Inspection on 26/10/05 for Longfield

This inspection was carried out on 26th October 2005.

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

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

Other inspections for this house

Longfield 14/04/08

Longfield 15/12/06

Longfield 31/05/05

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Longfield Fambridge Close Fambridge Road Maldon Essex CM9 6DJ Lead Inspector Brian Bailey Draft Report Unannounced Inspection 26th October 2005 10:15 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 DS0000063090.V261256.R01.S.doc Version 5.0 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 DS0000063090.V261256.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Longfield Address Fambridge Close Fambridge Road Maldon Essex CM9 6DJ 0208 8550055 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) Excelcare Holdings Mrs Anne Chitty Care Home 40 Category(ies) of Dementia - over 65 years of age (18), Old age, registration, with number not falling within any other category (40) of places Longfield DS0000063090.V261256.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 40 persons) Persons of either sex, aged 65 years and over, who require care by reason of dementia (not to exceed 18 persons) The total number of service users accommodated in the home must not exceed 40 persons 31st May 2005 Date of last inspection Brief Description of the Service: Longfield is a large purpose built single storey care home situated in a quiet residential area at Maldon. Excelcare Holdings plc owns the home and the manager is Anne Chitty. The home is close to local shops and within a half a mile of Maldon town centre. There are car-parking facilities at the front of the home. Residents’ accommodation is arranged within five self-contained group living units, each with its own group of bedrooms, lounge/dining area, bathrooms/WCs and kitchenette. There are thirty-three single bedrooms and three shared rooms. Access to all areas of the home is good. Longfield DS0000063090.V261256.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on 26th October at 10.15am. This was the second inspection of Longfield in the inspection year 2005/6. During the inspection, the manager, staff, three residents and two visitors gave their views about the home. The majority of residents were seen during the inspection. A tour of the building included a check of some bedrooms, bathrooms and the lounge/dining rooms. Records checked included staff rosters and training records, residents’ care records and finances, menus, medication, cleanliness, activities, health and safety matters and a check on the progress made to meet the requirements made at the last inspection. The inspection process also included observation of the midday meal and of staff carrying out their duties. What the service does well: What has improved since the last inspection? Four new beds had been purchased. The home now has a maintenance person on site that can deal with minor maintenance issues promptly. Excelcare has appointed a training coordinator who will be based at Longfield. Longfield DS0000063090.V261256.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Longfield DS0000063090.V261256.R01.S.doc Version 5.0 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 DS0000063090.V261256.R01.S.doc Version 5.0 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): 5. Residents and relatives benefit from being able to visit the home to determine whether the home will meet their needs and to ask questions about the services provided. EVIDENCE: Standards 1, 2 and 3 were assessed at the previous inspection. Prospective residents and their relatives are encouraged to visit the home to see the facilities and to meet the staff and residents. Evidence was available to show that people do take the opportunity to visit in order to assess whether the home will meet their needs. On the day of the inspection, a person was admitted who had already been to the home to see for themselves and staff had carried out an initial assessment. The manager had also received an assessment of the person’s needs from the placing authority. The home does not provide an intermediate care service. Longfield DS0000063090.V261256.R01.S.doc Version 5.0 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. Residents are looked after well in respect of their personal and health care needs. The home has an appropriate medication procedure that safeguards residents. EVIDENCE: A selection of three residents’ care records was inspected; these were detailed and covered all aspects of residents’ health, personal and social care needs. These records showed that reviews of plans were carried out on a monthly basis. The new procedures for recording residents’ information and needs were continuing to be introduced, which were easy to read, dated and signed. The daily records continue to vary in content, some were detailed and informative but others were too brief to convey any real information about the resident’s well being. Risk assessments were available that showed the home had identified those residents with mobility difficulties and at risk from falls. Longfield DS0000063090.V261256.R01.S.doc Version 5.0 Page 10 Records showed that residents’ health care needs were met. Arrangements were in place for residents to have any necessary health care equipment to relieve pressure, aid continence and ensure safe handling. An occupational therapist was attending the home to assess the needs of a resident. Records showed that residents had access to opticians, chiropodists, doctors and nurses whenever their services were required. Residents continued to point out that staff were always busy but they were helpful and generally patient, although this varied between staff members. Residents spoken to considered staff respected their right to privacy and that they treated them with dignity. They said that staff always knock on their bedroom doors. The home has appropriate policies and procedures for the administration and storage of medication. The Medicine Administration Sheet records seen were up to date. Medication not included in the monitored dosage system was dated on the day of opening. Longfield DS0000063090.V261256.R01.S.doc Version 5.0 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 and 14. The opportunities for residents to feel fulfilled, stimulated and to enjoy an interesting day is determined by their level of independence. EVIDENCE: The opportunities for residents to participate in activities continue to be minimal. Without an activities organiser, residents are reliant on care staff to sit and chat and to organise activities. It was evident that the stated interests of residents identified in their care plans were not being met. Residents spoken to do not want to complain and accept this because they considered staff were too busy looking after residents. One resident spoke of attending church services and of