Inspection on 30/01/06 for Longview

This inspection was carried out on 30th January 2006.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Longview 06/08/07

Longview 28/09/06

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

CARE HOMES FOR OLDER PEOPLE Longview Rosehill Goonhavern Truro Cornwall TR4 9JX Lead Inspector Ian Wright Announced Inspection 30th January 2006 10:00 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 Longview DS0000063014.V264162.R01.S.doc Version 5.0 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. Longview DS0000063014.V264162.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Longview Address Rosehill Goonhavern Truro Cornwall TR4 9JX 01872 573378 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) Longview Care Home Ltd Mr Yogesh K Patel, Mrs Neepa Patel, Mr Kanubhai R Patel Mrs Deborah Jane Blight Care Home 28 Category(ies) of Dementia - over 65 years of age (28), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (28) Longview DS0000063014.V264162.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19/08/05 Brief Description of the Service: Longview provides care for twenty eight service users. The home is registered to provide care for adults over 65 with mental disorder (excluding learning disability), or for adults with dementia. The home has predominantly single bedrooms with two shared bedrooms. The home has two lounges and a dining room. The home has a lift. All external doors are locked and alarmed due to the nature of the service user group. The home has very pleasant gardens. There is a seating area in the garden which can be used by service users. There is satisfactory car parking. The registered provider is Mr A Patel. Longview DS0000063014.V264162.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over eight and three quarter hours on 30th January 2006. The inspection was carried out on an announced basis. The inspection focused on previous statutory requirements and standards not inspected at the last inspection. Some of the other ‘key’ standards were also assessed. The inspector was able to speak to many service users and staff. Care practices were observed. The inspector also spoke to relatives of some service users. The inspector examined care and service records, and inspected the building. What the service does well: What has improved since the last inspection? What they could do better: Some improvement is required to the operation of the registered provider’s medication system. For example senior staff and night staff need training to administer rectal diazepam. Minor improvement is required to record keeping of the administration of medication. Longview DS0000063014.V264162.R01.S.doc Version 5.0 Page 6 Although some day activities are currently provided, the registered manager must explore further opportunities to improve day activities, and other opportunities for service user stimulation. Recruitment practices must be improved to protect service users from potential abuse. Caution must be taken when employing staff with criminal records, and/or poor employment references. Although staff training has continued to improve, the registered persons still need to ensure all staff receive training required by law. This includes infection control, food hygiene and first aid training. 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 DS0000063014.V264162.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Longview DS0000063014.V264162.R01.S.doc Version 5.0 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 the following standard(s): 1, 3, 4 Suitable information is provided to enable service users to make an informed choice to move to the home. Suitable measures e.g. a pre admission assessment, and links with external professionals are in place, so the registered provider can ensure staff meet the needs of service users. EVIDENCE: Copies of the statement of purpose, service user guide and pre admission assessments were inspected. Pre admission assessments are completed before the service user comes to live in the home. A suitable care plan is subsequently developed from this. Copies of social services / health assessments, regarding service user needs, are obtained where possible, before admission is arranged. Service users and their representatives are able to visit the home before making a decision to move there. Staff stated support from external professionals was positive; for example there are suitable links with social workers, district nurses etc. Nine staff have NVQ 2 or 3 in care. Longview DS0000063014.V264162.R01.S.doc Version 5.0 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 the following standard(s): 7, 8, 9, 10, Service users personal and health care needs are met appropriately. Some improvement is required to the operation of the medication system. EVIDENCE: All service users have suitable care plans which are reviewed regularly. These contain satisfactory information to enable staff to deliver care. Suitable links have been developed with GP’s, district nurses etc. Interventions by health care professionals are documented. The registered provider operates a generally satisfactory medication system. The pharmacist regularly reviews the medication system every two months. The inspector found some minor errors when inspecting the medication system. For example: • Records for the administration of doses of a painkiller were inaccurate. • Staff who administer medication (including night staff) need to be trained to administer rectal diazepam. • Aspirin held in the medication cabinet was not labelled. • Two halves of a tablet were found loose in the medication cabinet. Longview DS0000063014.V264162.R01.S.doc Version 5.0 Page 10 These matters need to be addressed. Where GP’s change service users’ medication, it is recommended the registered persons liaise with the GP to receive confirmation of these changes in writing. The inspector spoke to several service users who said their rights were respected, and they were treated with dignity by staff. Clothing is labelled so service users only wear their own clothing. Service users are only addressed by their preferred form of address. This is ascertained at the pre- admission assessment. Staff were observed working with service users in an appropriate manner. Longview DS0000063014.V264162.R01.S.doc Version 5.0 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 the following standard(s): 12, 15 Suitable routines are in place. Effort is required to improve activities available to service users. Meals are of good quality and support given to assist service users with their meals is satisfactory. EVIDENCE: The registered manager said service users are able to get up and go to bed when they wished. Breakfast is available for service users from 6am. A religious service is held on a monthly basis. Some activities are arranged for example there is an activity session arranged each afternoon. However the activities programme, and other opportunities for service user stimulation, could be expanded further. The registered manager needs to explore this. The inspector shared a meal with service users. This was to a good standard. Support provided by staff to service users was good. Service users said they were happy with food provided. Longview DS0000063014.V264162.R01.S.doc Version 5.0 Page 12 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 the following standard(s): 16, 18 Appropriate arrangements are in place so any complaints are resolved effectively. Although the