Inspection on 13/03/06 for Longview House

This inspection was carried out on 13th March 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Longview House 11/12/07

Longview House 03/05/05

Longview House 13/12/04

Longview House 20/07/04

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

CARE HOME ADULTS 18-65 Longview House 215 - 217 Longview Drive Huyton Knowsley Merseyside L36 6ED Lead Inspector Mr John Mullen Unannounced Inspection 13th March 2006 09:30 Longview House DS0000021468.V286403.R01.S.doc Version 5.1 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 House DS0000021468.V286403.R01.S.doc Version 5.1 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 Adults 18-65. 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 House DS0000021468.V286403.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Longview House Address 215 - 217 Longview Drive Huyton Knowsley Merseyside L36 6ED 0151-489-4334 0151 480 2521 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) 2 Care Mr Kenneth Brown Care Home 20 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (20) of places Longview House DS0000021468.V286403.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service Users to Include up to 20 (MD) Date of last inspection 3rd May 2005 Brief Description of the Service: Longview House is a purpose built building which accommodates up to 20 residents with mental health problems. It is situated in the Huyton area of Knowsley close to a variety of shops. The care home was registered with the Commission in 2002 and is owned by 2 Care. The position of registered manager is currently vacant. The care home offers stays of varying length and works towards assisting residents to live and work independently. The care home is divided into three units; the main part of the building, a unit to encourage independence and a separate, attached house for other residents. Longview House has reviewed its plans and wishes to concentrate on a new model of care providing short-term stays for adults requiring a period of help prior to returning to live independently. Longview House DS0000021468.V286403.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection of Longview House care home. A tour of the premises took place; staff were spoken to and care records inspected. Interviews were held with the deputy manager, an assistant manager, a member of the domestic staff, and two members of the care staff. Six residents were spoken to as well as three family members. What the service does well: What has improved since the last inspection? Since the last inspection a manager has been appointed and other management hours increased to ensure that the care home is now firmly directed in its work. Longview House has reviewed its model of care and has maintained better relationships with the local community. Food consumed is now well documented as well as further encouragement being provided for residents to actively participate in cooking and shopping for themselves. An aid for bathing has been acquired as well as more bedding to improve standards in the care home. Full risk assessments now are in place in terms of Longview House DS0000021468.V286403.R01.S.doc Version 5.1 Page 6 the premises and formal supervision is now being provided at the required intervals. In particular, a member of the domestic staff has been appointed which has had a considerable effect in improving the cleanliness of the premises. 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 House DS0000021468.V286403.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Longview House DS0000021468.V286403.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Longview House is meeting the needs of its residents in that their abilities are being developed actively. EVIDENCE: An interview with the deputy manager confirmed that the care home has reconsidered its role with residents and has decided to concentrate on a new model of care providing short-term stays for adults requiring a period of help prior to returning to live independently. This reaffirms a short-term, rehabilitation approach to residents. In the past, the care home has found difficulty in moving residents into new premises and a number of them have been accommodated for many years. The deputy manager stated that the care home is now taking a much more active approach in developing alternative care, using the key worker for this purpose so that it is seen as the responsibility of all staff. Interviews with care staff showed that they were actively promoting rehabilitation with residents and interviews with residents showed a number who were preparing to leave Longview House. Interviews with staff showed that they were aware of the difficulties in promoting this model of care but also showed that the care home was much more active in this process than they had been at the last inspection. All residents and families contacted felt that Longview House was meeting the needs of the former so that improvements in residents were being seen. Longview House DS0000021468.V286403.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9 Longview House has clear policies on risk so that these are minimised whilst care plans are developed. EVIDENCE: An examination of files showed that extensive risk assessments are taken on all aspects of residents’ care. These risk assessments are detailed and are regularly reviewed. Documentation also shows that the care home enters into specific contracts with residents about particular areas of risk associated with individuals so that clear guidelines are established for the behaviour of residents. Interviews with staff showed that they were very aware of the particular risks associated with individual residents and that the consequences of actions are explained to residents so that they are encouraged to minimise risks whilst taking part in everyday activities. Interviews with residents found them accepting of the guidelines within Longview House so that risks are minimised whilst residents are encouraged to live normal lives. Longview House DS0000021468.V286403.R01.S.doc Version 5.1 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15 and 16 Residents are encouraged to maintain outside links so that they are not isolated in the care home. Residents are encouraged to take part in daily routines so that they feel themselves fully involved in