Inspection on 15/11/05 for Longmead House

This inspection was carried out on 15th November 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 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

Longmead House 09/05/07

Longmead House 16/05/06

Longmead House 01/08/05

Longmead House 13/01/05

Longmead House 21/06/04

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

CARE HOMES FOR OLDER PEOPLE Longmead House Longmead House 1 Buxton Lane Caterham Surrey CR3 5HG Lead Inspector Denise Debieux Unannounced Inspection 15th November 2005 10:00 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 Longmead House DS0000013706.V253098.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. Longmead House DS0000013706.V253098.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Longmead House Address Longmead House 1 Buxton Lane Caterham Surrey CR3 5HG 01883 340686 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) Mrs Bridget Catherina McAleese Mrs Bridget Catherina McAleese Care Home 23 Category(ies) of Dementia - over 65 years of age (4), Old age, registration, with number not falling within any other category (23) of places Longmead House DS0000013706.V253098.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Up to 4 (four) service users within the category older people (OP) may fall within the category DE(E). 1st August 2005 Date of last inspection Brief Description of the Service: Longmead House is situated in Caterham in a residential area accessible to main routes. The property is a Victorian house converted to provide accommodation for 23 older people. It is sited in its own grounds with car parking spaces at the front of the house and a large garden at the rear of the property. The home is owned and run by the owner who also has a private home adjacent to Longmead House. Individual accomodation is provided in four double bedrooms with en suite facilities and fifteen single bedrooms, two of which have en suite facilities. Shared space consists of a large lounge, dining room and conservatory. The home is arranged on the ground, first and second floors. The first and second floors can be accessed via a passenger lift. Longmead House DS0000013706.V253098.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 5.5 hours and was the second inspection to be undertaken in the Commission for Social Care Inspection year April 2005 to March 2006. This inspection was carried out by Denise Débieux, Lead Inspector for the service. Mrs Bridget McAleese (Owner/Registered Manager) was present as the representative for the establishment. A tour of the premises took place. Two of the twenty service users were spoken with at length, with a further seven service users and four on-duty staff being spoken with during the tour. Some of the comments made to the inspector during the inspection are quoted in this report. The care plans, activity schedule and records, policies and procedures, service user surveys, medication storage and records, staff rota, staff training certificates and staff recruitment records were all sampled. The inspector would like to thank the manager, staff and service users for their time, assistance and hospitality during this inspection. What the service does well: What has improved since the last inspection? Longmead House DS0000013706.V253098.R01.S.doc Version 5.0 Page 6 The ongoing maintenance and redecoration of the home and gardens provide the service users with homely and comfortable surroundings in which to live. Formal staff supervision is now being introduced and the policy for the protection of vulnerable adults has been revised to reflect the Surrey local procedure. Staff spoken with felt that the recent review of the care planning system and the subsequent amendments made, had lead to improvements in the continuity of care that the service users receive. 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. Longmead House DS0000013706.V253098.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 Longmead House DS0000013706.V253098.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): NONE EVIDENCE: Standard 3 was fully assessed and met at the last inspection and was not covered on this occasion. Standard 6 does not apply to this home. Longmead House DS0000013706.V253098.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 and 9 Personal care and healthcare support and assistance was seen to be provided, where needed, in a respectful and sensitive manner. Policies, procedures and practices are in place to ensure the safe administration of medication. EVIDENCE: Service users spoken with were complimentary regarding the care they receive at the home. One service user, when asked if the staff look after her well, replied: ‘Oh yes, they certainly do.’ The home has reviewed their care planning and documentation system since the last inspection. The care plans sampled were comprehensive and clearly set out actions which need to be taken by care staff to ensure that all aspects of the personal, health and social care needs of the service users are met. Daily staff recording showed that the required actions are being carried out and the care plans were seen to be regularly reviewed and promptly updated should any new problems be identified. The staff spoken with during this inspection were positive regarding the new system and stated that they felt it was going well. Service users are all registered with a local GP and the services of other health care professionals are accessed via GP referral. Longmead House DS0000013706.V253098.R01.S.doc Version 5.0 Page 10 Medication administration record (MAR) sheets, medication storage and the lunchtime medication round was observed during this inspection. The medication administration and storage observed was in line with the home’s policies and procedures. All interactions observed between the staff and service users were seen to be caring and respectful. Longmead House DS0000013706.V253098.