Inspection on 19/05/06 for Longfield

This inspection was carried out on 19th May 2006.

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

Longfield 24/06/09

Longfield 06/10/08

Longfield 29/05/07

Longfield 06/12/05

Longfield 13/07/05

Longfield 16/03/05

Longfield 01/07/04

Longfield 24/02/04

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

CARE HOMES FOR OLDER PEOPLE Longfield Preston New Road Billinge End Blackburn Lancs BB2 6PS Lead Inspector Mrs Susan Hargreaves Unannounced Inspection 10:30 19 & 23rd May 2006 th X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Longfield DS0000005829.V289113.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Longfield DS0000005829.V289113.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Longfield Address Preston New Road Billinge End Blackburn Lancs BB2 6PS 01254 675532 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) Longfield (Care Homes) Limited Care Home 24 Category(ies) of Dementia - over 65 years of age (24), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (24) Longfield DS0000005829.V289113.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. A maximum of 24 service users requiring personal care who fall into the category MD(E) A maximum of 24 service users requiring personal care who fall into the category DE(E) That, taking into account the fact that the Home is presently accommodating 21 service users, Longfield Care Homes Ltd should provide at the Home at all times, staffing levels in accordance with the levels stipulated in Residential Care Homes Information Booklet 7 - Residential Care Homes for People who are Elderly and who also have a Mental Disorder, dated April 1997 - in respect of care homes accommodating between 16 and 20 service users. That, when the number of service users accommodated at the Home falls below 21, the maximum number of service users to be accommodated at the Home shall be 20, providing the staffing levels set out in condition 3 are complied with. That, if Longfield Care Homes Ltd wish to accommodate at the Home in the future, more than 20 service users, the staffing levels required be discussed with the CSCI and that (in substitution for paragrapg 3 above) the staffing levels imposed by the CSCI following such discussion be complied with. The service must, at all times, employ a suitably qualified and experienced Manager who is registered with the CSCI 6th December 2005 4. 5. 6. Date of last inspection Brief Description of the Service: Longfield Care Home provides 24 hour long term personal care for up to 24 older people who have a mental disorder or dementia. The property is a detached, converted house in its own grounds. The enclosed garden area is accessible to all residents. Parking for staff and visitors is available to the side of the property. Accommodation is offered in single and twin-bedded rooms. Communal rooms are spacious. The home is situated on a main road leading into Blackburn, approximately one and a half miles from the town centre and easily accessible by public transport. The current fee charged at Longfield is £385 per week. Additional charges are payable for hairdressing and newspapers. A copy of the statement of purpose and service user guide is available to prospective service users and their relatives on request. Longfield DS0000005829.V289113.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over two days. No additional visits have been made since the last unannounced inspection. At the time of this inspection 19 residents were living at the home. A tour of the premises took place and staff files and care records were inspected. Members of staff on duty, residents and visitors were spoken to. Discussions also took place with the manager and proprietor regarding issues raised during the inspection. What the service does well: What has improved since the last inspection? The manager was in the process of revising and improving all the care plans. This will ensure members of staff have clear instructions about how the identified needs of each resident are met. Residents were weighed monthly. A falls risk assessment had been completed for each resident. Since the last inspection to improve the environment for the residents the back staircase and landings have been redecorated and new carpets fitted. A new carpet has also been fitted in one of the lounges. To help residents to remember which room is theirs photographs are displayed on the bedroom doors. To protect residents from abuse recruitment procedures were thorough. Two written references and a CRB/POVA check were obtained for all new members of staff before they started working at the home. Members of staff were supported in their work by the manager and had an annual appraisal and regular supervision. Longfield DS0000005829.V289113.R01.S.doc Version 5.1 Page 6 To prevent the spread of infection the cook checked and recorded fridge, freezer and food temperatures daily. 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. Longfield DS0000005829.V289113.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Longfield DS0000005829.V289113.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Admission procedures were thorough. A pre-admission assessment was completed for each resident prior to admission. EVIDENCE: Prospective residents were visited and assessed by the manager and deputy manager prior to admission. The individual records of three residents were inspected. These contained a detailed pre-admission assessment. This assessment provided important information for the care plan. Prospective residents received confirmation in writing that their needs could met at the home. Information about the admission procedure was included in the statement of purpose and service user guide. Intermediate care is not provided at Longfield. Longfield DS0000005829.V289113.