CARE HOME ADULTS 18-65
Longford Longford 40 Massetts Road Horley Surrey RH6 7DS Lead Inspector
Lisa Johnson Unannounced Inspection 20th October 2005 02:00 Longford DS0000013705.V259013.R01.S.doc Version 5.0 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.V259013.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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.V259013.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Longford Address Longford 40 Massetts Road Horley Surrey RH6 7DS 01293 430687 01999 999999 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.V259013.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The age/age range of the persons to be accommodated will be: 18-65 YEARS 29th June 2005 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. Longford DS0000013705.V259013.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was the homes second inspection carried out in 2005/2006.The unannounced inspection took place over three hours and was carried out by one inspector. A full tour of the premises was undertaken and care plans policies and procedures and other required documentation was sampled. The inspector spoke to three service users and three members of staff in the home. This was a positive inspection and the inspector would like to thank the service users and staff for their cooperation during this inspection. What the service does well:
There was a homely, warm and friendly atmosphere in the home. There was evidence to support that service users are encouraged to be as independent as possible and observation confirmed that staff talk to service users and provide support when required. On the day of the inspection some of the service users and staff were seen sitting down together playing a game of scrabble. Good relationships were seen between service users and staff and it was clear that service users were happy and relaxed and enjoying being in the company of the staff and the wishes of individuals who wished to be alone was also respected. It was pleasing to see that service users have a range of recreational and leisure activities. This was seen by the range of interests and activities displayed in individual bedrooms which service users showed the inspector. One service user plays in a band and takes part in venues throughout the country and in France. Some service users have been on holidays including A trip to Spain and this was confirmed by service users spoken to. One service user said, “ I have been to the Isle of Wight”. Another service stated that she had been to Lapland last year. On the day of the inspection everybody was going to the local pub to have a meal. Longford DS0000013705.V259013.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? 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.
Longford DS0000013705.V259013.R01.S.doc Version 5.0 Page 7 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.V259013.R01.S.doc Version 5.0 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were assessed on this inspection EVIDENCE: For information on these standards please refer the report of 29th June 2005. Longford DS0000013705.V259013.R01.S.doc Version 5.0 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6&7 The home has developed and agreed with each individual a care plan that is based on assessment including risk taking. Individual goals are implemented but the outcome of reviews needs to be recorded by key workers. EVIDENCE: Three care plans were sampled. Plans were detailed and structured with clear goals identified and reviews take place six monthly. The manager said that all review meetings are in the process of being updated. Pen portraits and friendship circles were completed The home still needs to record how the service is meeting the individual goals on a regular basis and further action was required by the Commission for Social Care Inspection. Detailed risk assessments and management guidelines were in places, which were reviewed, signed and dated. Service users have their own back accounts and the inspector was informed that service users require support and assistance. The staff maintain adequate records for monies kept in the home on behalf of service users. Longford DS0000013705.V259013.R01.S.doc Version 5.0 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,14 & 17 The home supports service users to maintain independent living skills. Service users take part in fulfilling activities and participate in the local community. Service users engage in a range of leisure activities. Service users are provided with a well balanced diet. EVIDENCE: One service user is moving on to a more independent living scheme and staff were supporting this individual with the transition process including support for daily living skills with the involvement of other professionals including the behaviour specialist and care manager. It was clear that service users have a wide range of leisure and recreational activities. One service user was very keen to show the inspector her music centre and large range of videos and CDS. Another service user takes part in a band in which he plays the drums and he enjoys taking part in venues including a show in France. On the day of the inspection service users and staff were enjoying a game of scrabble, which was clearly being enjoyed by everybody, which was being followed by a trip to the local pub for a meal.
