Inspection on 31/07/06 for Longview

This inspection was carried out on 31st July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 01/11/05

Longview 12/05/05

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 Key Unannounced Inspection Site Visit 31st July 2006 08:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Longview DS0000018105.V306025.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. Longview DS0000018105.V306025.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Longview Address Little Gypps Road Canvey Island Essex SS8 8HG 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) 01268 682906 01268 510155 longview@runwoodhomesplc.com runwoodhomes.co.uk Runwood Homes Plc Manager post vacant Care Home 65 Category(ies) of Dementia - over 65 years of age (32), Old age, registration, with number not falling within any other category (65) of places Longview DS0000018105.V306025.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Personal care to be provided for up to 65 older people aged 65 years and over. Personal care to be provided for up to 32 older people aged over 65 years who have dementia. Total number of service users for whom personal care can be provided must not exceed 65. 27th April 2006 Date of last inspection Brief Description of the Service: Longview is registered to provide care and accommodation 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 occupancy 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. The range of fees was provided by the acting deputy manager as £359.80 £429.00 per week. There are additional charges for toiletries, hairdressing, newspapers and personal items. Copies of the home’s Statement of Purpose and Service Users Guide were available in the main entrance hallway. It was noted that inspection reports within the documents were out of date as was some information about the management of the home found in residents’ bedrooms. Longview DS0000018105.V306025.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The key inspection site visit took place over a period of 8.5 hours. As there were two inspectors, this equated to 17 hours on site. The visit mainly focused on the progress the home had made since the last visit and covered ‘key standards’. A partial tour of the home took place. Staff and residents were spoken with. Records were selected at random and various elements sampled and assessed. Survey/questionnaire letters had been sent/given to residents, GP’s, health & social professional and relatives. Received responses have been incorporated into this report. A notice was displayed in the home advising all visitors that an inspection site visit was taking place with an open invitation to speak with an inspector. The acting manager was on holiday. The inspectors were assisted by the acting deputy manager and a senior representative (Operational Manager) of Runwood plc. A full and detailed feedback from the site visit was provided both during and at the end of the day with opportunity for further discussion and/or clarification. What the service does well: What has improved since the last inspection? Longview DS0000018105.V306025.R01.S.doc Version 5.2 Page 6 There was no evidence of any significant improvement since the last inspection. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Longview DS0000018105.V306025.R01.S.doc Version 5.2 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 DS0000018105.V306025.R01.S.doc Version 5.2 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 & 6 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the site. Assessed care/health care needs had not been adequately recorded and therefore information available for staff was incomplete. Information available for interested parties was not current. EVIDENCE: Copies of the home’s Statement of Purpose and Service User’s Guide contained outdated inspection reports i.e. 12th May 2005. A Welcome Pack was on display in one bedroom providing details of a manager who left a significant time ago. Longview provides accommodation for residents with dementia care needs and misleading, inaccurate information is unhelpful. Documentation regarding recent admissions was not adequate in detail or content. The information available and provided was not sufficient enough to inform and give guidance to staff. (See information under standard 7) The home does not provide intermediate care. Longview DS0000018105.V306025.R01.S.doc Version 5.2 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 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the site. There was little evidence of a systematic approach to assessed care/health care needs being adequately recorded. Therefore, this could lead to residents being at risk. EVIDENCE: Nine care plans and associated records were viewed and various elements assessed. Only 3 were deemed to be adequate. There was little evidence of a robust systematic approach to record keeping within the care planning system. Information was missing, records/information was conflicting in identified places, ‘follow ups’ to events (e.g. medical intervention, hospital admission’s, skin tears etc) were not always evident, ‘cross referencing’ was inadequate, there was a lack of current risk assessment documentation and various standard items of documentation within the system had been left blank. For example, one resident had been admitted to hospital but his care plan had not been updated on return to the home, another resident had been reported as having a ‘skin tear’, but there was no further reference to this, another Longview