Inspection on 28/02/07 for Longcroft

This inspection was carried out on 28th February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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.

Other inspections for this house

Longcroft 03/03/06

Longcroft 27/09/05

Longcroft 22/03/05

Longcroft 05/08/04

Longcroft 12/02/04

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

CARE HOME ADULTS 18-65 Longcroft 58 Westbourne Road Lancaster Lancashire LA1 5EF Lead Inspector Mrs Joy Howson-Booth Unannounced Inspection 28th February 2007 10:30 Longcroft DS0000009993.V324180.R01.S.doc Version 5.2 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 Longcroft DS0000009993.V324180.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 Adults 18-65. 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. Longcroft DS0000009993.V324180.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Longcroft Address 58 Westbourne Road Lancaster Lancashire LA1 5EF 01524 64950 01524 844082 Longcroft@langleyhousetrust.org 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) Langley House Trust Mr Joseph Costello Care Home 14 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (14) of places Longcroft DS0000009993.V324180.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home shall accommodate a maximum of 14 Residents in the category MD (mental disorder). The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 3rd March 2006 Date of last inspection Brief Description of the Service: Longcroft is registered with the Commission for Social Care Inspection to provide care and accommodation for up to 14 younger adults with mental health needs. The home is one of a number operated by the Langley House Trust, which is a charitable organisation. The home is situated close to Lancaster City Centre and within close proximity of a number of facilities and amenities. It is a substantial detached property set within its own well maintained grounds. Care is provided on a 24 hour basis including waking watch support throughout the night. The home works closely with professionals from other agencies including local probation and mental health services in meeting residents’ needs. The current range of fees are from £564.85 for a shared room and £770.25 for a single room. Further details over fees can be obtained from the registered manager of the home. Longcroft DS0000009993.V324180.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the first site visit and was unannounced so the registered providers, registered manager, staff and residents were not aware of the visit. The site visit was carried out by two inspectors from the Commission. The site visit forms part of the overall inspection for the home which makes sure people are being cared for properly and to make sure the home is a safe place for people to live in. As well as the site visit, judgements have been made about the service based on information supplied by the registered manager. Comment cards were made available to service users and GP surgeries. Only one response was received from a GP surgery. The site visit took place over one day and included taking time to sit and speak with residents, observing staff on duty performing the day-to-day routines, speaking with staff, examining documents held in the home and speaking with the registered manager. The inspectors looked around parts of the home, including communal rooms, bathrooms and toilets. The tour also provided an opportunity to find out about any improvements made and to see if the home was a comfortable, clean and safe for people to live in. Additional information was also supplied from a pre-inspection questionnaire completed by the registered manager. The site visit was positive with everyone welcoming, friendly and co-operative during the visit. Longcroft has been assessed as an excellent home, although a number of recommendations have been made. What the service does well: The service continues to support residents to regain balance to their lives and this support is clearly given with respect and in a non-judgemental way. Care plans are comprehensive and detailed and residents are involved and contribute to these and their reviews. As detailed in the previous inspection report, the residents who live at Longcroft are deemed to be at risk of committing offences and as such, their support needs to be carefully planned. During this inspection it was again evidenced that records of all risks and measures required to reduce them are made and included in each resident’s care plan. Longcroft DS0000009993.V324180.R01.S.doc Version 5.2 Page 6 Communication and interagency working also takes place with the police and probation services. In viewing residents’ care plans, it was apparent that regular communication is carried out with the agencies and any concerns are immediately addressed. Residents take part in a range of appropriate activities which gives them opportunities for personal development, gaining skills and experience. Support is provided for this by staff on duty. Meals appear to be particularly appetising and very well enjoyed by the residents and again the home is being proactive in trying to make improvements to the benefit of the service users. Residents continue to feel that they are listened to and consulted about their care and feel the home is well managed. There is equal consideration given to all prospective employees. Training and development programmes are offered to all members of staff. The home has a very low turnover of staff with a number of staff having worked at the home for sometime. A number of the