Inspection on 24/05/07 for Longhill House

This inspection was carried out on 24th May 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Longhill House 07/12/05

Longhill House 15/09/05

Longhill House 10/02/05

Longhill House 28/09/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Longhill House Coldstream Close Hull East Yorkshire HU8 9LS Lead Inspector Beverly Hill Key Unannounced Inspection 24th May 2007 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 Longhill House DS0000000860.V334558.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. Longhill House DS0000000860.V334558.R01.S.doc Version 5.2 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 Limited Jane Margaret Anderson 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.V334558.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th December 2005 Brief Description of the Service: Longhill House is a purpose built care home located on the eastern outskirts of Kingston upon Hull in a mainly residential area. The home’s location provides service users with easy access to a variety of local shops, pubs and public transport etc. It is owned By Humberside Independent Care Association Ltd (HICA), which is a not for profit organisation. The home provides personal care and accommodation for a maximum of forty older people, some of whom may have memory impairment. The home is laid out on two floors with access to the upper floor via a passenger lift. There are thirty-eight single bedrooms and one shared bedroom. At the moment eleven of the bedrooms have en-site facilities although a programme of refurbishment is currently underway which will increase this number. There are four bathrooms and one shower room and sufficient toilets throughout the home. Communal areas consist of two lounges and a large dining room with doors leading onto a patio area. The home has a large lawned area at the rear and side of the property and a patio area with garden furniture. The home is accessible to wheelchair users. There is ample car parking facilities at the front of the building. The home is clean, tidy and welcoming. According to information received from the home the weekly fees are between £395.00 and £440. There is a top up system of £10 for a basic room and £20 for an en-suite room. Additional charges are made for hairdressing, chiropody, transport, newspapers, nametapes, holidays and outings and alcohol and cigarettes. Information about the home and services can be located in the statement of purpose and service user guide. Longhill House DS0000000860.V334558.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The visit to the home took place over one day. Throughout the day the inspector spoke to several service users to gain a picture of what life was like for people who lived at Longhill House. The inspector also had discussions with the registered manager, care staff, catering and domestic staff, the administrator and two relatives. The inspector looked at assessments of need made before people were admitted to the home, and the home’s care plans to see how those needs were met while they were living there. Also examined were medication practices, activities provided, nutrition, complaints management, staffing levels, staff training, induction and supervision, how the home monitored the quality of the service it provided and how the home was managed overall. The inspector also checked with service users to make sure that privacy and dignity was maintained, that people could make choices about aspects of their lives and that the home ensured they were protected and safe in a clean environment. The inspector also observed the way staff spoke to service users and supported them and checked out with them their understanding of how to maintain privacy, dignity, independence and choice. Prior to the visit to the home the inspector had sent out a selection of surveys to service users, some family members, a selection of staff members and professional visitors to the home. Those returned were checked and comments used throughout the report. There were very positive comments about the home in general and the care provided by the staff team. What the service does well: The home makes sure that people are only admitted to the home after they have had an assessment of their needs. Staff members also obtain assessments done by the local authority. This helps them decide whether or not people’s needs can be met in the home. The home provides a very pleasant environment for people to live and work in. It had a friendly and homely feel, and was clean with no unpleasant odours. One service user stated, ‘it’s always clean and comfortable’, whilst another said it was homely. One service user described the home as, ‘a four star hotel’. Visitors were welcomed at any time of the day and this was confirmed in discussions with service users and two relatives the inspector met on the day. Staff managed medication well. Longhill House DS0000000860.V334558.R01.S.doc Version 5.2 Page 6 There were plenty of activities provided for people and staff ensured they were given choices about their lives. One person stated, ‘It’s a lovely place, you can’t go wrong here’. People who lived at the home stated they liked the meals and drinks provided. There was choice on the menus and the home had been awarded a healthy heartbeat award for having health alternatives to the main meal. One catering staff member stated, ‘we are able to offer a varied menu even working within budget and still have scope for special treats’. The staff team clearly enjoyed their jobs and spoke to service users in a nice way. They have a low staff turnover, which means that there is consistency of care and staff get to know the people who live there very well. One survey from a person who lived at the home stated, ‘I understand the staff have other residents to take care of and I sometimes have to wait a few minutes but on the whole I am very happy with the service’. A relative stated, ‘they are always cheerful and offer support when and where necessary’. Staff members stated, ‘the atmosphere does us proud’, ‘ we have very good staff and give 100 to all service users’ and, ‘it’s a rewarding job knowing you are helping people who would struggle with everyday life’. Staff showed good understanding of how to make sure people remained as independent as possible. The induction and training provided in the home gave staff the opportunity to develop their