Inspection on 31/05/05 for Longfield

This inspection was carried out on 31st May 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 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 14/04/08

Longfield 15/12/06

Longfield 26/10/05

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 Farmbridge Close Fambridge Road Maldon CM9 6DJ Lead Inspector Brian Bailey Final Report Uannnounced 31st May 2005 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 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 I56 105 S63090 Longfield V230676 UI 31.05.05 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Longfield Address Fambridge Close, Fambridge Road, Maldon, Essex CM9 6DJ 01621 857147 01621 852254 Telephone number Fax number Email 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 plc, Ertosun House, 61 Widmore Road, Bromley, Kent, BR1 3AA. Mrs Anne Chitty Care Home (CRH) 40 Category(ies) of OP. Old age, over 65 years of age, Number 40 registration, with number DE(E) Dementia - over 65 years of age. Number of places 18 Longfield I56 105 S63090 Longfield V230676 UI 31.05.05 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 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 The registered person will maintain staffing levels at those declared at the point of registration. Any subsequent review will be undertaken in consultation with the Commission and with reference to the needs of the service users. Date of last inspection 5th February 2005 Brief Description of the Service: Longfield is a large purpose built single storey care home situated in a quiet residential area at Maldon. 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. Accommodation is arranged within five self contained group living units, each with its own group of bedrooms, lounge/dining area, bathrooms/WC’s and kitchenette. There are thirty-three single bedrooms and three shared rooms. Access to all areas of the home is good. Excelcare Holdings plc owns the home and the manager is Anne Chitty. Longfield I56 105 S63090 Longfield V230676 UI 31.05.05 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on Tuesday 31st May 2005 between 9.45am and 3.30pm. This was the first inspection of Longfield in the inspection year 2005/06 and since Excelcare took over the running of the home in March 2005. During the inspection, the manager, staff, four residents and one visitor gave their views about the home. The majority of residents were seen during the inspection. A tour the building included a check of some bedrooms, bathrooms and the lounge/dining rooms and kitchen. Records checked included the home’s statement of purpose and residents’ guide, staff recruitment procedures, staff supervision records, staff rosters, residents’ care records, health and safety matters and the menus. The inspection process included observation of the midday meal and of staff carrying out their duties. Of the twenty standards assessed, fourteen were met and six were partly or not met. The recent changeover between owners has been a difficult period of transition for the manager and staff. The manager is in the process of implementing new procedures and policies whilst trying to ensure they do not have an impact on residents. What the service does well: What has improved since the last inspection? There has been little change to the already good standards of personal care and the home’s ability to meet the health care needs of residents, although from discussions with staff, it was evident that staff morale is low. Whilst for the majority of residents, life at the home remains unchanged following the change of owner, some residents were anxious about the availability of staff and how busy they were. Longfield I56 105 S63090 Longfield V230676 UI 31.05.05 Stage 4.doc Version 1.30 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 I56 105 S63090 Longfield V230676 UI 31.05.05 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Longfield I56 105 S63090 Longfield V230676 UI 31.05.05 Stage 4.doc Version 1.30 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 standard(s) 1, 2 & 3. The admission procedure is managed well and the new pre-admission procedure will enable the manager to clarify whether they can meet the needs of prospective residents. Residents benefit from an agreement that enables them to be certain about the conditions of their stay at the home. EVIDENCE: The new owners have produced a statement of purpose and a service users guide. The statement of purpose requires further development to include details of room sizes and information on how the home will meet the needs of residents with dementia. The new owner has produced their own statement of terms and conditions for use between the home and residents. The statement includes the requirements of the National Minimum Standards and details items considered to be extra to the fees. The manager was intending to introduce these in the near future to replace previous agreements. Assessments were seen on residents’ files. A new pre-admission procedure and form, which is clear and comprehensive has been introduced