Inspection on 15/05/07 for Longview Residential Home

This inspection was carried out on 15th May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 Residential Home 20/05/09

Longview Residential Home 09/05/08

Longview Residential Home 08/06/06

Longview Residential Home 02/02/06

Longview Residential Home 04/11/05

Longview Residential Home 17/02/05

Longview Residential Home 14/09/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Longview Residential Home 66/68 Plymouth Road Plympton Plymouth Devon PL7 4NB Lead Inspector Jane Gurnell Unannounced Inspection 09:30 15th May 2007 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 Residential Home DS0000003482.V331176.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 Residential Home DS0000003482.V331176.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Longview Residential Home Address 66/68 Plymouth Road Plympton Plymouth Devon PL7 4NB 01752 337203 01752 337203 longviewpl7@btopenworld.com 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) Mr John Richard Underhay Mrs Isabel Margaret Underhay Care Home 15 Category(ies) of Dementia - over 65 years of age (15), Old age, registration, with number not falling within any other category (15) of places Longview Residential Home DS0000003482.V331176.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named service users of the MD(E) category. Date of last inspection 08.06.07 Brief Description of the Service: Longview is a detached property situated in a residential area of Plympton close to local amenities. The home is registered to provide accommodation and personal care for up to 15 women over the age of 65 for reasons of old age and dementia. Accommodation is provided over 2 floors, offering 11 single rooms and 2 double rooms. A stair lift provides access to the first floor, however there is one step at the top of the stairs and also steps at the main entrance, making access difficult for residents with mobility difficulties. There is a large lounge room and dining room on the ground floor, both of which have doors opening onto the patio. There are three bathrooms, two of which are on the ground floor. One of the ground floor baths is fitted with a bath hoist and although this room is safe it is in a poor state of repair. The other ground floor bathroom provides a short, sit-in type bath. The garden is well maintained and attractive. Information relating to the services provided at Longview can be obtained from the home. Currently the fees for the home range from £278.46 to £350 a week. Not included in the fees are the costs of chiropody, hairdressing, transport and residents’ personal items. Longview Residential Home DS0000003482.V331176.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place between 9.30am and 4pm on 15th May 2007. Both the Registered Providers, Mr and Mrs Underhay were present. Prior to this inspection the Commission had sent surveys to the relatives of the people living at Longview, all the staff employed at the home, as well as the GPs who have regular contact with the home to allow them to comment directly to the Commission about their experiences of the home. The results of these surveys were very positive with all having confidence that people were receiving a good quality service from the owners and staff. The inspector made a tour of the building and spoke to all of the 12 people currently living at the home as well as 3 care staff and the Registered Providers. Significant time was spent with the people who live at the home and observations were made of how people spend their day and their relationship with the care staff. The care plans for 3 people were examined in detail and medication records and documents related to the running of the home and the recruitment of staff were examined. What the service does well: The people living at Longview said that felt well cared for and that the staff were very kind. Many described the home as “one big happy family”, and one lady said the home was “superb”. Of the 12 surveys sent to relatives, 8 were returned and all praised the quality of the support provided by the staff and the owners. The following are an example of the comments made, “every care needed for my mother is given to her”, “I am more than happy with the care my mother receives at Longview. The staff look after her well” and “when my mother arrived at Longview she was a very frightened and agitated lady. Now my mother is far more relaxed and happy. I feel this is down to the care from the carers and Mr and Mrs Underhay”. One GP said “excellent and caring staff make this a home to be proud of”. It was evident through the observations made by the inspector that the staff have a friendly and respectful relationship with the people who live at the home. Both the private and communal area of the home were found to be very clean and tidy. Longview Residential Home DS0000003482.V331176.R01.S.doc Version 5.2 Page 6 What has improved 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. The summary of this inspection report can be made available in other formats on request. Longview Residential Home DS0000003482.V331176.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 Residential Home DS0000003482.V331176.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 5. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Pre-admission assessments and visits to the home enable people considering moving to Longview to have confidence that their personal care needs can be met at the home. EVIDENCE: A pre-admission assessment was available for a newly admitted lady and this detailed her care needs and provided staff with the information they require to be able to provide appropriate support. The Registered Providers described how people considering moving to Longview and their families are invited to spend time in the home to meet the staff and the other people who live there. The home’s Statement of Purpose, the document which details the services provided at Longview, is very brief and doesn’t necessarily reflect the experience of those consulted in this inspection process. The Registered Providers were advised to update this to reflect the positive experiences of those living in the home as well as the training undertaken and the Longview Residential Home DS0000003482.V331176.R01.S.doc Version 5.2 Page 9 qualifications gained by the care staff. This would provide people considering moving to Longview with a more positive description of the care home. Longview provides care to older people many of who have dementia and although staff have not received any formal training relating to this condition, they were knowledgeable about each person’s care needs. Longview Residential Home DS0000003482.V331176.