Inspection on 01/06/05 for Longlast

This inspection was carried out on 1st June 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Longlast 18/05/07

Longlast 08/06/06

Longlast 15/11/05

Longlast 10/11/04

Longlast 26/05/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 Longlast Thorpe Road Carlton Stockton-on-Tees TS21 1DR Lead Inspector Penni Hughf Unannounced 01 June 2005 10:00 st 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 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Longlast B51-B01 S10 Longlast V230418 010605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Longlast Address Thorpe Road Carlton Stockton-on-Tees TS21 1DR 01740 631931 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Annfield Care Mr Kevin P Teasdale Care Home 9 Category(ies) of LD - Learning Disability registration, with number of places Longlast B51-B01 S10 Longlast V230418 010605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th November 2004 Brief Description of the Service: Longlast is a nine bedded home which is registered to provide care to people with learning disabilities. The home is situated in a rural setting, on the outskirts of a village. Accommodation for the residents is provided in spacious single bedrooms, two of which have en-suite facilities, and there are three lounges/day rooms offering ample shared space. The building has been converted to enable it to offer spacious accommodation for the residents, and is set in its own grounds, with a large enclosed garden at the rear of the house. Transport is provided by the Proprietors, which enables residents to use the amenities of the village, as well as those further afield. The transport is also used for residents to experience regular outings and outside activities. Longlast B51-B01 S10 Longlast V230418 010605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took five hours and forty minutes and was carried out as one of the two statutory annual inspections required by the Care Standards Act 2000. On this occasion, the manager was not on duty and some records, particularly those of staff, were not available for inspection. A partial tour of the premises took place and care records and health and safety checks were inspected. Three staff on duty were interviewed, together with two of the nine residents. The other residents were either unable to talk, or did not wish to talk to the inspector. Two health professionals who visited during the inspection also spoke to the inspector. What the service does well: The home has a good recruitment procedure and the team works positively to support the residents’ quality of life. Residents spoken to feel they have a good relationship with both the manager and staff. Comments included “I like (staff member’s name,) he’s really nice. I like (staff member’s name,) she’s really nice, everyone is nice.” “If I was worried I would go to (Manager’s name.)” Meals are varied, well balanced and offer choice and variety. Residents said, “the food is very nice” and “I like the food here.” There are opportunities for residents to participate in a variety of activities developed for them by the manager and staff both inside and outside the home. Staff training continues to develop the staff knowledge base and staff are able to show how they communicate with residents by using various techniques such as signing, pointing and questioning. The home is good at providing a safe environment for the residents Longlast B51-B01 S10 Longlast V230418 010605 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Longlast B51-B01 S10 Longlast V230418 010605 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Longlast B51-B01 S10 Longlast V230418 010605 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 Admission procedures are robust and make sure that residents needs are assessed and can be met before admission takes place. EVIDENCE: Although no new residents had been admitted to the home since April 2002, a new policy and procedure had been developed, to ensure that the requirements of the National Minimum Standards would be met in any future admissions. At the last inspection, two of the case files of residents admitted prior to that date, checked during the inspection, contained a copy of both the care management assessment and care plan. The home’s Statement of Purpose stated that the home did not take emergency or unplanned admissions. Longlast B51-B01 S10 Longlast V230418 010605 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,9 & 10 The home is good at meeting most of the residents needs, but improved communication between staff and between manager and staff would make this even better. Residents are supported to make daily decisions and are helped to take acceptable risks. The home is good at maintaining confidentiality. EVIDENCE: Three care plans were examined during the inspection. All three contained detailed information. Quite different activities were identified for the three people. Risk assessments were on file supporting residents’ opportunities to be as independent as possible, covering subjects such as food handling, kitchen safety and mobility. Some residents said that staff talked to them about what they wanted to do, but others were unable to indicate whether or not they were aware of care plans, due to their complex needs. Longlast B51-B01 S10 Longlast V230418 010605 Stage 4.doc Version 1.30 Page 10 Staff interviews highlighted their in depth knowledge of the residents’ individual needs, and changes were recorded in care plans and risk assessments. Records showed that the care plans were reviewed regularly. At the last inspection, one resident, whose file the inspector examined, was experiencing some problems, which had resulted in a reduction in his opportunities to participate in activities outside the home. A behaviour team had been involved in providing input and recommendations to the home since then. Discussions with them and the staff suggested that staff had worked hard to carry out the recommendations set by the behaviour team, but that at times communication could be better, both between the manager and the staff, and particularly between different staff members. The behaviour team said that in April 2005 they had offered to attend a staff meeting at the home, to enable all staff to participate in looking at the recommendations, the barriers that got in the way of effective intervention, and what progress had been made. This had not yet been taken up by the home. All staff spoken to said that they would welcome such a meeting and would attend, whether or not they were on duty. Staff were clear about confidentiality and one of the residents the inspector spoke to said, “Staff would keep a secret.” Longlast B51-B01 S10 Longlast V230418 010605 Stage 4.