Inspection on 03/05/05 for Longview House

This inspection was carried out on 3rd May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Longview House 11/12/07

Longview House 13/03/06

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 L36 6ED Lead Inspector John Mullen Unannounced 3rd May 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 F53 F03 Longview House S21468 V225295 03.05.05 Stage 4.doc Version 1.30 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 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 PC - Care Home Only 20 Category(ies) of MD - Mental Disorder - 20 Places registration, with number of places Longview House F53 F03 Longview House S21468 V225295 03.05.05 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service Users to Include up to 20 (MD). Date of last inspection 13th December 2004 Brief Description of the Service: Longview House is a purpose built building which accomodates up to 20 residents with mental health problems. It is situated in the Huyton area of Knowsley close to a variety of shops. The home which was registered with the Commission in 2002 is owned by 2 Care. The registered manager is Mr Kenneth Brown. The home offers long and short term stays and works towards assisting residents to live and work independently. The home is divided into three units; the main part of the building, a unit to encourage independence and a seperate, attached house for other residents. Longview House has recently reviewed its plans and wishes now to concentrate on providing short term stays for adults requiring a period of help prior to returning to live independently. Longview House F53 F03 Longview House S21468 V225295 03.05.05 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 1 day and a total of 6 hours. It was a routine unannounced inspection. A tour of the premises took place; staff were spoken to and care records inspected. Interviews were held with the deputy manager and two mental health recovery workers. Thirteen residents were either spoken to or observed and one family member was later contacted. What the service does well: What has improved since the last inspection? What they could do better: At the time of the inspection the home did not have enough management hours. As a result, formal staff supervision was not being undertaken and there is a shortage of training opportunities for more experienced staff. This means that staff, although well motivated, are unable to fully develop their skills. In order to fulfil its aims the home must positively seek to move some Longview House F53 F03 Longview House S21468 V225295 03.05.05 Stage 4.doc Version 1.30 Page 6 residents to alternative accommodation and must reassess residents to see whether they are capable of controlling their own medication. To ensure that the home is safe for people living there it is important that water and fridge temperatures are correctly controlled and that appropriate risk assessments are in place. Longview House needs to maintain a good relationship with neighbours so that residents are supported locally. The home must show that food is adequate by recording what residents eat and extra bath aids would promote the independence of more disabled residents in the home. To ensure that the home meets the required standards of cleanliness domestic staff must be employed and bedding must be improved. 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 F53 F03 Longview House S21468 V225295 03.05.05 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Longview House F53 F03 Longview House S21468 V225295 03.05.05 Stage 4.doc Version 1.30 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 standard(s) 2 & 3 Longview House bases its work on full, detailed information on residents which means that staff have the necessary background information to meet their needs. Difficulties in finding alternative places for residents is limiting the ability of the home to move residents on when they are ready. EVIDENCE: An examination of a selection of case files found in each a full care needs assessment undertaken prior to admission. In addition, Longview House also provides a very detailed assessment of residents’ needs. Staff revealed a good understanding of residents’ needs and, when asked, staff could explain the plan of care for each resident with their individual programme of care. Residents interviewed felt that care staff both knew and looked after them well. Longview House maintains very thorough records and these showed that it was meeting the needs of residents in their care. An interview with the deputy manager revealed that outside, independent people have been used to represent residents when required to enable them to have their interests promoted. Residents felt their needs were being met but one expressed frustration with the delay in providing alternative accommodation for him. This was also the view of staff who said that some residents have been accommodated longer than necessary due to the lack of alternatives. Longview House F53 F03 Longview House S21468 V225295 03.05.05 Stage 4.doc Version 1.30 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 standard(s) 6,7 & 8 Care planning is well established which means that there is a personalised approach to care and residents are aware and agree with the aims of their stay in the home. Residents are encouraged to participate in the running of the home resulting in their having an active approach to their care. EVIDENCE: An examination of a selection of case files showed full care plans in each. They were up-to-date and had been reviewed regularly. Staff could describe the plan of care for residents and residents were aware of these plans and what they meant for their future. Each resident has a member of staff allocated to be particularly responsible for their care, which means there is a personal, individual approach in the home. Documentation seen showed residents are encouraged to take part in the home rather than being merely receivers of a service. There are community meetings, morning meetings, a food group and a leisure group. Observation of one morning meeting