skills and knowledge and staff members feel they are supported and well supervised by management. The home had been awarded part 1 and part 2 of the Local Authority Quality Development Scheme for ensuring care plans and a quality monitoring system was in place. Any complaints were looked at straight away and sorted out. The home has good policies and procedures and staff are aware of how to protect people from harm. What has improved since the last inspection? What they could do better: The home completes assessments prior to admission. Staff members need to make sure they formally write to service users or their representatives following assessment, stating that the home can meet their needs. The home produces care plans that state how peoples’ needs are to be met by staff. These must include the full range of needs with clear tasks for staff. Longhill House DS0000000860.V334558.R01.S.doc Version 5.2 Page 7 Risk assessments need to make sure they identify what staff must do to minimise any risks that have been identified. One person managed their own medication, which was really good for their independence, however they did not have a full risk assessment in place that managed this. It’s important that staff members have clear guidance in how to support people or care could be missed. The way the home completes checks on new staff coming to work at the home is usually very good. In some instances staff started work after an initial check but before the police check came back. When this happens, which should only be in exceptional circumstances, the staff must be closely supervised. The home must have some system in place to monitor the safety of bed rails. One of those checked did not comply with manufacturers instructions and could place service users at risk. These were replaced by the home quickly after an immediate requirement notice was issued. 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. Longhill House DS0000000860.V334558.R01.S.doc Version 5.2 Page 8 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.V334558.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 5 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Service users had assessments of need completed prior to admission and the home obtained copies of assessments completed by care management. This enabled the home to have full information about the service user in order to decide whether they can meet needs. The home offered visits and trial stays so people could assess the service prior to making a decision. EVIDENCE: The inspector examined six care files during the visit. There was evidence the home obtained assessments and care plans completed by care management and the manager confirmed they visited service users at home or in hospital to complete the homes in-house assessments. The information gathered enabled Longhill House DS0000000860.V334558.R01.S.doc Version 5.2 Page 10 the home to decide whether they were able to meet the persons’ needs within the home. Examination of the documents indicated all needs were identified and the date of completion was prior to admission. The manager needs to formally write to service users or their representatives, following the assessment stating their capacity to meet identified needs. Currently, as with other homes in the company, this information is provided verbally. The company had routine documentation used throughout all the homes. After admission the staff completed strengths and needs assessments, which related to service users activities of daily living and these informed care plans. They also completed personal profiles and fact files which identified diverse needs, routines and preferences. The manager and staff confirmed that the home offered short respite stays to enable people to see what the home was like. The first few weeks of admission were seen as a trial period, after which a review was held and the service user and their relatives discussed the option of permanent residency. This was confirmed in one of the care files where a service user had just completed six weeks respite stay and was due to have a review to discuss their residency. The home does not provide intermediate care services. Longhill House DS0000000860.V334558.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Service users health and social care needs were planned for and met in a way that promoted privacy and dignity. Some gaps in care plan formation and risk assessments means that staff may not have all the required written information about service users needs. The home safely managed and administered service users medication. EVIDENCE: The inspector examined six care files and they contained a wealth of information and assessments, including those completed by care management, to enable staff to formulate care plans. The files were well kept with individual sections making it easy to access information. Longhill House DS0000000860.V334558.R01.S.doc Version 5.2 Page 12 Identified strengths and needs were formulated into care support plans. Generally they indicated the persons needs and the tasks staff needed to complete to meet them but these could be completed with more detail to ensure care is not missed. For example one care plan stated, ‘staff to be aware of health problems’, and again, ‘staff to be aware of short term memory loss’, however the health problems were not identified in the strengths and needs section but in the personal profile so staff would have to read through this for information. There was no acknowledgement of the impact health problems and short-term memory had on the service user in the care plan. It was noted that some identified needs had not been planned for in all of the care plans examined. For example, one service user admitted six weeks prior only had night care planned for. Even though they were admitted for respite care they required a full care plan to ensure staff knew how to support them. Needs identified but not planned for in the other care files examined were, epilepsy management and continence promotion for one service user and financial management for two service user without any relatives. When plans of care were in place they detailed in part what service users could do for themselves and how staff must ensure these skills be maintained. They were written in a respectful way and promoted values of privacy and dignity. The care plans were evaluated every month and audited by senior staff and