CARE HOMES FOR OLDER PEOPLE
Longhill House Coldstream Close Hull East Yorkshire HU8 9LS Lead Inspector
George Skinn Unannounced Inspection 7th December 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.V262161.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.V262161.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.V262161.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 15th September 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 home’s location provides residents 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 home’s 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.V262161.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. What the service does well: What has improved since the last inspection? What they could do better:
The home operates a robust monitoring system which ensures that any areas of improvement are acted upon so the service is constantly monitoring its own performance. Longhill House DS0000000860.V262161.R01.S.doc Version 5.0 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Longhill House DS0000000860.V262161.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.V262161.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): EVIDENCE: Longhill House DS0000000860.V262161.R01.S.doc Version 5.0 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9 & 10 Residents are protected by the home policies and procedures for handling medication and residents feel they are treated with respect. EVIDENCE: There is a detailed medication policy in the home about the handling of medication. Records of medication received into the home are well maintained along with their administration and disposal. The home does not routinely facilitate self-medication. Those residents who wish to self medicate would be enabled in this process, subject to an assessment and agreement. Appropriate storage facilities for controlled medication are available. Some medication is stored in a fridge; the temperature of this is monitored and recorded on a daily basis. Senior staff that have been trained and assessed as competent administer medication in the home and sample signatures are retained. The health of residents on medication is monitored and recorded in case files regular medication reviews takes place with the GP. The organisation has
Longhill House DS0000000860.V262161.R01.S.doc Version 5.0 Page 10 developed a medication-training package, which has extend to a formal assessment process based on competency and understanding. Those staff responsible for the administration of medication are attending accredited training organised by the local colleges. The maintenance of resident’s privacy and dignity forms part of the staff induction programme. Residents spoken with confirmed that privacy and dignity is respected whilst personal tasks are being undertaken, assistance is always available but where possible independence is enabled. Medical examinations/ treatment is conducted in the privacy of the resident’s own room. The preferred form of address is recorded on all case files. Residents are informed in the statement of purpose about their rights to have a private phone fitted in their bedroom. Residents can use the home’s payphone to make and receive calls. Longhill House DS0000000860.V262161.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 & 14 The resident expectations are satisfied and their cultural and religious needs are met; resident’s choice is maintained. EVIDENCE: Staff provide a variety of choice and flexibility in the daily lives of the residents, with care being given to ensure that it reflects the wishes of the resident. Care plans indicated how even small preferences were to be accommodated like the preference for putting slippers on before the residents feet touch the ground. Leisure and social activities are arranged both in house and within the local community. Notices of forthcoming social events are displayed around the home. Residents interests are recorded in their individual care plans. Through discussion with residents it was evident they choose when to get up, go to bed, spend time in company, time alone etc. Whilst mealtimes are set residents are able to make choices about where they wish to eat and there is some flexibility around the timing and what they would like to eat. Longhill House DS0000000860.V262161.R01.S.doc Version 5.0 Page 12 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): EVIDENCE: Longhill House DS0000000860.V262161.R01.S.doc Version 5.0 Page 13 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): EVIDENCE: Longhill House DS0000000860.V262161.R01.S.doc Version 5.0 Page 14 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 & 30 The number and skill mix of the staff meet the needs of the residents. EVIDENCE: The National Care Standards Commission have been advised that recommended guidance should only be applied to new registrations. For homes registered prior to April 1st 2002 staffing levels must at least meet the minimum requirements of the previous regulatory authority. At the time of this inspection staffing numbers were found to meet those previous requirements. The home retains a copy of duty rosters. All staff employed by the home to care for residents are aged over 18 years and those staff left in charge are at least 21 years old. Dedicated domestic staff are employed in sufficient numbers to ensure the home is maintained in a clean and hygienic state. The staff are well equipped to undertake their duties as the company provide a comprehensive training diary. Mandatory training is provided and routinely updated as required. The process of planned supervision and development interviews identifies any areas of specialist training which the staff feel they need and this is provided as far as possible.
Longhill House DS0000000860.V262161.R01.S.doc Version 5.0 Page 15 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): 33 & 35 The resident live in a home which is well managed, and run in their best interest. EVIDENCE: The home has a quality assurance system in place, which seeks the views of all stakeholders; residents confirmed that they are regularly consulted via questionnaires. The quality audit tool focuses monthly on areas such as the environment, complaints, individual care etc. In addition to this the home manager undertakes her own monthly monitoring. The company produces an annual development plan which looks at the organisation as a whole as well as each individual home. Residents who are able to manage their own finances are encouraged to do so; this was confirmed during the inspector’s discussions with them. For those who are not as able then finances are managed in varying degrees dependant on
Longhill House DS0000000860.V262161.R01.S.doc Version 5.0 Page 16 individual abilities and wishes. This has resulted in a number of residents taking care of their own finances. Longhill House DS0000000860.V262161.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 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 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x x x x x x x x x STAFFING Standard No Score 27 3 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 3 x 3 x x x Longhill House DS0000000860.V262161.R01.S.doc Version 5.0 Page 18 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.V262161.R01.S.doc Version 5.0 Page 19 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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