CARE HOMES FOR OLDER PEOPLE
Longfield Manor West Street Billingshurst West Sussex RH14 9LX Lead Inspector
Mrs S Gawley Unannounced Inspection 26th July 2006 09:00 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 Manor DS0000024173.V306807.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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 Manor DS0000024173.V306807.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Longfield Manor Address West Street Billingshurst West Sussex RH14 9LX 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) 01403 786832 01403 782427 Dr Shafik Hussien Sachedina Mr Shiraz Boghani Mrs Jessica B Dabalus-Pinson Care Home 54 Category(ies) of Dementia - over 65 years of age (14), Old age, registration, with number not falling within any other category (40) of places Longfield Manor DS0000024173.V306807.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. A maximum of 14 persons in the category DE/E (Dementia) to be accommodated. A maximum of 40 persons in the OP category in need of nursing care may be accommodated. 7th December 2005 Date of last inspection Brief Description of the Service: Longfield Manor is a care home with nursing providing personal care and accommodation for up to forty older people and accommodation for fourteen service users with dementia. Forty eight service users are accommodated at this time. Dr. S. H. Sachedina and Mr. S Boghani privately own it. The home was opened in 1998 and is a two-storey building with wellmaintained grounds. The home has forty six single bedrooms and four-shared bedrooms all offering ensuite facilities. There is a passenger lift and comfortable sitting and dining areas, domestic in character. There is an attached day centre, which the service users can access. The home is located in Billingshurst close to shops and other local amenities. Longfield Manor DS0000024173.V306807.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was carried out on 26 07 06. The registered manager facilitated the inspection. The home was inspected against the National Minimum Standards. Documents held on file at the Commission were perused prior to the inspection. The head office was visited to inspect organizational policies and procedures and to discuss their implementation in the individual homes with the heads of care. On inspection eight residents were case tracked; the building was inspected including the laundry and kitchen. Residents and staff were spoken to elicit their opinion on the home. The majority of the National Minimum Standards were met, many falling in the good judgement with the exception of standards on the identity of residents on care plans and medicine administration charts and Recruitment. The fees charged range between £682 and £750 per week. What the service does well: What has improved since the last inspection? What they could do better:
The errors in the identity of residents on care plans and Medicine Administration Chart are serious and are described in the body of this report and are the subject of requirements of this inspection report Longfield Manor DS0000024173.V306807.R01.S.doc Version 5.2 Page 6 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 Manor DS0000024173.V306807.R01.S.doc Version 5.2 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 Manor DS0000024173.V306807.R01.S.doc Version 5.2 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): 1, Prospective residents have the information they need to make an informed choice about where to live. 2, Each resident has a written contract/ statement of terms and conditions with the home. 3, No resident moves into the home without having had his/her needs assessed and been assured that these will be met. 4, Residents and their representatives know that the home they enter will meet their needs. 5, Prospective resident service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Standard six is not applicable. EVIDENCE: There is a Statemant of Purpose and Service User Guide in place . A newly admitted resident and his relatives confirmed that they were given all information prior to admission. There was evidence of pre assessment in the care plans inspected and the recently resident spoken to stated that he felt the home met his needs very well. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service.
Longfield Manor DS0000024173.V306807.R01.S.doc Version 5.2 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. The resident’s health, personal and social care needs are set out in an individual plan of care. 8. Residents health care needs are fully met. 9. Residents, where appropriate, are responsible for their own medication. Policies and procedures for dealing with medicines are in place but the homes practices do not protect residents. 10. Resident feel they are treated with respect and their right to privacy is upheld. EVIDENCE: Residents spoken to stated that they are treated with respect and that carers are kind. Five residents were case tracked and all aspects need and care provided were recorded. Care plans are in place based on a assessmen of need and risk. There is a progression of wound care file which documents good progress in wound management and good outcomes. Health professionals are consulted as required and this is recorded although one GP visit did not have the reason recorded. There was also confusion in the title of two care plans in that the name of one resident is on the care plan of another as well as her own. The seriousness of this issue was discussed with the manager.
