Inspection on 22/10/07 for Longlands Nursing Home

This inspection was carried out on 22nd October 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

Longlands Nursing Home 28/09/06

Longlands Nursing Home 28/11/05

Longlands Nursing Home 29/04/05

Longlands Nursing Home 24/11/04

Longlands Nursing Home 15/06/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Longlands Nursing Home Pound Lane Cassington Oxfordshire OX28 1DL Lead Inspector Kate Harrison Unannounced Inspection 22nd October 2007 10:45 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 Longlands Nursing Home DS0000027162.V347093.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. Longlands Nursing Home DS0000027162.V347093.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Longlands Nursing Home Address Pound Lane Cassington Oxfordshire OX28 1DL 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) 01865 881440 01865 883286 longlands@schealthcare.co.uk Chiltern Care Homes Limited (part of the Southern Cross Healthcare Group) Susan Jones Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35), Terminally ill over 65 years of age (3) of places Longlands Nursing Home DS0000027162.V347093.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. On admission persons should be aged 60 years and over. Date of last inspection 28th September 2006 Brief Description of the Service: Longlands Nursing Home was formerly a private residence and is in a most attractive situation close to the church and centre of the village. A purpose-built extension has been added to provide a pleasant two-storey care home with nursing, providing 31 single rooms and two double rooms, all with en-suite facilities, including showers. There are several sitting areas and two dining rooms provided for people who live there. The grounds are extensive and attractive and provide a pleasant outlook from all the rooms. There is ample car parking space in front of the premises. The current range of fees for the home is £567 to £740 per week, with a higher fee applying to the suite of rooms. Details of charges are available by telephoning the home. Longlands Nursing Home DS0000027162.V347093.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection of the service was an unannounced ‘Key Inspection’. We arrived at the service at 10.45 hours and the inspection lasted for 6.5 hours. This inspection was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s manager, and any information that we has received about the home since the last inspection. We saw most areas of the home and looked at records and documents relating to the care of the people living at there. Because people are not always able to tell us about their experiences, we used a formal way to observe people in this inspection to help us understand. We call this the ‘Short Observational Framework for Inspection’ (SOFI). This involved us observing up to 5 people who use services for 2 hours and recording their experiences at regular intervals. This included their state of well being, and how they interacted with staff members, other people who use services, and the environment. We asked the views of the people who use the services and other people seen during the inspection or who responded to questionnaires we sent out, and their views are included in this report. We looked at how the service was meeting the standards set by the government and in this report made judgements about the outcomes for people living at the home. From the evidence seen and comments received, we consider that this home would be able to provide a service to meet the individual needs of people with diverse backgrounds, once the planned staff training is completed. What the service does well: The home is situated in a village and the location allows some of the people living at the home to join in village life. The home provides a welcoming atmosphere and people at the home enjoy the relaxed, comfortable surroundings. People at the home say that the staff members are ‘wonderful’, ‘good’ and ‘very kind’. Our observations show that people living at the home have a good relationship with the staff team, and that the staff members are kind, caring and skilled. People living at the home say that their healthcare needs are ‘usually’ met. The food provided is good, and fresh fruit and vegetables are provided. Longlands Nursing Home DS0000027162.V347093.R01.S.doc Version 5.2 Page 6 People said that the home is always clean and tidy. One comment was ‘The nursing home is kept clean and smell-free, which makes life more pleasant for everyone’. Relatives say they feel welcome in the home, and are able to be involved in the care of their relatives as they want. What has improved since the last inspection? What they could do better: The registered manager should seek the views of people living in the home about the regularity and type of activity they want, so that the home knows their expectations and can make a plan to suit. To help people become more independent, further advice needs to be sought on ways to make access to the gardens safe. More staff members need to gain the National Vocational Qualification in Care, so that the needs of the people living at the home can be better met. As a result of the inspection visit, the home has improved the overseas recruitment procedures to make sure that references about prospective staff can be relied on. Longlands Nursing Home DS0000027162.V347093.R01.S.doc Version 5.2 Page 7 The manager needs to get the latest infection control guidance for care homes, published by the Department of Health, and needs to implement the guidance regarding the sharing of slings and disinfection of equipment. 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. Longlands Nursing Home DS0000027162.V347093.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 Longlands Nursing Home DS0000027162.V347093.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 6. Standard 6 does not apply, as the home does not provide intermediate care. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People have their needs assessed, and the home confirms that they can meet their needs before moving into the home. EVIDENCE: The home uses the Southern Cross forms when visiting an individual to carry out an assessment of need after an enquiry has been made about admission to the home. The forms are comprehensive and include enough information about the individual’s needs so that the person carrying out the assessment can make a decision about admission to the home. We saw an assessment form related to a recent admission to the home. The manager had visited the individual and had arranged for the family to visit the home with the individual, to check out if it would be suitable for the needs of the individual. The home sends a confirmation letter that the individual’s needs could be met at the home. We saw the individual in the home, and noted that his/her needs were mostly being met. The individual’s evolving needs were noted, and the manager was making arrangements to meet them. Longlands Nursing Home DS0000027162.V347093.