generally this was an effective process in highlighting areas to be addressed. All service users had a review at six monthly intervals, whether this was conducted by the home or care management. There was evidence that service users or their representative signed agreement to the care plans. Some information when cross-matched led to confusion. For example, one service users strengths and needs stated there was no history of pressure sores but their waterlow risk assessment had a ‘very high risk’ score but no preventative plan was in place. The scoring may be more to do with the documentation used than the actual risk to the service user. However any identified risk must have a plan of care to minimise or prevent the problem occurring. One service user had bed rails in place but no risk assessment, just a statement that they could fall out of bed. Another person had a risk assessment for self-medicating, however it did not fully assess their capability to manage their medication and did not have clear guidance to staff in how to supervise the process. In a discussion with eight staff members it was clear they were aware of service users needs apart from one important health factor for one service user. Only the senior was aware of this, which could mean that care could be missed. This informal process cannot be relied on totally and identified needs must be written down in care plans to give clear guidance to staff. There was evidence that service users health needs were monitored and they had access to health professionals and services. The home had a treatment Longhill House DS0000000860.V334558.R01.S.doc Version 5.2 Page 13 room available to health professionals to see service users in private. The home had completed charts for particular needs, for example bowel care, weight and food and fluid monitoring. The manager audited accidents and made referrals to the GP where appropriate. Staff members spoken with and surveys received from them indicated that they had a good understanding of how to provide care that maintained privacy, dignity, choice and independence. This was confirmed in discussions with service users and they were observed to be smartly dressed in clean clothes, attention had been paid to nail and hair care and male service users had been assisted to shave. The inspector observed staff members speaking with service users in a respectful and genuinely caring way. One relative stated, ‘the home offers care and respect for patients, relatives and friends’. Medication was well managed. It was stored, recorded, administered and stock controlled appropriately. The home had a separate medication room. Longhill House DS0000000860.V334558.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home had flexible routines and promoted choice and individual decisionmaking. The home provided well-balanced meals, which met service users nutritional needs. EVIDENCE: Via discussion with staff members and service users it was evident that the home provided activities for people, for example bingo sessions, games such as cards, dominoes and ‘name that tune’, karaoke, reminiscence, manicures, baking, gardening, visiting entertainers and quizzes. Large print library books were obtained and daily newspapers purchased. The home had trips out to facilities in the local area and home shopping was arranged with a variety of clothes parties. Seasonal activities take place, for example summer fairs, and Christmas parties. One staff member described how they supported a service user to complete something they had wanted to do for years, that is take a Longhill House DS0000000860.V334558.R01.S.doc Version 5.2 Page 15 train journey to Scarborough. The home employed an Activities Coordinator to organise events and plan support for service users in maintaining social care needs. The home also has the use of a minibus. One service user stated, ‘I enjoy the activities, baking and bingo and love to go out on the trips’ whilst another said how much they enjoyed the company around them and having someone to talk to. One person described how they had enjoyed a trip to a local museum recently. Service users spoken with stated their visitors could come at anytime and could be seen in private. This was confirmed in discussion with relatives and in surveys received from them. The inspector observed the way staff received visitors and this was done with warmth and knowledge about them. Staff spoken to had an understanding of how to promote independence and choice, ‘we communicate with people’, ‘we close doors for personal care and knock on doors’, ‘we make sure people have choices with clothes, meals, where to sit, leisure and when to get up and go to bed’, and ‘one person has their meals at different times’. Service users confirmed this, ‘there are activities but I usually decline’, and ‘ I like to put gravy on my meals myself’ and, ‘I look after my own medication, I please myself and have quiet time in my own room’. The manager gave one example of how the home supported a service user and their family to make a choice to remain at the home when they became very poorly. The home accommodated the family when they wished to hold a family and friends get together there after the service users funeral. The manager also described how they had respected a service users right to choose particular staff for their care. Service users spoken with enjoyed the meals provided by the home, ‘the food is marvellous, beautiful and we get plenty to eat’, ‘ It’s a four star hotel’, ‘It’s tasty and well presented’. Menus were on display and they indicated choice and alternatives and service users confirmed alternatives were available in practice. One catering staff member stated, ‘we are able to offer a varied menu even working within budget and still have scope for special treats’. Special diets were catered for and the staff checked with service users if they had enjoyed their lunch or if they required anymore. Staff members were observed supporting service users to eat their meals in a patient and sensitive way. The home had gained the Healthy Heartbeat Award and scored extremely high in a recent visit by environmental health officers. Longhill House DS0000000860.V334558.