Inspection on 08/06/06 for Longview Residential Home

This inspection was carried out on 8th June 2006.

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

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

Other inspections for this house

Longview Residential Home 20/05/09

Longview Residential Home 09/05/08

Longview Residential Home 15/05/07

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 8th June 2006 10:00 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.V292803.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.V292803.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 NO FAX longviewplttopenworld.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 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 DS0000003482.V292803.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 02.02.06 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 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 but is in a poor state of repair. The garden is well maintained and attractive. Currently the fees for the home range from £278.46 to £330 a week. Longview Residential Home DS0000003482.V292803.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 during the day on 8th June 2006. Prior to the inspection the inspector had formally consulted with relatives; local GPs who have contact with the service users; the Community Nurse and a social worker from Social Services’ Review Team who has responsibility for the welfare of the local authority funded service users. The result of this consultation was very positive with all having confidence that the service users were receiving a good quality service from the owners and staff at Longview. The inspector made a tour of the building, spoke to 8 residents and the 3 care staff on duty and the Registered Provider, as well as examined care plans, medication records and documents related to the running of the home. This report incorporates the findings of the additional visit made to Longview on 11th April 2006 to asses whether the requirements made in the Statutory Requirement Notices issued in February 2006 in relation to staff training and service users’ care planning had been met. What the service does well: What has improved since the last inspection? The Registered Provider has addressed the 2 serious issues identified in the Statutory Requirement Notices issues in February: that care staff receive fire safety training and that each service user has a care plan that describes their needs and the action required by staff to meet those needs. Care staff have also received training in safe manual handling and first aid. Eight care staff have completed their NVQ 2 training and are awaiting certification. Longview Residential Home DS0000003482.V292803.R01.S.doc Version 5.2 Page 6 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 Residential Home DS0000003482.V292803.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.V292803.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4 The quality in this outcome area is adequate. This judgement has been made using the available evidence including a visit to the service. Pre-admission assessments enable prospective residents to have confidence that their personal care needs can be met at Longview. Dementia care training would enable care staff to provide more specialist support. EVIDENCE: Pre-admission assessments were available for two newly admitted residents: these detailed their needs and provided staff with the information they require to be able to provide appropriate care and support. These residents described how well cared for they were and one, who had been admitted for a short stay, said that she would return to Longview should the need arise. The home’s Statement of Purpose is very brief and doesn’t necessarily reflect the experience of those consulted in this inspection process. The Registered Provider was advised to update the home’s document to reflect the training Longview Residential Home DS0000003482.V292803.R01.S.doc Version 5.2 Page 9 undertaken and the qualifications gained by the care staff. This would provide prospective residents with a more positive description of the care home. The Registered Provider has obtained a training pack from the Alzheimer’s Association and gave assurances that he and the care staff would work through this training programme together ensuring that they had the knowledge and skills to better understand the condition of dementia and to provide personcentred support. Longview Residential Home DS0000003482.V292803.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 The quality in this outcome group is adequate. This judgement has been made using the available evidence including a visit to the service. Residents’ health, personal and social care needs are being met and residents are treated respectfully. EVIDENCE: The inspector received many comments of praise from residents and their relatives. Residents described the home as “excellent” and the care staff as “lovely and kind”. Relatives’ comments include “I can’t speak highly enough of the care; friendly and helpful owners and staff. It has made my Aunt’s life so much better” and “I have found Longview to be a well run home”. Both residents and relatives valued the “family feel” of this small home. Comments from health professionals, such as local GPs and community nurses, include confidence in the care staff and owners. Care plans are necessary documents to ensure that residents’ personal, health, social and religious and cultural needs are clearly identified. They provide care staff with the information they need to not only deliver consistent care but to Longview Residential Home DS0000003482.V292803.R01.S.doc Version 5.2 Page 11 recognise when personal care needs change or if a resident’s health is deteriorating. It is particularly important that specific care needs are recorded, for example nutritional needs such as diabetic, vegetarian or kosher diet, or the effects a person’s dementia has upon their abilities and wellbeing. At previous inspections the care plans were found to be out of date and did not contain information about the current care needs of the residents. At the inspection in February there were no care plans available for any of the residents. This situation has now been resolved and the Registered Provider has written care plans for each resident. Where able the Registered Provider had involved relatives in the writing of these plans. Mr Underhay was advised that future inspections will monitor the care plans to ensure they remain up to date. Medication is stored safely in the main office. The Registered Provider was advised to obtain a hard-backed, page numbered book to record controlled drugs: this will ensure that loose pages don’t get lost and reduce the risk that the record will be tampered with. Residents said that they were very well treated and the inspector witnessed those residents with confusion being treated gently and with respect by the Registered Provider and the care staff. Longview Residential Home DS0000003482.V292803.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 The quality in this outcome area is adequate. This judgement has been made using the available evidence including a visit to the service. Residents would benefit from more structured and planned leisure activities. Meals are of good quality and nutritious. EVIDENCE: Residents said how much they enjoy the meals offered at the home. They say they are plentiful and nutritious. A relative confirmed that whenever she has visited the meals have been of a good quality and sufficient amount. Records of the meals taken as well as any alternatives to the main menu were recorded to ensure the nutritional intake of the residents was monitored. Relatives confirmed that they are always made welcome and are kept fully informed of their relatives care needs. The Registered Provider described his plans to allocate a member of staff to assist Mrs Underhay with the responsibly of planning and facilitating leisure activities for the residents. He recognised that involvement in activities is beneficial for residents and saw this as an area for improvement. Longview Residential Home DS0000003482.V292803.