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Inspection on 28/11/05 for Longlands Nursing Home

Also see our care home review for Longlands Nursing Home for more information

This inspection was carried out on 28th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home is very well appointed and maintained to a high standard, and offers a comfortable, homely environment for the residents. Relatives and visitors are made to feel welcome and involved in the care provided and one relative commented, "Staff are always very friendly and caring".

What has improved since the last inspection?

There was nothing of any note to report at this time.

What the care home could do better:

The care planning process needs to be reviewed and discussed with all staff involved, to ensure that the assessed care needs are met. Risk assessments need to be carried out in moving and handling, falls and nutrition, and regularly reviewed.Medication such as eye and ear preparations that have a short shelf life once opened should be dated on opening.

CARE HOMES FOR OLDER PEOPLE Longlands Nursing Home Pound Lane Cassington Oxfordshire OX28 1DL Lead Inspector Philippa MacMahon Unannounced Inspection 28th November 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 Longlands Nursing Home DS0000027162.V268552.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. Longlands Nursing Home DS0000027162.V268552.R01.S.doc Version 5.0 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.V268552.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. On admission persons should be aged 60 years and over. Date of last inspection 29th April 2005 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 and two double rooms, all with en-suite facilities, including showers. The rooms are decorated and maintained to a high standard. There are several sitting areas and two dining rooms provided for service users. 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. Meals are traditionally English and a 4-week rotating menu is offered. Longlands Nursing Home DS0000027162.V268552.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and the second in the inspection year. The registered manager was on duty and involved in giving care to the residents, and the operations manager for the Oxford Group of Southern Cross homes was carrying out her routine visit. The inspector was given a warm welcome and the staff were very co-operative. Since the last inspection the company of Crown Homes has been taken over by Southern Cross. A consequence of this is that a lot of changes are occurring and staff are feeling less secure. The registered manager is doing a good job in supporting the team through the changes. The focus of this inspection was on addressing the key outcomes for residents not addressed in the previous visit. Care plans and the medication system were examined. Duty rosters and staff training were made available to the inspector, as were the maintenance and servicing documentation that is required by regulation. What the service does well: What has improved since the last inspection? What they could do better: The care planning process needs to be reviewed and discussed with all staff involved, to ensure that the assessed care needs are met. Risk assessments need to be carried out in moving and handling, falls and nutrition, and regularly reviewed. Longlands Nursing Home DS0000027162.V268552.R01.S.doc Version 5.0 Page 6 Medication such as eye and ear preparations that have a short shelf life once opened should be dated on opening. 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. Longlands Nursing Home DS0000027162.V268552.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 Longlands Nursing Home DS0000027162.V268552.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, 6 Every resident has a pre-admission assessment of his or her care needs before being admitted to the home. EVIDENCE: The sample of care plans examined each had a copy of the pre-admission assessment carried out by the registered manager. The home does not provide for an intermediate care unit. Longlands Nursing Home DS0000027162.V268552.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): 7, 8, 9 Most of the residents have a care plan in which their care needs are identified and the action required to meet those needs. It is not clear from the documentation that the residents’ care needs are being fully met. The medication system in place is in good order, apart from the storage of medication with a short shelf life. EVIDENCE: The inspector examined a sample of care plans and was able to look at the new company documentation being introduced incrementally. Overall the sample showed that appropriate care plans were written to ensure that the assessed care needs were met. However, in one instance a resident with complex care needs who was recently admitted to the home did not have a care plan. The assessment of care needs and the daily record showed that this person required a lot of nursing care. An immediate requirement was made that every resident in the home must have a care plan in which his or her care needs are identified and how these will be met. Longlands Nursing Home DS0000027162.V268552.R01.S.doc Version 5.0 Page 10 The sample of care plans examined did not have risk assessments carried out for nutrition, moving and handling and falls. Monthly reviews of the care plans have not been carried out. A resident with pressure wounds did not have a description of the wounds, ie measurements of the wounds. A photograph had been taken of the wounds but no date of when this had been done. Another resident