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home provides an environment where service users and relatives feel able to complain. Recruitment and selection, staff training and adherence to policies and procedures ensure the protection of service users from harm. EVIDENCE: The homes complaints policy was on display and via surveys most staff were aware of how to record and action complaints. No formal complaints had been received at the home or with the Commission. Complaints recorded were minor in nature and had been resolved quickly. Service users spoken with stated they would complain to someone if they were unhappy. Relatives spoken with knew the names of staff members and stated they felt able to complain and were confident issues would be sorted out quickly. All staff complete basic in-house training in the protection of vulnerable adults from abuse during induction. Some staff had completed the more informative local authority training. The home had policies and procedures in place and Longhill House DS0000000860.V334558.R01.S.doc Version 5.2 Page 17 staff members spoken with were aware of what to do if they suspected abuse had occurred. All stated they would report any abuse immediately to the manager and area manager. The manager was aware of allerting, referral and investigating procedures. The homes recruitment practices were generally robust and ensured via selection, interview, references and police checks that only appropriate staff members were recruited. There was a gap in the recruitment process regarding some staff starting employment after a povafirst check had been completed but prior to the return of the criminal record bureau check. This must only occur in exeptional circumstances and stringent supervision must be put in place. Longhill House DS0000000860.V334558.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 24 and 26 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home provided a well-maintained, clean and comfortable environment for service users. Service users had the opportunity to personalise their bedrooms, which made it homely for them. EVIDENCE: The home is laid out on two floors with access to the upper floor via a passenger lift. There are thirty-eight single bedrooms and one shared bedroom. At the moment eleven of the bedrooms have en-site facilities although a programme of refurbishment is currently underway which will increase this number. There are four bathrooms and one shower room and Longhill House DS0000000860.V334558.R01.S.doc Version 5.2 Page 19 sufficient toilets throughout the home. The home has a small visitors room and a room used by district nurses to treat service users in private. Communal areas consist of two lounges and a large dining room with doors leading onto a patio area with garden furniture. The home was nicely decorated and furnished. The manager confirmed some items of furniture were due to be replaced and if they needed items they could put in requests to headquarters. New bed linen and curtains had recently been purchased for rooms on the ground floor. Bedrooms had been personalised to varying degrees and service users confirmed they were able to bring in small items to decorate their room. Some service users had their own telephones. All bedrooms had privacy locks and lockable facilities were available. Service users and relatives spoken with were very happy with the home in general and the bedrooms, ‘the home is clean and comfortable’, ‘its homely’ and ‘it’s a nice clean home’. The home had sufficient laundry equipment and was fresh and clean. One bedroom had an odour but the manager was aware and was dealing with it. One person spoken with stated, ‘the laundry is very good’. Longhill House DS0000000860.V334558.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has good staff supervision arrangements and staff training opportunities, which means that service users are supported by trained and competent staff. Generally the company had sound recruitment processes, however a gap in the process identified during the visit may place service users at risk. EVIDENCE: The company ensured that new staff members completed a five-day block of induction, which included training in fire procedures, safeguarding vulnerable adults from abuse, moving and handling, health and safety, basic first aid and social care values and communication. The manager confirmed that skills for care induction booklets were to be available for new care staff to work through which covered required standards in separate modules and which will ensure that competency is assessed throughout the process. This will be an improvement on previous induction, as with other homes in the company, induction tasks were signed off but did not evidence any competency in care practices. Longhill House DS0000000860.V334558.R01.S.doc Version 5.2 Page 21 The home had a training plan and there was evidence that mandatory and service specific training was covered. Each staff member had a personal training plan that recorded the training participated in. According to information received from the manager in the pre-inspection questionnaire the home had 48 of care staff trained to NVQ (national vocational qualification) level 2 and 3. This level of training indicates the company is very committed to ensuring staff have the required skills and knowledge for their roles. Staff rotas were examined and showed there were usually six care staff members on duty during the day, five of them for full day shifts and one for half a shift. A new system of twelve-hour shifts had enabled the manager to plan cover and staff the home more efficiently. There were three, occasionally four staff members at night. The manager described how staffing levels could fluctuate when service users needs increase to enable more intensive support, for example during periods of illness and leading up to death. Service users and relatives spoken with and surveys received were complimentary about the care staff team. Comments were, ‘they are always cheerful and offer support when and where necessary’, ‘there is always a member of staff to greet you when visiting and always someone around for residents’, ‘I receive care very much’, ‘ the staff take care of me and my needs’, ‘I like the staff’, ‘staff are polite’, ‘the staff look after her well’, ‘the staff are lovely, very nice indeed’, ‘I’m well looked after’ and ‘I like all the staff’. The inspector observed staff talking to people in a friendly and courteous way, they were supportive at mealtimes and had time to sit and chat to people. The atmosphere was relaxed. Generally the home operated a robust recruitment process. References and criminal record bureau checks were obtained and checks made against the protection of vulnerable adults register. Care staff members were selected via an interview process. Usually staff only started work in the home after the return of the criminal records bureau check, however on some occasions staff members started employment after the return of the povafirst check but before the criminal record bureau check had returned. In exceptional circumstances this is acceptable but the home must put in place stringent supervision arrangements and the inspector could not see evidence of this. Longhill House DS0000000860.V334558.