care staff are trained to National Vocational Qualifications (NVQ). In addition, other specialist training is provided to ensure staff are skilled to deal with situations as they arise. This means that residents are cared for by suitably qualified and experienced staff. At the time of the visit the inspector saw friendly and caring exchanges between the staff on duty and the people living at the home, with each resident being treated as an individual and given the time and attention needed. The staffing of the home is maintained at a satisfactory level with additional staff being brought in as activities and demands arise. The health and safety of the residents and staff is treated seriously, with action taken promptly should an area of safety, etc., be identified. Information supplied by the home confirms that there are a range of policies and procedures which ensure residents are provided with the care they need and respects their rights irrespective of their race, gender, disability, sexuality, age, religion or beliefs. A small number of policies need to be updated or put in place. During the site visit, a number of residents were seen and spoken with and all appeared to be well cared for and content. A number of residents were able to voice their opinions and interactions between residents and staff were lively and demonstrate good relationships between both parties. One resident commented that “we’re a very happy band, we all get on well here”. Another resident commented “I have no cause to complain about anything at Longcroft. The staff are always helpful and friendly”. A GP comment card confirmed they are satisfied with the level of care provided by the home. Longcroft DS0000009993.V324180.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: No specific requirements were made following this site visit. However, a number of recommendations have been made, as follows : Information should be provided to staff regarding specific healthcare needs of residents so that staff are aware of any problems and symptoms the resident may be experiencing and what to look out for. The medication systems should be reviewed so that medication is received, stored and administered safely to residents. In addition, staff should receive update training in administration of medication and be assessed to ensure they are competent to administer medication and are informed of current guidance. The ongoing maintenance and building work should be completed and an ongoing programme put in place to ensure the home is kept well maintained. Single places should be made available to those residents who require them. All residents should have access to a smoke free communal lounge. The commission should be informed of events/incidents that occur in the home. Accidents or maintenance issues that are recorded should show that action has been taken to address the issues. Any recommendations outstanding from the fire officer’s report should be addressed promptly. Longcroft DS0000009993.V324180.R01.S.doc Version 5.2 Page 8 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. Longcroft DS0000009993.V324180.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Longcroft DS0000009993.V324180.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. A very thorough assessment is carried out in respect of all prospective residents to ensure the home can meet their needs properly. EVIDENCE: In viewing records of pre-admission assessments, it was evident that the home continues to work closely with other professionals when assessing a prospective resident’s suitability. Professionals such as probation officers, social workers and mental health specialists had been involved with those assessments viewed. An induction checklist is completed which includes information about the home, a lot of information about personal restrictions – why these are in place and what will happen if they are not adhered to, also how they will be monitored and what other professionals will be involved with those including probation, police etc. explanations of warning/eviction procedures, info on how to make a complaint and info re information holding, personal files and the residents’ entitlement to see information. Longcroft DS0000009993.V324180.R01.S.doc Version 5.2 Page 11 The home obtains a great deal of information from as many sources as possible and creates very through risk assessments for all areas of daily life. In addition, the home has local protocols in place which have been agreed by local social services and PCT, which mean that details of any new referral is passed on to them for them to agree as well as the home. Assessment processes takes several months to complete and involve trial visits / overnight stays etc. One resident comment card received confirmed that information was provided – “I was visited by the manager of Longcroft. I was well informed about it (the home). I was also given an information pack about the Langley House Trust and a personal protocol”. One visiting health care professional said ‘’Joe (the registered manager) always knows a lot about the men before they get here.’’ From discussions with the registered manager, it was clear that residents are helped to move on from Longcroft in an organised and sensitive way, with practical and emotional support being provided as necessary. Longcroft DS0000009993.V324180.R01.S.doc Version 5.2 Page 12 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 and 9 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. There are clear and very comprehensive care documents in place which mean staff know and understand areas of risk and how to meet residents’ needs. Residents feel consulted and make decisions about their lifestyles and feel listened to. EVIDENCE: Three care plans were examined and again found to be written to a very good standard and clearly state all needs. They are regularly reviewed in conjunction with the resident themselves and a whole host of other professionals including police, probation, mental health professionals, social workers etc. Care plans demonstrate that the residents are involved at every stage and constantly asked to contribute through key worker sessions. Longcroft DS0000009993.V324180.R01.S.doc Version 5.2 Page 13 All staff contributed to care plans evidencing that they are all involved and aware of their contents. Rights are often limited at this home but have to be, due to the nature of the mens’ needs and the fact that some of them are living in the community on licence with strong conditions attached. Much work is done with the men to help them understand this and to work through their concerns about having restrictions on their daily movements. There are many examples of how residents are encouraged to make their own decisions about things, such as education, activities and areas of daily living. Concerning risk taking, the service is extremely strong in this area. There is considerable risk involved with some of these men which is extremely well managed in conjunction with other professionals and often through the MAPPA (Multi Agency Public Protection Arrangements). Quite often restrictions exist in a number of areas but time is taken to discuss these with the men and help them to overcome any concerns that they have. In addition, work is done to help the men be as independent as possible and work towards their restrictions being relaxed (under a careful risk management framework). Levels of interagency working are very good, for instance, when a resident is going to do an unusual activity such as spend a weekend away with staff, risk assessments are completed and signed by the local police liaison officers (if appropriate). Longcroft DS0000009993.V324180.R01.S.doc Version 5.2 Page 14 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 15, 16 and 17 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. There are excellent arrangements in place to ensure residents are provided with opportunities to have a balanced, quality of life which means the residents can feel valued and are able to develop their skills. There are good arrangements and planning to ensure residents are provided with nutritional and appealing food to maintain a health lifestyle. EVIDENCE: Much emphasis on education and fulfilling activities was found in care plans and evidence was seen during the inspection. Some men were doing woodwork, others having music lessons and one resident was doing a first aid course. Longcroft DS0000009993.V324180.R01.S.doc Version 5.2 Page 15 Tutors from the local college who provide adult literary classes were visiting the home at the time of the inspection. Discussions take place with residents on a regular basis about the type of education and activities they would like to participate in. One resident who said he would like a laptop to carry out computer work (there are desk tops available in the home) was helped to explore charitable funding for this type of equipment. Some of the residents are involved with catering at the home. Others are involved with the research and writing of the Langley House Trust newsletter which is issued periodically. The new music room was seen during the site visit. The new music room was featured in the recent Langley House Trust magazine. Residents were involved in the creation of the room, there are murals on the walls and members of the public have donated instruments. A local police officer who is the homes liaison officer has ran a marathon and raised over £1400 for the room. Some of the men are doing music lessons now. There are necessary restrictions on community participation due to the nature of the men’s needs. But these are carefully risk assessed and in conjunction with other professionals regularly reviewed for each resident. Residents are encouraged to work towards increasing the time they spend in the community but in a very structured and closely managed way. The residents spoken with at the time of the inspection all confirmed that they were very happy with the meals provided. Information supplied by the home indicates that there are differing menus for each day, residents are involved in discussions about menus during house meetings and residents are involved in preparing and clearing away meals. The cook on duty was also spoken with who confirmed that there is always fresh food and vegetables available and she is currently working on improving the meals to ensure good nutrition and interest is maintained. At the site visit, one resident and the cook had been involved in preparing a Chinese banquet, with guests being invited from the local college and probation service. The residents appeared to enjoy this different food and the dining room was presented in a welcoming way, with chopsticks, prawn crackers, spring rolls and Chinese horoscopes being available for residents and guests to enjoy and which gave a lively talking point. All the residents spoken with said they had enjoyed the Chinese banquet – one said that the current cook was “very good”. Longcroft DS0000009993.V324180.