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,14,15,16 & 17 The home is good at making sure the residents are offered a variety of activities both inside and outside the home, and are helped to maintain relationships with their families. Staff are good at recognising resident’s needs and meeting them sensitively and helping residents to make the most of themselves. The home provides a healthy diet that the residents enjoy. EVIDENCE: On the morning of the inspection, one of the residents had gone for an induction to a computer course at Sure Start. She had been accompanied to the course by one of the support workers and returned in time for lunch. This lady also attended a literacy class once a week. She said of her activities, “It (the course this morning) was absolutely great. I did a little computer, I wrote my name on it. You can see what work you can do. What you would like to be. I still go to reading and writing. I go with ----- (member of staff).” Longlast B51-B01 S10 Longlast V230418 010605 Stage 4.doc Version 1.30 Page 12 Five residents attended the local adult training centre for between 2 and five days a week although on the day of the inspection, they were all at the home, as the day centres were closed for an annual break. Staff interviewed, said that one gentleman attended the Hindu Temple in North Ormesby on the first Sunday of every month. Two of the residents had attended church the previous weekend. Residents with complex needs (which included most of the residents accommodated at the home), received support through health care professionals and social workers. Staff interviewed said, “we talk to the residents. We watch their body language, (as many of the service users had little verbal communication). All the staff would recognise immediately if a resident was not their usual self.” Staff said that different resident’s needs were met by differing activities, which included baking, going for walks, going to discos, train spotting, going to the cinema, helping with the food shopping for the home and visiting the Tees barrage. The previous weekend, residents had visited Eden Camp, and one of the staff told the inspector that the residents were going to a model air show the following weekend. Staff said that they helped residents to keep in touch with their families with phone calls, and these were also logged in the resident’s care plans. Several residents visited their families on a regular basis, sometimes staying overnight. The home provided transport for those who needed it. Residents spoken to said that they liked the food. “The food is very nice.” “I like the food here.” On the day of the inspection, breakfast had consisted of cereal, toast, bacon sandwiches, juice and tea or coffee. For lunch the residents had sausages and mashed potatoes, carrots, turnips and cabbage, followed by fresh fruit salad or yoghourt. The teat time meal was planned to be cold meat salad with cottage cheese, black cherry gateau or fresh fruit. Supper would be crumpets or a piece of pizza and a hot drink. Longlast B51-B01 S10 Longlast V230418 010605 Stage 4.doc Version 1.30 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 &19 The home is good at providing care in a way that the residents like and staff are generally good at supporting residents emotional and physical needs. But staff should make sure that all residents are listened to and protected and supported if and when behaviour outbursts happen. EVIDENCE: Observation of the interaction between staff and residents throughout the day of the inspection, highlighted a good rapport between them, and residents appeared comfortable and confident with the way they were supported. Care plans contained sections on residents’ needs and objectives, risk assessments and social and emotional needs. Staff comments included, “I feel physical care needs are totally met. Everyone has a bath or shower every day. And emotional needs are met through observation and knowledge of their normal behaviour, for instance, if ---- is angry, I would go and talk to her, make her a cup of tea, give her some time. You have to use your judgement all the time.” “I believe the residents are happy most of the time. We meet their needs by following their choices. I like to talk to the residents and get to know them. I believe they trust me. It’s about being aware of how they’re feeling.” Longlast B51-B01 S10 Longlast V230418 010605 Stage 4.doc Version 1.30 Page 14 Only two residents were able or willing to give some verbal responses and these included, “I like -----. He’s really nice. I like -----, she’s really nice, the staff are good.” This comment was accompanied with a double ‘thumbs up’ sign. “I like the staff. I’m very happy with the staff. I’m not happy with the residents. One of them pushes me.” Staff questioned about this comment said that they thought it was a particular resident, whose behaviour was the subject of a positive reinforcement programme using antecedent, behaviour and consequence charts. However, staff needed to be alert to the impact these behaviours were having on other residents and try to ensure that they are both protected and supported. Longlast