enjoying the opportunities to go out with relatives. Another resident clearly enjoyed the opportunity to play the piano each day. From observation and discussion with residents, it was evident that residents that were able to read a book, watch television or knit were generally satisfied and content, but the more dependent residents lacked stimulation. The manager stated that an advertisement had been placed for an activities coordinator to be appointed. In the interim, the manager must seek alternative ways of enabling residents to maintain and develop interests and activities within and outside the home. Longfield DS0000063090.V261256.R01.S.doc Version 5.0 Page 12 Relatives and friends are encouraged to maintain contact with their relatives in the home and it was evident that visitors come and go as they please. One relative spoken with was complimentary about the services provided, although another visitor was less certain but did feel able to raise concerns with the staff and that action would be taken to rectify the problem. Residents spoken to were of the opinion that they were offered choice throughout the day. Staff were observed to be considerate and to offer choices. Longfield DS0000063090.V261256.R01.S.doc Version 5.0 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. Residents enjoy the benefits of a safe and secure setting and with the knowledge that their concerns would be acted upon. EVIDENCE: The home has a detailed complaints procedure that is included in the statement of purpose, the service users guide and displayed in the entrance area. There was a comprehensive process for recording any complaints or compliments received. The Commission had received two anonymous complaints since the last inspection. The issues raised were investigated and apart from one issue regarding confidentiality, which was rectified, the remaining issues were not substantiated. Longfield DS0000063090.V261256.R01.S.doc Version 5.0 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, 24 and 26. A clean and safe standard of accommodation is provided for residents, although the programme to replace bedroom furniture is incomplete. EVIDENCE: This large purpose built home is divided into five group living units each with its own bathroom/toilet, sitting/dining areas and a kitchenette. A central communal lounge is also provided. In general, the home is well maintained and decorated and furnished to a standard that creates a comfortable and homely atmosphere. Since the last inspection, some beds had been replaced, although some bedside lockers were still in need of replacement. All areas of the building were accessible to residents, although for safety reasons, two units designated for residents with dementia have restricted access to the whole building. The external area of these units had been made secure to prevent residents from wandering out to the road. Longfield DS0000063090.V261256.R01.S.doc Version 5.0 Page 15 The home was well ventilated and risk assessments were in place to allow residents to open their windows, particularly at night, and to be aware of the possible risks. The areas of the building looked at were clean and free of unpleasant odours. Longfield DS0000063090.V261256.R01.S.doc Version 5.0 Page 16 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 and 30. An experienced team of staff care for residents but training targets set by the National Minimum Standards for the end of 2005 will not be met. Residents may be placed at risk when left unsupervised unless a more coordinated approach is taken when staff take breaks. EVIDENCE: Staff rosters were available that showed that there were six staff on duty plus a shift leader during the morning and afternoon/evening shifts. One staff member was deployed in each of the units with one extra member in the unit caring for residents with dementia. It was noted again that on one unit staff were absent on one occasion before lunch for a period of up to 15 minutes. This was apparently when staff were taking a break but these need to be more coordinated to ensure residents are left for shorter periods as they are at risk when left unsupervised. Records showed that of the thirty-two care staff employed, a total of twelve have obtained a National Vocational Qualification at level 2 and two staff are in the process of taking the qualification. This means that the home will not achieve the target of 50 of staff to have the qualification by the end of December 2005. The home will need to provide evidence of when this target will be achieved in 2006. Evidence was available to show that new staff are required to undertake an induction course that meets the required standard. Longfield DS0000063090.V261256.R01.S.doc Version 5.0 Page 17 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): 35 and 38. Residents benefit from a well managed financial security system. Unless all matters relating to health and safety are addressed consistently, residents and staff may be at risk of an accident. EVIDENCE: Residents’ finances held by the home for safekeeping were checked at random. These were accurate, up to date and well recorded. All expenditure related to those items considered being extra to the fees, such as, newspapers, chiropody, hairdressing and toiletries. Longfield DS0000063090.V261256.R01.S.doc Version 5.0 Page 18 Standard 38 relating to the health, safety and welfare of residents was assessed at the last inspection and the only issue arising from that inspection was that the fire detection system required servicing. This has since been carried out. It was noted that a collection of mobile hoists in the central lounge had been left and these presented a serious trip hazard to staff, visitors and residents. Longfield DS0000063090.V261256.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 x 3 X X X X 2 X 3 STAFFING Standard No Score 27 3 28 2 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X 2 Longfield DS0000063090.V261256.R01.S.doc Version 5.0 Page 20 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 15 Requirement The daily records completed by care staff must provide a comprehensive picture of a residents well being. A broader range of leisure and social activities must be provided. (Timescale of 1/9/05 not met) 3 OP28 18 The manager must provide a plan of how and when the minimum target of 50 of staff to have a National Vocational Qualification at level 2 will be achieved in 2006. The manager must ensure that mobile hoists are not left out to create a trip hazard. 01/12/05 Timescale for action 01/01/06 2. OP12 16 01/01/06 4 OP38 12 01/11/05 Longfield DS0000063090.V261256.R01.S.doc Version 5.0 Page 21 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 OP23 Good Practice Recommendations The phased programme to replace bedroom furniture should be completed. Longfield DS0000063090.V261256.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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