CARE HOMES FOR OLDER PEOPLE
Longton Nursing & Residential Home 11 Marsh Lane Longton Preston Lancashire PR5 5ZJ Lead Inspector
Vivienne Morris Unannounced Inspection 6th March 2007 09:30 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 Longton Nursing & Residential Home DS0000025570.V323276.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. Longton Nursing & Residential Home DS0000025570.V323276.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Longton Nursing & Residential Home Address 11 Marsh Lane Longton Preston Lancashire PR5 5ZJ 01772 616144 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) MPS (Investments) Limited Mrs Joyce Hindle Care Home 58 Category(ies) of Old age, not falling within any other category registration, with number (58), Physical disability (6) of places Longton Nursing & Residential Home DS0000025570.V323276.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Within the overall total of 58 a maximum of 58 service users requiring either nursing or personal care who fall into the category OP - Old age, not falling within any other category. Within the overall total of 58 a maximum of 6 service users requiring either nursing or personal care who fall into the category PD - Physical Disability aged 60 - 65 years. Within the overall total of 58 a maximum of one named male service user in the category of PD (Physical disability) aged 27 years and above requiring either nursing or personal care. This condition will no longer apply should the service user no longer reside at Longton Nursing and Residential Home. 9th February 2006 2. 3. Date of last inspection Brief Description of the Service: Longton Nursing and Residential Home is located in a quiet residential area of Longton, close to local amenities and main bus routes. The grounds are landscaped with a large lawn to the rear of the building enabling service users to enjoy the pleasant surroundings. The home is registered to provide both personal and nursing care for the elderly, although a small number of places are available for people who have physical disabilities. Accommodation is provided on two floors served by a passenger lift. The majority of rooms are single, however a number of companion rooms are available for service users who wish to share facilities. En-suite facilities are available, comprising of wash hand basin and WC. The fees at the time of the site ranged from £436.80 - £546.00 per week. Additional charges were incurred for hairdressing, chiropody, magazines/newspapers and transport for trips. Longton Nursing & Residential Home DS0000025570.V323276.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. An unannounced site visit, which formed part of the key inspection process, was conducted over one day in March 2007. During the course of the site visit to this service, discussions took place with those living at the home, as well as relatives and staff. Relevant records and documents were examined and a tour of the premises took place, when a random selection of private accommodation was viewed and all communal areas were seen. Comment cards were received from twenty-three people involved with the service and their feedback is reflected throughout this report. The information provided by the home on the pre-inspection questionnaire has also been taken into consideration when writing this report. The inspector ‘tracked’ the care of three people during the site visit, not to the exclusion of other residents. The total key inspection process focused on the outcomes for people living at the home. The Commission for Social Care Inspection had not received any complaints about this service since the last inspection. What the service does well:
The information gathered before admission was detailed, providing staff with a clear picture of individual needs, so that the home was able to determine how the staff team could meet the assessed needs of people. The plans of care were well written documents, providing staff with clear guidance about how the assessed needs of people living at the home were to be met and how people were supported to maintain their privacy and dignity. Residents had been involved in the care planning process and a review of care provided was conducted on a monthly basis to ensure that current needs were reflected in the plan of care. One comment card received from a relative stated, “Excellent patient centred care given to all individuals when I have been visiting and another commented, I am extremely satisfied with the care given to my relative and I am most gratified to see that this level of care is extended across the whole spectrum to all residents without exception. A variety of external professionals had been involved in the care of people living at Longton Nursing Home to ensure that their health care needs were being appropriately met. A range of risk assessments were in place at the home to ensure that systems were in place to protect the health and safety of anyone on the premises. Longton Nursing & Residential Home DS0000025570.V323276.R01.S.doc Version 5.2 Page 6 Relatives spoken to were happy about how visitors were received into the home and they informed the inspector that the staff were all very friendly, kind and caring. Sufficient information was provided to people about the use of the local advocacy services to act on their behalf, should they so require and people living at the home were able to have some control over their lives by managing their own finances, should they so wish. Service users were provided with a nutritious, well-balanced lunch so that their dietary intake was adequate and those requiring support with eating their meals were assisted in a discreet manner, whilst others were encouraged to eat independently. The complaints procedure was freely available within the home and it was also included within the service users guide so that people were given enough information about how did they could make a complaint should they so wish. The policies and procedures in relation to safeguarding adults were in accordance with the Department of Health guidance ‘no secrets’, so that people knew the procedure to take should an allegation of abuse be received by the home. The home was tastefully furnished and pleasantly decorated to a high standard and the premises, both internally and externally were well maintained providing those living at Longton Nursing Home with a safe, clean, comfortable and homely environment in which to live. Effective infection control measures were in place to ensure that the health and safety of people was adequately protected. Staffing levels were calculated in accordance with the assessed needs of people to ensure that adequate care was delivered. Robust recruitment procedures and financial arrangements were in place at the home, which demonstrated that those living at Longton Nursing Home were adequately protected. A lot of training had been provided for all staff so that they were kept up to date with current policies, procedures and legislation and so that they were sufficiently trained to meet people’s assessed needs. The registered manager holds relevant qualifications, has a lot of experience and is appropriately trained to manage the care home. Residents, relatives and staff thought highly of her and they all felt supported by the management of the home. Systems were in place to ensure that the quality of service provided was closely monitored so that any shortfalls identified could be promptly addressed. Longton Nursing & Residential Home DS0000025570.V323276.R01.S.doc Version 5.2 Page 7 The health, safety and welfare of residents were protected by the policies, procedures and practices of the home so that any hazards, which could pose a potential risk, were minimised or eliminated. