Inspection on 04/11/05 for Longview Residential Home

This inspection was carried out on 4th November 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 Residential Home 20/05/09

Longview Residential Home 09/05/08

Longview Residential Home 15/05/07

Longview Residential Home 08/06/06

Longview Residential Home 02/02/06

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 PL7 4NB Lead Inspector Jane Gurnell Announced 4 and 20 October 2005 and 3 November 2005 th th rd 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 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 D52-D04 S3482 Longview V232613 041005 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Longview Residential Home Address 66/68 Plymouth Road, Plympton, Plymouth, Devon, PL7 4NB 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) 01752 337203 Mr John Richard Underhay Mrs Isabel Margaret Underhay Mr John Richard 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 D52-D04 S3482 Longview V232613 041005 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named service users of the MD(E) category. Date of last inspection 17.2.05 Brief Description of the Service: Longview is a detached property situated in a residential area of Plympton close to local ameneties. The home is registerd to provide accommodation and personal care for up to 15 women over the age of 60 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 is fitted with a bath hoist. The garden is well maintained and attractive. Longview Residential Home D52-D04 S3482 Longview V232613 041005 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was announced and undertaken over 3 days: 4th and 20th October and 3rd November 2005, to enable the Registered Providers to provide evidence of their progress in meeting the National Minimum Standards for Older People. The inspector made a tour of the building and spoke to 10 residents and 4 care staff. Mr and Mrs Underhay, the Registered Providers were available throughout the inspection. What the service does well: What has improved since the last inspection? What they could do better: All information acquired pre-admission, particularly for emergency admissions, must be formally recorded. The care plans do not provide an adequate description of the residents’ care needs and the action required by staff to meet those needs. Care staff had not received training in first aid, fire safety, moving and handling, food hygiene, health and safety, the protection of vulnerable adults or training relating to the care needs of older people or those with dementia: the Registered Providers had identified a training provider to address these training needs. The ground floor bathroom was in urgent need of repair and refurbishment. The laundry room floor must be sealed for ease of cleaning and to prevent cross infection. Radiators must be covered and hot water temperatures controlled where a risk to residents of burns and scalds has been identified. Induction training for newly appointed staff should meet Longview Residential Home D52-D04 S3482 Longview V232613 041005 Stage 4.doc Version 1.40 Page 6 the National Training Organisation’s specifications. The Registered Providers should seek advice regarding their own training in NVQ 4 in Care and the Registered Manager’s Award. A formal quality assurance system should be introduced. A copy of the home’s accounts should be sent to the Commission. Staff should receive formal supervision 6 times a year. The Registered Providers must obtain data sheets for all substances hazardous to health. Risk assessments relating to safe working practices must be undertaken to safeguard staff. Door locks of a type that are accessible from the outside by staff in an emergency should be fitted to bedroom doors. 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 Residential Home D52-D04 S3482 Longview V232613 041005 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Longview Residential Home D52-D04 S3482 Longview V232613 041005 Stage 4.doc Version 1.40 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 standard(s) 1, 3, 4, 5 Prospective residents cannot be certain that their care needs can be met at Longview, as care staff, although experienced, have received no formal training in caring for, or maintaining the safety of, older people. EVIDENCE: The Statement of Purpose has been reviewed since the last inspection and provided a description of the services provided at Longview. The Registered Providers undertake pre-admission assessments for planned admissions. For those residents admitted as an emergency, the Registered Providers take details over the telephone, however this information is not formally recorded. An assessment of the care needs of those residents admitted as an emergency is undertaken within 48 hours of admission. Prospective residents and their families are invited to visit Longview to meet with the staff and other residents prior to making a decision to move in. Those residents able to comment to the inspector said that that they were well cared for and were happy living at Longview. Longview Residential Home D52-D04 S3482 Longview V232613 041005 Stage 4.doc Version 1.40 Page 9 Care staff were very experienced having worked at Longview for a number of years, however they had not received training in fire safety, first aid, health and safety, moving and handling or food hygiene or training relating to the care needs of older people or those with dementia. The Registered Providers had identified a training provider to address these shortfalls in training and gave assurances that this would be dealt with as a matter of urgency. Longview Residential Home D52-D04 S3482 Longview V232613 041005 