Inspection on 12/05/05 for Longview

This inspection was carried out on 12th May 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

Longview 29/04/08

Longview 27/04/07

Longview 31/07/06

Longview 01/11/05

Longview 17/01/05

Longview 04/10/04

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Longview Little Gypps Road Canvey Island Essex SS8 8HG Lead Inspector Ann Davey Vicky Dutton Unannounced 12 May 2005 09:00 th 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 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. Longview I56 S18105 Longview V225557 120505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Longview Address Little Gypps Road Canvey Island Essex 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) 01268 682906 01268 510155 longview@runwoodhomes.co.uk Runwood Homes plc Mrs Johanna Maureen Fitzgerald Care Home 65 Category(ies) of OP Old Age (65) registration, with number DE(E) Dementia (32) of places Longview I56 S18105 Longview V225557 120505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Personal care to be provided for up to 65 older people aged 65 years and over. 2. Personal care to be provided for up to 32 older people aged over 65 years who have dementia. 3. Total number of service users for whom personal care can be provided must not exceed 65. Date of last inspection 17th February 2005 Brief Description of the Service: Longview is registered to provide care and accomodation for 65 older people. Thirty two beds are registered for residents with dementia and three beds are reserved for residents on a respite placement. One part of the site is used to provide day care. Longview is a 2 storey building and is nearby to local shops and community amenities. The home has access to local bus routes. All bedrooms are single occuancy and most have ensuite facilities. The home has a courtyard garden/patio area and other grassed areas surround the building. There are adequate parking facilities to the front of the home. Longview I56 S18105 Longview V225557 120505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over a period of 8.5 hours. As there were two inspectors, this equated to 17 hours input. The inspection focused mainly on the progress the home had made since the last inspection although a number of other standards of care were also considered. A partial tour of the premises took place and staff, residents and other records were selected at random and inspected. A large number of residents and staff were spoken and a visitor. A notice was displayed in the main entrance area throughout the day advising all visitors to the home that an inspection was taking place with an open invitation to speak with an inspector. An Operations Manager for Runwood plc was present for the second half of the day. The inspectors gave a full and detailed ‘feedback’ to the registered manager and the operational manager at the end of the visit with opportunity for clarification. Assurances were given that immediate action would be taken by Runwood plc to address the most serious shortfalls identified. A full response from Runwood plc will follow in due course. What the service does well: What has improved since the last inspection? It was positive to note that the home no longer relies on agency staff to maintain minimum staffing levels. In general the home has been through a very positive staff recruitment process and now has an established group of care staff. In addition, the appointment of a full time administrator has been a tremendous asset. The standard of care plan/risk assessment documentation Longview I56 S18105 Longview V225557 120505 Stage 4.doc Version 1.30 Page 6 has improved, although some development work is still required. The home has improved and developed the activities and social programme. 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. Longview I56 S18105 Longview V225557 120505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Longview I56 S18105 Longview V225557 120505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 & 5 Staff are suitable trained to meet the general needs of current residents and where appropriate, visits prior to an admission are arranged. EVIDENCE: Admission assessment documentation selected at random was appropriate in content and detail. The home should ensure that all other associated assessment documentation is kept on individual residents files, i.e. the funding agency’s own assessment documentation. It could become quite confusing if associated documentation is kept separately and there is no cross-referencing. Residents and a visitor confirmed that pre admission visits take place. Longview I56 S18105 Longview V225557 120505 Stage 4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9,10, & 11 Staff are not following the home’s policies and procedures concerning all medication practices which potentially place residents at risk. Residents’ personal and health care needs are not always know by staff and not always accurately reflected on the plans of care and/or risk assessments. Residents’ rights of privacy, sensitivity and dignity are not always upheld and/or evidenced through records. EVIDENCE: Senior staff were not following the homes