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The personal and healthcare of people living in the home are documented and met. EVIDENCE: Everyone living at the home has care plans showing what their health and personal care needs are, and also showing what action needs to be taken to meet the needs. The care plans we saw showed the risk assessments that were completed to make sure that the healthcare needs of the individual were met. There is some evidence of person centred care planning noted, where the views of individuals and/or their relatives are taken into account. The home has good medication procedures in place and all the necessary records about medication are up to date. Information from our survey and from comments on the day showed that people had confidence that their healthcare needs would be met at the home. From our observations staff members treat people living in the home with respect, and the manager has identified better ways of maintaining dignity when people are moved using the hoist in a communal area. Longlands Nursing Home DS0000027162.V347093.R01.S.doc Version 5.2 Page 11 The home’s management recognizes that there are some cultural and language difficulties between the staff group and the people living at the home, and some people who responded to our survey also commented on these difficulties. The manager is looking to find ways to improve the issue, and has identified suitable staff training so that the communication improves. Longlands Nursing Home DS0000027162.V347093.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People at the home are supported to live their daily lives as they choose to, but they would benefit from more organised activities. EVIDENCE: Appropriate music is played at times in different areas of the home, and it has a beneficial effect on several individuals, providing a relaxed informal atmosphere. The home’s activities organizer works 15 hours a week, usually during Wednesday and Friday, when dedicated time is spent with small groups of people, including short outings to village events. An exercise class is provided twice monthly, and a ‘Pets as Therapy’ dog visits every week. No organized trips out are possible at present, as the available minibus is not roadworthy. The manager is seeking to find alternative transport so that trips out can recommence. However, there are long periods when no organized activities are provided, and the manager said that although one member of staff is allocated to spend time with people when no activity is planned, this time is not protected. The registered manager should seek the views of people living in the home about the regularity and type of activity they want, so that the home knows their expectations and can make a plan to suit. Longlands Nursing Home DS0000027162.V347093.R01.S.doc Version 5.2 Page 13 From our observations people at the home have good relationships with staff members, and value interaction with them. People are able to decide how to spend their time, and in our survey said that staff members are ‘usually’ available to help if they need it. People can attend the local church services if they want to, and arrangements for clergy to visit individuals are made if requested. Visitors said that they are made welcome, and have good relationships with people living there and with staff. Regular meetings are organized to discuss issues with relatives, and the manager intends to improve the communication about planned meetings so that more people are aware of the dates. The home’s chef sources local food where possible, and has systems in place to know people’s food preferences. Individuals said that they enjoyed their food, and most people clearly enjoyed the social interaction in the dining room at lunchtime. Longlands Nursing Home DS0000027162.V347093.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are protected from abuse and they and their relatives know how to complain. EVIDENCE: The home’s complaints procedure is displayed in the home, and people said, through our survey, that they knew how to make a complaint. People living at the home know whom to complain to, as do relatives. Complaints are recorded, though some relatives say that it has taken time for some issues to be addressed. No complainant has contacted the Commission with information concerning a complaint made to the service since the last inspection. The home has a policy and procedures in place to safeguard individuals living at the home. All staff members have attended training in safeguarding vulnerable people. A requirement is made in this report to make sure that appropriate references are sought as part of the recruitment processes for people recruited from overseas, as this will help protect people living in the home, and this has been addressed. Longlands Nursing Home DS0000027162.V347093.R01.S.doc Version 5.2 Page 15 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 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a well-maintained safe home with pleasant surroundings. EVIDENCE: The home is situated in a village with local amenities, and has extensive grounds providing good space and a peaceful environment for the people living there. Communal areas are comfortable and the dining rooms are bright and welcoming. At a residents’ meeting in July 07 some individuals mentioned the difficulty of accessing the gardens on their own, because the slope on the ramped access was too steep. The registered manager has looked into getting remedial work carried out on the ramp, but has been advised that this is not practical. We recommend that further advice be sought on ways to make access to the gardens safe, so that more people can use the grounds safely on their own, and so can be more independent. Longlands Nursing Home DS0000027162.V347093.R01.S.doc Version 5.2 Page 16 One full time member of staff is responsible for the general maintenance of the building, and a system is in place for daily issues to be addressed. There is a system for checking the state of the wheelchairs, and this is carried out regularly. Refurbishment is carried out on an ongoing basis, and one dining room was being painted during the inspection visit. There are some communal areas where the carpet is lifting, causing small raised areas that could be trip hazards, and work to remove Clean Care’ published by the Department of Health, and should implement the guidance regarding the sharing of slings and disinfection of equipment in contact with bodily fluids. The home has no automatic disinfection facility, and although this has been identified as a need in past inspection reports, progress has not been made in installing one. The slings used to transfer people using a hoist are sometimes shared, and this is not in accordance with best practice. The manager should acquire copies of the ‘Infection Control Guidance for Care Homes’ and ‘Essential Steps to Safe, Clean Care’ published by the Department of Health and should implement the guidance, particularly in regard to the sharing of slings and disinfection of commodes. Due to the lack of an automatic disinfection facility, measures to prevent the spread of infection need to be robust. At present only 10 of staff have received training about infection control, apart from basis induction training, and the registered manager has organised more infection control training for next month for all the care staff. There is a dedicated team of staff to manage housekeeping tasks, and people said during the inspection visit that the home is always clean and tidy. Longlands Nursing Home DS0000027162.V347093.