registered persons have a satisfactory adult protection policy, failure to respond appropriately to recruitment checks could put service users at risk. EVIDENCE: The registered provider has not received any complaints since the last inspection. Service users and their representatives receive appropriate information how to make a complaint; for example a copy of the service user guide. The registered provider has a suitable adult protection procedure. The registered persons said staff receive a Criminal Records Bureau check, and where appropriate a Protection of Vulnerable Adults check. Where a disclosure has not been obtained staff are supervised. Staff are required to read the home’s policy regarding adult protection when they commence employment. However one member of staff was clearly not suitable to work in a care home due to a poor reference from another care home, and a Criminal Record check with a list of criminal convictions. At least one other staff had received a poor reference, from another care home, and had been employed. The registered persons must improve their decision making, following recruitment checks, so service users are better protected from potential abuse. Longview DS0000063014.V264162.R01.S.doc Version 5.0 Page 13 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 the following standard(s): 19, 26 Longview provides suitable accommodation to meet the needs of service users living there. The home is clean, pleasant and hygienic. EVIDENCE: The property is very well maintained, appears to be safe, is comfortable and homely. Furnishings and decorations are of good quality. The home has two lounges. Other facilities such as bathrooms and toilets are suitable. The home has two assisted baths. The home was clean and hygienic on the day of inspection. A sluice facility is provided. The registered manager said 3 domestic staff and a laundry person are employed. Longview DS0000063014.V264162.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30, Suitable staffing levels are provided to care for service users. Recruitment checks must be improved so service users can be assured they are in safe hands. Some improvement is still required so staff receive training required by law. EVIDENCE: Suitable staffing is provided. Rotas showed there is a minimum of four staff on duty between 0800 and 2100. Two waking night staff provide support between 2100-0800. The registered provider lives in the neighbouring property. Suitable information, as required by regulation, is obtained for staff employment records. However at least two staff had received poor references from previous care home employers. One of these staff members also had a criminal record, of which, some of the offences meant the person was unsuitable to work in a caring capacity. Both staff however had been employed. An immediate requirement was made requiring the registered persons to take legal advice to ascertain whether they were able to continue employing one of the staff so risk to service users was minimised. Nine staff currently have either an NVQ 2 or 3. Evidence of training delivered to staff continues to improve, although there are still some gaps in training required by law such as food hygiene, first aid and infection control. Staff have either completed or are completing training in dementia awareness. Longview DS0000063014.V264162.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 35, 37, 38 The registered persons are suitable to manage the home. The ethos, leadership and management are suitable to ensure the home is run in a satisfactory manner. Policies, procedures and records are generally satisfactory although some improvements are required as outlined elsewhere in the report. Health and safety precautions are satisfactory so service users and staff are safe, although some improvement is required to health and safety staff training as outlined elsewhere in the report. EVIDENCE: The registered persons are suitably experienced, qualified and skilled to carry out their role. Mr Patel purchased the home in 2005. Mrs Blight who previously owned the home and remained as temporary registered manager, has just resigned, and will be leaving the home shortly. Mrs M. Boyden was approved by the Commission for Social Care Inspection last week to be the new registered manager. Longview DS0000063014.V264162.R01.S.doc Version 5.0 Page 16 The registered persons appear to be approachable, and demonstrate a suitable attitude to ensure staff work in a caring manner. There are regular staff meetings which are documented. Records examined regarding the management of the home, and in regard to service users care are appropriate. The registered persons do not look after monies on behalf of service users. All service users monies are managed either by a relative or a legal representative. Where any expenditure takes place on behalf of service users, such as for toiletries, representatives are invoiced for these costs. Health and safety precautions are satisfactory for example in regard to servicing of moving and handling equipment, fire, electrical and gas equipment etc. Suitable health and safety risk assessments are completed. This includes ensuring service users are protected against the risk of Legionella. Longview DS0000063014.V264162.R01.S.doc Version 5.0 Page 17 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 3 X 3 3 X X 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 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 1 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X 3 X 3 3 Longview DS0000063014.V264162.R01.S.doc Version 5.0 Page 18 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. 1 Standard OP9 Regulation 13 Requirement Timescale for action 01/04/06 2 OP12 3 OP29OP18 The registered manager must: • Improve record keeping for the administration of medication. • Ensure all medication is correctly labelled, and administered only to service users who it is prescribed for. • Senior staff and night staff are trained to administer rectal diazepam. • Dispose of medication which was found loose in the medication cabinet. 16 The registered manager must 01/06/06 explore further opportunities to improve day activities, and other opportunities for service user stimulation. 10, 12, The registered persons must 01/04/06 13, 19, 37 improve recruitment practices so service users are better protected from potential abuse. 19 The registered persons must seek legal advice regarding whether they can dismiss a member of staff with a criminal DS0000063014.V264162.R01.S.doc 4 OP29 28/02/06 Longview Version 5.0 Page 19 5 OP30 18 record. The registered persons must report back to the Commission regarding what action they have taken. Staff must receive training appropriate to the work they perform. This must include training required by regulation for example first aid, manual handling. Staff must also receive training to assist them in an understanding of the needs of people with dementia. 01/06/06 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 OP9 Good Practice Recommendations Where GP’s change service users’ medication, it is recommended the registered persons liaise with the GP to receive confirmation of these changes in writing. Longview DS0000063014.V264162.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD 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 DS0000063014.V264162.R01.S.doc Version 5.0 Page 21 - 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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