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health, personal and social care needs of those living at Longview are being met and people are treated respectfully. Medication practices are safe. EVIDENCE: The people who live at Longview and their relatives valued the “family feel” of this small home. The inspector received many comments of praise; the home was described as “excellent” and “superb” and the care staff as “lovely” and “kind”. Relatives’ comments included “I am more than happy with the care my mother receives at Longview. The staff look after her well”; “they are very helpful. They have the necessary skills to look after my mother in her present condition. All staff are friendly and caring” and “when my mother arrived at Longview she was a very frightened and agitated lady. Now my mother is far more relaxed and happy. I feel this is down to the care from the carers and Mr and Mrs Underhay”. A GP said “excellent and caring staff make this a home to be proud of” Longview Residential Home DS0000003482.V331176.R01.S.doc Version 5.2 Page 11 The care plans for 3 people with whom the inspector had spent time were examined and these provided a clear description of their care needs and the action required by staff to meet those needs. Any risks, such as those associated with mobility or sensory impairment, were also clearly documented and highlighted in red to make them very easy to read. There was evidence that these plans had been reviewed and updated as necessary ensuring they provided a description of the person’s current needs. Medication is stored safely in the main office and records were accurate. The people who live in the home told the inspector that they were very well treated. The time spent observing residents daily life and care staff practices found the staff were very patient and the inspector witnessed people with confusion being treated gently and with respect by the Registered Providers and the care staff. The District Nursing Service visits the home frequently to support staff in meeting people’s health care needs and, when necessary, the Community Mental Health Care Team provides advice regarding a person’s mental health condition and offers specialist support. People with terminal illnesses may remain at the home if the staff team and the District Nursing Service can continue to meet their needs. Longview Residential Home DS0000003482.V331176.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Daily activities provide interest and stimulation for the people living at Longview. Meals are of good quality and nutritious. EVIDENCE: All of those people spoken to said how much they enjoyed the meals offered at the home, saying they were plentiful and nutritious. Records of the meals taken as well as any alternatives to the main menu were recorded to monitor each person’s nutrition. All those relatives consulted by the Commission praised the home and the care staff, saying they are always made welcome and are kept fully informed of their relatives’ care needs. The Registered Providers said daily activities are offered each afternoon, either by themselves or one of the care staff: this was confirmed by those people who were able to comment directly about this. Activities aren’t planned as such and people can request board games, a quiz, Bingo, listening to music or watching a film. Regular entertainers visit the home to provide musical entertainment and offer people the chance to play a musical instrument themselves. Longview Residential Home DS0000003482.V331176.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live at Longview and their relatives can be confident that any issues of concern or complaints would be taken seriously and dealt with promptly. EVIDENCE: The people living at Longview and their relatives said that the Registered Providers and care staff were very approachable and they felt they could bring any issues of concern to them. Neither the Registered Providers nor the Commission had received any complaints about this home prior to this inspection. The complaints procedure and information regarding advocacy and advice agencies was available in the main entrance way. Care staff had not received training relating to the protection of vulnerable adults but were aware of the procedure to follow should there be any suspicion of abuse. Longview Residential Home DS0000003482.V331176.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 23, 24, 25 and 26. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Improvements to the environment are necessary to protect the people who live at Longview from the risk of injury. EVIDENCE: The home was found to be very clean and tidy, with no offensive odours. Bedrooms and communal areas were pleasantly decorated. Bedrooms have not been fitted with door locks and therefore people are unable to lock their doors should they wish for privacy or to secure their belongings when they are not in their room. Doors from the lounge room and the dining room open onto a patio at the rear of the house. This provides a very pleasant seating area that was nicely decorated with tubs of flowers. The front garden is attractive but not secure for people with confusion to use unsupervised as it opens directly onto a busy road. Longview Residential Home DS0000003482.V331176.R01.S.doc Version 5.2 Page 15 The call bell system has been renewed since the previous inspection to a type that can only be cancelled at the point of call: this is particularly beneficial as it ensures that a call cannot be cancelled and then forgotten about should something else divert the staff member’s attention. The fire alarm system has also been renewed to a more modern and sensitive system. There are 3 bathrooms at the home: 2 on the ground floor and one on the first floor. One of the ground floor bathrooms, although safe to use, is in need of refurbishment following a leak underneath the floor. The people who use this bathroom confirmed that they felt it was safe to use but that it didn’t look very pleasant. They said they were looking forward to the new flooring being laid and the decorating being finished. Radiators are uncovered and place people at risk from burns should they come into contact with them when the heating is on. The risk is increased when people are alone in their bedrooms and who may be unable to call for help should they fall against them. There is also a risk of scalding from the hot water temperature in the bathrooms and bedroom sinks should these be used without the supervision of a staff member. Longview Residential Home DS0000003482.V331176.