B51-B01 S10 Longlast V230418 010605 Stage 4.doc Version 1.30 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 The home is good at making sure that staff understand the importance of dealing with any complaints immediately and providing clear, appropriate information for residents and relatives about how to make a complaint. Staff display a knowledge and understanding of Adult Protection issues, which protect the residents from abuse, but the policy must contain all contact information to support them. EVIDENCE: The complaints policy and procedure was kept in the office, together with the complaints forms. Staff interviewed knew where they were kept. The complaints procedure included a pictorial procedure for those residents with limited literacy skills. Staff comments on complaints included: “Complaints would always be dealt with, with the utmost importance. This was stressed to me at my interview. If there was a complaint, I would take it straight to the manager or senior on duty. I’m aware of the policy and procedure but couldn’t quote it.” “The complaints procedure and forms are kept in the office.” “I would go to a senior if I couldn’t deal with it myself.” One of the residents said “I would tell ----(manager) if I wasn’t happy with something.” There were no complaints recorded since the last inspection. Longlast B51-B01 S10 Longlast V230418 010605 Stage 4.doc Version 1.30 Page 16 At the last inspection, it was recommended that the adult protection procedure should include information about the Department of Health “No Secrets” guidelines, and Protection of Vulnerable Adults Scheme and this had been done. However, there were still no contact numbers in the policy for the social services adult protection co-ordinator, Commission for Social Care Inspection or the Police. This should be addressed to make sure that any senior in charge at any time had immediate access to them if necessary. There had been no adult protection referrals at the home. Longlast B51-B01 S10 Longlast V230418 010605 Stage 4.doc Version 1.30 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Standards not inspected on this occasion. EVIDENCE: Longlast B51-B01 S10 Longlast V230418 010605 Stage 4.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32 The home is good at making sure that staff are trained and qualified and understand how to meet the residents needs. EVIDENCE: One staff member said, “I did a one day induction to care before starting work in the home. Since I started I’ve done my fire training, and my first aid, although I haven’t got that certificate yet. I had an enhanced CRB (Criminal Records Bureau) check and POVA (Protection of vulnerable adults) check and had to provide names and addresses for two references.” This could not be checked on the staff files, as the manager was not on duty, and the staff personnel files were locked away. Another member of staff told the inspector that she had done her Safe Handling of Medicines course. Training records were available, which showed that 7 staff had undertaken a first aid course, and that all staff had attended a recent fire training course. The home employed thirteen care staff, excluding the manager, and one domestic. Three members of staff had successfully completed their National Vocational Qualification in care level 2 and three further staff were currently undertaking it. Five staff held their National Vocational Qualification at level 3, and two further staff were currently undertaking it. Two staff did not hold any qualification at NVQ. Longlast B51-B01 S10 Longlast V230418 010605 Stage 4.doc Version 1.30 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 The home is good at making sure that the residents’ welfare and safety is protected. EVIDENCE: Covers protected all the radiators in the home, and there were window restrictors on all first floor windows. There were thermostatic mixer valves on all taps except those in the laundry, which was kept locked. Two alternating taps were checked daily by the senior on duty and recorded in a maintenance file (examined.) Checks on the fire points, call system, fire exits and fire extinguishers and fire blanket were also recorded. Fridge and freezer temperatures were recorded and satisfactory. A kitchen-cleaning schedule was in place and up to date. owned by the home were also checked on a regular basis. The two vehicles Longlast B51-B01 S10 Longlast V230418 010605 Stage 4.doc Version 1.30 Page 20 An appropriate accident pad was in place, and accidents were recorded. However, these were all held on the individual resident’s files, and it was therefore impossible to trace them at the inspection, without going through every resident’s and staff member’s files. These need to be held in a central file, in order that a proper audit and analysis can take place. Longlast B51-B01 S10 Longlast V230418 010605 Stage 4.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Longlast Score 3 2 x x Standard No 37 38 39 40 41 42 43 Score 2 x x x x 3 x B51-B01 S10 Longlast V230418 010605 Stage 4.doc Version 1.30 Page 22 yes 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 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. 1. 2. 3. 4. Refer to Standard YA23 YA42 YA37 YA19 Good Practice Recommendations The point of contact names and telephone numbers for adult protecction referrals should be included in the adult protection policy All recorded accident forms should be held in a central file to allow analysis and inspection The manager should have successfully completed his National Vocational Qualification level 4 in care and management by 2005 Staff should be alert to the emotional impact behaviour outbursts might have on other residents. Longlast B51-B01 S10 Longlast V230418 010605 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Unit B, Advance St Marks Court Teesdale Stockton-on-Tees TS17 6QX 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. 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