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 and 20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents receive well planned support which takes into account all their personal and healthcare needs. Medication systems need reviewing as currently residents and staff are not being fully safeguarded. EVIDENCE: From the care files examined it is clear that the home is proactive in maintaining residents’ health. There is evidence on files that residents regularly have access to a range of healthcare professionals and specialists (for example, consultant psychiatrist and consultant psychologist). One resident has been supported over a recent bereavement to access a bereavement counsellor. Another resident has been provided with support to lose weight. Longcroft DS0000009993.V324180.R01.S.doc Version 5.2 Page 17 At the time of the site visit, the psychologist was on site undertaking her weekly visits and commented that Longcroft is a very relaxed home with a really good atmosphere. The psychologist stated “Joe (registered manager) gets lots of information about the men before they come and does risk assessments”. As evidenced in care plans, there are a lot of professionals involved with the mens’ care and they all work well together. The psychologist confirmed that staff do take on board any advice she gives and incorporate it in care plans. A GP comment card was also received and confirmed that the home communicates clearly and works in partnership with them; they are able to see their patients in private; the staff demonstrate a clear understanding of the care needs of the residents and any specialist advice is incorporated into the care plan; and they are satisfied with the overall care provided by the home. The GP also confirmed that medication is appropriately managed by the home. Recommendations were given as follows : One resident has specific healthcare needs. Whilst this information is contained in his care plan, there is not guidance for staff regarding monitoring, warning signs, etc. Whilst there is monitoring provided by the GP, it was recommended that staff should be made aware of the problems he might experience and what to look out for. One resident who had experienced some periods of ill health, had received very regular medication reviews. The Medication Administration Record sheets (MARs) and a sample of stocks were examined and the following found : It was noted that correction fluid had been used on medication records (RES 2’s) Dispersible aspirin was found in blister packs and was not identifiable to staff. This needs to be addressed straight away. In addition, instructions for dispensing this medication need to be clearly stated as this medication should be dispersed in water prior to taking. The last inspection recommended that medication should be recorded when entering the home. Medication records still did not evidence this. Clarification was given to the registered manager over this who advised that this would be addressed promptly. The home is currently using two separate formats for recording medication administration, this could be confusing. Longcroft DS0000009993.V324180.R01.S.doc Version 5.2 Page 18 More information needs to be included on MARS. For example, info from patient information leaflets such as timings in relation to food etc. In particular information about PRN (as required) medications needs to be added. Staff need to know why they are giving out certain medications, know what the medication is for and the circumstances when PRN medications should be given. This would avoid the potential for staff to overmedicate for the wrong reasons. Due to the needs of the residents, there are no self-medication procedures in place. It is recommended that the Statement of Purpose and Resident Guide clearly indicate that the home does not allow residents to self-medicate Information supplied by the home indicates that all staff who dispense medication have received training. A recommendation was also made that update training and competency assessment should take place for these staff. There is a controlled drugs book and controlled drugs safe in place, although currently no stocks of controlled drugs are held by the home. Longcroft DS0000009993.V324180.R01.S.doc Version 5.2 Page 19 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. The arrangements for dealing with complaints are good. Residents can speak up and feel that they are listened to. Residents are protected by trained staff who are supervised by a competent manager EVIDENCE: It was confirmed that the home’s complaints procedure remains in place and details all the required information. There are residents meetings which are held on a regular basis. Minutes of residents meetings were read and there is clear involvement of those residents who wish to do so. Residents have access to their own key worker to discuss any concerns or issues or, if needed, the registered manager. Comment card received from one resident stated that he knows how to make a complaint and “there is a detailed complaints procedure in my ESB protocol”. The resident also confirmed that they know who to speak to if they are not Longcroft DS0000009993.V324180.R01.S.doc Version 5.2 Page 20 happy and continued “staff are usually available to speak to if you have a problem”. Information supplied by the home confirmed that there have been no complaints received in the last 12 months and the commission has not received any complaints about this service either. In terms of protection, the home has robust procedures in place for responding to allegations of abuse. Staff training provides information on abuse awareness and also information on the management of violence and aggression, self harm and boundaries