Inspection on 15/08/07 for Longford

This inspection was carried out on 15th August 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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Longford 15/09/06

Longford 20/10/05

Longford 29/06/05

Longford 22/09/04

Longford 26/05/04

Longford 04/02/04

Longford 21/06/02

Similar services:

33 St John`s Church Road

Dovedale Court

Lyncol House

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

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

CARE HOME ADULTS 18-65 Longford Longford 40 Massetts Road Horley Surrey RH6 7DS Lead Inspector Mavis Clahar Unannounced Inspection 15th August 2007 09:30 Longford DS0000013705.V348940.R01.S.doc Version 5.2 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 Longford DS0000013705.V348940.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 Adults 18-65. 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. Longford DS0000013705.V348940.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Longford Address Longford 40 Massetts Road Horley Surrey RH6 7DS 01293 430687 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) Ashcroft Care Services Ltd Hayley Ann Whiteley Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Longford DS0000013705.V348940.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The age/age range of the persons to be accommodated will be: 18-65 YEARS 15th September 2006 Date of last inspection Brief Description of the Service: Longford is owned by Ashcroft Care Services. The home is a large detached house in a residential area of Horley, Surrey. The home is close to the town centre where facilities and amenities are available. The accommodation comprises of ground and first floor facilities. All bedrooms single and three have en-suite facilities. In addition there is one communal bathroom, a shower plus two toilets. There is ample space including two lounges and a large dining room. There is a spacious kitchen with a separate utility area. There is a large garden to the rear of the house and adequate parking is available at the front. The weekly fees range from £1480- £1821. Longford DS0000013705.V348940.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced site visit, which forms part of the home’s key inspection to be undertaken by the Commission for Social Care Inspection, was undertaken by Mrs Mavis Clahar on the 15th August 2007 and lasted for six hours and ten minutes; commencing at 09:05 hours and concluding at 15:15 hours. The first part of the inspection was spent talking to service users who were in the hall getting ready to go out to their day’s activities. Special time was spent with one service user who was waiting for her transport to take her to her family’s home where she was spending the day and night, returning the next day. Further time was spent in discussion with other service users who were very informative and gave a good account of their lives in the home and in the community. This was followed by discussion with the manager about the changes to the inspection processes under inspecting for better lives CSCI has implemented. An outline of how this visit would be conducted was discussed and agreed. The manager is new in post at this home but is an experienced manager registered by CSCI for another home within the company. She is in the process of being registered by the Central Registration team South East Region. A tour of the home and gardens was conducted. Each service user bedroom is personalised by the service user to suit his/her likes and his/her taste. One of the service users is a budding horticulturist who is very interested in gardening. His bedroom contains many of his certificates and plaques of which he is very proud. Generally the home is clean and tidy. The cabinet housing the wash hand basin in the bathroom next to the office is in need of repair and the patio is also in need of weeding and requirements were made to have these issues dealt with. The home has a huge garden, which is laid mainly to lawn, with easy access by the service users. The second part of the visit was spent reviewing service users care notes and sampling carer workers records, which were all up to date. The information contained in this report is gathered mainly from discussions with a number of service users, reviewing service users notes and records kept by the home, review of records kept at the home including staff records and discussions with care workers present on the day of the visit, and observations of staff and service users interactions. The final part of the visit was spent giving feedback to the manager about the findings of the visit. CSCI would like to thank all the service users and care workers who spent time speaking to us on the day and for making this visit such a pleasant one. Longford DS0000013705.V348940.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? A new full time manager has been appointed and new staff has been employed. All the requirements from the last inspection visit have been met. Longford DS0000013705.V348940.R01.S.doc Version 5.2 Page 7 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. Longford DS0000013705.V348940.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Longford DS0000013705.V348940.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Admissions to the home are not made until a full needs assessment has been undertaken to ensure the home can meet the needs of the service user. The assessment is conducted professionally and sensitively and involves the service users and their family or representative where appropriate, and the psychologist, and the occupational therapist. Where the assessment is undertaken by social services, the home obtains a copy and a copy of the care plans also. EVIDENCE: Review of service users files demonstrated that the home has established a good process of assessing service users needs. This has been enhanced by the joint development of service users care plans with service users. The assessment contains the documented evidence of the psychiatrist, psychologist and occupational therapist. It was noted that no two service users assessment of needs were identical. The manager said the service users are more involved in their assessment and so are able to make decision with support about their care and leisure pursuits. Longford DS0000013705.V348940.