CARE HOMES FOR OLDER PEOPLE
Longhill House Coldstream Close Hull East Yorkshire HU8 9LS Lead Inspector
George Skinn Unannounced Inspection 15th September 2005 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Longhill House DS0000000860.V251027.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 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. Longhill House DS0000000860.V251027.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Longhill House Address Coldstream Close Hull East Yorkshire HU8 9LS 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) 01482 376231 01482 701106 Humberside Independent Care Association Care Home 40 Category(ies) of Dementia - over 65 years of age (40), Old age, registration, with number not falling within any other category (40) of places Longhill House DS0000000860.V251027.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 10th February 2005 Brief Description of the Service: Longhill House provides personal care and accommodation for a maximum of 40 older people some of who may have memory impairment. It is owned By Humberside Independent Care Association Ltd (HICA) which is a not for profit organisation. The home is located on Longhill Estate, which is to the Eastern side of the city of Hull. The homes location provides service users with easy access to a variety of local shops, pubs and public transport etc. Longhill House occupies a purpose built property, which is laid out on two floors with access to the upper floor via a passenger lift. Thirty-eight of the homes bedrooms are single. The home has a large lawned area to the side of the property, which is accessible to wheelchair users. Longhill House DS0000000860.V251027.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection was undertaken over 6 hours. The building was looked at and some records were inspected. The majority of the residents and some of the staff group were spoken with. This included the acting manager. This is the first visit to the home since the last inspection in February. All those minimum standards inspected were met. What the service does well:
The home was found to be clean warm and welcoming. There were no malodours and the staff were working hard to meet the needs of the residents. The residents spoke positively about the home and their lives there commenting on how well the staff care for them. Relatives spoken with during the inspection were positive about the home and commented on the caring nature of the staff. Visiting District Nurses also commented on how well they thought the residents were cared for. The residents benefit from the homes record keeping as these are very well maintained and detailed instructing the staff in how to best care for the residents. These records contain a lot of detailed information which is relevant to the physical needs of the residents; likes, dislikes and other preferences are recorded which again help the staff to give a good service. The records are compiled with the involvement of the residents and their relatives if this is appropriate; record’s confirmed this, as did residents and relatives. Residents benefit from the staff being well trained and they were more than satisfied with the quality of care provided residents’ comments included “they can’t do enough for you” “they are all very kind and caring”. The home provide basic induction training which is given to all new staff when they start working this provides the staff with the skills to care for the residents properly. The home also provides more specialised training in dementia etc to enable them to meet the more personal needs of individual residents. Residents live in a safe environment as staff are trained in all aspects of health and safety Longhill House DS0000000860.V251027.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. Longhill House DS0000000860.V251027.R01.S.doc Version 5.0 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 Longhill House DS0000000860.V251027.R01.S.doc Version 5.0 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): 3 All residents have their needs assessed prior to moving into the home, this ensures their needs can be met. EVIDENCE: Some of those residents interviewed knew the home kept information about them and that they were involved in their care plans, however due the dependency levels of the majority of the residents many were unaware of this. All relatives spoken with confirmed that they are involved in their relatives care and the compilation of care plans. The care plans did demonstrate that all the residents are involved in the process of care planning, or have someone acting on their behalf. Residents are admitted to the home having undergone an assessment by either the Local Authority or senior staff from the home. The format of the homes needs assessment covers all required areas; copies of completed assessments were detailed and appropriate. Copies of the Local Authority assessment and care plans are obtained prior to admission for those residents
Longhill House DS0000000860.V251027.R01.S.doc Version 5.0 Page 9 referred through the local Social Services care management teams. In addition to the pre admission assessment the home undertakes a further assessment of strengths and needs once the resident has arrived. It is on the basis of both these assessments that the residents plan of care is formalised. Longhill House DS0000000860.V251027.R01.S.doc Version 5.0 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 the following standard(s): 7&8 Residents care records ensure personal care needs are well met by the staff group. EVIDENCE: Each resident has a plan of care, which has been devised from the assessments; or the resident’s next of kin is involved in the formulation of these and subsequent reviews. The way in which the care plan recorded likes, dislikes and preferred routines demonstrated the residents had been consulted. A form has been devised which asks the resident where appropriate, or their relatives to acknowledge that they are aware and agree with the contents of the care plan signed copies of these were on the residents’ files. Care plans set out in detail the action to be taken by staff; these are linked to individual risk assessments. Each care plan is reviewed on a daily, weekly and monthly basis. Risk assessments relating to falling, moving and handling are available.
