Inspection on 29/05/07 for Longfield

This inspection was carried out on 29th May 2007.

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 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

Longfield 24/06/09

Longfield 06/10/08

Longfield 19/05/06

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 29th May 2007 09:30 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.V336550.R02.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 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.V336550.R02.S.doc Version 5.2 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 Miss Dawn Irene Watson Care Home 24 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (24), Mental Disorder, excluding learning of places disability or dementia - over 65 years of age (24) Longfield DS0000005829.V336550.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Within the overall total of 24 a maximum of 24 service users requiring personal care who fall into the category MD(E) Within the overall total of 24 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. Within the overall total of 24 there can be a maximum of 1 service user who falls into the category of DE. 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 Longfield DS0000005829.V336550.R02.S.doc Version 5.2 Page 5 and a half miles from the town centre and easily accessible by public transport. The current fee charged at Longfield is £400 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.V336550.R02.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. A key unannounced inspection, which included a visit to the home, was conducted on the 29 May 2007. No additional visits have been made since the last inspection. Two residents completed a survey. Both of these residents stated they always received the care and support they needed. One GP also completed a survey. This stated resident’s healthcare needs were always met and privacy and dignity was respected. At the time of this inspection 20 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 regarding issues raised during the inspection. What the service does well: What has improved since the last inspection? Following the last inspection care planning has improved. Appropriate risk assessments for nutrition and the development of pressure sores are in place. Care plans address all identified personal and healthcare needs. A record of the food provided for individual residents was kept. Improvements to the premises include redecoration of the lounges, the hall Longfield DS0000005829.V336550.R02.S.doc Version 5.2 Page 7 and staircase and five bedrooms. New beds and some new bedroom furniture have also been purchased. 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. The summary of this inspection report can be made available in other formats on request. Longfield DS0000005829.V336550.R02.S.doc Version 5.2 Page 8 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.V336550.R02.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. A thorough admissions procedure ensured the needs of people using the service were identified and met. EVIDENCE: The care records of two residents were inspected. These records contained a detailed assessment completed before admission. The manager explained that the assessment had been completed over the telephone for one of these residents who had been living in another part of the country. She also explained the normal procedure was for two senior members of staff to visit and assess prospective residents in hospital or their own home prior to admission. One of these members would then be on duty to welcome the new resident on the day of admission. Prospective residents or their relatives received confirmation in writing that their needs could be met at the home. Standard 6 is not applicable to this service. Longfield DS0000005829.V336550.R02.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The personal and healthcare needs of each resident were identified and met. Medication was managed safely. EVIDENCE: The care plans of two residents were inspected. These identified the needs of each resident and explained how these needs were to be met. Appropriate risk assessments were in place along with guidance for staff about how to manage the risks. Care plans were reviewed monthly and up dated when the needs of the resident changed. Residents relatives were involved in care planning and signed their agreement of the care plan. There was also a space for relatives to comment. One relative had written, ‘Dad is well cared for’. Each resident had a day book in which care workers recorded information about their health and wellbeing during eah shift. Longfield DS0000005829.V336550.R02.S.doc Version 5.2 Page 11 Handover sheets were used to inform staff coming on duty about the condition of eah resident. Residents were registered with a GP and has access to other healthcare professionals. Medication was stored correctly inside a locked trolley which could be secured to the wall. The temperature inside this trolley was checked and recorded daily. Records for the management of medication were seen to be up to date. These included records of the receipt and disposal of unused medication. However, handwritten instructions on the medication administration record for one resident were not signed or witnessed. There was also evidence of safe practice in the recording of a change in medication for one resident. This involved the GP giving instructions separately to two care workers over the telephone. Both care workers had then signed the medication record. Personal care was carried out in the privacy of the resident’s own room or bathroom. Care plans provided guidance for care workers about how to maintain privacy and dignity. One care plan instructed staff to cover the resident with a towel in order to maintain privacy and dignity. Members of staff were observed attending to residents in a caring and professional manner. One members of staff explained in detail how they promoted privacy and dignity for all residents. Longfield DS0000005829.V336550.R02.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Resident’s decisions were respected and they were supported by care workers to have a fulfilling lifestyle. EVIDENCE: A variety of leisure activities were organised every day by members of staff. These included, cards, noughts and crosses, dominoes, skittles, darts, snakes and ladders, reading and discussing books about historic Blackburn and gardening. Members of staff also took residents individually to the local shops and the pub. A physiotherapist visited every fortnight for music and movement. Outside entertainers regularly visited the home and relatives and friends were invited to these events. Special occasions were also celebrated these included birthdays, St Patricks day, St. Davids day, Valentines day and a football day for the cup final. A ‘Eurovision Day’ was held to celebrate the song contest was held. This involved selecting food from a European menu e.g. Italian pizza, Hungarian goulash, Irish coffee etc. Longfield DS0000005829.V336550.R02.S.doc Version 5.2 Page 13 Resident’s interests, hobbies and spiritual needs were recorded in their individual care plans. A clergyman regularly visited several residents at the home. Visitors were welcomed into the home at anytime. One gentleman visiting his wife regularly stayed for lunch. Residents were encouraged to make decisions about lifestyle and daily routine. Their preferred time of getting up and going to bed was recorded in their individual care plans. The meal served at lunchtime on the day of the inspection looked appetising and wholesome. The mealtime was unhurried allowing residents time to chat and enjoy their meal. Care workers sat at the dining tables with residents who needed help with feeding. The menus were varied and alternatives to the set meal were readily available. All the residents asked said they had enjoyed their lunch. One resident said the meals were always good. Longfield DS0000005829.V336550.R02.