written instructions concerning the signatures that are required when the manual transcribing of medication instruction has taken place. This has been raised with the home on 4 occasions now. In additional, senior staff were operating a ‘nebulizer’, but had received no training. If staff do not follow the homes written policies and procedures concerning medication issues, residents are potentially at risk. Care needs within plans of care did not always detail specific needs and there was a lack of assessment in some areas. Some plans of care had not been reviewed since March 2005. Detail within documentation on one occasion, varied greatly from a senior member of staff’s perception of a specific clinical diagnosis. Within the daily observational records, there was not always a Longview I56 S18105 Longview V225557 120505 Stage 4.doc Version 1.30 Page 10 ‘follow up’ or ‘follow through’ concerning specific incidents. This tended to leave some care and medical issues inconclusive. Residents are potentially at risk if their care needs are not fully identified and know to all staff. It was however positive to note the significant improvement in the standard of care plan documentation since the last inspection. Some residents did not have any form of leg covering. Staff told the inspectors that the reason for this action was documented within individual plans of care, but residents choice was not evidenced. The resident ‘pay telephone’ was out of order at the last inspection, and has still not been mended. Residents are unable to use a phone facility independent of the home. Residents’ rights of privacy and dignity are not being upheld at all times. Due to a general lack of storage facility within the home, a number of bedrooms had boxes of new incontinent pads stored in them. This does not promote the dignity of these residents when they have visitors. A reference in one care record had been made using insensitive language. One resident had been very recently bereaved, but the care plan made no reference to this and there were no written instructions on how this resident’s very specific care needs were to be met at this crucial time in a sensitive manner. Residents have full access to all health care professionals as/when required. Longview I56 S18105 Longview V225557 120505 Stage 4.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 14 & 15 Residents are provided with a meaningful and appropriate activities/social programme and there is opportunity for family and friends to visit. There are issues concerning the choice of food offered and/or the surroundings in which residents can eat, to be resolved. EVIDENCE: The home provides a meaningful activities/social programme Monday - Friday for all residents. This extends to residents who are more withdrawn and/or on bed rest. The home employs two enthusiastic activity co coordinators who complement each with different skills and abilities. This aspect of care is clearly enjoyed by residents. The home has arranged a number of events to celebrate VE day in an appropriate manner. Residents spoke of being ‘bored’ with always having sausages in one shape or another at mealtimes. The current menus seen did indeed refer to sausages being provided on very regular intervals for either lunch or tea. When this was raised with a senior member of staff, residents’ views had been noted and new menus are in draft form. However, the home had not thought to inform residents about this development. It was also confirmed that residents who wish to have their warm evening meal in their rooms on the 1st floor and not ‘allowed to’ for health and safety reasons. In addition, residents who use the 1st floor lounge said they too were not ‘allowed’ to eat a ‘hot’ tea upstairs. Longview I56 S18105 Longview V225557 120505 Stage 4.doc Version 1.30 Page 12 Residents who remain on the 1st floor at evening meal times are provided with ‘cold’ tea or sandwiches only. This practice has been raised with the home on a previous occasion and is unacceptable. Dining tables were not presented well for meals. There was a lack of respect shown for residents in this respect. In general, staff were observed to be assisting with feeding in a sensitive manner. The food prepared and served for lunch looked appetising. Longview I56 S18105 Longview V225557 120505 Stage 4.doc Version 1.30 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18 There is an established complaints procedure, but not all residents are aware of it. There is an established ‘Protection from Abuse’ policy/procedure, but the home should ensure that all staff are aware of it. EVIDENCE: In general, residents felt able to raise any aspect of concern or complaint with a member of staff. However, as raised within standard 15, when a concern is made, the home have a duty to ensure that the process is followed through and residents are fully informed of the outcome. There have been no entries in the complaints log since 25/3/03. The home confirmed that this record was not up to date as some records are held off site. This is not acceptable. In addition, the last recorded ’infringement of (residents) rights’ was 26/2/02, these records were not up to date. Staff