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Longton Nursing & Residential Home DS0000025570.V323276.R01.S.doc Version 5.2 Page 8 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 Longton Nursing & Residential Home DS0000025570.V323276.R01.S.doc Version 5.2 Page 9 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The preadmission process was thorough enough to ensure that the staff team could adequately meet individual needs. EVIDENCE: At the time of the site visit the inspector ‘tracked’ the care of three people living at the home. The care records seen showed that detailed information had been obtained prior to admission and that the needs of people had been thoroughly assessed, to ensure that the staff team could meet the individual needs of everyone moving into the home. The detailed assessments had been retained on residents’ files so that those working at the home were aware of individual assessed needs. Longton Nursing & Residential Home DS0000025570.V323276.R01.S.doc Version 5.2 Page 10 The assessed needs of those admitted to the home were consistently recorded within the care plan therefore staff were provided with detailed information as to how service users’ needs were to be met. One relative said that he had seen the plan of care for his relative and a staff member had discussed it with him. Staff spoken to knew about the needs of people and how to access the care plans, policies and procedures, which showed that they were able to obtain relevant information if they needed it. Longton Nursing & Residential Home DS0000025570.V323276.R01.S.doc Version 5.2 Page 11 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 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care needs of people living at the home were being consistently met and their privacy and dignity was always respected. EVIDENCE: The care of three people living at the home was ‘tracked’ during the course of the site visit. All three plans of care had been developed from the information gathered prior to admission, so that staff were aware of the assessed needs of people living at the home. The care planning process had improved significantly and information recorded was consistently detailed, providing staff with clear guidance as to how the assessed needs of the individual residents were to be met. Residents or their relatives had been given the opportunity to be involved in the care planning process, so that they could have some in put into the care provided. The plans of care had been consistently reviewed every month to
Longton Nursing & Residential Home DS0000025570.V323276.R01.S.doc Version 5.2 Page 12 show that the needs of people were being regularly assessed so that their current needs were accurately reflected. The pre inspection questionnaire and the care records showed that a variety of external professionals were involved in the care of people living at the home to ensure that their health care needs were being appropriately met. A specialised nurse was at the home, providing health care support, during this site visit. Comment cards received showed that everyone was treated equally and the majority of people felt that they received medical support when needed. Appropriate pressure relief was being delivered and specialised equipment was seen to be provided to make the lives of people living at the home as comfortable as possible. All comment cards received from relatives and General Practitioners showed that they were satisfied with the overall care provided to the people living at the home. A variety of assessments were in place so that the health and safety of people living in the home was protected within a risk management framework. The management of medications was in general satisfactory. However, hand written entries on the Medication Administration Records had not been signed, witnessed and countersigned in order to reduce the possibility of any transcription errors. The pulse rate for one resident had not been recorded prior to the administration of digoxin tablets to ensure safe administration of medications. Two staff members had not witnessed the disposal of unwanted medications before the disposal company collected the container to reduce the possibility of any drug misuse. The inspector observed staff speaking to residents in a respectful manner and knocking on bedroom doors before entering to ensure that privacy and dignity was consistently maintained. A written policy was in place and available to staff, which demonstrated that those living at the home were supported to maintain their privacy and dignity at all times. Induction records showed that staff had been instructed to treat service users with respect and care records demonstrated that the wishes of people were respected in relation to maintaining privacy and dignity when giving personal care. Longton Nursing & Residential Home DS0000025570.V323276.R01.S.doc Version 5.2 Page 13 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 and 15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Social and recreational activities did not always meet residents’ expectations. However, the rights of people were upheld and they could make informed choices. Not all residents found the meals to be consistently appetising. EVIDENCE: The home employed a person to be responsible for the organisation and provision of activities, so that some entertainment was provided for those living at the home. Out of the nineteen comment cards received from residents, five said that there were usually suitable activities provided, six felt that there were sometimes activities in which they could take part and two people said that there were never any activities in which they were able to participate. Some residents spoken to during the site visit said that there wasn’t a lot of activities going on in the home, but that they were happy to amuse themselves and would not want to join in anyway. One resident said, “I sometimes get bored as there is nothing really to do. We did have some trips out last summer though” and another commented, “I am happy as I can listen to music in my room. Although the sandwiches are poor at tea time the other meals are good”.