DS0000018105.V306025.R01.S.doc Version 5.2 Page 10 resident was receiving the services of a community nurse for a pressure sore but there was no reference on the care plan to this intervention, another record stated that a resident was ‘’shouting out as if in agony’ and ‘groaning whenever he was awake’ but there was again there was no further reference to this. This is the 5th time shortfalls have been identified in relation to the care planning process/records/system. Throughout the day, residents were observed to be left unsupervised in lounges for significant periods of time. One inspector assisted residents as there was little evidence of staff activity or presence, and residents were observed to be assisting each other for the same reason. The general management of staff deployment within the home is inadequate. By the late afternoon, resident supervision was a little better, but the inspectors observed one member of staff in a room of about 15 residents just leaning against a wall, not engaging or interacting with any resident. For relatively long periods of time especially in the morning, the majority of residents were left unattended in 2 of the 3 ground floor lounges with only fuzzy TV’s for company. The response to call bells activated at random varied from a good response to no response. Residents had been left in bed with access to a call bell. Chairs were being used against beds to ‘stop them rolling out’. One bed had a chair on one side and was placed against a radiator on the other. There was no evidence of any adequate documentation concerning this practice. There was little evidence of a systematic management approach to care routines in the morning. This was identified at the last inspection. Staff themselves were friendly and courteous, but there was little management supervision of tasks being undertaken. Residents were complementary about the care they receive from staff but some said that they found communication difficult with staff whose first language is not English. This is of concern because if residents cannot make themselves understood and do not have the confidence that their needs and requirements are being understood, there is a potential for misunderstandings and mistakes to occur. Staff must be able to communicate effectively with residents. The home must review their systems to ensure that residents’ rights of dignity and privacy are met. One resident had her name written around the bottom of her slippers (this may have been at the request of the family, but the home were unable to clarify), one resident was allowed to walk around in a ‘see through’ dress’ with no belt, a catheter bag strapped to a resident leg was left ‘on display’, clothes in wardrobes and drawers were screwed up, false teeth were left on display, soiled bedclothes were in bedrooms/top of wardrobes, Longview DS0000018105.V306025.R01.S.doc Version 5.2 Page 11 underwear was left over radiators in bedrooms, wrong names were on bedroom doors, boxes of tissues, walking frames, there was evidence of bedding with a private logo printed on them being used etc. The majority of residents were dressed appropriately, but staff as the day progresses could afford greater care to residents’ general presentation. Records demonstrated that residents have access to health care professionals, but the home’s recording associated with these visits/consultation requires urgent review. Details and examples of this were discussed with the home. Records associated with medication administration practices were selected at random and found to be in good order. There was no evidence of PRN (as/when necessary) protocols in place. The storage of medication was tidy and in good order. Senior staff that deal with medication spoke of their training and had an adequate understanding of medication issues. It was of concern that the morning medication round had stated at 8am and was only just finishing at 10.45am. Lunchtime medication was started again 12.30pm. The concern about this is that there must be continuity in the frequency of drug administration. Some residents because of their diagnosed medical condition must receive their drugs via a robust regime. Daily routines and work patterns must be in place for the benefit of residents. Tubs, tubes and containers of creams and lotions were found in residents’ bedrooms without any reference to whom they belonged. During the afternoon teatime in the small lounge area, frail residents were left to balance hot drinks on their laps. No saucers were provided and there was an inadequate supply of small tables. The care and attention observed to be given to the more frail residents during these periods of time by staff was inadequate. Details of this observation were given to the home. Please see comments made under standard 15 concerning this aspect of care. Shortly after arriving at the home, the fire alarm was activated. It was of concern to the inspectors that this event was met with relative complacency by staff. It was established that the ‘toaster’ had set the alarm off. It transpired that this was a regular occurrence, yet nobody had taken the responsibility to address the situation. Staff spoken after the alarm had been cancelled about the cause, intimated that they didn’t know what happened and were routinely going about their work again. Prior to the alarm going off, the inspectors had noted one fire door that could not be closed properly and three others which had been ‘propped’ open. The concern was that having reported this to the deputy manager in the morning, the situation was the