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 679 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are involved in the review of their care, and agreed changes are documented in their care plans, thereby ensuring all care workers have access to this new information. The home encourages service users to make decisions about their daily lives, and to take risks as part of their independent lifestyles, with assistance from the key worker when necessary. EVIDENCE: Random review of service users files demonstrated that service users assessed needs are documented in the care plans and the evaluations demonstrated that changing needs are recorded. In discussion with two service users, I they were able to tell us that they are involved with their care plans and that they are able to agree or disagree any changes to the plan. Other service users were not able to vocalise their thoughts, but sign language, and their body Longford DS0000013705.V348940.R01.S.doc Version 5.2 Page 11 language told us they were also involved. It is obvious from the information contained in the care plan that the service users were involved in assessing their changing needs, and achieving their personal goal. Care workers spoken to say the assessment of needs is carried out over a period of time and that the service users and their families are very involved. We observed that the majority of the care plans are signed and the others have noted on the front they are awaiting signature of care manager. It was apparent that service users made decisions about their lives. The inspector was shown brochures from Isle of Wight by one service user identifying where they were going for their holidays. The key worker told us service users are encouraged and supported to make decisions for themselves even when there might be risks involved. Suitable risk assessments are drawn up with suitable management should the need arise. The home’s documentation on service users’ choices is based on Respect, Independence, Community participation and Community presence. In discussion with care workers we were told service users are involved in the care of their home, and two service users who spoke at length with us supported this. We observed one service user vacuuming the hall on our arrival at the home. The home have a weekly menu-planning meeting followed by food shopping which involves the service users. Some service users are encouraged to do their own laundry with the support of their key worker. Longford DS0000013705.V348940.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 15 16 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The service has a strong commitment to enabling service users to develop their skills, including social, emotional, educational, cultural communication and independent living skills. Service users are encouraged and supported to identify their goals, and aspirations and work to achieve them. EVIDENCE: The observed relationship between care workers and service user was relaxed and friendly creating a warm and friendly homely feeling. Service users are encouraged to live a full life and to partake in age related activities such as going to the pub, having meals out attending college of further education, horse riding, cycling, visiting the library and going to the cinema. Their religious beliefs are acknowledged and encouraged. One service user told us they have part time employment and that they also attend college to further their interest in their hobby. Longford DS0000013705.V348940.R01.S.doc Version 5.2 Page 13 Review of service users records and in discussion with care workers it was documented that Service users are encouraged to make friends outside of the home and to keep in touch with their friends and families as they wish. Service users are enabled to entertain their guest in the privacy of their bedroom if they so wish. The manager told us that the home is run on the basis that it is a family home. Each member is allocated tasks within their capabilities and sometimes tasks are allocated that will stretch the service user, who is always supported and enabled by their key worker and service users achievements are always acknowledged. The care workers aided by the service users provide catering service for all at the home. The inspector did not sample the mid-day meal but the service users said it was delicious, and the amount was right. The inspector observed a good amount of dry, frozen and fresh food in the home. Service users are allowed to make drinks as they wish with assistance from their key worker. One service user told us that at their weekly menu-planning meeting they discuss the advantages of a healthy diet. They discuss foods rich in carbohydrates, fats, proteins minerals etc and how these foods are necessary for body building and keeping the body healthy. Longford DS0000013705.V348940.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18 19 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Carers understand the principles of giving personal care and support and are responsive to varied and individual requirements of the service users. They recognise that the delivery of personal care is highly flexible, consistent and reliable ensuring that service users receive personal care and support in the way they prefer; and that their emotional and health needs are met. None of the service users at this home are assessed as capable to selfadminister their medication. Staff trained to do so administers medication, service users are thereby being protected by the home’s policies and procedures on administration of medication. Processes are in place to manage the death of service users. EVIDENCE: Discussions with Service users, manager and care workers and review of care plans indicated each service user received the agreed personal care and support as directed in the care plans. Physical and emotional needs identified in the care plans are also met. The care plans are reviewed on a regular basis, Longford DS0000013705.V348940.R01.S.doc Version 5.2 Page 15 visits to the doctor dentist, and dietician are carried out on a as required basis. Daily care notes are documented dated and signed by the key worker or other care worker as necessary. Review of randomly selected service user files revealed that no service user at the home is risk assessed as capable to self-administer their medication. A review of the medication records demonstrated that medication is being administered within the home’s policy and guidelines of administration of medicines. Service users records demonstrated that letters have been sent to all relatives requesting information on dealing with the handling of service users’ death. Longford DS0000013705.V348940.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home operates in a manner that supports service users to air their views and concerns, which are acted upon before they can become complaints. Robust safeguarding policies are in place to protect the service users from abuse neglect and self-harm. EVIDENCE: Since the last inspection one complaint was received at CSCI, which was referred under the local authority multi-agency safeguarding adult procedure, with satisfactory outcome. The home has a complaints policy and procedure, and in discussion with service users we were told they knew how to complain and who would deal with their complaint. Service users told us their key worker makes sure everything is ok so they do not have to complain about anything. Random sample of care workers files and in discussion with care workers it was evidenced that care workers are being trained to recognise and report any act or suspicion of abuse to service users. The manager and care workers spoken to supported this by the production of the staff training record. Longford DS0000013705.V348940.