from April Longfield I56 105 S63090 Longfield V230676 UI 31.05.05 Stage 4.doc Version 1.30 Page 9 2005. The file of a recently admitted resident showed that the form was being used. Longfield I56 105 S63090 Longfield V230676 UI 31.05.05 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7 & 8. Residents are looked after well in respect of their personal and health care needs but are at risk when staff are absent from the units and they are left unsupervised. EVIDENCE: Care records were detailed and covered all aspects of residents’ health, personal and social care needs. Records showed that reviews of plans were generally carried out on a monthly basis. The new owner had produced new procedures records, which the home had adopted. These were easy to read and to follow. Risk assessments were available that showed the home had identified those residents with mobility difficulties and at risk from falls. 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. Files showed that residents had access to opticians, chiropodists, doctors and nurses whenever their services were required. A visiting district nurse confirmed that the standard of care provided was good, that the home communicated well any Longfield I56 105 S63090 Longfield V230676 UI 31.05.05 Stage 4.doc Version 1.30 Page 11 concerns they may have about a resident. Residents said that staff were always busy but they were helpful and patient. Observation of showed that they were attentive towards residents, sensitive to their needs and assisted residents in a gentle and courteous manner. Staff were observed to be able to attend to residents personal care needs for when they were available but had little time to spend on meeting residents’ social and emotional needs. Longfield I56 105 S63090 Longfield V230676 UI 31.05.05 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 & 15. Residents are offered a balanced varied and enjoyable diet. Residents are unable to participate in interesting and enjoyable activities. EVIDENCE: Residents’ care records showed the type and frequency of activities. These showed that in the majority of cases, activities were limited and generally referred to residents watching television and being seen by the hairdresser. The preferences of residents as described in the care records were in general not being provided. There were no activities provided throughout the time spent with residents in the units. One resident said “There is nothing to do, I would like more things to do but the staff are too busy” Four residents described the meals provided as good and confirmed that they always had a choice. The menu showed that a choice was offered and records detailed the selections made by residents at breakfast, dinner and tea. The midday meal observed was appetising in appearance and nicely presented. Cold drinks were provided on the dining tables, which were well laid out. Good food stocks were available. The kitchen was clean, well equipped and organised. The cook was aware of residents’ likes and dislikes and was provided with information about any special dietary requirements. Fresh fruit and vegetables were available. Mealtimes were observed as relaxed and residents were able to take as long as they wanted over their meals. Longfield I56 105 S63090 Longfield V230676 UI 31.05.05 Stage 4.doc Version 1.30 Page 13 No complaints were made about the food although two residents spoke of the evening meal being too early at 4.30pm. Longfield I56 105 S63090 Longfield V230676 UI 31.05.05 Stage 4.doc Version 1.30 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 & 19. 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. The home or the Commission had received no complaints since the last inspection. There was a comprehensive process for recording any complaints or compliments received. A protection of vulnerable adults policy and a whistle blowing policy document were available. Staff training on the protection of vulnerable adults continues to be provided. Residents spoken with said they would not hesitate to speak to the staff if they had a complaint. One resident said that they felt safe and secure at the home. Longfield I56 105 S63090 Longfield V230676 UI 31.05.05 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 21, 23, 25 & 26. A clean and safe standard of accommodation is provided for residents, however, the programme to replace bedroom furniture is incomplete and poor ventilation in some bedrooms at night does not provide a comfortable environment for some residents. 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. There remained some beds and bedside lockers that were rather shabby in appearance. Residents had been enabled to personalise their bedrooms. 