Longton Nursing & Residential Home DS0000025570.V323276.R01.S.doc Version 5.2 Page 14 A game of dominoes was in play during the visit to this service, which was being enjoyed by all those concerned. One resident said that she enjoyed the manicures and beauty therapy. A number of residents were seen reading newspapers and some were assisted to the coffee morning at the local church, which residents confirmed is a weekly activity. Information about the provision of activities was displayed and was included within the statement of purpose and service uses guide, so that people knew what was going on in the home. Records were kept of what activities people joined in with and if they were enjoyed, which showed that those who were less able to participate were given the same opportunities as others by the provision of 1:1 activities. One resident said, “I go to the coffee morning at church each week, and I join in which activities I want to. I’m quite happy with the activities which are provided”. The pre inspection questionnaire showed that policies were in place in relation to equal opportunities, which included an explanation of the six principals of care, including rights, fulfilment, independence and choice, showing that all those living at the home were given the same opportunities to make decisions and informed choices. The plans of care showed that people’s choices had been taken into consideration and they included information about the leisure interests of residents so that staff were able to provide activities in accordance with people’s preferences. The care plans recorded people’s social histories well so that staff could get a clear picture of each person’s life, interests and hobbies. One service user confirmed that religious ministers visited the home regularly to conduct services and the statement of purpose supported this information. Plans of care had been written in relation to individual religious beliefs, showing how people could be supported in meeting their spiritual needs. A visiting policy was in place at the home and information relating to visiting was also included in the statement of purpose and service user guide to ensure that all interested parties were aware of the visiting arrangements of the home. Relatives were seen to be visiting people in private and visitors spoken to felt that they were made to feel welcome to the home at any time and that a friendly environment was provided for both residents and visitors. The comment cards received supported this information. One visitor said, “ The staff have a sense of humour which I think is really important”. Personal possessions adorned individual rooms, where appropriate to create a homely environment and audits of service users’ belongings had been conducted on admission to protect the safety of individual’s personal possessions.
Longton Nursing & Residential Home DS0000025570.V323276.R01.S.doc Version 5.2 Page 15 People living at the home were able to manage their own finances, if they so wished and if they were capable to do so, showing that they were able to have some control over their lives. The pre inspection questionnaire showed that two people living at the home were using an advocate to help them in making decisions. Leaflets were freely available in the home informing people how to access advocacy services, should they wish to do so. The four weekly menus were examined and were found to provide a choice of well-balanced meals to ensure that those living at the home received a nutritious dietary intake. The menu of the day was clearly displayed, so that people were aware of the choices they had been given for lunch. The chef was seen offering people the choices available on the menu and a resident confirmed that there were alternatives to the menu available if required. The pre-inspection questionnaire showed that residents were offered a choice of menu and that special diets were provided as required. The food served at lunchtime was appetizing and well presented in order to aid nutrition. The inspector noted that specialised utensils were provided to aid in independent eating, but that people were also supported with their meals in a dignified manner as needed. One resident said, “ The food is always good and we get plenty of it. I enjoy my meals, there is always a choice”. However, quite a number of residents said that the evening meal was poor, in that the selection of sandwiches was always the same and the bread was often rather stale. Of the nineteen comment cards received from residents, thirteen said that they always liked the meals at the home; five said that they usually enjoy the food and one said that they never liked the meals. This issue was discussed with the registered manager, who is advised to monitor the quality of meals served and to act according to findings. The dining rooms were found to be relaxed areas for people to eat in, with well-presented tables and unhurried atmospheres, so that those dining were comfortable and enjoyed having their meals in pleasant surroundings. Longton Nursing & Residential Home DS0000025570.V323276.R01.S.doc Version 5.2 Page 16 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 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints were well managed and people living at the home were adequately safeguarded. EVIDENCE: A detailed complaints procedure was in place at the home, which was displayed prominently and which was included within the service users guide, showing that people were given enough information about making a complaint should they wish to do so. However, four of the nineteen comment cards received from residents indicated that they did not know how to make a complaint, should they wish to do so. Residents spoken to at the time of the site visit said that they would know what to do if they were not happy about something. A system was in place at the home so that any complaints received could be recorded and any recurring patterns identified and regularly monitored. The pre-inspection questionnaire showed that the home had not received any complaints since the last inspection. The Commission for Social Care Inspection had not received any complaints about this service since the last inspection. Policies and procedures were in place at the home in relation to safeguarding adults, which were in accordance with Department of Health guidance, so that people were fully aware of the action to take should an allegation of abuse be reported to the home.