for staff involvement. The home has a ‘no restraint’ and ‘non-contact’ policy in place but equips staff through training to de-escalate situations. Individual care plans have details of specific protocols for individual residents where intervention may be necessary. Importantly, both the registered manager and staff are very knowledgeable about the support needs of individual residents and are able to intercept and diffuse situations as required. The home also has close liaison with police, probation and other services who provide support and guidance as needed. The home’s relationship with the local police was discussed and the registered manager confirmed this is very good and has become stronger over the years. For example, the home had a resident abscond a few weeks ago. He was recalled in just a few hours. The home also enjoys a very good relationship with probation services and are working well with social services and PCT. Longcroft DS0000009993.V324180.R01.S.doc Version 5.2 Page 21 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24, 25 and 30 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Longcroft is generally a safe place for people to live in although some improvements are still required. Residents feel safe and their accommodation is comfortable. EVIDENCE: A tour of the home took place, although none of the residents’ individual rooms were seen. The following points were noted : The basement music room – there is a damp problem in here – but this is to be addressed within a few days. Longcroft DS0000009993.V324180.R01.S.doc Version 5.2 Page 22 A new music room has been developed from basement space which has provided a much improved space for men to use. Staff have been involved in painting murals on the wall and the overall effect is a relaxing and quiet room. There are a number of communal areas in the home. The main lounge is used to smoke in quite a lot and whilst there is another lounge, this is sometimes used by other people for meetings etc. It is recommended that the home ensure that residents have access to a smoke free lounge when they want it. There are CCTV cameras in a number of communal areas in the home. While this is not generally encouraged, it is accepted that these are necessary to meet the needs of the residents living there. The presence of cameras has been clearly stated on the Resident guide. There are a number of improvements still required in the home; in particular some bathrooms need updating. These are to be addressed in building works due to commence this week. In addition, all windows are to be replaced. The home still has a number of shared rooms – 14 places, 6 are shared and 8 are single, however, one of the shared rooms is currently being used as a single, giving a ratio of 2 shared and 9 single – Langley House Trust plan to address this issue in the future. The manager advised that much time has been spent discussing the planned building works with residents. They have been reassured that they will try to ensure that the building works disrupt them as little as possible and agreements have been reached that builders won’t start work before 9am and will not work at weekends. Overall the building provides a warm, comfortable and clean environment for the residents. The redecoration work has added to this and the planned work noted above will again enhance the environment. Comment card received from one resident stated that “the standard of cleaning is usually quite high”. No concerns were raised over the standard of cleanliness during the tour. Longcroft DS0000009993.V324180.R01.S.doc Version 5.2 Page 23 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 34 and 35 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. The level and calibre of staff is very good. Residents are cared for by a team of trained and dedicated staff. EVIDENCE: Information supplied by the home confirmed that staffing levels are dependent on the needs of the residents and are increased dependent on activities or outings. At times this involves other paid staff, although the home has the services of two volunteers. The home has used the same domiciliary agency for some domiciliary work which has provided consistency for the resident involved. The home has a low turnover of staff. Two staff have been appointed since the last inspection and their files were examined. These files contained all the required information (application form, 2 references, CRB and POVA, records of training and development and supervision). Copies of CRB and POVA records are held by the main Langley House Trust head office, although Longcroft DS0000009993.V324180.R01.S.doc Version 5.2 Page 24 confirmation of receipt of these are on each file. The files are well organised and sectioned off. There is a formal interview procedure, with questions and a record of the interview being kept by all interviewers involved. All files had copies of identification – passport, driving licence, birth certificates in place. The registered manager confirmed that volunteers have also undergone a CRB check through the main Langley House Trust head office. New staff are provided with an in-depth and formalised induction programme. As individual sections are completed these are signed off by both the member of staff and the registered manager. Each member of staff is also provided with a staff handbook and code of conduct by the home. All staff have a personal development plan and copies of these were supplied by the home. These detail existing training and qualifications, current training and future training and development needs. 