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 and 14 The routines of daily living and activities are flexible and varied to suit individual service users’ wishes. Contacts with family and friends are encouraged and service users are encouraged and enabled to exercise choice and control over their lives. EVIDENCE: The routines of daily living are arranged to suit individual service users’ preferences and choices. This was reflected in the care plans sampled and confirmed by service users spoken with. There are a number of service users at the home who are able to mobilise freely and independently in the home. A few service users are able to go out unaccompanied and access the local community as they wish. There is an occupational therapist who provides exercise classes twice a week and also arranges reminiscence therapy. There are poetry readings, music evenings, afternoon board games and other activities. Newspapers are delivered and relevant issues are discussed in discussion groups. Service users are able to choose which activities they attend or participate in and their individual rooms were all seen to contain many personal possessions which were arranged to suit their individual wishes. Longmead House DS0000013706.V253098.R01.S.doc Version 5.0 Page 12 There are no restrictions to visiting times and staff support and encourage service users to maintain family links and friendships inside and outside the home. The inspector was advised that the home do not handle the financial affairs of any service users and that service users or their representatives handle their own financial affairs where appropriate. Longmead House DS0000013706.V253098.R01.S.doc Version 5.0 Page 13 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): 18 All required policies and procedures on the protection of vulnerable adults are in place and now reflect the local Surrey procedure. EVIDENCE: The home has a whistle blowing policy in place that is included in their service users’ guide. The policy on prevention of abuse has now been brought into line with the Surrey local procedure and the manager and deputy have their names on a waiting list for the next available date for the Surrey Multi-agency Protection of Vulnerable Adults training course. All service users spoken with said that they felt safe at the home with one service user commenting: ‘Oh yes, very safe.’ Longmead House DS0000013706.V253098.R01.S.doc Version 5.0 Page 14 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): 21 and 26 An ongoing maintenance and redecoration programme provides the service users with clean, pleasant and homely surroundings in which to live. EVIDENCE: The home was toured during this inspection. The maintenance and redecoration programme for the home was seen to be ongoing with plans being made to refurbish all bathrooms. The manager has consulted an occupational therapist for advice prior to commencing the work, which is now expected to start early in the new year. Laundry facilities are sited in the basement with washing machines suitable for the needs of the service users at the home. On the day of inspection the home was found to be warm and bright with a homely atmosphere and a high standard of housekeeping apparent. Longmead House DS0000013706.V253098.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Staffing numbers are sufficient to meet the needs of the current service users. Action must be taken to improve the staff recruitment and training procedures to ensure that the service users’ safety is protected and that staff are fully trained to perform the work expected of them. EVIDENCE: Care is provided during the daytime shifts by three care workers and at night time by one waking member of staff with the manager on call next door. The home is working towards having 50 of their care workers qualified to National Vocational Qualification (NVQ) level 2 in care or higher by 31st December 2005. Three of the twelve care workers have already achieved NVQ level 2 and two have achieved NVQ level 3. The remaining seven care workers are undergoing the NVQ level 2 training and hope to be finished within the next few months. Staff training is provided by an external company with much of the training being provided ‘in house’. Certificates were posted showing that all staff have had recent first aid training and the inspector was advised that manual handling refresher training is arranged for the near future. However, there was no clear record of training undertaken and all staff need an individual training and development assessment and profile. A recommendation and requirements have been made on these issues. Longmead House DS0000013706.V253098.R01.S.doc Version 5.0 Page 16 During the inspection two staff files were sampled. The home obtains two written references and applies for Criminal Record Bureau checks for all new employees. However, applicants are not asked to provide a full employment history, gaps in employment were not always fully explained and there was no recent photograph or proof of identity evidence in the files. One member of staff was working while waiting for the return of a CRB certificate but there was no evidence that a POVAfirst check had been made. In addition and in instances where staff commence employment on the basis of a POVAfirst check, whilst waiting for the CRB certificate to be returned, the manager was not fully aware that additional measures have to be put in place in line with recent legislation. Also discussed at this inspection was that all staff need to be supplied