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care was given in a manner, which promoted the privacy and dignity of all residents. Care plans did not contain detailed information relating to all aspects of care. This meant there was the potential for some care needs not to be fully met. Medication was managed efficiently promoting good health. EVIDENCE: The individual care plans of three residents were inspected. These plans identified the personal care needs of each resident and explained how these needs were met. A falls risk assessment had been carried out for each resident. However, where a risk of falls had been identified a care plan giving information about the action being taken to address this risk was not in place. Nutritional assessments did not clearly identify the level of risk. Risk assessments relating to pressure sores were not in place for any of these residents. The manager explained that she was in the process of revising and improving the care plans. The care plan for the recently admitted resident was of a different style to the other two. This care plan was clearly written and provided guidance for staff to follow to ensure the care needs of the resident Longfield DS0000005829.V289113.R01.S.doc Version 5.1 Page 10 were met. The resident’s relatives had been involved in the development of this care plan. Care plans were reviewed monthly and updated when the needs of the resident changed. Residents were registered with a GP and had access to other healthcare professionals. At the time of the inspection none of the residents were self-medicating. Appropriately trained members of staff administered all medication. Records relating to the management of medication were seen to be up to date. A photograph of the resident was kept with the medicines administration record along with a list of the resident’s medication and common side effects. Medication was stored correctly in a locked trolley and cupboard. The temperature of these areas were checked and recorded daily. Personal care was carried out in private. Screens were provided in shared bedrooms. Members of staff were observed attending to residents in a caring and professional manner. Two members of staff explained in detail how they promoted privacy and dignity for all residents. Longfield DS0000005829.V289113.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The daily routine was flexible in order to meet the needs and preferences of residents. A variety of social activities were organised. Visitors were welcomed into the home at anytime. The meals were wholesome and menus were varied. EVIDENCE: A variety of leisure activities were organised by members of staff. These were advertised in the home and included, gardening, beauty days, photography and reminiscence, relaxation, dominoes, cards, noughts and crosses, skittles and craft activities. A physiotherapist visited every fortnight for music and movement. Outside entertainers regularly visited the home and relatives and friends were invited to these events. Resident’s interests, hobbies and spiritual needs were recorded in their individual care plans. Visitors were welcomed into the home at anytime. A clergyman regularly visited several residents at the home. The manager explained that the daily routine was flexible. Residents did not get up early unless they chose to do so. Residents had personalised their rooms with ornaments, photographs etc. Longfield DS0000005829.V289113.R01.S.doc Version 5.1 Page 12 The meal served at lunchtime on the first day of the inspection looked appetising and wholesome. The mealtime was unhurried allowing residents time to chat and enjoy their meal. Members of staff were observed assisting residents in a sensitive manner. The menus were varied and alternatives to the set meal were readily available. All the residents asked said they had enjoyed their lunch. Longfield DS0000005829.V289113.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints would be taken seriously and investigated. Members of staff had a clear understanding of adult protection issues. EVIDENCE: A copy of the complaints procedure was displayed in the home and included in the statement of purpose. A record of concerns and the action taken was seen. No formal complaints have been made to the home since the last inspection. One concern has been raised with CSCI. Policies and procedures relating to the protection of vulnerable adults were in place. This issue was discussed with two members of staff. They were aware of the procedure and said they would report any concerns immediately. Longfield DS0000005829.V289113.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was clean, comfortable and well maintained. Laundry facilities were appropriate for the size of the home. EVIDENCE: At the time of the inspection the home was clean, free from offensive odour and well maintained. This provided a safe and comfortable environment for the residents. To further improve the environment for the residents a planned programme for the redecoration and refurbishment was in place. This included new floor covering and redecoration of the dining room and ground floor corridor. The garden was well kept and provided a secure area for residents to sit outside when the weather permitted. Although the laundry room was very small the equipment was appropriate for the size of the home. An infection control policy was available and several members of staff had completed training in infection control. Longfield DS0000005829.V289113.R01.S.doc Version 5.1 