awareness of POVA (Protection of Vulnerable Adults) procedures was patchy. One member of senior staff was hesitant about the process, whilst a number of care staff were very clear about their responsibilities in reporting a suspected incident. Residents are potentially at risk if all staff are not clear about their role related responsibilities concerning POVA issues. Since the last inspection there has been two substantiated POVA incidents within the home. The Commission for Social Care Inspection is satisfied that the outcome concerning the staff involved has been managed appropriately by Runwood plc. Longview I56 S18105 Longview V225557 120505 Stage 4.doc Version 1.30 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 23, 24, 25 & 26 The overall standard of furnishings, décor, cleanliness and fitments within the home is of a satisfactory standard, although some areas require a programme of repair and decoration. Some physical aspects of/within the environment were potentially dangerous to residents. EVIDENCE: Residents’ bedrooms in the main were appropriately decorated, furnished and equipped. Many were very personalised, creating a warm homely atmosphere. The home has recently introduced regular ‘walking premises audits’ by senior staff to identify any problem areas. This initiative has been positive and the outcome of these ‘walks’ has benefited residents in that their environment is monitored on a regular basis. The home had no unpleasant odours in any area of the home. Runwood plc are fully aware that some areas of the home are in a less that satisfactory state of repair and decoration. The home continues to lack storage and shelving space, whereby wheelchair and lifting equipment are stored in corridors, bathrooms, around corners and in Longview I56 S18105 Longview V225557 120505 Stage 4.doc Version 1.30 Page 15 visitors lounge areas. The lack of storage space means that latex gloves and plastic bags used for incontinent pads are left within easy reach of residents with dementia. This is a potential risk to residents. Although Runwood plc have now cut a hole through the radiator boxing so that residents have access to the heating controls in their respective bedrooms, the design of these ‘boxes’ is inappropriate and residents would have difficulty operating the controls. A list of matters requiring the homes attention was left with the manager. This included broken equipment, lack of small tables to place hot drinks on, inappropriate use of yellow clinical bags left in bedrooms, missing commode lids/covers, broken bath panel, inaccessible call bells and lack of infection control aids i.e. gloves and accessible liquid soap in critical areas. The laundry/iron area containing chemicals and electrical machinery was left unsupervised. This places residents at potential risk. Within dining area (which had a resident in at the time) an unguarded, unsupervised heated food trolley had been left. The surface temperature was so hot that the inspector obtained a burn to her finger that later blistered. Leaving trolleys unguarded is extremely dangerous and puts residents at risk. The trolley was removed and a senior member of staff asked the kitchen staff to ‘check out’ the temperature as she felt that the surface temperature should not have risen so high. Longview I56 S18105 Longview V225557 120505 Stage 4.doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 & 30 The homes recruitment and induction process was insufficient to safeguard and protect residents. Staffing levels appeared adequate to meet the needs of residents. EVIDENCE: It was positive to note that the home is no longer reliant on agency staff to maintain appropriate staffing levels. The home has now appointed a full time administrator and has minimal staff vacancies. Moral in the home was positive and all staff spoken with were cooperative and helpful. The home currently has a vacancy for a deputy manager. This appointment should be made as soon as possible, as the registered manager carries a heavy workload. Staff confirmed that they have training opportunities, regular staff meetings and supervision sessions. Although much of the interaction between staff and resident was task oriented, rapport was appropriate and in general residents were not left for too long in a group situation unsupervised. The only exception to this was during the mid afternoon tea session when a group of residents were noted to be left unsupervised for over 20 minutes. The inspection coincided with a visit from the hairdresser. This activity was clearly enjoyed by residents. Residents spoke positively about members of staff and the care received. The 4 most recent recruitment records were viewed. Some contained no references whist others only had one, the information and detail regarding the post to which they were recruited varied on Home Office work permits, Longview I56 S18105 Longview V225557 120505 Stage 4.doc Version 1.30 Page 17 Runwood plc employee ‘check lists’, applications forms, letters of acceptance, letters to banks and Criminal Records Bureau disclosures. There was no consistent approach to the completion and availability of induction and training records, many were not