Longview House. EVIDENCE: Contact with family members showed that they were welcome to come to Longview House although in practice, residents tended to visit them instead. They said when visiting they were welcomed by staff at the care home so that they felt comfortable on visits. An interview with the deputy manager confirmed that families see residents wherever they wish although they tend to use the communal rooms in the care home. The interview also revealed that Longview House has an appropriate and professional approach to the question of personal relationships between residents of the care home and that staff guide residents appropriately when necessary. The interviews also showed that the care home accesses specialist advice for residents in this area so that they have the benefit of full information. Interviews with residents revealed no problems in retaining family links and friendships within Longview House so that they felt able to be part of a wider environment. Longview House DS0000021468.V286403.R01.S.doc Version 5.1 Page 11 Longview House holds a series of meetings in order to involve residents in the life of the care home. These include morning meetings, community meetings, food groups and leisure groups, which is an attempt to cover all important areas of communal living for residents. Since the last inspection, the care home has started a Spanish group which currently only involves three residents but is an innovative and unusual development and shows an imaginative approach to activities. Interviews with residents confirmed that all have a key to their bedrooms and have full access to the building. There is a rota of duties publicised on the notice board and interviews with residents confirmed that they all have some responsibilities in the home which they had no problem with, recognising the value of this. Longview House DS0000021468.V286403.R01.S.doc Version 5.1 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 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 Longview House actively promotes the mental and physical wellbeing of its residents as part of its programme of care. EVIDENCE: Examination of files showed that the care home actively promotes the mental and physical health of residents with their cooperation. The files have an individual section on medical attention which shows that health needs are promoted actively. The care home has good relationships with the local mental health service and interviews with staff showed that psychiatric input is regular and easily accessible. The description of a recent readmission to hospital showed that this was managed speedily and effectively so that the distress associated with this process was minimised. An interview with one resident with specific physical problems showed that he is receiving the required attention so that his condition is improving. Contact with family members revealed that all felt their relative had improved in health since their admission to the care home. Longview House DS0000021468.V286403.R01.S.doc Version 5.1 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 Prevention of abuse guidelines and training need to be updated so that there is a full understanding of responsibilities in this area. EVIDENCE: An examination of 2 Care’s policy on the protection of vulnerable adults found it not to coincide with the local authority’s policies, so that there is a possibility of a misunderstanding of the procedure to be followed following any such allegation. In particular, the guidance states that “the care service manager is responsible for coordinating investigations of suspected abuse” which is contrary to the local authority procedures and could lead to other agencies’ roles being compromised. This guidance does also say that the local authority’s procedures must be obtained and followed which, again, is confusing and needs to be clarified. 2 Care has a document on working with vulnerable adults as a guidance note for staff and this is of a very good standard so that staff are clear about their responsibilities in this difficult field. An examination of training records held by the care home showed a lack of training in this area which needs to be addressed so that staff are fully aware of this subject. There has been no recent allegation of abuse of any of the residents living in Longview House and no complaint was received during the inspection from either residents or families, who all expressed confidence in the care home. Longview House DS0000021468.V286403.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Longview House has suitable premises for its purpose but needs to upgrade some areas to maintain standards. The appointment of a domestic member of staff has distinctly improved the level of cleanliness within the care home. EVIDENCE: A tour of the premises found the care home to be improved in appearance and generally comfortable. More bedding has been bought since the last inspection and some new fire doors fitted. Most bedrooms seen were comfortable and pleasant in appearance, if cluttered. One other bedroom seen was of a less acceptable standard in terms of carpeting and furnishing generally and needs to be upgraded. The dining room area needs decoration and some more furnishings but, otherwise, there has been a distinct improvement to the general décor of the care home so that residents can take more pride in their surroundings. Residents interviewed commented positively on the improvements and were more active in maintaining standards within the care home. Families contacted were happy about the standard of accommodation available for residents so they were happy for their relatives to stay in Longview House. Since the last inspection, the care home has acquired a domestic member of staff. The improvement to the cleanliness of Longview House is very marked Longview House DS0000021468.V286403.R01.S.doc Version 5.1 Page 15 as a result of this so that it is now at an acceptable standard. Contact with the domestic member of staff showed that she is enthusiastic about her work and observations on the day showed that she interacted well with residents so that this has also added so the general atmosphere within the care home. Staff and residents alike commented on the improvement to the cleanliness of Longview House so that they felt happier in working and living there. Longview House DS0000021468.V286403.