Inspection on 12/08/08 for Longueville Court

This inspection was carried out on 12th August 2008.

CSCI found this care home to be providing an Adequate service.

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

Longueville Court 12/04/10

Longueville Court 22/04/09

Longueville Court 30/10/07

Longueville Court 13/02/07

Longueville Court 20/02/06

Longueville Court 19/08/05

Longueville Court 12/01/05

Longueville Court 13/07/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

CARE HOMES FOR OLDER PEOPLE Longueville Court Village Green Orton Longueville Peterborough PE2 7DN Lead Inspector Don Traylen Unannounced Inspection 10:00 12th & 13 August 2008 th 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 Longueville Court DS0000024316.V369990.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. Longueville Court DS0000024316.V369990.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Longueville Court Address Village Green Orton Longueville Peterborough PE2 7DN 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) 01733 230709 01733 230716 peter.barlow@barchester.com www.barchester.com/oulton Barchester Healthcare Homes Ltd Post Vacant Care Home 105 Category(ies) of Dementia (2), Dementia - over 65 years of age registration, with number (39), Old age, not falling within any other of places category (101), Physical disability (24), Physical disability over 65 years of age (1), Terminally ill over 65 years of age (101) Longueville Court DS0000024316.V369990.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 1 (one) named male over the age of 65 years with Physical Disabilities Dementia (DE) 1 - The one place for one person under 65 years is for a named individual only Dementia DE = 1 female, is for a named person for the duration of their residency only 30/10/2007 Date of last inspection Brief Description of the Service: Longueville Court was opened in 1995 as a modern, purpose-built, spacious care home on two floors, providing nursing and personal care for up to 105 people over the age of 65 years. The registration was varied in November 2004 for the home to provide care for up to 24 persons with physical disabilities in a dedicated unit within the home. Longueville Court is owned by Barchester Healthcare Homes Limited and is situated overlooking the quiet village green of Orton Longueville, approximately two miles from the centre of Peterborough. The building is a country house style, built on two levels and divided into four units: Memory Lane and Robin unit are on the ground floor and Skylark and Kingfisher unit are on the first floor. Memory Lane provides care to elderly persons who have dementia related care needs. Robin provides care to people less than 65 years of age who have physical disabilities, whilst Skylark and Kingfisher provide nursing care. Longueville Court provides en-suite facilities in all rooms except one. It has an atmosphere of spaciousness and comfort. The company claim, to have created places that are not at all clinical or institutionalised, in their ‘Welcome to Barchester Healthcare’ pamphlet. The home has attractive and secure inner courtyard garden and a sensory garden. The home attracts enquiries from an area greater than it’s immediate PCT locality. The home informs all interested parties by providing their ‘Welcome to Barchester’ pamphlet, their Service User Guide and Statement of Purpose and the previous CSCI inspection report. The CSCI inspection reports are also available from the CSCI website. Fees charged are between £789 to £1000 per week and represent nursing care costs. Longueville Court DS0000024316.V369990.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is “1 star”. This means the people who use this service experience adequate quality outcomes. Since the last key inspection on the 30/10/2007, a random unannounced pharmacist inspection was carried out on the 29/01/2008 and on the 17/04/2008 a further random unannounced inspection was carried out to focus on the outstanding requirements concerning care planning and the administration of medication. The home has been the subject of an extensive nutritional assessment conducted by the intuitionalist from Peterborough Community Services for Health & Social Care” following concerns raised about meals and appropriate dietary needs. Two inspectors carried out this inspection on the 12/08/2008 and a pharmacist inspector conducted an inspection on 13/18/2008. The acting manager was present on both days and feedback was provided to him during and at the end of the both days. The home completed an Annual Quality Assurance Assessment (AQAA) and several survey forms were returned from people living at the home. Methods used during the visit included: • Case tracking one person’s care arrangement. • Three people’s care plans were assessed. • Observations of interactions between care staff and people living at the home • Observations during a mealtime • Assessing the recruitment records of two care staff • Assessing the training records • Assessing medication administration records • Assessing the systems used by management to assure quality • The views of people living at the home and experiences of their care. • Two visitors were asked for their experiences of the care provided by the home. Longueville Court DS0000024316.V369990.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: The home must immediately implement an hourly regime for offering fluid to the person whose care plan indicated this was in place. The home must do this by maintaining the record of each time fluid is offered to this person. An Longueville Court DS0000024316.V369990.R01.S.doc Version 5.2 Page 7 Immediate Requirement was made during this inspection for this to be put into place. Care staff must be facilitated to maintain a clear and precise record of any ‘peg-feed’ system used by having an appropriate system to achieve this. Care planning for social development and accessing the wider community should be planned for people wanting to do this and especially for people with physical disabilities. People had been consulted for their preferences and activities, although their personal and social development was not recorded as an element of care planning. An arrangement for a driver of the home’s two vehicles should be made so that people can regularly use this facility and can plan their life with this assistance. Recruitment records must include the details expected by the Care Home Regulations 2001. All staff must receive appropriate supervision. 