revealed that a large proportion of residents attended and that they were encouraged to express opinions. Chores are divided between residents and they accepted that they should help with the daily tasks of running the home although staff say that some take part more willingly than Longview House F53 F03 Longview House S21468 V225295 03.05.05 Stage 4.doc Version 1.30 Page 10 others. All residents manage their own finances to some degree and where there are limitations in their ability to join in any activity this is documented. Longview House F53 F03 Longview House S21468 V225295 03.05.05 Stage 4.doc Version 1.30 Page 11 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 standard(s) 12,13 & 17 The home has a programme of activities, which attempts to keep residents active although participation varies. There is an attempt to keep good relationships with neighbours, which has been put at risk by some residents’ behaviour. The absence of some recording means that the home cannot always show that it is providing a healthy diet. EVIDENCE: Residents are encouraged to engage in activities if they so wish. Two have voluntary jobs, two are attending computer courses and two are taking guitar lessons. A number take part in gardening at the home. Although the willingness of residents to participate varies as does their abilities, a number of residents felt that these activities were useful in helping them to recover from their illness and to prevent boredom. Residents use local facilities as they wish. The complaints’ book recorded some concerns from neighbours about the behaviour of some residents, which has caused some hostility, which staff have tried to minimise. Residents felt there were no unreasonable limits on their activities, which they felt enabled them to live a fuller life. This was showed by the morning meeting, which Longview House F53 F03 Longview House S21468 V225295 03.05.05 Stage 4.doc Version 1.30 Page 12 discussed, amongst other things, both activities and voting at the General Election. Menus are based on individual choice. Residents are encouraged to shop and cook according to individual abilities. Not all food eaten in the home is recorded which means that it cannot always be shown that residents are being provided with a healthy diet although residents spoken to were happy with the food on offer. Longview House F53 F03 Longview House S21468 V225295 03.05.05 Stage 4.doc Version 1.30 Page 13 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 standard(s) 18 & 20 The home supports residents in a way that helps them to be independent and responsible although this would be improved with some extra aids to assist with bathing. The small number of residents who are able to take their own medication will reduce the number able to progress from the care home to other accommodation as this is a key factor in enabling residents live independently. EVIDENCE: Residents thought they were supported in a way that preserved their dignity and that personal care was provided in accordance with their need for privacy. A tour of the premises showed that residents locked their bedroom doors when out of the room and that staff only entered when invited to. Staff said that in the case of three residents the lack of bathroom aids meant that bathing was not as easy or comfortable for these residents as it could be. Documentation seen showed that the individual workers talked to residents regularly about their personal care and that residents are encouraged to take responsibility for this whenever possible. Longview House has full policies and procedures for the giving of medicines and a check on documents showed they were being correctly applied. Only two of the eighteen residents are currently responsible for their own medicines. In interviews with the deputy manager and other staff, the opinion was given Longview House F53 F03 Longview House S21468 V225295 03.05.05 Stage 4.doc Version 1.30 Page 14 that potentially more residents could be responsible for their medicines. As the home wants to settle more residents in the community their ability to handle medication will be crucial to this and a more active approach to this will be needed. Longview House F53 F03 Longview House S21468 V225295 03.05.05 Stage 4.doc Version 1.30 Page 15 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 standard(s) 22 The home has a full and appropriate complaints’ procedure, which means that residents and families will have any concerns dealt with fully. EVIDENCE: An examination of the complaints’ book revealed that there had been seven complaints since the last inspection. All had been dealt with appropriately and in accordance with good practice. The complaints’ procedure is made available to each of the residents and they have used it when necessary. Neither residents nor a relative spoken to had had to use the procedure but were aware how to do so if necessary. Longview House F53 F03 Longview House S21468 V225295 03.05.05 Stage 4.doc Version 1.30 Page 16 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 standard(s) 24,26 & 30 Longview House is a suitable home to accommodate residents with mental health needs but some further improvement to the premises is required to improve the living space for residents. The absence of domestic staff means the home is not at the required level of cleanliness. EVIDENCE: A tour of the premises found the home to be generally comfortable and suitable for its purpose. Some bedrooms were cluttered and with poor bedding which was commented on by one family member contacted although residents were happy with their rooms. There have been some improvements to the decoration of the bathrooms but the temperature of the water in one was too high which could put residents at risk of scalding. It is part of the purpose of Longview House to increase the domestic skills of residents and to encourage them to help clean the home. However, it has been clear for some time that domestic help is also required. Longview House is trying to recruit such help but has not yet done so. The result is that the level of cleanliness is short of that