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The physical layout of the home enables service users to live in a welldesigned and comfortable environment, which encourages independence. EVIDENCE: Overall, the home is fairly well maintained, and service users are encouraged and enabled to personalise their bedrooms. Requirements were made to repair the wash hand basin cabinet situated in the bathroom next to the office and to have the weeds cleared from the patio. The home presents as a safe place to live with bedrooms that meet the National Minimum Standards for Younger People. The management has a good infection control policy; they seek advice from external specialists, e.g. infection control, and encourage their own staff to work to the home’s policy and procedures to reduce the risks of infection. It was noted in care workers file that they attend regular training sessions on Longford DS0000013705.V348940.R01.S.doc Version 5.2 Page 18 Health and Safety issues. Care workers spoken to were knowledgeable about suitable storage and disposal of waste. The home presents as comfortable with attractive gardens which is easily accessible to service users. Longford DS0000013705.V348940.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32 34 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care workers in the home are trained, skilled and in sufficient numbers to support the service users who live at the home, and to support the smooth running of the home. The homes’ recruitment policy and the training given to care workers ensure suitably selected and qualified staff meets service users needs. EVIDENCE: Review of service users care plans indicated their named key worker supports service users. Review of care workers training files indicated the manager encourages and enables carers to undertake external qualifications beyond the basic requirements to enable staff to assist the service users achieve the agreed care and social needs. In discussion with care workers, and supported by the manager it was revealed that staff training is high on the agenda for the home. Review of the staff rota indicated that adequate numbers/skill mix of care workers are on duty over any twenty-four hour period to meet the needs of the service users. One carer plus another on call carer cover night duty. In Longford DS0000013705.V348940.R01.S.doc Version 5.2 Page 20 discussion with care workers it was verified that the home provided training and regular updates for them. A number of careers have completed the National Vocational Qualification (NVQ) in care at both Level 2 and L3. Review of documentation and in discussion with the manager we were told that a number of carers are in the process of undertaking both Level 2 and Level 4 NVQ. In discussion with care workers we were told that each member of staff is now issued with a copy of the General Social Care Code of Conduct. The home has a good recruitment policy and procedure, based on their equal opportunities policy that has the needs of the service users at its core, which is adhered to. It was noted that all members of staff were recorded as having had an application to the Criminal Record Bureau (CRB). Review of staff files demonstrated Schedule 2 of the Care Homes Regulations 2001 (Amended) was being observed by the home. Longford DS0000013705.V348940.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37 39 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management and administration of the home is based on openness and respect, has effective quality assurance systems to ensure service users views are obtained and acted upon. The manager ensures that care workers follow the policies and procedures to maintain the health, safety and welfare of the service users. EVIDENCE: The deputy manager who was acting up as manager has resigned form her post, and a new manager who is registered with Surrey CSCI for another home within the group of homes have been managing this home since March 2007. The manager is in the process of registering with the South East Regional Longford DS0000013705.V348940.R01.S.doc Version 5.2 Page 22 registration department, to be the registered manager for this home. The manager is in possession of the Registered Manager’s Award. There is a strong ethos of being open and transparent in all aspects of the running of the home. The manager is service user focused and leads and supports a strong staff team who have been recruited and trained to a high standard to meet the changing needs of the service users. It was evident from discussions with service users that they were involved in the management of the home. One service user told us “It is much nicer here now we have Gill as manager”. Documented evidence from service users/care workers meetings were available, and service users appeared very confident to speak with a stranger in their home about their life in the home. The manager told us that service users and care workers opinions were listened to and acted upon. Service users are encouraged and supported to make choices even when these choices might involve some degree of risks, for which appropriate risk assessment is completed Each service user is registered with the local GP practice, which they access as required. Chiropody service and dental service is also accessed as required. Service users have access to the wider primary health care services and the manager told us she is aware of whom to contact if the need arises. The manager ensures that at all times the health, welfare and safety of the service user and care staff are promoted and protected by having suitable numbers of trained care workers on duty at all times to meet the assessed needs of the service users. Longford DS0000013705.V348940.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 x 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 x LIFESTYLES Standard No Score 11 X 12 3 13 4 14 X 15 4 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 X 3 X X 3 x Longford DS0000013705.V348940.R01.S.doc Version 5.2 Page 24 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. 2. Standard YA24 YA24 Regulation 23 (2) (b) 23 (2) (o) Requirement Repair the cabinet housing the wash-hand basin in the bathroom next to the office. Remove all weeds from the patio and keep it weed free. Timescale for action 16/11/07 16/11/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Longford DS0000013705.V348940.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South Cowley Oxford OX4 2SU 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 Longford DS0000013705.V348940.R01.S.doc Version 5.2 Page 26 - 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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