Inspection on 09/05/07 for Longmead House

This inspection was carried out on 9th May 2007.

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 16/05/06

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 Lesley Garrett Unannounced Inspection 9th May 2007 10:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address DS0000013706.V339634.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. DS0000013706.V339634.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 DS0000013706.V339634.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). 16th May 2006 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. The fees for this service range from £365 to £550 per week. DS0000013706.V339634.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘Key Inspection’. The inspector arrived at the service at 1030 and was in the service for four and a half hours. It was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s manager, and any information that CSCI has received about the service since the last inspection. The inspector asked the views of the people who use the services and other people seen during the inspection or who responded to questionnaires that the Commission had sent out. We looked at the home’s records and completed a tour of the building. The inspector looked at how well the service was meeting the standards set by the government and has in this report made judgements about the standard of the service. What the service does well: What has improved since the last inspection? A requirement was made following the last visit in May 2006 that the home ensures that they obtain all the relevant documentation required before employing staff. This requirement has been met. DS0000013706.V339634.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. DS0000013706.V339634.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 DS0000013706.V339634.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3. People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including visits to this service. All people who use the service have a pre-admission assessment and are confident that their needs will be met. The home does not provide intermediate care beds. EVIDENCE: People who use the service have a pre-admission assessment prior to admission to the home. The manager stated that she carries these out and will sometimes be accompanied by her deputy. We observed an assessment that had already been completed and this is then kept in the personal folder of the person who uses the service. The manager stated that this document is then used to write the care plans following admission. DS0000013706.V339634.R01.S.doc Version 5.2 Page 9 One survey returned to us stated ‘someone came and checked what the home was like and then I came and had my hair done before I moved in’. Another stated ‘when my daughter visited she was given lots of information by the matron’. DS0000013706.V339634.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 & 10. People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including visits to this service. People who use the service have individual plans, which reflect the care and support they require and their health care needs are fully met. The medication policies and procedures that are in place and implemented by staff protect these people. The privacy and dignity of the people who use the service are respected. EVIDENCE: We sampled two individual plans of care and found them to contain a good variety of individual plans and risk assessments. The manager stated that the carers look at a care plan every week so that by the end of the month all plans have been reviewed. The manager also told us that plans were just being updated to include a life history and we observed a sample of this. We observed evidence that people who use the service or their representatives had been consulted about the care plans and signatures seen. One relative DS0000013706.V339634.R01.S.doc Version 5.2 Page 11 stated ‘I feel Longmead look after mum very well and are prepared to do more than they need to’. The manager stated that the general practitioner (G.P.) visits every week and in between when necessary. The manager told us that she meets with the G.P. every six months where they review all of their health care needs. If changes are required the manager said she will discuss with the people who use the service first and give clear explanations about any changes being considered. One relative stated ‘when things have had to be changed with mother the manager is in touch with us at a very early stage’. Other health care professionals that support the home are the district nurse, who again the manager said was a good support to them, the opticians and dentist. The manager stated that the home has the support of a local pharmacy for all their medication needs. We observed that blister packs are used and their supplies are delivered every month. The manager stated that as part of their quality system the pharmacist visits the home every year to do an audit. The manager also showed us that all staff that administer the medicines have had training. One survey form returned to us said ‘all my medication has been explained to me and why I have it. It is given to me by a member of staff at the appropriate time of day’. The home has a privacy and dignity policy, which we observed. Staff were observed knocking on bedroom doors prior to entering and addressing the people who use the service by their preferred name, which is documented, in their individual plans of care. All rooms are now single and visitors and visiting professionals have the opportunity to see the people who use the service in private. DS0000013706.V339634.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 & 15. People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including visits to this service. People who use the service are supported to exercise choice and control in all that they do and the food is of a good quality. EVIDENCE: The manager explained to us that the home is without their activities organiser at the moment but the staff are now allocated to provide this activity. Activities take place every afternoon and this includes poetry readings, puzzles and reading the newspapers together. One comment received said ‘there are a variety of activities organised for me and I am encouraged to carry on with my own hobbies’. The manager said that ministers from various religious groups visit the home to visit the people who use the service. We observed the notice board, which displayed those activities that would take place outside of the home. There is a lunch organised by a local charitable organisation and people who use the service have been asked who would like to attend this. The manager also said that some people would be attending a local school for afternoon tea and a concert. DS0000013706.V339634.R01.S.doc Version 5.2 Page 13 Visitors can visit at any time the manger said and one comment received said ‘Longmead is always welcoming to me’ and another said ‘I can visit at anytime and my father can phone me whenever he wants to’. The manager said that people who use the service are always given choices by the staff. People who use the service told us that they could decide when to get up in the morning and go to bed. Choices are given with food and we were told that ‘I know if I do not want to join in any activity I don’t have to and I can eat my meal wherever I like’. During a tour of the building we observed that the bedrooms had been personalised with their own possessions. The home employs a full time chef and a cook to cover days off. We observed the lunchtime meal and people who use the service all said they were enjoying their meal and had been given choice. On the day of the visit lunch was roast chicken but an alternative was available and a soft diet for those requiring this. A survey returned to us stated ‘all the food is very good’ and another told us ‘ the food is excellent I can’t fault it’. DS0000013706.V339634.