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The overseas recruitment procedures have been improved as a result of the inspection visit, and more staff members need to gain the National Vocational Qualification in Care, so that the needs of the people living at the home can be better met. EVIDENCE: There is a staff rota showing the mix of nursing and care staff members on duty over each 24 hours, and a separate rota for housekeeping and catering staff members. From our observations, the number of care staff on duty was appropriate to meet the needs of people in the home on the day of the inspection visit. The care staff team are valued by the people living at the home, and individuals made several positive comments about them collectively and individually at the time of the inspection visit. One visitor also commented on the friendliness and helpfulness of the team. New staff members are recruited overseas as well as locally, but does not follow the same procedures regarding references when recruiting overseas as when recruiting locally. Locally recruited staff members complete the Southern Cross application form, and two referees names are given who are contacted for a reference. Longlands Nursing Home DS0000027162.V347093.R01.S.doc Version 5.2 Page 18 We found that references about overseas staff members are not in response to a request from the organization, but are of a ‘to whom it may concern’ type, and there is no evidence available that they are authentic. An immediate requirement was made that the references be authenticated, and action was taken quickly to address the situation. The Southern Cross managers have confirmed that the overseas recruitment procedures have been amended to make sure that the recruitment procedures regarding references are appropriate. The home has recently improved the induction training for new staff, so that it now meets the appropriate standards. The home has an ongoing training programme to meet the needs of the people living at the home, including training in the care of people with dementia. The training matrix makes it easy to show which staff members need training, so that the manager can arrange appropriate courses. All the staff members attended fire safety training since the last inspection visit. At present the numbers of staff members with National Vocational Qualifications at Level 2 in Care do not reach the expected level of 50 , and the manager is working to improve the numbers. Longlands Nursing Home DS0000027162.V347093.R01.S.doc Version 5.2 Page 19 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, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered manager is working to improve outcomes for the people living at the home. EVIDENCE: The manager has been at the home for some years and recently gained the Registered Manager’s Award. The Southern Cross organisation provides support to the manager, and a senior manager carries our unannounced quality monitoring checks regularly. The additional post of administrator and supporting equipment recently provided at the home is having a positive effect on the running of the home, and will allow the registered manager to concentrate more on the management of the home. The registered manager regularly consults with residents and relatives, and is moving more towards a person centred approach, so that individuals and their relatives will feel that they have more say in the running of the home. A Longlands Nursing Home DS0000027162.V347093.R01.S.doc Version 5.2 Page 20 quality monitoring survey has recently been carried out, and results will be analysed. The manager intends to feed back information to the people living at the home and to relatives, and to implement improvements from the information supplied. Some petty cash is kept securely in the home, and records are kept, and were accurate at the time of the inspection visit. The registered manager has gained a Health and Safety certificate since the last inspection visit, and is responsible for the implementation of the home’s health and safety procedures. There is a fire risk assessment in place, and systems are in place to make sure that all the necessary safety checks are carried out regularly. The home has a health and safety policy statement, and training is provided so that staff members are aware of their responsibilities to work safely. Longlands Nursing Home DS0000027162.V347093.R01.S.doc Version 5.2 Page 21 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Longlands Nursing Home DS0000027162.V347093.R01.S.doc Version 5.2 Page 22 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 OP29 Regulation 19 (1) (c) Requirement Authenticated references must be supplied for the two members of staff identified. Timescale for action 30/11/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP26 Good Practice Recommendations Provide a mechanical sluice disinfection machine for cleaning sanitary equipment. This recommendation remains from the previous inspection report. The registered manager should seek the views of people living in the home about the regularity and type of activity they want, so that the home knows what their expectations are and can make a plan to suit. Further advice should be sought on ways to make access to the gardens safe, so that more people can use the grounds safely on their own. The registered manager should acquire copies of the booklets ‘Infection Control Guidance for Care Homes’ and ‘Essential Steps to Safe, Clean Care’ published by the Department of Health, and should implement the guidance DS0000027162.V347093.R01.S.doc Version 5.2 Page 23 2 OP12 3 4 OP19 OP26 Longlands Nursing Home regarding the sharing of slings and disinfection of equipment in contact with bodily fluids. Longlands Nursing Home DS0000027162.V347093.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Oxford Office 4630 Kingsgate Oxford Business Park South Cowley Oxford OX4 2SU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Longlands Nursing Home DS0000027162.V347093.R01.S.doc Version 5.2 Page 25 - 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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