same late afternoon. The Operations Manager then took immediate action. Residents were clearly at risk, yet the home had done nothing about it. The management of care provided at this home requires urgent review. Some aspects as detailed within this report leave residents at potential risk. There are a number of repeated shortfalls. Longview DS0000018105.V306025.R01.S.doc Version 5.2 Page 12 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): 12,13,14 & 15 Quality in the outcome area is poor. This judgement has been made using available evidence including a visit to the home. There was no established system whereby residents know what is available at mealtimes and/or records to evidence that an adequate balanced diet has been provided. There was no evidence that residents are routinely encouraged to exercise choice and control over their lives. EVIDENCE: The home employs two identified activity coordinators. Clearly their input and interaction with residents is enjoyed and their contribution appreciated. It was strange to note that the ‘activity programme’ is put together by the home’s management and not those directly responsibly for this aspect of care. However outside of organised activities, the inspector’s observed very little routine interaction between staff and residents. Some staff interacted very well and engaged with residents appropriately, others did not. As detailed within the report previously, residents were left for long periods of time without adequate stimulation. It was however encouraging to see evidence of some residents’ personal hobbies and interests within their respective bedrooms. Clearly many residents enjoy visits from family and friends. It was however disappointing that the designated visitor’s room was not ‘fit for purpose’ as it Longview DS0000018105.V306025.R01.S.doc Version 5.2 Page 13 was being used as a storage facility and contained broken furniture. The Operational Manager said that this had been raised with the home the previous week and was disappointed that the room had not been cleared. The resident’s unplugged pay telephone phone was located in the ‘smoker’s room’. The location of the phone would have meant that any resident wanting to use it independently would have had difficulty in finding it. Despite the deputy manager being informed in the morning of the inspectors’ comments, the 2 menu boards within the home remained blank or still referred to the previous day food provision throughout the day. The home provides accommodation for residents with dementia care needs and this sort of practice can only lead to their further confusion. Those nutrition records sampled were either incomplete or inadequate. There was no reliable record to evidence that residents have/are receiving an adequate diet. This was identified at the last inspection. It was however encouraging to see that 24 hour fluid charts kept on identified residents were in good order. The comments from residents about food ranged from good to not so good. Staff were seen to be ‘standing over’ residents whilst they were being ‘fed’. One resident was seen to be assisting another resident with their food, as there were no staff present. The home can only ‘seat’ 56 residents at meals times in their 2 dining areas (home is registered for 65), one frail resident was seen to be turned away from both dining areas because there was no seat for her. This resident went into the lounge area for her meal. Unless the home can make suitable arrangements for all residents to have their meals at dining tables, the Commission will consider taken action as the current situation is not acceptable. Mid morning, residents’ protective tabards were seen lying on the floor in the main dining area, there was also a knife. The situation was still the same late morning. When asked about this, the inspector was told that either they had fallen on the floor or a resident had done it. No attempt had been made to make the area tidy. Tables laid for supper/tea were seen to have as many as 3 different styles of crockery on them. As well as the crockery and cutlery, the chairs in the main dining area were ‘mix and match’. Throughout the day because of the lack of interaction and supervision observed, there was little evidence that many residents especially the more physical and mentally frail, are provided with adequate relative choice and control over what happens to them within the context of their lifestyle within the home. Longview DS0000018105.V306025.R01.S.doc Version 5.2 Page 14 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is an established complaints procedure in place. Senior staff did not have an adequate understanding of POVA reporting procedures. EVIDENCE: The home’s complaints procedure was displayed and records were in reasonable order. The home should ensure that records are ‘finished off’ properly and maintained in accordance with ‘in house’ guidance. For example, one form had not been completed properly or ‘signed off’, and on another form, the complaint had not been ‘concluded’ properly. Care staff were clear that if they saw, heard or felt uncomfortable about any aspect of care within the home, they would report it to the ‘person in charge’. Two members of senior staff were spoken with about POVA issues. Senior members of staff are left ‘in charge’ of the home’. Both staff had an adequate understanding of POVA awareness, but neither were conversant or were able to competently explain their understanding of POVA reporting procedures. Failure to follow the correct procedures could place residents at