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. Longueville Court DS0000024316.V369990.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 Longueville Court DS0000024316.V369990.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): 3,6, Quality in this outcome area is good. People are assured they will be assessed prior to moving into the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All people are assessed either by the commissioning authority of the Primary Care Trust making the placement, or by the home for people who are privately funding their care. It was discussed with the manager that people who are privately funding their care are entitled to an assessment of need by the Local Authority’s Social Services. As the home provides nursing care there is an expectation that any potential nursing element of their care charges, is assessed. Intermediate care is not provided and therefore Standard 6 is not applicable. Longueville Court DS0000024316.V369990.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, Quality in this outcome area is adequate. People are assured of a written care plan but need to be assured that detailed aspects of their care will be accurately maintained and that appropriate healthcare will always be provided. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last key unannounced inspection on 30/10/2007, random inspections were carried out on the 29/01/2008 and on the 17/04/2008. The inspection on the 17/04/2008 reported that, “Records revealed that people’s health and welfare is not assured and people are at continuing risk of not receiving appropriate care and that their care records are inaccurately maintained.” Records revealed that people’s health and welfare is not assured and people are at continuing risk of not receiving appropriate care and that care records are inaccurately maintained. Longueville Court DS0000024316.V369990.R01.S.doc Version 5.2 Page 11 The administration of medication was assessed on the 17/04/2008. It was recorded: “ There are clear policies and procedures on the safe use of medicines to protect residents but some aspects are not followed….Requirements have been made on previous inspections for the records made when medicines are given to people to be accurate and complete. This requirement has therefore not been met and a new timescale for action has been given. Inspection of care plans showed that where medication is prescribed on a ‘when required’ basis, there were no detailed guidelines as to when and how such medicines are used. Some people have medication given to them disguised in food or drink. Although these had been noted in the care plans, the home’s own policy requirements about the need for multidisciplinary approvals and records of this had not been followed.” Inspection 12th & 13th/08/2008 At this inspection, care plans had been rewritten and represented in a wellinformed and instructive content. Not every care plan for every resident was seen. The plans included adequate information about a person’s needs and how they should be met, at the time when the plans were re-written. However, when needs had changed, the plans were not always reviewed to accurately reflect and describe how care had changed. One person’s care was tracked. She had been admitted to hospital due to concerns over her hydration status and rampant diarrhea. She returned to Longueville Court after approximately one month on the 07/08/08. It was recorded in her care plans that she was at high risk of pressure sores and ulceration and was “too unwell to get out of bed”. Her care plan indicated she had pressure sores and needs associated with skin integrity and nutrition. Her plan indicated on the 10/08/2008 that she had pressure sores and was “on a food chart, fluid chart & turn chart and on 11/08/2008 recorded: “we will offer and assist her with fluids hourly, at least 1-2 litres per day” (Catheter Care) and showed that she was at risk of not eating and not drinking and in her Nutrition / Hydration plan on 08/08/12008 needed “water hourly” and on 10/08/2008, “she needs proteins to heal the pressure sores on her heels”. Her plan did no say how these fluids should be given to her. Although it was recorded on the 10/08/2008 that she “was spitting out the food” no food had been recorded as given or offered on that day, or any other day between the 07/08/2008 and 12/08/2008 apart from 10mls of ‘Fortisip’ on 10/08/2008. Her fluid charts showed on 12/08/2008 that minimal opportunity of drinking fluids had been offered, when only three occasions were recorded and only 100mls of fluids had been consumed during the previous 13 hours up to 11:50 am on the 12/08/2008. Her fluid charts showed the following total amounts of fluid consumed: 07/08/2008= 08/08/2008= 09/08/2008= 10/08/2008= Longueville Court 400mls fluid 875 mls fluid 450 mls fluid 270 mls fluid DS0000024316.V369990.R01.S.doc Version 5.2 Page 12 11/08/2008= 610 mls fluid 12/08/2008= 100mls fluid (as at 11:50 am) When we saw her at 11:50 am on 12/08/2008 in her room, she was lying in her bed and was leaning quite considerably over towards her left side, in a position that appeared to indicate that she was uncomfortable and not able to alter her position. She was asked if she was comfortable and if she wanted a drink. She indicated with a sound and this was understood to indicate that she might have been thirsty. She raised her hand to her mouth at this point. She was asked if she wanted to be moved. She again made a sound to indicate this may have been wanted. I informed her that I would ask for care assistants to come and help her. We immediately summoned two care staff and the acting manager was informed. An ‘Immediate