Longfield Manor DS0000024173.V306807.R01.S.doc Version 5.2 Page 10 Policies and procedures on administering medicines are in place to ensure the safety of residents. Training in the safe handling of medicines is provided by Boots Pharmacy. The nurse who facilitated the inspecion of medicine stated that there are not any residents who self medicate at present. There was an error also in the identity of residents on the Medicine Administration Charts of the two residents mentioned above with both charts stating the residents are in the same room. Neither of the residents in fact resides at that room number. One of these residents is allergic to penicillin but this was not marked on the chart. The other is receiving controlled drugs. This poses a serious risk to health, safety and wellbeing of these residents and to the resident in the room in question. The care plans in place are of good plan and content but the scores in this section are brought down by the serious issue of incorrect resident identity and details present on documentation. Quality in this outcome area is poor. This judgement has been made from evidence gathered both during and before the visit to this service Longfield Manor DS0000024173.V306807.R01.S.doc Version 5.2 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. Resident find the lifestyle experienced in the home matches expectations and preferences, and satisfies their social, cultural, 13, religious and recreational interests and needs. 13. Residents maintain contact with family/ friends/ representatives and the local community as they wish. 14. Residents are helped to exercise choice and control over their lives. 15. Residents receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. EVIDENCE: The registered manager is committed to the activities in the home. She discussed the days out arranged for the residesnts such a pub lunches or trips to the coast. She expressed a desire to arrange more of these but the mini bus is shared within the organisition. Further outings are accessed via the local dial a ride. The schedule was available for inspection. There is an activities schedule in place, residents can access the attached activities day centre and activities can be carried out in the comunal areas. Seasonal events are also provided. Staff spoken to stated that they felt the social needs of the residents were well addressed. Visitors are welcome at the home. Residents spoken to stated that they are treated with respect and have choice over lifestyle and that they are happy with the activities on offer. There is varied menu in place and choice is offered to residents who when spoken to stated
Longfield Manor DS0000024173.V306807.R01.S.doc Version 5.2 Page 12 that they were very happy with the food on offer and the the chef tries to please them. The kitchen was inspected and the new chef and cook were spoken to who stated that systems within the kitchen work well. Kitchen recordes are up to date and there was evidence of a recent deep clean. There was, however some food in the fridge and freezer which was unlabled and undated and the sill of one freezer was soiled. These issues were discussed with the chef and the registered manager. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Longfield Manor DS0000024173.V306807.R01.S.doc Version 5.2 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. will 17. 18. Residents and their relatives and friends are confident that their complaints be listened to, taken seriously and acted upon. Resident’s legal rights are protected. Residents are mostly protected from abuse EVIDENCE: There is a complaints policy in place in the home but it needs to be updated with the details of cscii and complaints are recorded. A copy of this policy is given to all residents. Residents and staff spoken to confirmed this. The recorded complaints were discussed with the manager and they were appropriately managed with no outstanding issues. Abuse procedures inspected at head office are comprehensive but need some clarification on the reporting of avbuse , the head of elderly care is undertaking this. The issue of residents identy being incorrect on documentation poses a risk to the health,safety ans wellbeing of residents. Residents legal rights are protected and they are facilitated to vote. Those residents wishing to go to the poling station are transported there. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Longfield Manor DS0000024173.V306807.R01.S.doc Version 5.2 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, Residents live in a safe, well-maintained environment. 20, Residents have access to safe and comfortable indoor and outdoor communal facilities. 21, Residents have sufficient and suitable lavatories and washing facilities. 22, Residents have the specialist equipment they require to maximise their independence. 23, Service users’ own rooms suit their needs. 24, Residents live in safe, comfortable bedrooms with their own possessions around them. 25, Residents live in safe, comfortable surroundings. 26, The home is clean, pleasant and hygienic EVIDENCE: The chef and cook were spoken to and kitchen records were inspected which were up to date. The requirement of the environmental health report of Dec 05 has been met and there is evidence of a deep clean of the kitchen in Feb. of this year. There was still some slight soiling around one freezer seal and some unlabeled food in one freezer and fridge. The laundry was clean and organised
Longfield Manor DS0000024173.V306807.R01.S.doc Version 5.2 Page 15 and the laundry assistant discussed the systems in place to avoid clothing being misplaced. All parts of the home inspected were neat clean and free from offensive odour. Rooms were personalised with resident’s own belongings. The lounges, dining room and outdoors space is attractive and comfortable. Residents confirmed that they are satisfied with the comfort and furnishings in the home. There is a rolling plan of maintenance. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service Longfield Manor DS0000024173.V306807.R01.S.doc Version 5.2 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. The numbers and skill mix of staff meets resident’s needs. 28, Residents are mostly in safe hands at all times. 29. Residents are not supported and protected by the home’s recruitment policy and practices. 30. Staff is trained and competent to do their jobs. EVIDENCE: Residents are protected and have their needs met by the provision of suitable numbers and appropriately trained staff. Staff rota inspected showed this. There is a staff training programme in place. Staff records inspected showed that staff are commencing employment without Criminal Records Bureau clearance. This was discussed with the registered manager. Staff spoken to confirmed that they have supervision. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Longfield Manor DS0000024173.V306807.R01.S.doc Version 5.2 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): 31. Residents 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. 33. The home is run in the best interests of residents. 35. Residents’ financial interests are safeguarded. 36. Staff are appropriately supervised. 37. Residents rights and best interests are not always safeguarded by the homes record keeping policies and procedures 38. The health, safety and welfare of residents and staff are promoted and mostly protected. EVIDENCE: Policies and procedures were read at head offiice. Residents feel that the home is run in their best interestsand they are consulted in the running of the home. Residents stated that they are happy with the way the home is run and feel that they can approach management of the home if there is a problem. The manager is completing the Registered Managers Award. The system of
Longfield Manor DS0000024173.V306807.R01.S.doc Version 5.2 Page 18 handling resident’s money is appropriate. Staff stated that the management team is approachable and they feel supported. Supervision is in place. The health, safety and welfare of residents and staff is ensured through home maintenance and staff training, there is however a deficiency in documentation highlighted elsewhere in this report, which poses a risk to the residents. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Longfield Manor DS0000024173.V306807.R01.S.doc Version 5.2 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 3 3 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 2 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 2 2 Longfield Manor DS0000024173.V306807.R01.S.doc Version 5.2 Page 20 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 OP29 Regulation 19 Requirement Timescale for action 30/09/06 2. OP37 17 The registered person operates a thorough recruitment procedure based on equal opportunities and ensuring the protection of service users Records required by regulation 30/09/07 for the protection of service users and for the effective and efficient running of the business are maintained, up to date and accurate 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 Manor DS0000024173.V306807.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Southampton Hub Office 4th Floor, OverlineHouse Blechynden Terrace Southampton Hampshire SO 15 1GW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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