further risk. Longview DS0000018105.V306025.R01.S.doc Version 5.2 Page 15 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): 19,20,23 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The premises audit identified areas/aspects which still require attention and improvement for the wellbeing of residents. EVIDENCE: Some shortfalls in respect of the above standards have now been outstanding for 3 inspections. In general residents bedrooms were homely and comfortable. Many were personalised. Communal dining/lounge areas ranged from being adequate to being over crowded with not enough seating. Furniture tends to be ‘mix and match’ throughout in these rooms. Generally residents’ wardrobes were far too small to accommodate their personal clothing. This had resulted in finding Longview DS0000018105.V306025.R01.S.doc Version 5.2 Page 16 clothing screwed up and left in the bottom or tops of wardrobes and doors could not be closed. The home said that regular premises/room audits take place. However, if they are routinely taking place there was little evidence of their effectiveness. Although the inspectors’ audit took place in the morning, a number of identified issues had been inadequate for a significant period of time. For example: The visitor’s room (see previous section) was not comfortable or adequate, some commodes in use were not ‘unwrapped’ properly as bits of the original packing had been left on the arm rests and legs, some towels were in poor condition, lids were left off commodes, lifting slings had been left on floors, an unexplained pest control box was on a bathroom floor, of the 5 chairs in the staff room, 4 were broken, some furniture in bedrooms was in poor condition, there was poor and ‘tatty’ decoration throughout the home, there are still no mattress covers on beds, tiles in bathrooms were broken/chipped, there was a broken glass door in an ensuite, some call bells were not accessible, there remains fuzzy TV’s throughout the home, wheelchairs were not always in a clean condition, the hairdresser room was open but unsupervised, bath plug holes were in a dirty condition, there remains a lack of small tables for residents’ to place hot drinks on, there is insufficient dining furniture to allow all residents to sit in one of the designated dining areas and toilet brushes had been left in an unhygienic condition/place. It was established that over the previous two days parts of the home did not have any hot water. On the day of the visit, one half of the home still didn’t have hot water, whilst the other half had water hot enough to scald. The acting deputy manager said that she had been unable to contact a handyman and the Operational Manager said that she knew nothing of this until she came late morning. The Operations Manager arranged for a handyman to immediately attend and rectify the water problem and to look at the fire door that could not be closed. It has already been recorded that fire doors were found propped open or were not able to be closed and call bells were not always responded to. For those residents with care needs associated with dementia, there is still inadequate directional/orientation signage around the home. One resident asked an inspector about direction. Most of the signage is in text form and for residents’ with care needs associated with dementia, this is inadequate. A full report of the inspectors’ findings was given to the acting deputy manager during the morning and a summary was given to the Operational Manager late afternoon. Longview DS0000018105.V306025.R01.S.doc Version 5.2 Page 17 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 Quality in this outcome area is poor. This judgement had been made using available evidence including a visit to the service. Staff rotas, staff records and staff practice must improve to ensure the wellbeing of residents and to be in line with regulatory requirements. EVIDENCE: Staff spoken with were helpful, pleasant and friendly. All those seen wore an identified uniform. The staff rota for the day and the previous day was inaccurate in content and detail. This shortfall had been identified at the previous inspection. Full details were made known to the acting deputy manager and the Operational Manager. The home is hoping to introduce an assessment tool whereby an informed decision can be made about staffing levels vs dependency levels. However, through observation at the inspection, there were insufficient staff on duty to provide adequate supervision for residents. This has been referred to in previous sections of the report. In addition, there was no evidence of effective line management in respect of monitoring/supervising staff functions during the day. Staff were ‘busy’, but these were task orientated functions and little time was actually spent with residents within the lounge areas. Longview DS0000018105.V306025.R01.S.doc Version 5.2 Page 18 There was documentation evidence that staff meetings and staff supervision sessions take place. Staff said that they receive training. When asked for staff training records, the inspector was advised that these are being updated. However, as a direct result of this inspection staff training needs to be reviewed and competencies assessed accordingly. This is with particular reference to care plan training, fire procedures, care practices, risk assessment, general record keeping together with other matters identified within the report. Two staff recruitment files were viewed. Records seen were in good order but there was no evidence of a robust induction programme. Blank