Requirement’ form with a requirement to record the hourly provision of fluids was made. The home responded and ensured this record was kept and have since supplied the Commission with written evidence of this record for the two days, the 13th and 14th August 2008. The outcome for this person was that her care was at risk of being overlooked. There were not any other records kept for nutritionally supplemented fluids, or proteins, being offered to her from 07/08/2008 onwards, after she had returned from hospital. She had been referred to the Dietician and her GP for advice on the 10/08/2008 and the tissue viability nurse was planned to be contacted. There were no available records for any mouth care. She had been reported to spit out her food. There were no risks assessments or plan of care for her ability to swallow, dysphagia and aspiration. Another person’s care record showed that there was a regime in place for her to receive some of her nutritional fluids and food through a Percutaneous Endoscopic Gastronomy (PEG) tube. Whilst there was a clear and medically provided instructions of the regime to follow for the use and the maintenance of the equipment, the hand written entries made by care staff in the record were not clearly written and did not fully describe the task undertaken. This was because the form used did not allow enough space for a precise record to be maintained and staff were able to only complete brief details. When this was discussed with the acting manager, he said he would redesign the form. This issue has been reported because of the previous serious difficulties encountered when this person’s tube became blocked and the intervention of the Peterborough Older Person Support Team were necessary to ensure the correct action was taken to admit the person to hospital to resolve the serious issues of poor attention through the actions of one agency workers employed at night. It is relevant that one person commented in a survey: “New staff are not always given sufficient training on how I eat and drink. I would like new staff to be shown how I eat before they feed me, because I can easily choke”. Longueville Court DS0000024316.V369990.R01.S.doc Version 5.2 Page 13 One person living at the home with needs associated with his Physical Disability was fully involved in his care planning. His care plan was read and discussed with him. He was conversant with his plan and knew that he could access this at anytime he wanted. The plan did not refer to how his social development and interests might be achieved, or to any plan for him to enjoy or participate in the wider community and this has been further reported under ‘Daily Life and Social Activities’. Another person who shad previously stated that she wanted her care plans kept in her room was listened to and was given this choice. On the 13/08/2008, a pharmacist inspector examined practices and procedures for the safe use and recording of medicines. Medicines were stored securely for the protection of residents. Temperatures of medicines storage areas are well controlled and recorded regularly to maintain the quality of medicines used for residents. We looked at the medication in use, and the medication records for people on two of the units (Memory Lane and Kingfisher) as well as care records for a number of people. Records made when medicines are received, administered and disposed of are of good quality and provide a clear audit of medicines in use. The accuracy of records made when medicines are administered to residents has improved and so the requirement made about this at the last inspection has been met. When people look after and take their own medicines, risks to themselves and other people had been assessed well and the documentation clearly demonstrated this. We watched some medicines being given to residents on one unit during the morning and this was done in a professional way with due regard to people’s dignity and personal choice. People’s dignity was observed to be upheld when staff knocked on doors before entering. At lunchtime when people were assisted with their meal by polite and attentive staff in the Memory Lane unit, they were treated with careful attention at a pace that suited them. Their table settings and utensils and plates that were laid out for people indicated they were treated in a respectful and ordinary manner. It was also respectful of the chef to visit people at the end of their meal to enquire if they had liked their food. One person thought her dignity was not sufficiently recognised when she stated she did not want any male carers to provide assistance with her personal care at anytime and considered her care plan did not accurately record this. The nurse in charge amended her plan, when this was explained. Longueville Court DS0000024316.V369990.R01.S.doc Version 5.2 Page 14 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, Quality in this outcome area is adequate. People are assured of some activities within the home but are not assured there is a choice and an activity to suit them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Comments received from people in surveys included: “During the day I would like to be able to go out, to do shopping and events. We are not able to go out in the minibus because of limited number of drivers. There are no activities at weekends and I do not leave my room unless my parents take me out”. “There are many activities each week. Some I enjoy”. The programme for arranged activities within the home has improved and it has an emphasis on the interests of people living in the Robin unit part of the home. A weekly roster is arranged for activities mainly within the home by the three activity workers employed by the home and include sailing at a nearby water park. An essential aspect of their activities is speaking and talking to Longueville Court DS0000024316.V369990.R01.S.doc Version 5.2 Page 15 people who are unable, or not wanting to participate in the events that are organised. One persons’ care plan did not include his interests outside of the home in the wider community and how he