required, particularly in the kitchen area. Longview House F53 F03 Longview House S21468 V225295 03.05.05 Stage 4.doc Version 1.30 Page 17 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 & 36 Training for experienced staff needs to be increased both to help their motivation towards the work and to further improve their knowledge. Staff supervision has been interrupted by the shortage of managers and this is reflected in staff not feeling as supported in their work as previously. EVIDENCE: The home has individual training records for staff which showed that new staff have been given a large amount of training in the last year but this was not the case with more experienced staff. This was confirmed in interviews with staff. Two newly appointed staff have had a large amount of training, including a full induction programme. One member of staff who has worked in the care home for four years had not had any training this year. Food hygiene and abuse detection were two areas identified by staff as requiring more training. Residents were happy with the staff in the home who they thought were competent and caring towards them. Staff said that the shortage of managers meant they were not being supported as they would wish and this was having an effect on the running of Longview House. The deputy manager admitted that formal supervision of staff has not been possible due to the extra workload for the two managers. Longview House F53 F03 Longview House S21468 V225295 03.05.05 Stage 4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 41 & 42 The absence of the registered manager means that some aspects of the running of Longview House have deteriorated and the pressure on the remaining managers has been great. The home presents as a safe and secure place for residents although some improvements are further required. EVIDENCE: The registered manager has been absent from this home since November 2004 which means it has been managed by the deputy manager and one assistant manager since this date. This is far short of the number of managers that 2 Care assess as required. Plans are in place to have one senior manager, one manager, two deputies and one assistant manager to run this home. A number of consequences have arisen from this shortage. Because the managers are rarely doing sleep-ins, records show that one member of staff has done ten sleep-ins in a month. The deputy manager has had no leave either taken or planned between October 2004 and July 2005. In interview, she admitted feeling exhausted. Staff interviewed confirmed that the lack of Longview House F53 F03 Longview House S21468 V225295 03.05.05 Stage 4.doc Version 1.30 Page 19 management hours was affecting their work not only through extra sleep-in duties but also through the lack of formal supervision. Records showed that regular fire drills and tests of systems are taking place but that a fire risk assessment has not recently been undertaken. A tour of the premises found it generally to be a safe and secure building although one fridge temperature was too low, water temperature in a bathroom was too high and a recent risk assessment on the premises has not been undertaken. Records seen had been filled in consistently and to a good standard to ensure that residents are being supported in a correct manner. Longview House F53 F03 Longview House S21468 V225295 03.05.05 Stage 4.doc Version 1.30 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 2 x x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 2 x x x 2 Standard No 11 12 13 14 15 16 17 x 3 2 3 x x 2 Standard No 31 32 33 34 35 36 Score x x x x 2 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Longview House Score 2 x 2 x Standard No 37 38 39 40 41 42 43 Score 1 x x x 3 2 x F53 F03 Longview House S21468 V225295 03.05.05 Stage 4.doc Version 1.30 Page 21 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 13 Regulation 30 Requirement The registered person to ensure that domestic hours are provided in the home. (Previous timescale of 1st April 2005 not met.) The registered person to ensure that residents stays in the home are in accordance with Longview Houses aims and objectives. The registered person to ensure that residents are reminded of their responsibilities to maintain good relationships with the community. The registered person to ensure that all food consumed by residents is documented. The registered person to provide aids for bathing in the home. The registered person to risk assess residents to see whether more are capable of controlling their own medication. The registered person to ensure that a good standard of bedding is provided for residents. The registered person to ensure that more training opportunities are made available for more experienced staff including in the F53 F03 Longview House S21468 V225295 03.05.05 Stage 4.doc Timescale for action 1st September 2005 1st December 2005 1st September 2005 1st August 2005 1st September 2005 1st October 2005 1st October 2005 1st October 2005 2. 3 4 3. 13 16 4. 5. 6. 17 18 20 16 23 13 7. 8. 26 35 16 18 Longview House Version 1.30 Page 22 9. 36 18 10. 37 8 11. 42 13 area of food hygiene and the protection from abuse. The registered person to ensure that staff are formally supervised at the intervals prescribed by the NMS. The registered provider to ensure that there are adequate management hours available in the home. The registered person to ensure that there is a risk assessment taken on the premises, that water and fridge temperatures are maintained at the correct level and that the fire risk assessment is updated. 1st April 2006 1st July 2005 1st July 2005 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 Good Practice Recommendations Longview House F53 F03 Longview House S21468 V225295 03.05.05 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Burlington House, South Wing, 2nd Floor 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. Extracts may not be used or reproduced without the express permission of CSCI Longview House F53 F03 Longview House S21468 V225295 03.05.05 Stage 4.doc Version 1.30 Page 24 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!