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 I56 105 S63090 Longfield V230676 UI 31.05.05 Stage 4.doc Version 1.30 Page 16 A tour of the building concluded that the bedrooms, lounges, dining rooms and kitchen were clean and pleasant smelling. The home has two small internal courtyards. The home has enough bathrooms and toilets for residents. None of the bedrooms have en-suite toilets. The home has taken precautions to ensure the temperature of hot water is controlled to minimize accidents from scalding. One resident said they were not happy about the lack of ventilation in the bedroom at night. The residents also said that staff did not always open the window vents in the corridors during periods of warm weather. Longfield I56 105 S63090 Longfield V230676 UI 31.05.05 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 & 29. The procedures for the recruitment of staff are robust and protect residents. The number of care staff on duty is not sufficient to meet the needs of residents and have the potential to place residents at risk. EVIDENCE: Staff rosters showed that six staff were on duty during the morning and afternoon/evening shifts, which is one staff member less than the number available at previous inspections. One staff member was deployed in each of the units with one extra member in the unit caring for residents with dementia. Five staff said that they were unhappy about the reduction and two residents said they were always short of staff. During the visit, staff were observed to assist their colleagues on other units, which resulted on one occasion, when a unit was left unsupervised by staff for twenty minutes. Three staff files looked at during the inspection showed that the manager was following procedures and carrying out all the necessary recruitment checks for new staff. The files were well maintained and kept secure. Criminal Records Bureau disclosure checks were examined. A consistent theme throughout the inspection was the low level of staff morale brought about by the changes introduced by the new owners. Staff spoke about the changes to staff rosters, of plans to introduce further changes to the current deployment of staff, their worries about the future and particularly the reduction in the number of staff on duty each day. Residents spoken with also Longfield I56 105 S63090 Longfield V230676 UI 31.05.05 Stage 4.doc Version 1.30 Page 18 commented on the apparent lack of staff and of being left alone for periods throughout the day. Longfield I56 105 S63090 Longfield V230676 UI 31.05.05 Stage 4.doc Version 1.30 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 36 & 38. The home is managed effectively and residents enjoy the benefits of a safe and secure setting. EVIDENCE: The manager was registered by CSCI in 2004 and has completed her training to obtain a National Vocational Qualification level 4 in management and care. A visitor and staff provided positive feedback about the manager. Staff said they felt well supported by senior staff and they received supervision on a regular basis, which was recorded on their files. A new Quality Assurance system is to be introduced to replace the system previously used by the home. The most recent survey was carried in early 2005, when there was a good response about the services provided and there were no recommendations made. Longfield I56 105 S63090 Longfield V230676 UI 31.05.05 Stage 4.doc Version 1.30 Page 20 The annual service of the fire safety equipment expired but other heath and safety matters were well managed. The last recorded fire drill was held on 24/5/05. Records showed that staff had received training on moving and handling, food hygiene and first aid. Valves are fitted to ensure safe water temperature and surface temperatures of radiators. The current liability Insurance certificate expires on 24/5/06. Longfield I56 105 S63090 Longfield V230676 UI 31.05.05 Stage 4.doc Version 1.30 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 3 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 x 3 x 2 x 2 3 STAFFING Standard No Score 27 1 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x 3 x x 3 x 2 Longfield I56 105 S63090 Longfield V230676 UI 31.05.05 Stage 4.doc Version 1.30 Page 22 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. 1. Standard 1 Regulation 4 Requirement The statement of purpose must be amended to include room sizes and provide information about how the home intends to care for people with dementia. A range of leisure and social activities must be provided. Residents bedrooms and lounge areas must be adequately ventilated. The staffing levels must be sufficient to meet the needs of residents at all times. The fire detection system, must be serviced at appropriate intervals. Timescale for action 1/09/05 2. 3. 4. 5. 12 25 27 38 16 23 18 23 1/9/05 1/9/05 1/7/05 1/7/05 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 23 Good Practice Recommendations The phased programme to replace bedroom furniture should be completed. Longfield I56 105 S63090 Longfield V230676 UI 31.05.05 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Fairfax House Causton Road Colchester 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. Extracts may not be used or reproduced without the express permission of CSCI Longfield I56 105 S63090 Longfield V230676 UI 31.05.05 Stage 4.doc Version 1.30 Page 24 - 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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