Inspection on 29/09/05 for Longridge Court

This inspection was carried out on 29th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Longridge Court 20/07/08

Longridge Court 01/08/07

Longridge Court 02/05/06

Longridge Court 04/04/05

Longridge Court 12/10/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Longridge Court Bulls Cross Stroud Gloucestershire GL6 7HU Lead Inspector Lynne Bennett Unannounced 4th April 2005 07:30 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Longridge Court Version 1.10 Page 3 SERVICE INFORMATION Name of service Longridge Court Address Bulls Cross Stroud Gloucestershire GL6 7HU 01823 331712 01452 810711 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Voyage Ltd Lisa Richards CRH 14 Category(ies) of Learning Disability - 14 registration, with number Physical Disability - 14 of places Longridge Court Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: Lisa Richards to complete NVQ level 4 Managers Award by December 2005 Date of last inspection 12th October 2004 Brief Description of the Service: Longridge Court was first registered in July 2004. It is owned and managed by Voyage Ltd. The home will provide accommodation to 14 service users with a learning and/or physical disability in two separate dwellings. At present there are 8 service users living at Longridge Court. Service users living in the main house may have high care needs, such as wheelchair dependence, auditory and visual impairment, autistic spectrum disorder or epilepsy. Service users living in the annexe may have additional low level challenging behaviour. Situated near to the village of Painswick, Longridge Court is in a rural location and has easy access to the neighbouring towns of Stroud, Cirencester and Gloucester. 10 service users will live in the main house and the annexe will accommodate 4 service users. Both residences are self-contained with single rooms that have en-suite facilities. The house has a lounge, quiet lounge and dining room, whereas the annexe has a combined lounge/diner. Voygage are considering reducing the numbers of service users to 9 in the main house and 3 in the annexe. A variation form has been supplied to the organisation. Longridge Court Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over five and a half hours starting early in the morning on a day in April. The inspection was the result of an anonymous complaint about four issues and the expressions of concern by two other people. The inspector spoke with the registered manager, two members of night staff, two other members of staff and an agency worker. Service users living at Longridge Court have complex needs and most are unable to express their opinions about the care they are receiving. So during the course of the inspection the inspector observed the care being provided to four service users in the main house and three service users in the annexe. The inspector examined a number of records including care plans, staff files, health and safety records, the staff rota and information relating to an investigation. What the service does well: What has improved since the last inspection? There has been an improvement in the quality of care planning and risk assessment. Key workers are completing monthly reviews of these records. Specialist equipment and adaptations are being provided for service users before they move into the home. Moves into the home are delayed if equipment has not been provided. The service has shown that it can change to meet the needs of service users – reducing numbers to 12 so that additional communal space is created in the annexe and creating a level area to the front of the property which is accessible to people using wheelchairs. Longridge Court Version 1.10 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Longridge Court Version 1.10 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Longridge Court Version 1.10 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2,3,4 and 5 There is a clear admissions policy and procedure in place that the home is following ensuring that the home is able to meet service users’ needs. Visits to the home provide the opportunity for prospective service users to meet staff and other people living at Longridge Court before deciding to move in. EVIDENCE: Service users are referred to Longridge Court by social workers from placing authorities. Full assessments are received in addition to an assessment undertaken by the registered manager and reports from schools and other professionals such as Speech and Language Therapists. The registered manager visits service users in their homes, school or day care provision to complete her assessment when she will decide if the home can meet their needs. An assessment will be made about the type of specialist equipment and adaptations that may be necessary. Occupational therapists are involved in this process. Service users visit the home informally for a meal and overnight stays prior to making a decision whether or not they wish to move in or not. Full records of these visits are not being maintained. Service users do not move into the home until the necessary specialist equipment and adaptations are in place. Agreements between service users, their placing authority and Voyage are not kept in the home. A statement of terms and conditions is still to be put in place for all service users. Longridge Court Version 1.10 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7 and 9 Representatives of service users are involved in the review of care plans ensuring that service users’ needs are being met by the home. There is an improvement in the quality of record keeping safeguarding risks and the health and welfare of service users. EVIDENCE: Comprehensive care plans are in place identifying the needs of service users and how these will be met. These are being reviewed on a monthly basis but are not being signed by key workers. Key workers complete a monthly summary about the service users well being. Service users are not able to sign care plans but there was clear evidence that representatives of service users are involved in the review of plans. Service users are having a review after three months and an annual review is being scheduled. Restrictions and limitations to choices or freedoms are recorded in care plans for the use of bedsides, listening monitors, the use of bolts on en suite doors and keypads on rooms. Consent forms are in place. Behaviour management guidelines for one service user indicated that the home arrange a multi disciplinary meeting. It appears that this has not been done. Longridge Court Version 1.10 Page 10 Financial records did not confirm that service users are being