Longhill House DS0000000860.V251027.R01.S.doc Version 5.0 Page 11 Residents’ health care needs are met and staff ensure they have access to health care services to meet their assessed needs. Equipment is available for the promotion of tissue viability and the prevention of pressure sores. Despite the frailty of some of the residents none have pressure sores, this is a credit to the staff and their high standard of practise in this area. Longhill House DS0000000860.V251027.R01.S.doc Version 5.0 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 the following standard(s): 13 & 15 The resident are able to have visitors at any reasonable time. Residents are provided with a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. EVIDENCE: Visitors to the home were welcomed at any reasonable time. Relatives confirmed that they were always made welcome and could see their relatives in private if they chose to. Information regarding maintaining family contact and visiting arrangements is detailed in the Statement of Purpose and Service User Guide The quality of the meal was very good and the way in which it had been cooked had taken into account residents needs. The staff who are responsible for serving the meals know residents likes and dislikes. Residents spoke positively about the quality of the meals comments were: “the food is always nice”, “You always get a good choice at every meal time”. Assistance is offered to residents with individual needs. The mealtime is a very relaxed and social occasion with the staff interacting well with the residents. Longhill House DS0000000860.V251027.R01.S.doc Version 5.0 Page 13 Residents are offered a choice at each mealtime; the menu indicates that cooked alternatives are available at both lunchtime and teatime. Longhill House DS0000000860.V251027.R01.S.doc Version 5.0 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 the following standard(s): 16 & 18 Both relatives and resident knew whom to complaint to and had confidence that their complaints would be taken seriously. The residents are protected from abuse. EVIDENCE: A complaints procedure is available which encourages residents and relatives to express their dissatisfaction without fear of repercussion. This procedure includes contact details for CSCI. Complaints are seen as an opportunity to improve the service as a whole or more specifically for an individual. Residents and relatives all said they felt the management style of the home encouraged them to speak out and they were satisfied that they would be listened to and issues acted on, they would not hesitate in bringing such matters to the staffs attention. Residents are protected from abuse with robust procedures in place for responding to any suspicion. All staff receive formal training on abuse and the protection of vulnerable adults. The home does have a detailed system for the management of residents’ finances, which protects residents from financial abuse. The homes policies and procedures preclude staff from involvement in the making of wills or receiving gifts. Longhill House DS0000000860.V251027.R01.S.doc Version 5.0 Page 15 Longhill House DS0000000860.V251027.R01.S.doc Version 5.0 Page 16 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 & 26 Residents live in a home which is kept clean, hygienic and free from offensive odours. Systems are in place for the control of infection. EVIDENCE: The home is clean and tidy all areas both communal and private are well maintained and welcoming. There is an infection control policy in place to protect the residents from the risk of cross infection. Staff were seen to be using protective clothing again to eliminate the risk of cross infection for the residents. Longhill House DS0000000860.V251027.R01.S.doc Version 5.0 Page 17 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 29 The residents are protected by the homes recruitment and selection procedures EVIDENCE: The organisation has a detailed recruitment procedure. As part of this inspection six random staff files were seen. From these files it was evident that two references were sought. CRB checks are undertaken along with a health assessment. A copy of the General Social Care Code of Conduct is made available to staff. All staff are provided with written terms and conditions within 8 weeks of employment and copies of these are retained at headquarters. The organisations policy and procedures regarding the recruitment of volunteers outlines a thorough process, which includes the obtaining of references and a CRB check, the home does not currently have any volunteers. Those staff files seen did included a copy of passport and birth certificate. Longhill House DS0000000860.V251027.R01.S.doc Version 5.0 Page 18 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 38 Residents live in a home which is well managed and has effective administrative procedures to ensure that their health, safety and welfare is protected. EVIDENCE: The home has a detailed Health and Safety policy. Safe working practices are maintained by the provision of training to staff in the form of moving and handling, basic food hygiene, first aid at work, basic first aid, infection control and fire safety. Systems are in place to ensure that all the homes equipment and building maintenance is up to date. Hazard notifications are circulated to the home manager, action taken and then retained for staff to see. Hot water is regulated to control the risks of Legionella along with the risk of scalding. The CSCI has received an application from the acting manager for registration.
Longhill House DS0000000860.V251027.R01.S.doc Version 5.0 Page 19 Longhill House DS0000000860.V251027.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 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 x 13 3 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 x 3 x x x x x x 3 STAFFING Standard No Score 27 x 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x x x x 3 Longhill House DS0000000860.V251027.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 Longhill House DS0000000860.V251027.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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