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including visits to this service. The people who use the service are protected by the home’s complaints policies and safeguarding procedures. EVIDENCE: The manager stated that the home keeps a complaints log but she has not received any complaints. She said that any verbal concerns that are told to her are always dealt with immediately, then documented in the individual plans and an incident form would be completed to demonstrate any action that has been taken. No complainant has contacted the Commission with information concerning a complaint made to the service since the last inspection. We observed that the home has the local authorities procedures for safeguarding adults and the home’s own policy follows these procedures. The manager stated that the home has had no referrals under these procedures since the last inspection. Documentation observed by us demonstrated that staff have had training in safeguarding adults and this takes place regularly. DS0000013706.V339634.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including visits to this service. People who use the service live in a well-maintained environment, which was clean and hygienic. EVIDENCE: The manager accompanied us on a tour of the building and we observed that some re-decoration had taken place in some of the unoccupied rooms and new carpet laid. Downstairs the bathroom was nearing completion as a new shower has been installed. The manager stated that the bathrooms are the next thing to be refurbished, as the people who use the service cannot access all of the baths available. The home has a refurbishment programme in place for this year and the manager showed us this document. DS0000013706.V339634.R01.S.doc Version 5.2 Page 16 Bedrooms had all been personalised by the people who use the service and all rooms when they become vacant are re-decorated. One person told us ‘I have a lovely room and those doors lead right into the garden. I can go out there if I want to’. The laundry was situated in the basement and the home does not employ anyone to do the washing; instead, the manager said all staff are allocated to do this task. A comment received by us said ‘Longmead is kept very clean and fresh. There are no unpleasant smells anywhere’. DS0000013706.V339634.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 & 30. People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including visits to this service. Staff in the home are trained, skilled and in sufficient numbers to fill the aims of the home and meet the changing needs of people who use the service. EVIDENCE: We spoke with the manager and observed the staff rota and found that staffing levels were sufficient to meet the needs of the people who use the service. One comment received said ‘there are members of staff on hand at all times. If I request anything it is acted upon very quickly’. The manager stated that the home has had no need to use agency staff as the staff all offer to cover any vacant shifts if they are able to do so. The manager told us that all the care staff at the home have the National Vocational Qualification (NVQ) at level 2 or 3. One survey retuned to us said ‘the care staff have the necessary skills and experience to look after the people properly’. The manager also told us that all staff have an induction and they use a nationally recognised induction programme, which we were shown. We sampled two staff recruitment folders and found that all the necessary documentation to enable the home to employ staff was in place. DS0000013706.V339634.R01.S.doc Version 5.2 Page 18 A pre-inspection questionnaire was returned to us, which showed us the training that has taken place in the last twelve months. The manager stated the training included medication and risk assessments. Mandatory training had also taken place and this included moving and handling, food hygiene and safeguarding adults. DS0000013706.V339634.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31 33 35 & 38. People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including visits to this service. The home is run by a manager fit to be in charge and is run in the best interests of the people who use the service. The health and safety of the people who use the service are promoted and protected. EVIDENCE: The manager said that she has been at the home for twenty years and is also the co-owner. Evidence seen suggested that she keeps herself updated as she attends all the training that her staff attend. A comment received by us said ‘ the home appears very well run with lots of staff’. The manager said that last year she completed her registered managers award. DS0000013706.V339634.R01.S.doc Version 5.2 Page 20 Good quality audit systems are in place, which ensures that people who use the service are satisfied and content. The manager said that following a new admission she will always ask them to complete a questionnaire to ensure that their needs are being met. We saw some examples of these questionnaires. The manager said that she consults with the people who use the service regularly and holds regular resident meetings. Minutes of these meetings were seen displayed on the notice board and the actions that have been taken if a problem had been noted. Meetings are held every two months and the manager stated that she also seeks the views of other visiting professionals and stakeholders. The manager stated that money is not kept at the home for safekeeping for any person who uses the service. All necessary health and safety checks have taken place and we looked at the records provided on the pre-inspection questionnaire and also spoke to the manager. All certificates are current and the manager identified no health and safety issues during the site visit. DS0000013706.V339634.R01.S.doc Version 5.2 Page 21 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 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 DS0000013706.V339634.R01.S.doc Version 5.2 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. 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. Refer to Standard Good Practice Recommendations DS0000013706.V339634.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 DS0000013706.V339634.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. 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