with a copy of the General Social Care Council (GSCC) code of conduct and practice. A recommendation and requirements were made regarding these areas of recruitment. Longmead House DS0000013706.V253098.R01.S.doc Version 5.0 Page 17 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): 31, 33, 35 and 36 Service users benefit from a well supervised and supported staff team and from the clear management approach at the home. The home has an effective quality assurance and monitoring system in place that is based on seeking the views of the service users. Policies and procedures are in place to protect service users’ financial interests. EVIDENCE: The manager is a registered nurse and has now completed her Registered Manager’s Award (RMA) training. The deputy manager is nearing completion of her NVQ level 4 in management and plans to go on to complete her RMA. The manager/owner is in day to day control of the home and all interactions observed between the manager and staff during this inspection clearly demonstrated that the home has a close and caring staff team. The manager stated that she meets regularly with all staff and it was apparent that the staff felt at ease and able to approach the manager at any time. Longmead House DS0000013706.V253098.R01.S.doc Version 5.0 Page 18 Formal staff supervision is now being introduced. One staff member told the inspector that she was looking forward to her first session and had already completed her supervision discussion notes in preparation. The home’s quality assurance and monitoring system is based on seeking the views of service users and includes informal information gathering and formal surveys. One service user told the inspector that: ‘If I don’t like something I only have to mention it to the manager and she sorts it out.’ All interactions observed between the between the manager, staff and service users were inclusive, caring and respectful. All service users spoken with were complimentary about the staff and all said that they felt safe at the home. Longmead House DS0000013706.V253098.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 X X 3 X X X X 3 STAFFING Standard No Score 27 3 28 3 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 3 X x Longmead House DS0000013706.V253098.R01.S.doc Version 5.0 Page 20 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 OP29.4 Regulation 18(4) Requirement Timescale for action 15/01/06 2 OP29 3 OP29 The registered person must supply all staff with a copy of the GSCC code of conduct and practice. 19(1)(a-c) The registered person shall not Sched 2 employ a person to work at the care home unless the person is fit to work at the care home and he/she has obtained, in respect of that person, the information and documents specified in paragraphs 1 to 9 of Schedule 2 of the Care Homes Regulations 2001, as amended by The Care Standards Act 2000 (Establishments and Agencies)(Miscellaneous Amendments) Regulations 2004. 19(11) Where the registered person (a-c) permits a new worker to start work with a POVAfirst check but prior to receipt of a valid CRB certificate the registered person must: • Appoint a member of staff (the staff member), who is appropriately qualified and experienced, to supervise the new worker. DS0000013706.V253098.R01.S.doc 15/11/05 15/11/05 Longmead House Version 5.0 Page 21 4 OP29 5 OP29 6 OP30 7 OP30.4 So far as possible, ensure that the staff member is on duty at the same time as the new worker. • Ensure that the new worker does not escort service users away from the care home premises unless accompanied by the staff member. 19(1)(a-c) The registered person must Sched 2 obtain all information and documents specified in paragraphs 1 to 9 of Schedule 2 of the Care Homes Regulations 2001, retrospectively, for each member of staff employed by the home after The The Care Standards Act 2000 (Establishments and Agencies)(Miscellaneous Amendments) Regulations 2004 came into force on 26th July 2004. 19(1)(a-c) The registered person must Sched 2 obtain a recent photograph and proof of identity for all other staff employed at the home prior to 26th July 2004. 18(1)(c) The registered person must (i) contact the local Health and Safety and Environmental Health Officers for advice and guidance on the required mandatory training in all safe working practices i.e. fire safety; first aid; control of infection; manual handling; food safety; and ensure that the appropriate training is provided. 18(1)(c) The registered person must carry (i) out a training and development assessment and individual training profile for each member of staff. • 28/12/05 15/01/06 15/02/06 15/02/06 Longmead House DS0000013706.V253098.R01.S.doc Version 5.0 Page 22 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 OP29 Good Practice Recommendations It is recommended that the registered person revise the home’s staff application form in line with the requirements of the amended Schedule 2 of The Care Homes Regulations 2001. It is recommended that the registered person compile and maintain a staff training log showing all mandatory and service specific training provided and/or booked for all staff. It is recommended that the registered person include the views of relatives and stakeholders in the community (i.e. GP’s, visiting Health Professionals, Care Managers etc) in the home’s quality assurance surveys. The results of any surveys to be correlated and included in the service users’ guide with copies to CSCI, Eashing Office. 2 OP30 3 OP33 Longmead House DS0000013706.V253098.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Longmead House DS0000013706.V253098.R01.S.doc Version 5.0 Page 24 - 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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