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36 and 38 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is managed well and has a good system for monitoring the quality of care services the home provides. Improvements in the monitoring system for bed rails will ensure service users safety and wellbeing are promoted and protected. EVIDENCE: The registered manager has worked in the care sector for many years and has completed the Registered Managers Award and a National Vocational Qualification in care at level 4. She has also completed training courses Longhill House DS0000000860.V334558.R01.S.doc Version 5.2 Page 23 throughout the year reflecting her commitment to improving her knowledge and skills. Staff spoken with felt supported by the manager and surveys commented on her supportive and approachable manner, ‘she’s excellent, very approachable’, ‘issues were dealt with fairly’, ‘will sort things out’, and ‘listened and did her best to resolve the issues’. There was evidence that staff members were supported by the provision of regular supervision. Supervision records were well organised, up to date and covered all the required areas. Staff also had annual appraisals, which identified training needs. Meetings were held for service users and staff. There was evidence that the views of service users, staff and relatives were listened to and acted on. The manager and staff members reported that the company provided them with a good structure of support, which included an area manager and a health and safety officer. The home has a good quality assurance system in place, which consists of audits and questionnaires to seek the views of all stakeholders. The quality audit tool focuses on all areas of service provision with different tasks each month. Results of audits and questionnaires are analysed and plans produced to rectify any shortfalls. The auditing processes should be refined in some areas to address shortfalls in care plans and risk assessments. The manager keeps a monthly record of the action taken to address shortfalls and keeps senior managers informed of progress. The company produces an annual development plan, which looks at the organisation as a whole as well as each individual home. The inspector was able to see records of thank you cards and letters, and donations to the amenity fund received from relatives. One letter stated they were, ‘highly delighted’ with the care received. Service users finances were well managed with individual records maintained on a computerised system. Receipts were obtained for money deposited into the personal allowance system and when staff members assisted service users to purchase items form local shops and on outings. The company had introduced third party top ups last year and these were paid by someone other than the service user. The administrator audited finances fortnightly and the manager, monthly. The home was also audited by the company on an annual basis. Documentation indicated that moving and handling equipment was serviced regularly and fire drills and alarms completed. Staff completed health and safety training in induction and safety posters were on display in the home. Bed rails were checked throughout the home during the visit and one was found not conform to manufacturers instructions. An immediate requirement notice was issued for the home to address the problem. Information received Longhill House DS0000000860.V334558.R01.S.doc Version 5.2 Page 24 from the home satisfied the inspector that the company’s health and safety officer had checked the rails and replaced the one mentioned. Longhill House DS0000000860.V334558.R01.S.doc Version 5.2 Page 25 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 2 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 4 3 X X 3 X 3 STAFFING Standard No Score 27 4 28 2 29 2 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 3 X 3 4 X 2 Longhill House DS0000000860.V334558.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? No 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 OP3 Regulation 14(1)(d) Requirement The registered person must ensure that the home formally writes to service users or their representatives following assessment stating their capacity to meet identified needs. The registered person must ensure that all assessed needs have plans of care in place to provide staff with written guidance on the tasks they must perform to meet them. The registered person must ensure that service users with identified risks have them planned for with clear steps in how to minimise the risks. The registered person must ensure that stringent supervision arrangements are in place in the exceptional circumstances when staff members start work after the povafirst check but prior to the return of the criminal record bureau check. The registered person must ensure that bedrails for the identified bed conform to manufacturers instructions. DS0000000860.V334558.R01.S.doc Timescale for action 30/06/07 2 OP7 15 20/07/07 3 OP8 13(4) 20/07/07 4 OP29 19 30/06/07 5 OP38 13(4) 26/05/07 Longhill House Version 5.2 Page 27 Immediate Requirement notice issued – within 48 hours. The registered person must improve the monitoring of bedrail provision to include a system of documenting checks made on the ongoing need for them and maintenance of them. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP28 Good Practice Recommendations The home should continue to work towards 50 of care staff trained to NVQ Levels 2 and 3. Longhill House DS0000000860.V334558.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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 Longhill House DS0000000860.V334558.R01.S.doc Version 5.2 Page 29 - 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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