50 of the staff are trained to National Vocational Qualification Level II. At the time of the site visit, some staff were involved in a first aid training course which also included one of the residents. Residents who completed a comment card or were spoken with all confirmed they were happy at the home. One resident wrote “I have no cause to complain about anything at Longcroft. The staff are always helpful and friendly”. Longcroft DS0000009993.V324180.R01.S.doc Version 5.2 Page 25 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39 and 42 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Residents live in a well managed home run by a competent and experienced manager who ensures their involvement and makes sure the environment is safely maintained. EVIDENCE: The current manager is registered with the Commission and has the necessary experience and training to undertake this role. From observations made and from speaking with residents at the home, the home continues to be very well managed with residents feeling supported and valued. The culture of the home is respectful and sensitive to the differing needs of the residents and the Longcroft DS0000009993.V324180.R01.S.doc Version 5.2 Page 26 support required by the staff team. This is due to the lead provided by the registered manager and other members of the management team who balance the security and protection of the residents with a strong desire to provide them with a quality of life and personal development. There are residents meetings which are held monthly and, from reading minutes of these meetings, resident’s contributions continue to be welcomed over changes and ideas for the future. The home has an open culture, which enables residents to express their views, and concerns in a safe and none blame environment. The registered manager had hoped to achieve the Investors in People award for the home but this has been delayed. It is hoped that the home can again work towards the award in the future. The home has an internal quality assurance framework in place which enables quality to be assessed in a formal way. A selection of maintenance records were examined, including the maintenance book for the home and the fire drill book. Advice was given that the maintenance book needs to be signed off when tasks are completed. Information supplied by the registered manager confirms that the home has an electrical certificate in place, along with a portable appliance certificate. Confirmation was given that the home has a fire risk assessment in place and recommendations made by the Fire Officer have been addressed. One outstanding recommendation is to be addressed with the planned building work. In addition, the home has a “fire grab bag” which contains a range of useful items (torch, keys, list of residents, contact numbers, etc.) and would be invaluable should an emergency evacuation of the premises be needed. Risk assessments are carried out, as required, on safe working practices although these are usually included within individual residents’ protocols. The home’s accident book was seen which was appropriately completed and complies with the Data Protection Act 1998. However, the registered manager was advised of Regulation 37 which requires the commission to be notified of events affecting residents and the home. Information supplied by the home confirmed there are a full range of policies and procedures which are reviewed. Longcroft DS0000009993.V324180.R01.S.doc Version 5.2 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 4 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 4 ENVIRONMENT Standard No Score 24 3 25 2 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 x 32 x 33 X 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 4 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 X 4 X 3 X X 3 X Longcroft DS0000009993.V324180.R01.S.doc Version 5.2 Page 28 no 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. Standard Regulation Requirement Timescale for action 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 YA19 Good Practice Recommendations Information should be provided to staff regarding specific healthcare needs of any resident so that staff are aware of any problems and symptoms the resident may be experiencing and what to look out for The medication system should be reviewed so that medication is received, stored and administered safely as indicated in this report. In addition, staff should receive update training and assessment to ensure they are competent to administer medication and are informed of current guidance Following the home’s refurbishment a rolling programme of routine maintenance should be developed to ensure all parts of the home are kept in a reasonable state of repair Single places should be made available to all residents who require them All residents should have access to a smoke free communal lounge The commission should be informed of incidents/events as DS0000009993.V324180.R01.S.doc Version 5.2 Page 29 2. YA20 3. 4. 5. 6. Longcroft YA24 YA25 YA30 YA42 outlined in Regulation 37 of the Care Standards Act 2000 7. 8. YA42 YA42 Accidents or maintenance faults recorded should evidence that they have been followed up and addressed Any recommendations outstanding from the fire officer’s report should be addressed to ensure the safety of the residents in the home Longcroft DS0000009993.V324180.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Longcroft DS0000009993.V324180.R01.S.doc Version 5.2 Page 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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