had an indwelling catheter that was in situ on admission and there was no record of when it was inserted and details of the type and size of catheter used. It is recommended that a review of the care planning system and how the residents’ health care needs are being met is carried out and includes all the staff who are involved in the care provision. The inspector examined the medication system and found that overall the system is in good order and appropriate records are up to date and complete. However, on three separate medicines - eye and ear preparations that have to be discarded after one week or month after opening - no start date was placed on the container. This is not good practice and it is recommended that all staff who administer medication should be informed of the need to date the container on this type of preparation at the time of opening. Longlands Nursing Home DS0000027162.V268552.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): None of this section of outcomes was addressed at this inspection. EVIDENCE: Longlands Nursing Home DS0000027162.V268552.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): 16, 18 There is a complaints system in place. Every effort is made to protect residents from abuse. EVIDENCE: The registered manager takes complaints very seriously and has a file should any be lodged. A copy of the complaints procedure is prominently in place in the entrance hall. All staff have training in issues of the protection of vulnerable adults and the inspector examined the staff training files earlier in the year when these were kept at the head office of the previous owners. Longlands Nursing Home DS0000027162.V268552.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): 19, 26 The residents live in a safe and pleasant home. EVIDENCE: All areas of the home were found to be well maintained, clean and hygienic. Longlands Nursing Home DS0000027162.V268552.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, 29, 30 The number and skill mix of staff is sufficient to meet the care needs of the residents. EVIDENCE: The staff roster was examined and showed that there are sufficient numbers of staff on duty to meet the care needs of the residents. Although the numbers are down due to maternity leave, extended leave, and waiting for Criminal Records Bureau checks before starting new staff, the numbers do not fall below the agreed staffing statement with the previous Oxfordshire Health Authority. The home’s recruitment policies and procedures were examined earlier in the inspection cycle as they were held at the head office of the previous owners. The inspector also saw the training documentation in the same way. Longlands Nursing Home DS0000027162.V268552.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, 38 Southern Cross is committed to quality assurance and has various systems that will be implemented in the home. The residents’ finances and valuables are safeguarded. All necessary servicing and checks are in place regarding equipment, and the general service systems within the home. EVIDENCE: The registered manager has an open door policy and staff, relatives, residents and visitors have ready access to discuss any issues. Relatives spoken to at the inspection said how they felt that they could bring any issues or concerns to the registered manager. Longlands Nursing Home DS0000027162.V268552.R01.S.doc Version 5.0 Page 16 As the company has recently been taken over, the patients’ questionnaire previously used has been disbanded. As the change of company settles down, Southern Cross will be implementing its quality assurance process across the five homes in Oxfordshire. The operations manager sends regular monthly reports to the Commission following her visit to the home, regarding the regular day-to-day running of the home. Regular audits of various systems within the home are also carried out during these visits. Those residents wishing to have money or valuables kept in the safe are enabled to do so and receipts and records of all transactions are kept. The staff are all trained in moving and handling, fire safety and food hygiene, and a number also have first aid training. All staff receive induction training. All necessary servicing and maintenance of equipment is carried out on a regular basis and records are kept. Longlands Nursing Home DS0000027162.V268552.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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X X X X 3 Longlands Nursing Home DS0000027162.V268552.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. 1. Standard OP7 Regulation 15(1) Requirement An immediate requirement was made that every resident in the home must have a care plan in which his or her care needs are identified and how these will be met. Timescale for action 28/11/05 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 OP8 Good Practice Recommendations It is recommended that a review of the care planning system and how the residents’ health care needs are being met should be carried out and includes all the staff involved in the care provision. It is recommended that all staff who administer medication should be informed of the need to date the container on medicines with a short shelf life at the time of opening. 2 OP9 Longlands Nursing Home DS0000027162.V268552.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South Cowley Oxford OX4 2SU National Enquiry Line: 0845 015 0120 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.V268552.R01.S.doc Version 5.0 Page 20 - 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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