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, 10, 11 There is a risk that residents’ health, personal and social care needs may not be fully met as lack of detail in care plans may lead to inconsistencies in the provision of care. Residents are treated respectfully. EVIDENCE: Care staff were able to fully describe the personal and health care needs of the residents, however this was not reflected in the care plans where only a brief description of general care needs was recorded. The Registered Providers acknowledged that the part-time care staff, particularly those who worked at the weekends, may not have the same level of knowledge of care needs as those staff who work at Longview full-time. Changes to the residents’ care needs were communicated verbally amongst the staff team but were not recorded in the care plans. Those residents able to comment said that the care staff and the Registered Providers treated them respectfully and that they were very well looked after. The inspector was able to observe those residents with confusion being treated kindly and with care. Longview Residential Home D52-D04 S3482 Longview V232613 041005 Stage 4.doc Version 1.40 Page 11 Residents with terminal illness may continue to live at Longview if their needs can continue to be met by the care staff and the District Nursing Services. Senior care staff administer medication and had received training by the local pharmacist. A measured dose system of medication administration is used within the home to reduce the risk of medication errors. Medication is stored safety. Longview Residential Home D52-D04 S3482 Longview V232613 041005 Stage 4.doc Version 1.40 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 standard(s) 12, 13, 14, 15 Routines are flexible and leisure activities reflect the preferences of the residents. Meals are varied and nutritious. EVIDENCE: Residents said that they enjoy living at Longview. Mrs Underhay facilitates daily activities with the residents which include Bingo, quizzes and board games. External facilitators provide reminiscence sessions and exercises, and musicians and singers visit at least monthly. Four relatives, through the use of the Commission’s comment cards, praised the care staff and said that they were made very welcome. Residents said that the food was very good, and drinks and snacks were always available. Records of the meals taken as well as any alternatives to the main menu were recorded. More detailed records were maintained to monitor the diet and fluid intake of residents with additional nutritional needs. Longview Residential Home D52-D04 S3482 Longview V232613 041005 Stage 4.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 18 Residents and relatives can be confident that any issues of concern would be taken seriously and dealt with promptly. EVIDENCE: Residents said that the Registered Providers and care staff were very approachable and they felt that could bring any issues of concern to them. The complaints procedure and information regarding advocacy and advise agencies was available to residents and visitors in the main entrance way. Care staff had not received training relating to the protection of vulnerable adults. The Registered Providers had a copy of Plymouth City Council’s Alerter’s Guide for Adults at Risk and were aware of the procedure to follow should there be any suspicion of abuse. Longview Residential Home D52-D04 S3482 Longview V232613 041005 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 23, 24, 25, 26 Residents live in a very pleasant, well-maintained home that is comfortable and warm. Bathing facilities require upgrading to continue to meet residents’ needs. EVIDENCE: The home was very clean and comfortable, well maintained and free from offensive odours. One of the ground floor bathrooms was in urgent need of repair and refurbishment. A discussion was held regarding the level of damage to the floor from a leak and it was agreed that a builder’s report was necessary before making a decision regarding the future use of this bathroom. Radiators were not covered and the temperature of hot water was not controlled posing a risk to residents of burns and scalds. Longview Residential Home D52-D04 S3482 Longview V232613 041005 Stage 4.doc Version 1.40 Page 15 The laundry room floor required sealing to ensure ease of cleaning following the instillation of a new washing machine and tumble drier. The washing machine provides a sluicing programme and meets disinfectant standards to control the spread of infection. Longview Residential Home D52-D04 S3482 Longview V232613 041005 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29, 30 Staff are employed in sufficient numbers to meet the needs of those currently living at Longview, but they do not have the required training to ensure the health and welfare of residents is fully protected. 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. Residents and relatives said that the care provided at Longview is very good. Nine care staff have recently enrolled to undertake NVQ 2 training and this will address some of the shortfall in ensuring staff have the skills to meet the health and safety needs of the residents. See standard 38. The Registered Providers said that vacancies for care staff arise infrequently. An in-house induction programme is provided whereby a new member of staff works alongside a more experienced member of staff. This programme does not meet the National Training Organisation’s specifications and the Registered Providers were advised to seek advise from their training provider. Those care staff files examined included the necessary documentation including Criminal Record Bureau disclosures. Longview Residential Home D52-D04 