supplied with a record of monies held for them by Voyage. This information must be made available to them. A range of risk assessments are in place indicating high, medium and low risks. These documents are colour coded providing staff with an immediate indication of the risk. They are being reviewed to provide clearer instructions to staff on how to reduce identified risks. Risk assessments are signed and dated. Longridge Court Version 1.10 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15,16 and 17 An individualised programme of social, leisure and educational activities provides a full and varied lifestyle for service users. Their families are encouraged to be involved in their life at the home. Changes are being made to the provision of food due to the complex needs of some service users. EVIDENCE: Service users access facilities in the local village and the nearby towns. They are able to use one of three people carriers. Service users are provided with a range of social, leisure and recreational activities such as horse riding, ten-pin bowling and hydrotherapy. Two service users attend local colleges and others have activities provided at the home, including massage, cooking and music therapy. Two service users appeared to have enjoyed a music therapy session on the morning of the inspection. Close contact is maintained with their families who regularly visit the home. Some service users are also supported to visit their families. Staff are developing regular links with the families of service users. Longridge Court Version 1.10 Page 12 Service users are supported to be as independent as possible and are provided with a range of choices about activities of daily living. They were observed choosing where to spend their time and with whom. Dietary needs are recorded in care plans and information is kept securely in the kitchen. Some service users have complex needs and so various alternatives are provided at each meal. Service users were observed having sandwiches, crisps or pasta with either yoghurt or rice pudding to follow. A range of frozen meals is being provided for a short period of time from a commercial food supplier. Fresh fruit is available. It was intended to appoint a cook to prepare fresh meals once the home is full. Longridge Court Version 1.10 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 and 19 There has been a significant improvement in the access to healthcare professionals ensuring that the health and physical needs of service users are being met. EVIDENCE: Care plans provide information about the way in which service users would like to be supported in their personal and health care needs. Specialist adaptations and equipment are provided to ensure that service users’ physical needs can be met. A new service user is waiting to move into the home upon delivery of a specialist bed. Service users are registered with a GP. The complaint received from the surgery at the time of the last inspection has been resolved. The registered manager has provided the surgery with key information about all service users and has improved communication between the home and the surgery. Service users are being referred for input from other healthcare professionals such as occupational therapists and a consultant psychiatrist as well as for outpatient appointments. Service users are registered with dentists, opticians and a chiropodist. Longridge Court Version 1.10 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 standard(s) 22 and 23 Arrangements for the protection of service users are not satisfactory placing them at possible risk of harm or abuse. EVIDENCE: The Commission for Social Care Inspection received a complaint from an anonymous caller about the care of a service user, the effectiveness of the manager, a ban on using agency staff and employing a member of staff without a Criminal Records Bureau check. The first two issues were unresolved, the third not upheld and the last was upheld. The Commission also received two expressions of concern about the lack of induction training and the conduct of staff. The first concern was upheld and the last unresolved. Staff are aware of the ‘whistle blowing’ procedure, which they have used. The registered manager has taken action as a result of this keeping full records. Poor practice within the home is being challenged and dealt with appropriately. As a result of investigations carried out by the registered manager changes have been made to the ways in which night staff work. Night staff described their duties and the support needed by service users. The home has a copy of ‘No Secrets’ and should have a copy of the local procedures. Staff must receive training in the protection of vulnerable adults. Staff have not received training in the management of challenging behaviour or C.A.L.M. techniques. Staff spoken to said that this training would help them to cope effectively with any incidents which may occur. Longridge Court Version 1.10 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 standard(s) 24,25,27,28,29 and 30 The home provides safe, comfortable and pleasant accommodation that will meet the lifestyles and needs of the present service users. EVIDENCE: Longridge Court is a large spacious home, providing two individual dwellings. Service users’ bedrooms have en suite facilities with specialist adaptations and equipment where appropriate. Recently renovated the accommodation is of a high standard and fixtures and fittings of a good quality. There are additional toilets, bathrooms and laundries in both dwellings. Both properties were clean and tidy. Service users are encouraged to decorate their rooms to reflect their lifestyles and personalities. Their families are also involved in this process if they wish. Service users were observed spending time in communal spaces in both the main house and annexe, as well as enjoying the spacious gardens. The grounds to the front of the property have an area which is accessible to people using wheelchairs. Longridge Court Version 1.10 Page 16 Voyage will be applying to reduce the registration for the home to 12, reducing the number of rooms in each dwelling by one. Staff are planning to turn the spare room in the annexe into a sensory room. Longridge Court Version 1.10 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34 and 35 Staff morale although improving is low resulting in some staff turnover which is disrupting consistency of care to service users. The training opportunities available to the home are not being fully utilised resulting in an under skilled staff group. EVIDENCE: Staff spoken with were aware of their roles and responsibilities and the aims and objectives of the