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are employed in sufficient numbers to meet the needs of those currently living at Longview. Recruitment practices protection vulnerable people. EVIDENCE: The majority of the care staff have worked at Longview for many years and as such have a great deal of experience in caring for older people. The people living at Longview and their relatives said that the care provided at Longview is very good. One relative described her mother’s wellbeing had increased considerably since moving into the home as a direct result of the care and support provided by the owners and staff team. Eight care staff completed their NVQ level 2 training, a nationally recognised care qualification for which staff have had their work performance and knowledge evaluated by an external training organisation. Through this training staff received further training in first aid and health and safety ensuring they have the knowledge to deal with emergencies. There are usually 3 care staff on duty during the morning until 1pm and 2 in the afternoons and evenings. In addition the Registered Providers are on the premises most days including at the weekend. Care staff undertake the cleaning and the meal preparations, but those people who were able to directly comment upon the promptness of the assistance they received confirmed there Longview Residential Home DS0000003482.V331176.R01.S.doc Version 5.2 Page 17 are sufficient staff and they have not had to wait for assistance. At night there are 2 staff: one who “sleeps-in” and who can be called upon in an emergency and another who is a “part-sleeper”, that is to say, she may sleep for part of the night but must check on the welfare of the residents every 2 hours or more often if there is a need. At the time of this inspection no resident had significant night-time needs and none had been identified as at risk from wandering at night. Five of the 13 staff surveys sent out by the Commission were returned: all felt that they were well supported to undertaken their role and that the Registered Providers were approachable. Mr Underhay was described as “always doing things for the residents” and that the “residents come first”. Two staff files were examined and were found to contain the necessary documentation including 2 written references and a Criminal Record Disclosure check, ensuring as far as possible only suitable staff are employed at Longview. One newly appointed member of staff has been provided with the “Skills for Care” induction training that provides new staff with information about the principles and values of providing good quality care. Longview Residential Home DS0000003482.V331176.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 37 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The management of the home is open, positive and inclusive. The health and safety of the people who live at Longview is placed at risk by failure to address health and safety issues. EVIDENCE: Although neither of the Registered Providers have a formal qualification in management or care, they have 7 years experience in running the care home, and are well thought of by those who live at Longview, their relatives and the staff team who all confirmed that the Registered Providers are in the home frequently and are very approachable and friendly. There is no formally recorded quality assurance process at Longview to enable the Registered Providers to demonstrate how they consult with people living at Longview Residential Home DS0000003482.V331176.R01.S.doc Version 5.2 Page 19 the home about the quality of services provided. All those people who live at Longview who were able to comment about this as well as their relatives confirmed that the Registered Providers do frequently check with them that their needs are being met and to look for ways to improve their quality of life. Care staff receive informal supervision daily and said they feel well supported to undertake their role. They said they are able to speak freely to the Registered Providers about the care needs of the residents and their own training and development needs. Money is held for safekeeping in the home’s safe for a number of residents. Mr Underhay makes a small amount available so that people have access to money at all times should they wish to purchase anything. This arrangement ensures that the bulk of the money is held safely and only he and his deputy have access to this. The fire alarm system has been renewed, with new sensors and control panel being fitted and a new call bell system has been installed upgrading these facilities to those that are more sensitive and/or more beneficial for residents’ care. As noted in the outcome group relating to the environment, uncovered radiators and uncontrolled hot water temperatures place the people who live at the home at risk from burns and scalds. The Registered Providers have given assurances that these matters will be attended to and made safe by the end of July. The Commission will undertake a further random inspection of the home after this time to monitor compliance. Longview Residential Home DS0000003482.V331176.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 3 2 X 3 2 1 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 X 3 3 3 2 Longview Residential Home DS0000003482.V331176.R01.S.doc Version 5.2 Page 21 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 OP25 OP38 4. OP25 OP38 13(4)(a) Regulation 13(4)(a) Requirement Timescale for action 31/07/07 Radiators in the home must be assessed for the risk they present to people that use the service and action taken to minimise any identified risk. The hot water temperature in 31/07/07 the home must be assessed for the risk of scalding it presents to the people that use the service and action taken to minimise this risk. 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 OP1 Good Practice Recommendations The Statement of Purpose should be updated to include the positive experiences of the people living at the home as well as the training undertaken and qualifications gained by the staff. The Registered Providers should complete the refurbishment of the ground floor bathroom. 2. OP19 OP21 Longview Residential Home DS0000003482.V331176.R01.S.doc Version 5.2 Page 22 3. 4. OP24 OP33 Door locks of a type that are accessible from the outside by staff in an emergency should be fitted to bedroom doors. The Registered Providers should formally record their consultation with regard to the quality of the services provided at Longview. Longview Residential Home DS0000003482.V331176.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Residential Home DS0000003482.V331176.R01.S.doc Version 5.2 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. 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