might achieve his aspirations that he described to us. This reflected a tradition of care planning followed by the home to provide a safe yet insular approach. This type of care is not the expressed choice of people who we spoke to and was seen as restrictive and a failure to acknowledge their potential. The recent improvements in the organised activities were arranged after people had been consulted and this has encouraged and facilitated people to enjoy aspects of the community. Two people said the people living in the Robin unit do not get together regularly to formally decide their ongoing activities and would like to do this. One person said he wanted more personal development and social life outside of the home. He thought that there were sufficient activities within the home, but not enough assistance for him to participate in the wider community. Another person living in the Robin unit repeated this same view. Another person thought her dignity was not sufficiently recognised when has stated she did not want any male carers to provide assistance with her personal care at anytime and considered her care plan did not accurately record this. A nurse amended her plan when this was explained. During this discussion and during the feedback given to the acting manager, it was agreed that external and local community access is restricted because there is no arrangement for a regular person to drive the two vehicle that are owned by the home. Meals and food and the quality of these have improved since the last inspection. People have been consulted about the meals and their complaints about food listened to. Staff changes have been made to achieve new goals for food standards. Peterborough Primary Care Trust’s Dietician has been instrumental in effecting change in the home. She has re-assessed people dietary needs and provided extensive advise for the home about people’s nutritional status, their needs and precise types of types of diet. She has monitored and ensured the quality is appropriate. Longueville Court DS0000024316.V369990.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): 16,18, Quality in this outcome area is good. Whilst the home has a policy to confront abuse, people are not assured that staff are equipped with enough information about protecting them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home’s policies for complaints and for adult protection are satisfactory and had been adhered to. Complaints have been made about food that have been satisfactorily dealt wit through the encouragement and advise of Peterborough Primary Care Trust’ Dietician as well as the home’s adopting a positive approach to this issue. A recent complaint was made to the home relating to the problems of a gastronomy PEG feed tube becoming blocked. The complainant made the matter known to the commission and became the subject of a safeguarding matter. The complaint was dealt with by the home in an open manner and timely manner and at all times communication with the complainant was maintained. The complaint was referred as a safeguarding matter to the Local Authority Safeguarding/Adult Protection Team, who fully investigated. We discussed the issue with the complainant during this inspection on the 12/08/2008. Longueville Court DS0000024316.V369990.R01.S.doc Version 5.2 Page 17 Two care staff were asked about abuse and reporting abuse and were unaware of where any contact details were in the home should they need to independently report abuse, although they said they would report immediately to the manager any suspicion they had. Since the last key inspection in October 2007, a number of concerns have been raised and reported as safeguarding issues. The home has been consistent in reporting abuse when necessary and has worked co-operatively, at all times, in any investigation carried out by the Safeguarding Team for Peterborough Primary Care Trust. Longueville Court DS0000024316.V369990.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): 19,26, Quality in this outcome area is good. People are assured of a clean and well maintained home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is spacious comfortable and remains very well maintained. There were no noticeable offensive odours. Longueville Court DS0000024316.V369990.R01.S.doc Version 5.2 Page 19 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, Quality in this outcome area is adequate. People are assured care staff are trained, but are not fully assured a detailed record of their recruitment is maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Annual Quality Assurance Assessment (AQAA) sent by the home stated they had in place an appropriate induction programme based on the ‘Skills for Care Council’s’ Induction Standards. Two staff reported their induction was good. Records showed that induction last 3-5 days. Both care staff were asked about their training for adult protection that was covered in their induction. They did not know the overall picture of what can be done to protect people and who deals with protection. They did not know where any contact details were kept should they ever need to independently report an allegation of abuse. Further training in abuse awareness had not been provided although they both expected this would be planned for them. A training record was read, but the overall training plan was not available and the training manager was on annual leave and this information could not be produced. There was no way to determine how many staff needed training in adult abuse and what training was planned for the future. The training arrangements made for a number of staff included ‘Peg feed training’; care Longueville Court DS0000024316.V369990.R01.S.doc Version 5.2 Page 20 planning; catheter care; dementia awareness; Fire training; Health and Safety; Induction (CD ROM): Mental Capacity Act; Moving and Handling. The Training Manager who also works as a nurse for 10 hours each week delivers much of this training. We saw training arrangements posted near to the staff room for a range of training topics. As stated in the last report there