home. Agency staff are being used for both day and night shifts. Staff files contain evidence of staff qualifications, experiences and skills. A number of the staff are inexperienced in the field of caring for people with complex needs. To compensate for this experienced staff from other Voyage South homes are now working in the home on a temporary basis. Recruitment and selection is processed through Voyage South based in Taunton. The home presently has several vacancies and three new staff are due to start shortly. Staff have been employed in the home without a current Criminal Records Bureau check in place, although the organisation had received a PoVA first check and two references. The home must ensure that if new staff need to be appointed without Criminal Records Bureau checks they firstly contact the Commission, then obtain two references, full employment Longridge Court Version 1.10 Page 18 history and a PoVAfirst check. A named member of staff must supervise new staff until the Criminal Records Bureau check is obtained. Voyage provides a comprehensive induction programme including the LDAF foundation course. New staff are due to start this shortly including mandatory training. New staff are not expected to take the lead in manual and handling tasks until they have received the training. Staff will be completing training in The Total Communication Approach. Five staff have NVQ Awards in Care and two other staff are being registered. A training matrix is in place for staff. This needs updating. Training certificates are on staff personal files. Staff spoken to stated that staff meetings are starting to take place with regularity each month and that communication is improving. They felt that moral had been low but that the use of staff from other homes instead of relying on agency staff had been a positive move. Longridge Court Version 1.10 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,41 and 42. The manager has a good understanding of the areas in which the home needs to improve to ensure that service users receive a consistent quality of care. EVIDENCE: The registered manager has considerable experience in the field of learning disability. This is her first post as a registered manager. She is completing a NVQ Registered Managers Award at Level 4. Staff spoke highly of the registered manager recognising that she had joined the home at a very difficult time. They felt that she was improving communication and trying to be proactive about the staffing situation. A letter from the local surgery commented on the positive affect the registered manager had made to their relationship with the home. Records are kept securely within the home. Accident and injury records although kept in the locked office must be stored securely. The complaints Longridge Court Version 1.10 Page 20 procedure needs amending so that reference to the NCSC is replaced with Commission for Social Care Inspection. Staff are attending training in first aid, manual handling, basic food hygiene and fire. Night staff must have fire training every three months. Records are maintained to ensure safe systems are in place for fire, electrical appliances, hazardous products, legionella and servicing of equipment. Longridge Court Version 1.10 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. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 3 3 2 Standard No 22 23 ENVIRONMENT Score 2 1 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 2 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 4 4 4 3 3 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 2 Standard No 31 32 33 34 35 36 Score 3 3 2 2 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 3 3 x x 2 2 x Longridge Court Version 1.10 Page 22 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 5 Regulation 5(1)(c) Requirement A statement of terms and conditions must be put in place. (Previous timescale of 31 December 2004 not met) The registered person must arrange a multi disciplinary review A record of money received on the service users’ behalf must be made available to them. (Previous timescale of 12 November 2004 not met) The registered person must ensure that nutritional and wholesome food is prepared for service users. Staff must receive training in the protection of vulnerable adults and in the management of challenging behaviour.(Previous timescale of 31 December 2004 not met). The registered person must ensure that there are appropriate levels of staff in the home at all times and that the employment of temporary staff does not affect the continuity of care. The registered person must ensure that if appointing a staff Version 1.10 Timescale for action 04 June 2005 04 June 2005 04 June 2005 2. 3. 6 7 12(1)(a) 15(2) 17(2) Sch. 4 Para 9 16(2)(i) 4. 17 04 June 2005 04 July 2005 5. 23 18(1)(a) (c) 13(6) 6. 33 18(1)(a) (b) 04 April 2005 7. 34 19(1) 04 April 2005 Page 23 Longridge Court 8. 9. 34 34 13(4)(c) 18(2) 19(4)Sch 2 10. 35 18(1)(c) 11. 12. 41 41 17(1)(b) 22(7)(a) 13. 42 23(4)(d) member under exceptional circumstances without a CRB the Commission must be informed and a PoVA first check must be obtained. A risk assessment must be put in place for new staff commencing without a CRB in place The registered person must ensure that staff employed without a CRB in place are supervised by a named person and does not escort service users away from the home. The registered person must ensure that new staff complete their induction programme and attend manadatory training. Accident and injury records must be stored securely. The complaints procedure must include the address and telephone number of the local office of the (Previous timescale of 31 December 2004 not met) Night staff must receive training every three months 04 April 2005 04 April 2005 04 June 2005 04 April 2005 04 Juy 2005 04 May 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. 6. Refer to Standard 4 6 23 28 35 Good Practice Recommendations Records should be kept of visits made by new service users. When care plans are reviewed on a monthly basis staff shoulld sign and date a record to confirm this. A copy of Gloucestershire Adults at Risk procedures should be obtained. Consideration should be given to extending the communal spaces available to those living in the annexe. The training matrix should be updated. Version 1.10 Page 24 Longridge Court Longridge Court Version 1.10 Page 25 Commission for Social Care Inspection 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester GL3 4AB 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 Longridge Court Version 1.10 Page 26 - 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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