CARE HOME ADULTS 18-65
Longlast Thorpe Road Carlton Stockton-on-Tees TS21 1DR Lead Inspector
Stephen Smith Unannounced Inspection 15th November 2005 01:30 Longlast DS0000000010.V265537.R01.S.doc Version 5.0 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 Longlast DS0000000010.V265537.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 Adults 18-65. 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. Longlast DS0000000010.V265537.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Longlast Address Thorpe Road Carlton Stockton-on-Tees TS21 1DR 01740 631391 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) Annfield Care Mr Kevin Paul Teasdale Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Longlast DS0000000010.V265537.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The number of persons shall not at any one time exceed 9 adults with learning disabilities 1st June 2005 Date of last inspection 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 a field. The transport is also used for residents to experience regular outings and outside activities. Longlast DS0000000010.V265537.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced and was undertaken in three and a quarter hours by one inspector. The purpose of the inspection was to inspect the home in terms of the key National Minimum Standards not covered at the last inspection. During the visit the inspector interviewed one resident and spoke informally to another two. Additionally the inspector observed interactions between staff and the residents, interviewed the manager and spoke informally to two staff members. A tour of the premises was undertaken and records examined including staff recruitment and training records. Questionnaires were sent to residents’ family members with four being returned to the inspector and a preinspection questionnaire was completed by the manager. What the service does well:
The home does a good job I terms of most of the standards assessed at this inspection. Questionnaires from relatives showed that they are pleased with the care provided by the home to their family members. One said in the questionnaire returned, “My daughter (name) is making good progress. Staff are competent and approachable. (Name) is very happy at the present.” Another relative wrote, about her relative living at the home, “Longlast is a place he likes to be and he is very settled there.” The home provides residents with good opportunities to take part in activities and events in the community and to keep up relationships with their family members. It is also good at looking after resident’s medication and making sure that they get the correct medication they need to keep them well. The home is a good place for people to live; it has pleasant, large gardens and is well looked after. Residents have bedrooms that reflect their personalities and are able to have their belongings around them and there is plenty of suitable communal space for them to spend time together. The home is well maintained and kept clean and tidy. The manager is good at checking the backgrounds of new staff members to make sure that they are suitable to work with vulnerable adults. He also makes sure that staff get good training to help them to do their job of looking after people better. The home is also good at working with residents and their relatives to find out what they thinks about the care provided and makes sure that it takes action about any comments or suggestions that are made. Longlast DS0000000010.V265537.R01.S.doc Version 5.0 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 DS0000000010.V265537.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Longlast DS0000000010.V265537.R01.S.doc Version 5.0 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 the following standard(s): The standards relating to Choice of Home were not assessed at this inspection. EVIDENCE: Longlast DS0000000010.V265537.R01.S.doc Version 5.0 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 the following standard(s): The standards relating to Individual Needs and Choices were not assessed at this inspection. The standards relating to Individual Needs and Choices were not assessed at this inspection. EVIDENCE: Longlast DS0000000010.V265537.R01.S.doc Version 5.0 Page 10 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 the following standard(s): 13 Longlast supports residents to be involved in a range of activities within the community based on their own needs and interests. EVIDENCE: The manager provided the inspector with a summary list of the range of activities undertaken by residents at the home. This list included information about where various activities can be accessed. The resident interviewed told the inspector about the things that she enjoys doing and the activities she take part in. She said, “I go to the pub with (staff member) and “We go on holiday, I’ve been to Scarborough and other places.” She also gave a list of other activities she enjoys but said, “Sometimes I just like staying in.” A list of residents’ and staff members’ birthdays was displayed in the home and the resident confirmed that birthdays are celebrated by special events. Longlast DS0000000010.V265537.R01.S.doc Version 5.0 Page 11 Other information was displayed in the home about the activities that people undertake and the placed they go to visit. At the time of the inspection visit residents were arriving back at the home from a range of day activities and were talking to staff members about their day and the things that they had done. The manager described how staff members support people to join in with activities and events in the community and it was clear that other residents had been helped to go out into the community by staff members. Questionnaires returned from family members of four residents said that they are made welcome in the home and able to spend time privately with their relatives. Evidence was available in the home and in residents’ bedrooms of the involvement of families in the home and of the interests and activities of the residents. Longlast DS0000000010.V265537.R01.S.doc Version 5.0 Page 12 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 the following standard(s): 20 The home’s arrangements for making sure people get the correct medication are good and make sure that residents wellbeing is protected and promoted. EVIDENCE: During the inspection the home’s arrangements for receiving, storing, administering, recording and returning resident’s medication were examined and discussed in depth with the manager. At the time of the inspection visit, medication was seen to be correctly stored with accurate records reflecting the stocks held. The manager described how the recording system used makes sure that medication is double checked before administration to ensure that all the necessary medication needed by a resident is prepared and then administered. Effective arrangements are in place to receive medication from the pharmacy and to check that the correct medication is received. A recording system is in place for when unused or any spoiled medication needs to be returned. The manager said that staff members have to have undertaken a safe handling of medication training course before they administer medication. The file of a staff member, who has been at the home for some time, contained a certificate to show that this training has been undertaken.