S3482 Longview V232613 041005 Stage 4.doc Version 1.40 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34, 36, 37, 38 The efforts of the Registered Providers and their staff to provide a caring home for the residents is being undermined by the lack health and safety training. EVIDENCE: Although neither Registered Providers has an NVQ qualification or the Registered Manager’s Award, they do have many years experience in caring for older people and for those with dementia: Residents, relatives and staff said that they felt the home was well managed. The Registered Providers are present at the home most days and as such oversee the quality of the care and other service provided, although no formal consultation takes place with residents and relatives. Staff said that they receive frequent informal supervision from the Registered Providers either individually or in small groups. The financial accounts for the home were not examined at the time of the inspection as the Registered Providers had employed a new accountant who Longview Residential Home D52-D04 S3482 Longview V232613 041005 Stage 4.doc Version 1.40 Page 18 was preparing these: the Registered Providers gave assurances that a copy would be sent to the Commission. Documentation relating to the maintenance of equipment is well maintained however that relating to residents care plans and staff training require review to ensure that needs are fully documented and staff have the necessary skills to ensure the health and safety of the residents is maintained. Weekly testing and the servicing of the fire safety equipment were recorded. Data sheets for all substances hazardous to health used in the home must be obtained to ensure the safe use of these. Staff must receive training in first aid, fire safety, moving and handling, food hygiene and health and safety to ensure the health and safety of the residents and themselves in protected. Risk assessments relating to safe working practices must be undertaken to safeguard staff. The kitchen was found to be very clean and the fridge, freezer and cooked food temperatures were recorded indicating that regular cleaning and monitoring takes place. Longview Residential Home D52-D04 S3482 Longview V232613 041005 Stage 4.doc Version 1.40 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 2 2 3 x HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 1 3 3 3 1 2 STAFFING Standard No Score 27 3 28 3 29 3 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 2 3 2 2 x 2 3 1 Longview Residential Home D52-D04 S3482 Longview V232613 041005 Stage 4.doc Version 1.40 Page 20 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 OP3 Regulation 14 Requirement Information relating to residents care needs acquired preadmission must be formally recorded. Care staff must receive training relating to the care needs of older people with dementia. Care Plans must include a detailed description of residents needs and the staff action required to meet those needs. Residents health care needs must be recorded in the care plans. The Registered Providers must obtain a report from a building company to identify the nature of the damage to the ground floor bathroom and the work necessary to repair this. The radiators and pipework identified as posing a risk of burns to residents must be covered or have guaranteed low temperaute surfaces. Design solutions must be in place to ensure that water is stored at a temperature of at least 60 degrees centigrade, distributed at 50 degrees centigrade and delivered at close D52-D04 S3482 Longview V232613 041005 Stage 4.doc Timescale for action 30.11.05 2. 3. OP4 OP7 18 15 31.03.06 31.12.05 4. 5. OP8 OP21 12 23 31.12.05 30.11.05 6. OP25 13 31.3.06 7. OP25 13 31.3.06 Longview Residential Home Version 1.40 Page 21 to 43 degrees centigrade 8. 9. 10. 11. 12. 13. 14. 15. 16. OP26 OP33 OP38 OP38 OP38 OP38 OP38 OP38 OP38 13 24 13 13 13 13 13 13 13 The laundry room floor must be sealed. The Registered Providers must introduce a formal quality assurance system. Care staff must receive fire safety training. Care staff must receive manual handling training. Care staff must receive training in first aid. Care staff involved in food preparation must receive training in basis food hygiene. Care staff must receive training in health and safety. Registered Providers must obtain data sheets for all substances hazardous to health. Risk assessments relating to safe working practices must be undertaken to safeguard staff. 15.12.05 30.4.06 31.12.05 31.12.05 31.1.06 31.1.06 28.2.05 28.2.06 31.1.06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP18 OP30 Good Practice Recommendations Care staff should receive training relating to the protection of vulnerable adults. The Registered Providers should provide induction training to newly appointed staff that meets the National Training Organisations specifications. Care staff should have an individual training and development assessment and profile. The Registered Providers should seek advice from their training provider regarding NVQ 4 in Care and the Registered Managers Award. The Registered Providers should send a copy of the homes accounts to the Commission. Care staff should receive formal supervision at least 6 times a year. D52-D04 S3482 Longview V232613 041005 Stage 4.doc Version 1.40 Page 22 3. 4. 5. OP31 OP34 OP36 Longview Residential Home 6. OP24 Door locks of a type that are accessible from the outside by staff in an emergency should be fitted to bedroom doors. Longview Residential Home D52-D04 S3482 Longview V232613 041005 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP 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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