record formats were in place but had not been completed. This shortfall was identified at the last inspection. Other references to ‘staffing’ have been made through this report. Longview DS0000018105.V306025.R01.S.doc Version 5.2 Page 19 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): 31,33,35 & 38 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Management systems within the home remain inadequate and place residents at potential risk. EVIDENCE: The Commission is in receipt of an application for the position of a registered manager. It is of concern that shortfalls identified at this inspection have remained not addressed for a number of inspections now. There was little evidence of robust local management strategies being in place. Strategies concerning fire Longview DS0000018105.V306025.R01.S.doc Version 5.2 Page 20 procedures, care planning, risks assessments, staff deployment/management and records required by statute in particular, are weak and place residents at potential risk. Records relating to residents personal monies being held by the home were viewed at random. Records were in good order. The home should give consideration to ensuring that residents’ personal monies are available to them upon request at weekends/evenings or amend the Statement of Purpose/Service User’s Guide to reflect the current arrangements. It was positive to see that residents are provided with a lockable facility within their bedrooms for items such as monies or personal belongings. A random sample of records as required by regulation was seen during the visit. These included maintenance records of the passenger lift and lifting/moving equipment. Records regarding fire alarm testing, fire fighting equipment checks and fire drills were inadequate. For example, the home was unable to demonstrate and explain the difference between a fire alarm test and a fire drill. Because of the regular occurrences of the alarm being activated because of the toaster, these two records had become ‘multi purpose’. With regard to fire fighting equipment being checked, these records did not identify which/what equipment had been checked. Furthermore, the ‘bed list’ which the acting deputy manager said would be given to Fire & Rescue in the event of them attending the home was not accurate. One resident identified on the ‘list’ was no longer accommodated and another resident had changed rooms. Accident records identified that a significant number of falls had occurred last month in the home during the evening and night period. There was no evidence that management have reviewed/assessed the situation to try and determine a common theme/reason. This matter was raised at the last inspection and must be addressed as residents are at risk. The Operational Manager agreed that the storage arrangements of some records held within the home’s office needs review as locating some of the required current records was difficult. Longview DS0000018105.V306025.R01.S.doc Version 5.2 Page 21 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 2 X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 2 10 1 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 1 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 1 1 2 X X 3 X X 2 STAFFING Standard No Score 27 1 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 2 X 3 2 X 1 Longview DS0000018105.V306025.R01.S.doc Version 5.2 Page 22 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 OP1 Regulation 4,5 & 6 Requirement The registered person must make review and make available a current Statement of Purpose and Service User’s Guide. Timescale for action 30/09/06 2 OP3 14 The registered person must 30/09/06 ensure that an adequate care needs assessment takes place prior to any admission and this is evidenced through documentation in accordance with statutory requirements. Documentation must be in place to demonstrate that the home can meet assessed care needs. The registered person must ensure that all residents have a comprehensive plan of care in place. This must include details of the care required, risk assessments, an adequate assessment of dependency level(s), care plan review and adequate daily records. Records must be kept in accordance with regulatory requirements and the NMS. The previous timescales of 30/09/06 3 OP7 15 Longview DS0000018105.V306025.R01.S.doc Version 5.2 Page 23 17/1/05, 12/6/05, 1/12/05 and 31/05/06 to meet this standard has not been achieved. This is the 5th repeat requirement. 4 OP9 13 The registered person must 30/09/06 make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines. This requirement is in respect of PRN protocols not in place and non-named/ labelled creams and lotions in residents’ bedrooms. 5 OP10 12 The registered person must review systems in the home to ensure that residents are cared for in a dignified, respectful manner. The home must ensure that systems are reviewed so that residents are assisted and cared for dignified, respectful manner and call bells are answered promptly. Other examples are within the report. 6 OP12 12 The registered person must review systems in the home to ensure that residents are cared for in a dignified, respectful manner. This includes ensuring residents are appropriately supervised and not left for long periods of time without adequate stimulation and interaction. Other examples are with the report. 