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels were appropriate to meet the assessed needs of the residents. Recruitment procedures were robust. Training for all members of staff was actively encouraged. EVIDENCE: Examination of the duty rota confirmed that a sufficient number of staff were on duty for all shifts to meet the assessed needs of the residents. The files of four recently appointed members of staff were inspected. These files indicated that all the required pre-employment checks to ensure protection of the residents had been completed prior to appointment. The manager explained that recruitment was ongoing to ensure that a sufficient number of staff was employed to provide cover for holidays and sick leave. It was evident from discussion with members of staff and the manager that training was actively encouraged. This included induction training for new employees, moving and handling, first aid, basic food hygiene, infection control, fire safety, dementia awareness and medication. An organisational training plan was in place. Five members of staff had an NVQ level 2 in care and three had NVQ level 3 (47 of care staff). A further three members of staff were working towards NVQ level 2 and two towards NVQ level 3. Longfield DS0000005829.V289113.R01.S.doc Version 5.1 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, 37 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has an experienced and competent manager. The views of residents and their relatives were sought and acted upon. Appropriate procedures and training were in place to safeguard the health, safety and welfare of residents. EVIDENCE: The registered manager was an experienced carer and had almost completed NVQ level 4 in care. She had also completed training in dementia awareness, fire safety, first aid, moving and handling and basic food hygiene. The proprietor through regular meetings to discuss issues relating to the home supported the registered manager. A residents and relatives meeting was held on 24 April 2006. At this meeting residents and relatives were encouraged to discuss any aspect of the care and service provided. One relative who had attended the meeting said their views had been listened to and action taken. As a result the relatives and friends Longfield DS0000005829.V289113.R01.S.doc Version 5.1 Page 17 notice board had been moved to the entrance hall so all visitors could easily read it and the range of activities had increased. The manager explained that these meetings were to be held every four months. Satisfaction questionnaires were distributed to residents and relatives every six months. These were evaluated and the results displayed on a bar chart. An annual plan for developing and improving the service was in place. The home had achieved the Blackburn with Darwen Social Services Quality Assurance Award. This award was reviewed annually. Policies and procedures were reviewed annually by the proprietor and up dated when necessary. Transactions involving resident’s money were seen to be well maintained and up to date. All members of staff had an annual appraisal and regular supervision. Records of these were seen. Policies and procedures relating to safe working practices were available. General risk assessments for the home were in place along with clear instructions about how to deal with these risks. A member of staff qualified to administer first aid was on duty for all shifts. Fire alarms and emergency lighting were tested weekly. Fire drills took place monthly. A fire risk assessment was in place. Records of the routine servicing of equipment were seen, including up to date gas safety and electrical installation certificates. Records maintained by the cook included fridge, freezer and food temperatures. However, A record of the food provided for individual residents was not kept. Longfield DS0000005829.V289113.R01.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 2 3 Longfield DS0000005829.V289113.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 13(4)(b) (c) Requirement The registered person shall ensure that (b) any activities in which service users participate are so far as reasonably practicable free from avoidable risks; and (c) unnecessary risks to the health or safety of service users are identified and so far as possible eliminated. When a risk assessment states that a resident is at risk of falls a care plan must be in place to address this risk. The registered person shall ensure that the care home is conducted so as - (a) to promote and make proper provision for the health and welfare of service users; (b) to make proper provision for the care and, where appropriate, treatment, education and supervision of service users. Risk assessments relating to pressure sores must be completed for each resident. Nutritional risk assessments must clearly identify the level of risk. Records of the food provided for service users in sufficient detail to enable any person inspecting the record to determine whether DS0000005829.V289113.R01.S.doc Timescale for action 30/06/06 2. OP8 12(1)(a) (b) 30/06/06 3. OP37 17(2) Schedule 4 23/05/06 Longfield Version 5.1 Page 20 the diet is satisfactory, in relation to nutrition and otherwise, and any special diets prepared for individual service users. Accurate records of the food provided must be kept for all residents. (Timescale of 18/11/05 and 06/12/05 not met) RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Longfield DS0000005829.V289113.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Longfield DS0000005829.V289113.R01.S.doc Version 5.1 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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