was a lack of clear evidence to show if the training was individually planned or systematic. The AQAA stated that 24 out of a total of 54 care staff have an NVQ level 2 award in care and 8 more were working towards this or a higher award. The home reported this as 59 working towards NVQ level 2 or above. The AQAA claimed there were 54 permanent care staff employed and showed there were 66 full time nursing/care staff and 10 part-time care/nursing and 29 noncare/nursing staff. Another page showed a different total of total of 116 care/nursing staff from different ethnic backgrounds. Staffing levels have increased slightly at night time and during the day. There were comments from staff in the Memory Lane part of the home that “staff can be a bit thin on the ground…every one of these residents is vulnerable and many require 2 people for any manoeuvring /transferring”. One care assistant told us that more staff should be provided at key times such as mealtimes. Recruitment details for two recently employed care staff showed that not all details provided to the home were clear. The CRB was only a copy of part of the disclosure document and was undated. A reference for one care worker was unclear because it referred to a different name. Longueville Court DS0000024316.V369990.R01.S.doc Version 5.2 Page 21 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): 31,33,38, Quality in this outcome area is adequate. People are assured the home currently has in place a competent acting manager who leads by example and has promoted people’s best interests. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last key inspection on 17/04/2008 the registered manager has resigned. An acting manager has made a significant contribution by providing clear leadership and being open in his communications with staff and with the Commission and with Peterborough Primary Care Trust, who have been monitoring the home. He has reacted positively to providing an improvement plan that the home has put in place. There have been improvements in staff Longueville Court DS0000024316.V369990.R01.S.doc Version 5.2 Page 22 attitudes that were demonstrated in the relaxed, yet attentive care given by staff and the timeliness that people were responded to when in need of assistance. Communications between management and people in the Robin unit have improved under the leadership of the acting manager. People said they had felt that they had previously not been listened to. There was an example of good communication, respect and inclusion when one person was invited to be part of the recruitment process for new care staff. It was seen in the records that the acting manager had positively responded to the complaints made known to the home. There are some continuing management issues relating to communication that can be further improved. These are highlighted in the following: • • • • • • • the lack of effective monitoring of the care tasks carried out by night time care staff the need to monitor the training and qualifications of agency staff ensuring that care plans accurately reflect changed needs the lack of any visible and audited measurement of the effectiveness of training, such as induction training and adult protection and the understanding that staff have of this issue the promotion of adult protection within the home ensuring the home knows and has planned for the preferences of people. dialogue about the external activities that people wish to pursue Supervision is another area of communication that needs qualifying. Staff reported they received group supervision and this was recorded. However, the record of these was brief and an explanation and detail of the discussion and supervisory elements should be recorded. Two staff told us they could request individual supervision should they want, but otherwise individual supervision did not occur. There were no other meetings of a team nature, or for staff on each unit, other than these group supervision meetings. One nurse told us that she did not receive supervision. Fire alarm certificates and fire testing and fire drill practice were in order as were emergency light and power. Regulation 37 reports had been sent regularly to the Commission. Longueville Court DS0000024316.V369990.R01.S.doc Version 5.2 Page 23 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 2 8 1 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 3 STAFFING Standard No Score 27 2 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X N/A X X 3 Longueville Court DS0000024316.V369990.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15(2)(b) Requirement The home must make proper provision of care by ensuring that fluids are offered regularly when this has been identified in their care plan and that this is recorded as a part of the care plan record, so that the person is not at risk of neglect. An immediate requirement form was left for this requirement. Recruitment records must include the details expected by the Care Home Regulations 2001. Timescale for action 13/08/08 2 OP29 19 & Schedule 2 13/10/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP7 Good Practice Recommendations The form used to record the regime for one person who is fed through a PEG feed system should be suitable for the information to be recorded, so that a clear and satisfactory DS0000024316.V369990.R01.S.doc Version 5.2 Page 25 Longueville Court 2 3 4 OP7 OP12 OP18 record of the persons care is kept. People’s expectations and capabilities regarding their care and social development should be recorded as an aspect of their care plans. An arrangement for a driver of the home’s two vehicles should be made so that people can regularly use this facility and can plan their life with this assistance. The home should promote safeguarding more vigorously so that staff can independently report abuse. Longueville Court DS0000024316.V369990.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Longueville Court DS0000024316.V369990.R01.S.doc Version 5.2 Page 27 - 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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