Longford DS0000013705.V259013.R01.S.doc Version 5.0 Page 11 One service user had been on a recent holiday to Spain and another service user said, “I have been to the Isle of Wight”. The homes menu plan was sampled and consisted of meals that were nutritious Snacks and drinks are available through the day and service users were seen helping themselves to Longford DS0000013705.V259013.R01.S.doc Version 5.0 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 21 Individual plans need to be implemented in respect of service users wishes regarding dying and death. EVIDENCE: The manager stated that the individual wishes of service users including the service users family (if that is what the service wants) regarding dying and death are being discussed at individual care reviews, which are currently ongoing. Further action has been required by the Commission for social Care Inspection to ensure this is completed. Longford DS0000013705.V259013.R01.S.doc Version 5.0 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 The home is able to demonstrate that there is an accessible complaints procedure. Written policies and procedures were in place to ensure that residents are protected from abuse. EVIDENCE: There is an accessible complaints procedure in place, which is in symbol and pictorial format. Two staff spoken to confirmed that they had attended training in the protection of vulnerable adults and were knowledgeable and clear in recognising abuse and what appropriate action they would take. Policies and procedures were in place, which was also seen on display on the notice board in the hallway. Positive relationships were seen between service users and staff and it was clear that service users were happy and relaxed and enjoying being in the company of the staff. Longford DS0000013705.V259013.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Individuals live in a homely environment, which is clean and hygienic. There are some identified maintenance issues that require attention to ensure that service users live in a well maintained and comfortable home. EVIDENCE: The home is generally well maintained and provides a homely atmosphere and is close to local amenities. The home has recently acquired new furniture in the sitting room, which has enhanced a homely appearance. The manager stated that there are currently plans in place to level out the bottom of the garden and to install a summerhouse. The home was cleaned to a high standard. Laundry facilities were sited separately to the kitchen and soap and disposable towels were provided for hand washing. Infection control procedures were in place. The two sitting rooms require redecoration and some external redecoration is required particularly at the front of the house. A broken garden fence to the rear of the house needs to be replaced. A requirement was made that the timescales of completion time for this work is to be made to the Commission for Social Care Inspection. A further immediate requirement was made that a step in the back door needs urgent attention because of its slippery surface to promote the health and safety of service users and staff. Longford DS0000013705.V259013.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33 & 36 The home is able to demonstrate that they have an effective team who are able to meet the needs of the service users Staffing levels were adequate to meet the needs of service users. Staff receive regular formal supervision. EVIDENCE: Staff spoken to have a good knowledge of the needs of the service users they support and awareness of individuals care plans. Effective communication was seen between staff members. On the day of the inspection there were sufficient levels of staff on duty. Four staff was on duty with another member of staff who was working until five o’clock. There are currently two staff vacancies. Staff in the home cover for any shortfall if it arises and the use of agency is minimal and is avoided if possible to maintain consistency for service users. Staff spoken to confirmed that they receive regular supervision and felt supported by the registered manager and it was clear from discussions that staff attend training and development. One supervision session is to discuss personal issues and a separate meeting is held to discuss key worker roles and responsibilities and records were sampled. Longford DS0000013705.V259013.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 42 & 43 Appropriate records were maintained that ensure the health and safety of service users and staff. EVIDENCE: A number of records were sampled including accident records that were recorded appropriately. The first aid box and water temperatures are checked and recorded weekly. Fire records were up-to-date. Water and gas certificates were in place. The employer’s liability insurance certificate was on display in the hallway and a health and safety inspection was completed. The overall business plan is set by the organisation but the manager is able to contribute by submitting proposals for the home. The manager receives a budget for the home where copies of statements are maintained Longford DS0000013705.V259013.R01.S.doc Version 5.0 Page 17 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 X X X Standard No 24 25 26 27 28 29 30
STAFFING Score 2 X X X X N/A 3 LIFESTYLES Standard No Score 11 3 12 3 13 X 14 3 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score 3 X 3 X X 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Longford Score X X X X Standard No 37 38 39 40 41 42 43 Score X X X X X 3 3 DS0000013705.V259013.R01.S.doc Version 5.0 Page 18 Yes 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 YA 13 Regulation 15 (2) Requirement The registered manager must ensure that the review and progress of individual goals are recorded to ensure that goal action plans are being met. The registered manager must complete a procedure to ensure that each service users wishes are considered in relation to dying and death. (Previous timescale of 29th September not met). A step leading out of the back door requires urgent attention to ensure the health and safety of service users and staff. a) A fence must be replaced in the back garden. b) Timescales are to be made available to the Commission for Social Care inspection for the planned redecoration work for the two sitting rooms and to the front of the house. This is to ensure that service users have a well maintained and comfortable home to live in. Timescale for action 20/01/06 2 YA 21 13 20/01/06 3 YA 38 23 (2)(6) 20/10/05 3 YA 24 23 (2)(6) 20/01/06 Longford DS0000013705.V259013.R01.S.doc Version 5.0 Page 19 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.V259013.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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