7 OP14 12 The registered person must review systems in the home to ensure that residents are cared DS0000018105.V306025.R01.S.doc 30/09/06 30/09/06 30/09/06 Longview Version 5.2 Page 24 for in a dignified, respectful manner. Residents’ wishes and feelings must be sought and recorded. System must be in place to ensure residents are provided with choice and control. This includes residents being able to know what food is available, having a choice of where to eat their meals, an appropriate facility to entertain their visitors and having easy access to their designated phone. Other examples are within the report. 8 OP15 16 The registered person must be able to demonstrate that all residents are provided with a balanced nutritional diet. The timescales of 01/12/05 and 31/05/05 meet this requirement has not been achieved. This is the 3rd repeat requirement. 9 OP18 13 The registered provider must 31/07/06 ensure that all staff are trained and assessed as being competent to deal with laid down POVA reporting procedures. This is with particular reference to senior staff left ‘in charge’. The registered provider must ensure that all residents are protected from harm. This is with immediate effect. 10 OP19 23 The registered person must ensure carry out a full premises audit to ensure that the environment is compliant with statutory requirements. A copy of the audit together with a DS0000018105.V306025.R01.S.doc 30/09/06 30/09/06 Longview Version 5.2 Page 25 works to be carried out schedule timescale must be sent to the Commission. Previous timescales for action of 01/12/05 and 08/06/06 have not been met in full. The home must be made safe, adequately furnished/decorated, facilities be available, be ‘fit for purpose’, be in working order and be maintained to a good standard of repair. Signage throughout the home must be put in place for the wellbeing of those residents who have care needs associated with dementia. 11 OP20 23 The registered person must 30/09/06 ensure that residents have adequate dining space, an adequate visitors facility and the furnishing in communal rooms are of a good quality. Other examples are provided within the report. Previous timescales for action in respect of works being carried out of 01/12/05 and 08/06/06 have not been met in full. 12 OP26 23 The home must ensure that systems are reviewed and in place to ensure that the home is clean, pleasant and hygienic. For example, there must be a system whereby soiled linen is dealt with properly and not left in rooms, tables are wiped, there is adequate hot water to maintain adequate hygiene standards, wheelchairs are maintained in a clean condition. Other examples are contained DS0000018105.V306025.R01.S.doc 30/09/06 Longview Version 5.2 Page 26 within the report. Previous timescales for action of 01/12/05 and 08/06/06 have not been met in full. 13 OP27 17 The registered person must ensure that an accurate staff rota is maintained and made available at all times. The previous timescales of 30/11/05 and 8/05/06 to meet these requirements have not been achieved in full. This is the 3rd repeat requirement. 14 OP28 18 The registered person must 30/09/06 ensure a system is developed and maintained to ensure that suitably qualified, competent and experienced persons are working at the home in such number as appropriate for the health and welfare of residents. The previous timescales of 30/11/05 and 8/05/06 to meet these requirements have not been achieved in full. This is the 3rd repeat requirement. 15 OP29 17 The registered person must maintain a record of all staff induction. The previous timescales of 30/11/05 and 8/05/06 to meet these requirements have not been achieved in full. This is the 3rd repeat requirement. 30/09/06 30/09/06 Longview DS0000018105.V306025.R01.S.doc Version 5.2 Page 27 16 OP30 17 & 18 The home must implement and maintain an appropriate system whereby all staff training has been identified, arranged and undertaken. The previous timescales of 30/11/05 and 8/05/06 to meet these requirements have not been achieved in full. This is the 3rd repeat requirement. 30/09/06 17 OP31 10 The registered person must ensure that the home is managed on a daily basis with sufficient care, competence and skill. Immediate arrangements must however be made to ensure that residents are safe and that their assessed care needs are being met. The registered person must ensure that the home is managed on a daily basis with sufficient care, competence and skill. Arrangements must be made to ensure that the home is run and managed in the best interests of residents on a daily basis. 30/09/06 18 OP33 10 30/09/06 19 OP36 12 & 13 The registered person must 30/09/06 ensure staff supervisory systems are reviewed, implemented and maintained to enable residents to be cared for in an appropriate, adequate and sensitive manner. The report contains further examples and details. The registered person must ensure that the home is adequately managed on a daily DS0000018105.V306025.R01.S.doc 20 OP38 10,12,13, 16,17,18, 23 & 24 31/07/06 Longview Version 5.2 Page 28 basis with sufficient care, competence and skill. Immediate arrangements must be made to ensure that residents are safe and that their assessed care needs are being met. 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 OP16 Good Practice Recommendations The registered person should ensure that all entries within the home’s complaints log are ‘finished’ off properly. See report. Longview DS0000018105.V306025.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection South Essex Local Office 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 DS0000018105.V306025.R01.S.doc Version 5.2 Page 30 - 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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