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 and 35 Longview House has an appropriate staff group, which would be improved by more vocational training so that they are fully equipped for their role. Training is being provided but needs to be available equally so that all staff can remain up to date. EVIDENCE: Interviews with a number of staff at all levels within the care home showed them to be very positive about the work and committed to their roles. Observed interaction between staff and residents was friendly, positive and appropriate resulting in a relaxed and pleasant atmosphere within Longview House. Residents spoken to were complimentary about the staff of the care home and this was echoed by relatives contacted. Interviews with staff were noticeably much more positive than at the time of the last inspection. Staff attributed this to a full staff group and positive leadership resulting in a clearer and more fulfilling direction in the work of the care home. The deputy manager stated that only four out of the twelve members of staff currently have a vocational qualification which is less that is required so that staff do not have the level of qualifications to fully meet their responsibilities. An interview with a newly appointed member of staff showed she had had a full induction programme so that she was fully prepared to undertaken her role. In addition, a programme of core training has been prepared for her which she was very positive about and anxious to complete. Training Longview House DS0000021468.V286403.R01.S.doc Version 5.1 Page 17 documents seen showed that basic training has been provided for staff and that they are being translated into individual training plans for care workers, so that they can develop appropriately. The training documents plus an interview with a more experienced member of the care staff showed that the training is not being always given to refresh knowledge as is required to enable staff to remain up to date. This is a matter that has been raised on previous inspections but is not yet resolved. An interview with the deputy manager showed that a generous training budget is available for the next financial year and it is important that training opportunities are available for all levels of staff so that all have the opportunity of remaining refreshed with their knowledge. Longview House DS0000021468.V286403.R01.S.doc Version 5.1 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 and 39 Although there has been a significant increase in management hours resulting in a better performance from the care home, there is still the need for a registered manager to be appointed for the sake of stability. Quality assurance procedures are in place to improve the service on offer. EVIDENCE: Longview House at present has a manager but no registered manager has been in place since November 2004 which means that the full direction of this care home has not been in place. To date, the Commission has not received an application from 2 Care for the registration of a manager which now needs to be actioned as a matter of urgency. An interview with the deputy manager and an assistant manager as well as care staff showed that there had been a much better direction to Longview House following the appointment of a manager. In addition, the management hours, which were significantly low at the time of the last inspection, have now been filled along with staffing vacancies generally so that the problems of management are nowhere near as acute as they were previously. The deputy manager stated that 2 Care is actively seeking to fill the post of registered manager to complete the Longview House DS0000021468.V286403.R01.S.doc Version 5.1 Page 19 management structure and comments from residents and families alike confirmed that there is a much better direction to the care home than previously. 2 Care has in place a number of elements of a quality assurance system, including a regular survey of residents’ opinions. A survey dated 4th October 2005 showed that generally satisfactory comments about the care home were made and a full analysis of this survey was present in Longview House to show an open approach to residents’ views. 2 Care provides an annual plan for the care home and has an external quality assurance process provided by senior managers. Documents and interviews with residents showed that regular meetings are held with residents to discuss life in the care home generally and families contacted were aware of these meetings. The experience with Longview House showed that they have generally implemented requirements resulting from inspection reports although sometimes this has taken long than was originally requested. Longview House DS0000021468.V286403.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 X 3 3 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 X 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X 3 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 X X 2 X 3 X X X X Longview House DS0000021468.V286403.R01.S.doc Version 5.1 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 YA20 Regulation 13 Requirement The registered person to risk assess residents to see whether more are capable of controlling their own medication. (Previous timescale of 1st October 2005 not met). The registered person to ensure that more training opportunities are made available for more experienced staff including in the area of food hygiene and the prevention of abuse. (Previous timescale of 1st October 2005 not met). The registered person to upgrade the dining room and one bedroom. The registered person to ensure that more NVQ training is provided for staff. The registered person to make application to the Commission for a manager to be registered. Timescale for action 01/09/06 2. YA35 18 01/12/06 3. 4. 5. YA24 YA32 YA37 23(2) 18(1)© 8 01/09/06 01/12/06 01/09/06 Longview House DS0000021468.V286403.R01.S.doc Version 5.1 Page 22 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 YA23 Good Practice Recommendations The registered person is recommended to use the local authority’s prevention of abuse procedures. Longview House DS0000021468.V286403.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG 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. 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