Longlast DS0000000010.V265537.R01.S.doc Version 5.0 Page 13 The manager also said that once this training has been undertaken staff members have to observe medication being administered then be supervised carrying out the task before they are able to undertake it themselves. Individual residents’ medication record sheets contain photographs of the person to help ensure that residents receive the correct medication. The resident spoken to said “I couldn’t look after my own tablets, I’d get muddled. The staff do it for me and I like that; I always get the tablets I need.” During the inspection the manager demonstrated a thorough knowledge of the various medications taken by residents, their purpose and effects and the working of the home’s medication system. Longlast DS0000000010.V265537.R01.S.doc Version 5.0 Page 14 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 the following standard(s): The standards relating to Concerns, Complaints and Protection were not assessed at this inspection. EVIDENCE: Longlast DS0000000010.V265537.R01.S.doc Version 5.0 Page 15 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 the following standard(s): 24 and 30 Longlast is a clean, homely, comfortable and attractive place for people to live. EVIDENCE: Longlast is comfortable, well decorated and domestic in nature. A tour of the premises during the inspection showed that it is well maintained. The home’s fittings and fixtures are homely and ‘ordinary’ in nature and meet the needs of the residents without appearing obtrusive or specialised. The home has two large communal lounge areas that give residents a choice of a more busy or quieter area. All the bedrooms are decorated individually based on the preferences and tastes of residents and are personalised and comfortable. Externally, the home appears in good condition and is set in attractive gardens. These are well maintained; at the time of the inspection work was being undertaken to cut the lawns and tidy the gardens for winter. A resident spoken to said that she enjoys playing football in the home’s garden. Longlast DS0000000010.V265537.R01.S.doc Version 5.0 Page 16 At the time of the inspection visit the home was clean. The manager described how the home works hard to prevent odours and to keep the home clean despite the pronounced needs of some of the residents. The home’s laundry area is appropriately equipped with washing facilities suited to its purpose and clear arrangements are in place to ensure that items are washed correctly. A careful process of maintaining kitchen hygiene is in place with a structure cleaning programme and records of refrigerator and freezer temperatures being maintained as well as the temperature of hot food served to residents. Longlast DS0000000010.V265537.R01.S.doc Version 5.0 Page 17 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34 and 35 Residents are kept safe by an effective process to ensure that staff members are suitable people to work with vulnerable adults. Residents benefit from being cared for by a staff team that gets good training. EVIDENCE: The recruitment files of three staff members were examined. Two files were in relation to staff members recently employed at the home who were still in their probationary period. The other file was that of a staff member who had worked at the home for some time. All files examined contained an application form including the person’s full employment history. Any gaps identified were explored and two written references for the person were in place including one from the person’s most recent employer. Commendably, the manager had telephoned the referees to verify the written reference. Evidence was in place to show that Criminal Records Bureau disclosures at Enhanced level had been received for the staff members prior to them starting work in the home. Longlast DS0000000010.V265537.R01.S.doc Version 5.0 Page 18 The files of the two new staff members did not contain copies proof of their identity as is required by Schedules 2 and 4 of the Care Homes Regulations 2001, though this was in place in the file of the staff member who had been at the home for some time. The manager pointed out that this proof of identity had been seen when the person’s Criminal Records Bureau disclosure had been applied for and explained that he arranges for this information to be on file as soon as the person’s probationary period is completed; the files examined confirmed this. In order to comply fully with Regulations 17 and 19 of the Care Homes Regulations 2001 proof of identity must be retained on the files of all staff members whether or not they are still in their probationary period. All files examined contained evidence that that the staff member concerned received an in house induction to the home and there was evidence to show that staff receive induction to Skills for Care specification. The home has a structured training programme for all staff that identifies when time limited training needs to be renewed and identified specific learning needs for staff members. Files examined contained copies of certificates showing that staff receive a significant amount of training in areas appropriate to the group of people cared for at the home. A relative stated, in a questionnaire returned, that staff members are ‘competent’. Longlast DS0000000010.V265537.R01.S.doc Version 5.0 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 and 39 Residents benefit from living in a home managed by an experienced and competent manager. Good arrangements exist for seeking the views of residents and their families about the running of the home and making improvements based on these views. EVIDENCE: During the inspection the manager demonstrated his knowledge of the home and its operation. He clearly knows the residents well and is aware of their needs and how to provide for them. The home’s systems and procedures, established by the manager, show his competence in the role. The manager has completed the work for his NVQ level 4 in management but has not this work verified yet. This should take place as soon as possible to ensure that he has the qualifications set out in Standard 37 of the Care Homes for Adults (1865) National Minimum Standards.
Longlast DS0000000010.V265537.R01.S.doc Version 5.0 Page 20 The home has a system in place to seek the views of residents and their All relatives who completed families about the running of the home. questionnaires said that they are consulted about the care provided by the home. Evidence was available to show that any issues raised in this quality assurance process are dealt with promptly. All relatives who returned questionnaires said that they are made aware of inspections of the home and have access to inspection reports. It is positive to note that, though no requirements were made at the last inspection of the home, the good practice recommendations made had been actioned by this inspection. One relative stated in the questionnaire that, “He (resident) can make his preferences known and likes living there.” It was noted that the home does not have a fax machine, this makes it difficult to send written information to the Commission for Social Care Inspection quickly. Regulations 16 of the Care Homes Regulations 2001 states that care homes must have this facility. Longlast DS0000000010.V265537.R01.S.doc Version 5.0 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 X X X X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X X X Standard No 24 25 26 27 28 29 30
STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X X 2 3 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Longlast Score X X 3 X Standard No 37 38 39 40 41 42 43 Score 2 X 3 X X X X DS0000000010.V265537.R01.S.doc Version 5.0 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 YA34 Regulation 17, 19 Requirement Evidence of the proof of identity, as set out in Schedules 2 and 4 of the Care Homes regulations 2001, must be retained in the files of all staff members, The registered person must provide the home with facilities for communication by facsimile transmission. Timescale for action 23/12/05 2 YA40 16 27/01/06 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 YA37 Good Practice Recommendations The manager should possess National Vocational Qualification level 4 in care and management by 2005. Longlast DS0000000010.V265537.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Tees Valley Area Office 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
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