Inspection on 16/05/06 for Longmead House

This inspection was carried out on 16th May 2006.

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

Longmead House 09/05/07

Longmead House 15/11/05

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 Key Unannounced Inspection 16th May 2006 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.V295874.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Longmead House DS0000013706.V295874.R01.S.doc Version 5.2 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.V295874.R01.S.doc Version 5.2 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). 15th November 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 situated 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. The home provides service users with a reasonable standard of accommodation, which consists of 15 single bedrooms, 2 of which have en suite facilities and 4 double bedrooms with 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 by a passenger lift. Longmead House DS0000013706.V295874.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit took place over 5 hours and was carried out by Denise Débieux, Regulation Inspector. Mrs Bridget Catherina McAleese (Registered Provider/Manager) was present as the representative for the establishment. A tour of the premises took place. Three of the twenty-one service users were spoken to at length; with a further twelve service users and five on-duty staff being spoken with during the tour. In addition, seven service user survey forms were completed and handed in to the inspector on the day of this visit. Some of the comments made to the inspector and made on the survey forms are quoted in this report. The service user contracts, care plans, staff training log, staff recruitment records, health and safety check lists, menus, medication records and storage were all sampled. The lunchtime meal and medication round was observed and the home was toured. This was a positive visit with many improvements having been made and all but one of the previous requirements having been met. The inspector would like to thank the service users and staff for their time, assistance and hospitality during this visit. What the service does well: What has improved since the last inspection? Since the last inspection in November staff recruitment procedures have been amended and the manager has concentrated on reorganising staff training records and ensuring that all required training is provided and up to date. Staff spoken with all mentioned how they had enjoyed the recent training they had attended and were looking forward to courses booked for the near future. Longmead House DS0000013706.V295874.R01.S.doc Version 5.2 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. 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.V295874.R01.S.doc Version 5.2 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.V295874.R01.S.doc Version 5.2 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 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each service user is only admitted to the home following a needs assessment to ensure that the home can meet the service user’s identified needs. The home does not offer intermediate care. EVIDENCE: The care plans sampled all contained detailed assessments of the service users’ needs and included information regarding their preferences and previous likes and dislikes. All service users surveyed felt that the staff always listen and act on what they say, with one service user adding that the staff are: ‘Always very supportive.’ Longmead House DS0000013706.V295874.R01.S.doc Version 5.2 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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal care and healthcare support and assistance is planned and 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: 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 health and personal care needs of the service users are met. These care plans were very detailed and included the assistance required, with emphasis placed on the way the service users want their care to be provided. Care plans are regularly reviewed, with the service user signing to indicate their agreement. Daily notes are kept that reflect the care given and any changes or new concerns are recorded and acted upon. During the tour of the home staff were observed to always knock before entering the service users’ bedrooms and all interactions observed between staff and service users were seen to be caring and respectful. Longmead House DS0000013706.V295874.R01.S.doc Version 5.2 Page 10 One service user stated ‘I’ve always been very well looked after – staff are excellent’. All service users confirmed that they felt they received the care and support they needed. The medication administration records, medication storage, policies and procedures were all sampled and found to be in order. The lunchtime medication round was observed and seen to be in line with the homes policies and procedures. All staff responsible for medication administration have recently attended update training. Service users that wish to handle their own medications are assisted to do so, based on a risk assessment, and lockable storage is provided in their room. It has been recommended that the home carry out a more formal risk assessment for service users wishing to self-medicate and a sample form has been sent to the home for reference. Longmead House DS0000013706.V295874.R01.S.doc Version 5.2 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, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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. The meals in this home are good, offering both choice and variety and catering for special dietary needs. 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 who are able to mobilise freely and independently in the home. Two 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, quizzes, music evenings, afternoon board games and other activities. Newspapers are delivered and relevant issues are discussed in discussion groups. Longmead House DS0000013706.V295874.R01.S.doc Version 5.2 Page 12 All service users spoken with stated they enjoyed the activities, with a number saying how much they enjoy the quizzes and ‘sing songs’. One service user did mention that she would like the activities to be planned more in advance so that she knew what was happening the next day. This comment was passed to the home manager for further action. 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. 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. Menus sampled showed that the home offers a varied and well-balanced menu, with service users able to choose alternatives if they do not want the dish that is on the menu on the day. The lunchtime meal was taking place during this visit. Lunch was a home made quiche and the food was well presented with all service users saying how much they had enjoyed their meal. During the meal the atmosphere in the dining room was pleasant and relaxed, with ample staff available to offer help and assistance as needed. Longmead House DS0000013706.V295874.R01.S.doc Version 5.2 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): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a simple, clear and accessible complaints procedure which includes timescales for the process. All required policies and procedures are in place to ensure that service users are safeguarded from harm or abuse. EVIDENCE: There have been no complaints to the home or to CSCI since the last inspection and all service users spoken with were aware of who to talk to if they were unhappy with their care. The home has a whistle blowing policy in place that is included in their service users’ guide and their policy on prevention of abuse is in line with the Surrey local procedure. All service users spoken with said that they felt safe at the home with one service user commenting: ‘Oh yes, very much so.’ Longmead House DS0000013706.V295874.R01.S.doc Version 5.2 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): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The location and layout of the home and gardens are suitable for their stated purpose. 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 visit. The maintenance and redecoration programme for the home was seen to be ongoing with two bedrooms very recently redecorated. The plans to refurbish the bathrooms are underway with the new bathroom equipment already purchased. The manager is awaiting confirmation of a date when the work will be commenced, it is thought that this will be within the next four weeks. Laundry facilities are sited in the basement with washing machines suitable for the needs of the service users at the home. Longmead House DS0000013706.V295874.R01.S.doc Version 5.2 Page 15 On the day of this visit the home was found to be warm and bright with a homely atmosphere and a high standard of housekeeping apparent. Longmead House DS0000013706.V295874.R01.S.doc Version 5.2 Page 16 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The numbers and skill mix of the staff meets service users’ needs. The home now has a staff training programme which incorporates all areas needed to ensure, as far as reasonably possible, that service users are in safe hands at all times. Staff recruitment procedures have been improved but work needs to be completed on making sure that all required information has been obtained on current employees. 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 has now achieved 50 of their care workers qualified to National Vocational Qualification (NVQ) level 2 in care or higher. The manager and deputy manager have now been awarded their Registered Manager Awards, three of the eleven care workers have achieved NVQ level 3 in care and six have achieved NVQ level 2. Staff training is provided by an external company with much of the training being provided ‘in house’. The manager has now reviewed all staff training records and has developed individual staff training assessments and profiles for all staff. Training input has been substantial since the last inspection, with staff completing their NVQ training in care, required safe working topic updates have been provided as well as additional training in the protection of Longmead House DS0000013706.V295874.R01.S.doc Version 5.2 Page 17 vulnerable adults and medication care and control. This work has met all training requirements made at the last inspection. Staff spoken with at this visit were enthusiastic about the training they had received and one commented that she had enjoyed the training very much and felt an increase in confidence as a result. All service users spoken with felt that the staff were well trained with one commenting that ‘I’ve always been well looked after, the staff are excellent.’ Since the last inspection the manager has now obtained proof of identity and recent photographs for all staff. The home’s application form has been reviewed and amended to reflect the requirements of the Care Homes Regulations regarding staff recruitment. The manager has also decided that no new staff will commence their employment until a full Criminal Records Bureau (CRB) certificate has been received. All staff have now been supplied with a copy of the General Social Care Council (GSCC) code of conduct and practice. Two staff files were sampled during this visit and found to contain all required information except that there were still some possible gaps in employment that need to be explored in more depth. There was also a discrepancy in the dates of employment when comparing a reference with the employment dates given by one employee. The requirement made at the last inspection has been carried forward for a further four weeks in order that this work can be completed in full. Longmead House DS0000013706.V295874.R01.S.doc Version 5.2 Page 18 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 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users benefit from the clear management approach at the home. The home has a quality assurance and monitoring system in place that is based on seeking the views of the service users but results of recent surveys need to be correlated, action plan drawn up and carried out and the results published. Service users’ financial interests are safeguarded by the policies and practices of the home. All other policies, procedures and practices are in place to ensure, so far as is reasonably practicable, the health safety and welfare of service users and staff. EVIDENCE: The manager is a registered nurse and holds the Registered Manager’s Award (RMA) qualification. Longmead House DS0000013706.V295874.R01.S.doc Version 5.2 Page 19 The manager/owner is in day to day control of the home and all interactions observed between the manager and staff during this visit clearly demonstrated that the home has a close and caring staff team. It was apparent that the staff felt at ease and able to approach the manager at any time. 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, with service user meetings held every other month. The manager has recently begun carrying out surveys with service users and has also surveyed some visiting professionals. The manager stated that this is with a view to completing the home’s annual quality assurance review by the end of this year. Once all the surveys of service users, their relatives/representatives and other stakeholders in the community have been completed it was discussed that the results will need to be correlated, an action plan formulated to improve any issues identified and the results then published to the service users, CSCI and included in the home’s service users’ guide. The annual development plan needs to be based on a systematic cycle of planning – action – review etc. The recommendation made at the previous inspection has been carried forward to this report as not yet fully met. All policies, procedures , practices and safety checks are in place to ensure, so far as is reasonably practicable, the health safety and welfare of service users. Staff were observed to be following these procedures on the day of this visit. All interactions observed between the between the manager, staff and service users were inclusive, caring and respectful. One service user told the inspector that: ‘the staff are very good, I would recommend them. We have a very friendly relationship, they do their very best for me.’ Longmead House DS0000013706.V295874.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Longmead House DS0000013706.V295874.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP29 Regulation Requirement Timescale for action 13/07/06 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 Care Standards Act 2000 (Establishments and Agencies)(Miscellaneous Amendments) Regulations 2004 came into force on 26th July 2004. (Timescale of 28/12/05 not met) Longmead House DS0000013706.V295874.R01.S.doc Version 5.2 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 OP9.2 Good Practice Recommendations It is recommended that a formal risk assessment is carried out and documented regarding service users who wish to self-medicate, this risk assessment to be reviewed on a monthly basis or more regularly if indicated. It is recommended that service users are provided with information, in advance, regarding planned activities. 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. (Carried forward from inspection of 15/11/05) 2 3 OP12.4 OP33.2 OP33.4 Longmead House DS0000013706.V295874.R01.S.doc Version 5.2 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.V295874.R01.S.doc Version 5.2 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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