Longton Nursing & Residential Home DS0000025570.V323276.R01.S.doc Version 5.2 Page 17 Staff spoken to confirmed that they had received training in relation to safeguarding adults and the training matrix seen supported this information. Staff were aware of what they should do if they had any concerns about the welfare of anyone in their care to ensure that appropriate action would be taken. Longton Nursing & Residential Home DS0000025570.V323276.R01.S.doc Version 5.2 Page 18 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 and 26. Quality in this outcome area is Excellent. This judgement has been made using available evidence including a visit to this service. The home provided a safe, well-maintained environment for people to live in, which was clean, pleasant and hygienic. EVIDENCE: The home had been extended and extensively decorated since the last inspection, providing an additional six bedrooms, a shower room and a wet room. A tour of the premises took place during the site visit when the home was found to be tastefully decorated and furnished to a high standard, providing a very homely and comfortable environment for people to live in. Longton Nursing & Residential Home DS0000025570.V323276.R01.S.doc Version 5.2 Page 19 The communal lounges and dining rooms were pleasant and comfortable for people to sit during the day, providing a homely environment for those living at the home. The building was fit for purpose and was maintained to a good standard of repair so that people living at the home were provided with a safe environment. Odour control was effective so that the home was pleasant smelling. Out of the nineteen comment cards received, seventeen people said that the home was always fresh and clean and two indicated that it was usually fresh and clean. Residents spoken to were satisfied with the standard of private and communal accommodation provided. One resident said, “This home is always very clean and the girls keep my bedroom clean and tidy too”. The laundry department was suitable for the needs of the residents and it was well organised, providing sufficient equipment, so that laundry was completed in a timely fashion. Detailed policies were in place at the home to ensure that the control of infection was being adequately met so that the health and safety of people living there was appropriately safeguarded. Longton Nursing & Residential Home DS0000025570.V323276.R01.S.doc Version 5.2 Page 20 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 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff working at the home were skilled and in sufficient numbers to meet changing needs of residents. However, there were not enough care staff who were appropriately trained to fulfil the aims of the home. The recruitment procedures adequately safeguarded those living at the home. EVIDENCE: At the time of the site visit there were 53 people living at Longton Nursing Home. The number of staff on duty was being calculated in accordance with the assessed needs of people living at the home and records showed that a good skill mix of staff made up the staff team so that residents’ needs were being met. The pre-inspection questionnaire showed that agency staff were used as required, although the inspector was told that the same agency staff work at the home so that continuity of care was maintained. Equal opportunity policies were in place at the home to ensure that everyone applying for work was treated the same and was given the same job opportunities.