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents felt able to express their concerns to staff at the home. Staff had a good understanding of protection issues. EVIDENCE: A copy of the complaints procedure was included in the service user guide and displayed on the family and friends notice board. No complaints have been made to the commission since the last inspection. Concerns were expressed to the manager by the relatives of one resident about the care given before they took the resident out. The manager took appropriate action and also apologised to the relatives. Policies and procedures relating to the safeguarding of vulnerable adults were in place. All members of staff had completed the Blackburn with Darwen protection of vulnerable adults training. A poster about safeguarding was displayed on the office door. Safeguarding was included induction training for all new employees. This issue was also discussed with three members of staff. They said they would report any concerns immediately. Longfield DS0000005829.V336550.R02.S.doc Version 5.2 Page 15 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. 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 premises were well maintained and provided a comfortable and ‘homely’ environment for the residents. EVIDENCE: Since the last inspection there has been extensive redecoration of the premises. This included both lounges, the hall and staircase and five bedrooms. New carpets have been fitted in the lounges and some new chairs purchased. New beds and some bedroom furniture have also been purchased. To promote the safety of residents another grab rail has been fitted on two staircases. This means there are grab rails on both sides of the stairs. At the time of the inspection the home was clean, tidy and free from offensive odour. Longfield DS0000005829.V336550.R02.S.doc Version 5.2 Page 16 The garden was well kept and provided a secure area for residents to sit outside when the weather permitted. 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. The door of this room had recently been up graded in order to meet current fire regulations. An infection control policy was available and several members of staff had completed training in infection control. An infection control policy was available. Longfield DS0000005829.V336550.R02.S.doc Version 5.2 Page 17 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. 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. Members of staff had the skills and knowledge necessary in order to meet the needs of the residents. Recruitment procedures were thorough. EVIDENCE: The duty rota confirmed that a sufficient number of staff were on duty for all shifts in order to meet the assessed needs of the residents. The files of four members of staff appointed since the last inspection were examined. These files indicated that all the required pre-employment checks to ensure protection of the residents had been completed prior to appointment. It was evident from discussion with members of staff and the manager that training was encouraged. This included induction training for new employees, moving and handling, first aid, basic food hygiene, health and safety, fire safety, dementia, infection control and medication. Six care workers had an NVQ level 2 in care and four had NVQ level 3 (75 of care workers). A further two care workers were working towards NVQ level 3. Longfield DS0000005829.V336550.R02.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,37 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 was effectively managed and provided person centred care for the residents. EVIDENCE: The registered manager is an experienced carer and has completed NVQ level 4 in health and care. She is currently studying for the NVQ registered manager’s award. Members of said the manager was helpful and supportive. The management at Longfield have achieved the Blackburn with Darwen Social Services Quality Assurance Award. This award is reviewed annually. A resident’s survey was carried out at the end of December last year. The survey form was in a large print illustrated easy read format. The residents Longfield DS0000005829.V336550.R02.S.doc Version 5.2 Page 19 were asked to circle a smiley or a sad face in response to the questions. From these surveys the manager had identified the laundry system needed to be improved. A relatives survey had been carried out and these also identifed problems with the laundry. The manager addressed this problem by employing another member of staff for domestic duties. Three visiting professionals had completed surveys, all these provided positive feedback for the manager. Families and residents meetings took place every three months minutes from the last two meetings were seen. At these meetings menus were discussed and changed as a result. Records of transactions involving resident’s money were seen to be well maintained and up to date. Policies and procedures relating to safe working practices were available. Fire alarms and emergency lighting were tested monthly. Fire drills were held approximately every 6 months. Residents were involved in these. An up to date fire risk assessment was in place. Records of the routine servicing of equipment were seen. These included an up to date electrical installation certificate. The gas safety certificate was dated 20/05/06 and arrangements were made to renew this at the time of the inspection for later in the week. Records of the testing of small electrical appliances were not available. However a letter was received by the commission confirming that this had been completed on 30 May 2007. Records maintained in the kitchen included fridge, freezer and food temperatures. A cleaning schedule was also available. Records of the food taken by individual residents were kept. During the inspection poor practice was observed when two care workers transferred a resident from an armchair to a wheelchair using the inappropriate under arm lift. Although the manager later said this resident was able to stand it was obvious that at the time the moving and handling procedure was observed this resident was unable to weight bear and appropriate equipment should have been used to effect a safe transfer. The manager also explained that both care workers had received training in moving and handling and were due to attend a refresher course the following week. Longfield DS0000005829.V336550.R02.S.doc Version 5.2 Page 20 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 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 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 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X 3 2 Longfield DS0000005829.V336550.R02.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP38 Regulation 13(5) Requirement To prevent residents from being injured members of staff must always use approved safe moving and handling procedures. Appropriate equipment must be obtained if necessary. Timescale for action 29/06/07 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 OP9 Good Practice Recommendations Hand written instructions on the medicines administration records should be signed and witnessed. Longfield DS0000005829.V336550.R02.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway 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 Longfield DS0000005829.V336550.R02.S.doc Version 5.2 Page 23 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!