people living there. Each person had a care plan, daily records and monitoring records. Care plans were based on information secured during the initial care needs assessment and were developed as staff got to know the individuals strengths and limitations. Care plans were available for the identified needs and abilities of each person and supplied staff with the information needed to make sure the persons needs were met safely and appropriately. For example, the manager had identified that one of the people we were case tracking was subject to mood swings. She had developed a risk assessment and care plan for staff to follow if the persons mood changed. Staff said this guidance Care Homes for Older People Page 12 of 27 Evidence: worked. Records sampled showed that people had been regularly weighed to ensure they were not gaining or losing a significant amount of weight, which could be an indicator of an underlying health need. The care plans are evaluated on a monthly basis or more often if needed and changes are made to the care plans if there is a change in the need of the person. Surveys completed by staff members confirmed care plans are regularly updated and all information is passed over during handover at the beginning of every shift. A person commented, I feel confident in dealing with the residents as I am well informed of their individual needs and also the day to day routine of the home in general. Another staff member told us at the visit, We are told about residents current needs on hand over and can read the care plans. This shows that peoples needs are reviewed each day with any changes in care shared by all staff so that individuals receive the support and care required at all times. The home keeps a record of contacts that each person has with health care professionals and this showed that they have regular contact with them. The home also has visiting outside professionals who provide optical, auditory and chiropody care. Daily records require some improvement in relation to how staff record descriptions of people. For example, one daily record consistently stated, X is ok and X ok, no problems. It is recommended that staff receive guidance to ensure what they record is not an opinion but is a description of events. During our visit the people we saw had been well supported with their personal care and clothing. All the people living there were well dressed in individual styles that were reflective of their age, the weather and the activities they were doing. People who use the service told us that staff always promote and respect their privacy and dignity. Staff were seen referring to people by their preferred form of address, and we saw staff knocking on peoples doors and waiting for a response before they entered the room. One person commented in their completed survey My relative feels safe and secure despite a number of medical conditions. Another person said the staff are all very good. We examined systems for the management of medication. A monitored dosage (blister packed) system is used. Medication was safely stored in a locked trolley, which are kept in a locked clinical room. Care Homes for Older People Page 13 of 27 Evidence: The facility for storing controlled drugs (CD) was satisfactory and complies with legislation. The contents of the controlled drug cabinet were audited against the controlled drug register and the quantities were correct. Medication Administration Record (MAR) sheets maintained an accurate record of medicines administered to people. We also saw medication audits undertaken by the Primary Care Trust pharmacist. These audits are completed on a regular basis and allow the manager to take action if any shortfalls are highlighted. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. An activity programme provides opportunities for meaningful stimulation for people who are able to participate. People are supported by the home in maintaining contact with their families and friends. Meals are well balanced and nutritious. Evidence: People we talked to said that they were happy with the daily routine. They said that they were free to get up and go to bed whenever they chose. They also said they were satisfied with the range of social and leisure activities provided in the home. These included music and movement sessions, a visiting musician, bingo and board games. Aromatherapy and manicure sessions are also arranged, and we saw staff helping several ladies with their nails at the time of our visit. Other people enjoyed a film show in the large lounge. Staff sat and chatted with people who enjoyed this one to one time and the banter they engaged in with the staff members. One person commented in a survey returned to us, There are many activities such as music and movement, film shows pantomine etc. I dont always attend, but I am always asked. There is an open policy for visiting and relatives are always made welcome and included in the lives of those who live there. Several people go out with their family Care Homes for Older People Page 15 of 27 Evidence: and friends, and we saw people visiting during our visit, all of whom were very complimentary about the home. One visitor described the service as excellent. Comments by peoples relatives in surveys indicates they are made to feel welcome at the home and kept informed and updated of any changes to their relatives care. People are encouraged to personalise their own rooms with their own possessions. Some of the rooms we saw had been decorated in this way and were homely and welcoming. The home recognises the importance of supporting people with making choices about their lives. We observed a midday meal in the dining room and chatted with people at their tables. Tables were attractively set with table cloths and condiments. The main meal of the day was served at approximately 1pm. People had a choice of cottage pie with fresh vegetables, or ham or cheese salad. Vegetables were served separately by staff which meant people could make choices on what vegetable they wanted and portion size. People were also offered second helpings, which is good practice. There are drinks and snacks available on request and at regular intervals throughout the day. The staff have access to the kitchen and food at all times and the people who live there are encouraged to drink plenty of fluids at all times to maintain their well being. Comments received from people living at the home indicate satisfaction with the meals provided at the home. One person told us, We always have lovely meals here. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home can be confident that their concerns will be listened to and acted upon. There are systems in place to respond to suspicion or allegations of abuse to make sure people living in the home are protected from harm. Evidence: There is a comprehensive complaints procedure on display in the reception of the home. This is available in large print to assist people with visual impairments to access the information and is included in the statement of purpose. There are a number of thank you cards and letters on display, which suggests satisfaction with the service provided. The manager also periodically reminds residents and visitors that a suggestion box is available so that people can voice their opinions on any aspect of the home. People who use the service and visitors told us they would have no hesitation complaining about the service if necessary. The culture within the home is open and allows and supports people to raise concerns. Surveys returned to us also indicated confidence that any concerns they might raise would be addressed. Comments received included; We have never had to raise a concern about care, and I have every confidence that the manager would address any concerns I would raise if I had any, which I havent. Care Homes for Older People Page 17 of 27 Evidence: The home has an adult protection policy, which gives staff guidelines to follow, should there be an allegation of abuse. An examination of the homes training records verified that staff receive training on safeguarding vulnerable people. We spoke to staff and they were able to tell us what action they would take if an allegation of abuse was made and this should ensure that people are safeguarded from harm. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well maintained providing an attractive, homely and clean place to live. Evidence: The home is very well maintained and has been extended and upgraded to a very high standard. The building is clean, light and spacious with good sized bedrooms, most with ensuite facilities. People moving to the home are encouraged to bring furniture and personal belongings with them (provided they will fit in their room). Several bedrooms, including those belonging to the people involved in case tracking, were viewed. Rooms were comfortable, well decorated and had furniture and co-ordinating soft furnishings. Rooms viewed were personalised with peoples own belongings. One person commented; I am very happy here, I am most comfortable. Outside there are well maintained lawned grounds, flower beds and mature trees. Several people said they get a lot of pleasure from the gardens. Some helped with gardening, planting tubs and pots with seasonal flowers. The home was clean and fresh and free from any unpleasant odours. The laundry room, although small, has sufficient commercial equipment to provide an effective laundry service to people. It was clean and tidy on the day of the inspection visit. Care Homes for Older People Page 19 of 27 Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are sufficient competent staff on duty to meet the needs of people living in the home. People are protected by robust recruitment procedures. Evidence: There are four or five care assistants on duty throughout the day and three care assistants throughout the night. In addition to care staff the home also employs kitchen, housekeeping and maintenance staff to ensure that all aspects of peoples needs are met whilst living at the home. The responses to our surveys gave a very positive view of staffing arrangements, with people saying they always get the care they need. Comments included: Staff are always very caring and helpful, and I never have to wait long for someone to come if I need help. Staff receive training in a range of mandatory health and safety and care related subjects including moving and handling, fire safety, infection control, first aid and palliative care. This means that staff are well equipped to provide care for the people using the service, and people are reassured to know that they are in safe hands. The manager has developed a staff training matrix, which sets out topics that staff will be trained in over the next 12 months. This helps the manager to co-ordinate and plan training, and also to see when, or if a member of staff is in need of training in a specific area of care or health and safety. Staff spoken to confirmed they attend Care Homes for Older People Page 21 of 27 Evidence: courses and the manager keeps copies of their certificates in a file. Staff induction training is provided at the start of their employment, and records show the content of the induction is in line with Skills for Care guidance. This helps to equip new staff in delivering care to people using the service. Examples were seen of induction courses being signed off as completed with the specific date against individual topics and it was clear who the trainer was. The manager told us that 13 staff have an National Vocational Qualification (NVQ) in Care with four people working towrds obtaining this qualification. This should ensure that a knowledgeable and skilled workforce can meet peoples needs individually and collectively. We looked at how well people are protected through the homes recruitment process. Two staff files were reviewed and these were found to contain all of the relevant information including two written references, POVA first checks (Protection Of Vulnerable Adults) and Criminal Records Bureau checks. Robust recruitment procedures and pre-employment checks should protect the vulnerable people living at Long Lea. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed by an experienced and competent person to ensure the service is run in the best interests of people living in the home. Evidence: The manager holds a management diploma and a nursing degree in addition to other qualifications and is well qualified to manage the home. Staff told us in surveys they are well supported by the manager. Comments received from staff in surveys and on the day of the visit include: I feel my manager is very supportive in every aspect of the homes day to day activities; My manager always asks me if things are ok, both manager and deputy are very approachable; and We run a home with very high standards of care. I enjoy working at Long Lea. Prior to the inspection the manager had completed an Annual Quality Assurance Assessment (AQAA) and returned it to us. This had been completed to a high standard and gave us information about the home, staff and people who live there, Care Homes for Older People Page 23 of 27 Evidence: improvements and plans for further improvements. There is a quality assurance and monitoring process which is based on ensuring the home is meeting the needs of the people living in the home. This involves an internal audit against identified standards. For example, medication management and food provision. Residents and staff meetings are held and these give people the opportunity to share their ideas about the home, while providing a social activity. Minutes of these meetings were reviewed. It appeared from the minutes that actions are taken to try and resolve any concerns raised in the interests of the people living at the home. While some feedback is being obtained the home should work towards formalising this information into a quality assurance system and produce an annual report on its findings, including an action plan to address any areas where improvements could be made. People are able to leave small amounts of money with the home for their day to day use. We looked at the systems in place for doing this and found them to be satisfactory. The home keeps good records of all transactions and is able to provide an audit trail for people so that they can see where their money has been spent, for example, to the hairdresser or chiropodist. Staff supervision records show that staff have regular formal supervision sessions to ensure that they are performing their job role. Staff training and development needs are identified to make sure they are able to meet the needs of the people living in the home. The health and safety of people living in this home is protected by good staff training, up to date safety checks and regular maintenance of the building and equipment. We sampled some of the safety certificates and found them to be in order. Fire procedures and fire checks were all up to date. During the tour of the home it was observed that all corridors were clear of obstructions and the building is kept in a safe condition. The manager has shown throughout our visit and within the completed AQAA that she is determined to make further improvements to the home so that people living there have good quality outcomes. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 Daily records should contain sufficient information to determine what sort of day the person had and who and what this involved. The system for reviewing and improving the quality of care provided should be further developed to demonstrate that the home is being run in the best interests of those living in the home. 2 33 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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