Longton Nursing & Residential Home DS0000025570.V323276.R01.S.doc Version 5.2 Page 21 Residents spoken to felt that their needs were being fully met and that the staff were patient and did not rush them when assisting them with activities of daily living. The pre inspection questionnaire showed that there was a total of thirty three care staff employed at the home, twelve of whom had achieved a National Vocational Qualification at level 2 or above, giving a total of 36 of care staff suitably qualified. Formal induction processes had been adopted by the home so that staff understood their role and were able to perform the duties expected of them. . The pre inspection questionnaire showed that a wide range of training was provided for staff so that people working at the home were competent to look after the people in their care. All staff completed mandatory core-training courses to ensure that there was a skilled workforce and that people had the necessary knowledge to meet the needs of the people they were caring for. Staff spoken to felt that a lot of training was provided to meet their needs and the training certificates available on staff files supported this. Three staff files were examined at the time of the site visit. It was found that recruitment procedures were being followed in day-to-day practice and that sufficient checks had been undertaken on staff to ensure that those living at the home were adequately protected. Longton Nursing & Residential Home DS0000025570.V323276.R01.S.doc Version 5.2 Page 22 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 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was well managed by a competent person, having effective systems in place for monitoring the quality of service provided. The health, safety and welfare of people living at the home were sufficiently protected. EVIDENCE: The manager of Longton Nursing Home has been in post for many years. She has the required qualifications and experience and is competent to run the home. During the time she has been in post she has worked hard to improve the service and to provide an increased quality of life for residents. She has the skills to operate the home efficiently and effectively for people living there. There was a strong belief of being open and transparent in all areas of running
Longton Nursing & Residential Home DS0000025570.V323276.R01.S.doc Version 5.2 Page 23 the home so that people were kept informed of matters involving them. The manager had completed a variety of additional training courses and was resident focused. She leads and supports the staff team who have been appropriately recruited, so that those living at the home are adequately protected. A variety of surveys were being conducted annually so that the views of residents, their relatives and stakeholders were obtained about how the service was performing. The information gathered was put together and produced to show interested parties the strengths and weaknesses of the service. A variety of meetings were held, with minutes kept, so that people were informed of any relevant matters. The home had been accredited with an external award, showing that it was audited on a regular basis by external professional bodies. The registered manager had put in place a variety of regular, detailed checks. This enabled her to identify and address any shortfalls within the systems in place at the home and closely monitor the quality of service provided. The registered person ensured that visits to the service were conducted at least every month, when a full report was made so that the service could be monitored. Systems were in place at the home to ensure that residents’ finances were adequately protected. The relatives of residents were often responsible for the management of their money. However, personal allowances for a small number of people were retained by the home, if residents were unable or did not wish to manage their own affairs. Clear records were kept of any money or valuables retained at the home on behalf of service users so that the possibility of any mishandling was reduced. A wide range of risk assessments had been conducted, which were sufficiently detailed, showing that systems had been put in place in order to reduce the possibility of injury to people living at the home. The pre-inspection questionnaire showed that all systems and equipment within the home had been appropriately checked so that the health and safety of people living at the home was protected. This was confirmed by examination of a random selection of service certificates. Accidents occurring in the home had been accurately recorded so that the manager was able to audit and monitor the frequency of accidents. The environment was free from any hazards, which could pose risks to those living at the home. The registered manager informed the inspector that the work, which needed to be undertaken on the electrical installation, had now been completed, making the system safe. Fire drills are conducted periodically to ensure that all staff are familiar with the fire procedure and evacuation plan within the home. However, a record
Longton Nursing & Residential Home DS0000025570.V323276.R01.S.doc Version 5.2 Page 24 was not retained of staff attendance so that the home’s fire warden could ensure that all staff were involved in a fire drill at least annually. Policies and procedures were in place at the home in relation to Health and Safety issues and Infection Control practices, so that staff were aware of the importance to ensure that the health, welfare and safety of people living at the home was consistently protected. Longton Nursing & Residential Home DS0000025570.V323276.R01.S.doc Version 5.2 Page 25 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 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 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 Longton Nursing & Residential Home DS0000025570.V323276.R01.S.doc Version 5.2 Page 26 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. 1. 2. 3. 4. 5. 6. Refer to Standard OP9 OP9 OP9 OP12 OP15 OP28 Good Practice Recommendations All nurses responsible for giving medications should take and record pulse rates prior to the administration of Digoxin. Any hand written annotations on the Medication Administration Records should be signed, witnessed and countersigned. It is recommended that two staff members witness unwanted medicines being disposed of in the drug waste bin. The registered manager should audit the level and type of activities provided and should determine what people wanted to do in relation to activities. The registered manager should monitor the variety and quality of food served and act according to her findings. The home should continue to work towards 50 of care staff achieving a National Vocational Qualification at level 2 or above.
DS0000025570.V323276.R01.S.doc Version 5.2 Page 27 Longton Nursing & Residential Home 7. OP38 A record should be retained of staff involved in fire drill training. Longton Nursing & Residential Home DS0000025570.V323276.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection 2nd Floor, Unit 1 Tustin Court Port Way Preston PR2 2YQ 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
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