available. This practice is unacceptable and places residents at potential risk. Longview I56 S18105 Longview V225557 120505 Stage 4.doc Version 1.30 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 36, 37 & 38 Management and administration systems within the home require intervention and support to develop. EVIDENCE: The registered manager has dealt with a number of quite complex management issues within the home since the last inspection. Some of these experiences have created a huge learning curve for the home in general. The manager demonstrated a good awareness of residents’ needs and commitment to address the shortfalls identified. Staff said they found her management style open and positive. Due to the deputy manager’s post being vacant, the manager’s workload carries extra responsibilities and duties. This has an impact of what can be reasonably managed within her contracted hours. Runwood plc are fully aware of the situation. Longview I56 S18105 Longview V225557 120505 Stage 4.doc Version 1.30 Page 19 It is of concern that many of the shortfalls identified within the report potentially put residents at risk i.e. medication, staff recruitment, health & safety issues for example. In view of the manager’s current workload, it is disappointing that Runwood plc through their regular Regulation 26 visits have not been more proactive in monitoring these aspects to primarily assist in the daily management of the home and address any identified shortfalls. Current Regulation 26 reports inform of some shortfalls, but do not provide any timescale for compliance, how the compliance will be achieved, how progress will be monitored, what support/training is to be provided, or another method to support the home found. Longview I56 S18105 Longview V225557 120505 Stage 4.doc Version 1.30 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 1 COMPLAINTS AND PROTECTION 2 2 x x 3 3 2 3 STAFFING Standard No Score 27 3 28 x 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 2 3 3 2 x x 3 2 2 Longview I56 S18105 Longview V225557 120505 Stage 4.doc Version 1.30 Page 21 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 7 & 11 Regulation 15 Requirement The registered person must ensure that all residents have a comprehensive plan of care. This must include all details of the care required, risk assessments, health care records and medication issues. Records must be kept in accordance with regulatory requirements and the NMS. The registered person must ensure that appropriate arrangements are in place concerning the training of staff who deal with medication in respect of documentaion and administration The registered person must ensure that the dignity of residents is upheld at all times. This is with reference to residents wearing leg covering of their choice and providing suitable storage space for incontinent pads. The registered person must make suitable and appropriate arrangements in order that the views and wishes of residents are respected and acted upon. Systems must be set up to I56 S18105 Longview V225557 120505 Stage 4.doc Timescale for action 12/6/05 (previous timescale of 17/2/05 not met) 2. 9 & 30 13 12/6/05 (previous timescale of 17/2/05 not met) 12/6/05 3. 10 16 4. 14,15, 33 & 37 12 12/6/05 Longview Version 1.30 Page 22 5. 16 22 facilitate dialogue and better communication The registered person must ensure that residents are fully aware (according to ability) of the homes complaints procedure. The registered person must ensure that all staff are aware of the homes Protection of Vulnerable Adult reporting procedures. The registered person must ensure that the home is in a good state of repair, there is adequate storage space, appropriate furniture for residents to place hot drinks on and that the environment and equipement within it, is safe and suitable for residents. 12/6/05 6. 18 13 12/6/05 7. 19, 20, 25 & 38 23 12/6/05 (previous timescale of 17/2/05 concerning providing adequate storage space and furniture was not met) 12/6/05 (previous timescale of 17/2/05 not met) 12/6/05 8. 29 19 The registered person must ensure that robust recruitement procedures are in place and kept in accordance with regulatory requirements. The registered person must review the manner in which the Regulation 26 visits are undertaken and reported on. The present process provides no timescale for compliance and no monitoring system. 9. 38 26 Longview I56 S18105 Longview V225557 120505 Stage 4.doc Version 1.30 Page 23 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. Refer to Standard 3&5 31 Good Practice Recommendations The registered person should ensure that all admission documentation is held in one place to avoid confusion. The registered person should ensure that an appropiate deputy managers appointment is made without delay to assist the manager with her extra duties and responsibilities at this stage. Longview I56 S18105 Longview V225557 120505 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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 Longview I56 S18105 Longview V225557 120505 Stage 4.doc Version 1.30 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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