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 The quality in this outcome area is adequate. This judgement has been made using the available evidence including a visit to the service. 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 Provider had a copy of Plymouth City Council’s Alerter’s Guide for Adults at Risk and was aware of the procedure to follow should there be any suspicion of abuse. Longview Residential Home DS0000003482.V292803.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 24, 25, 26 The quality in this outcome area is adequate. This judgement has been made using the available evidence including a visit to the service. Improvements to the environment are necessary to protect the residents from harm. EVIDENCE: The outstanding requirements to refurbish the ground floor bathroom following a leak; seal the laundry room floor; cover radiators and make safe the hot water have, due to the risks these pose to the health and safety of residents, caused the quality in this outcome area to be adequate. Otherwise the home is very clean and well maintained. The Registered Provider gave assurances that these outstanding requirements would be completed this year. Bedroom doors should be fitted with locks to enable residents to lock their doors for privacy and security. Longview Residential Home DS0000003482.V292803.R01.S.doc Version 5.2 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, The quality in this outcome area is adequate. This judgement has been made using the available evidence including a visit to the service. Staff are employed in sufficient numbers to meet the needs of those currently living at Longview. Recruitment practices protection vulnerable residents. 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. Eight care staff have recently completed their NVQ 2 training and are awaiting certification. As identified in the Choice of Home section, care staff should undertake more specialised training in the care needs of people with dementia. Those staff files examined contained the necessary documentation including references, ID checks and Criminal Record Disclosure checks. Longview Residential Home DS0000003482.V292803.R01.S.doc Version 5.2 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 34, 35, 36, 38 The quality in this outcome area is adequate. This judgement has been made using the available evidence including a visit to the service. More formal quality assurance processes would ensure the health, safety and welfare of the residents and care staff are promoted and the quality of the service improved where necessary. EVIDENCE: Neither of the Registered Providers have NVQ 4 in Care or the Registered Manager Award, although they do have several years experience in caring for older people with dementia. Mr Underhay undertakes the responsibility of managing the home on a day-to-day basis and as such he is obliged to meet the regulations set out for a Registered Manager, i.e. qualifications relating to the needs of the residents and the management of the home. Longview Residential Home DS0000003482.V292803.R01.S.doc Version 5.2 Page 17 The Registered Providers have addressed the significant health and safety issues identified in previous inspection reports and staff have received training in first aid, manual handling and fire safety to ensure they are able to deal with emergencies and accidents. Further training in health and safety and infection control would protect the wellbeing of residents and care staff and Mr Underhay gave assurances that he is in consultation with the environmental health department for this. The majority of care staff have received training in basic food hygiene to enable them to safely prepare meals: Mr Underhay was advised to keep this under review to ensure all those involved with food preparation were appropriately qualified. Residents said that both the Registered Providers are in the home frequently and they have the opportunity to speak with them. There is no quality assurance process at Longview to enable the Registered Providers to formally consult with residents, relatives or staff about the quality of the care and services provided and identify areas for improvement. As those consulted by the inspector were happy to make their comments known, Mr Underhay was advised to develop a formal quality assurance consultation process to evidence the quality of the services provided by him and his staff team. The results of this consultation can be included in the home’s Statement of Purpose to inform prospective residents and their families of the experiences and recommendations of those currently living at the home. Care staff do not receive formal supervision regarding care practices and their own learning and development needs, but say they are able to speak freely to the Registered Providers when they are in the home. A copy of the home’s financial accounts was sent to the Commission and no concerns over the home’s viability were identified. Money is held for safekeeping in the home’s safe for a number of residents. Mr Underhay makes a small amount of money available at all times in case a resident wishes to purchase anything. This arrangement ensures that access to the bulk of the money is restricted and only he and his deputy have access to this. Longview Residential Home DS0000003482.V292803.R01.S.doc Version 5.2 Page 18 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 2 X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X 2 X X 2 2 2 STAFFING Standard No Score 27 3 28 3 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 3 3 2 X 2 Longview Residential Home DS0000003482.V292803.R01.S.doc Version 5.2 Page 19 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 OP4 Regulation 18 Requirement Care staff must receive training relating to the care needs of older people with dementia. This requirement has been included in previous reports and the timescale has been extended. 2. OP12 16 Residents must be provided with stimulating and meaningful activities. This requirement has been included in previous reports and the timescale has been extended. 3. OP21 23 The Registered Providers must complete the repair work and making safe the ground floor bathroom. This requirement has been included in previous reports and the timescale has been extended. 30/09/06 30/09/06 Timescale for action 31/12/06 Longview Residential Home DS0000003482.V292803.R01.S.doc Version 5.2 Page 20 4. OP25 13 The radiators and pipe work must be covered or have guaranteed low temperature surfaces. This requirement has been included in previous reports and the timescale has been extended. 30/09/06 5. OP25 13 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 to 43 degrees centigrade. This requirement has been included in previous reports and the timescale has been extended. 30/09/06 6. OP26 13 The laundry room floor must be sealed. This requirement has been included in previous reports and the timescale has been extended. 30/09/06 7. OP31 10 Mr Underhay, the Registered 31/12/06 Provider with day to day responsibility for the running of the care home, must undertake appropriate training to ensure he has the skills necessary to manage a care home and as such must seek advice from their training provider regarding NVQ 4 in Care, the Registered Managers Award. This requirement has been included in previous reports and the timescale has been extended. Longview Residential Home DS0000003482.V292803.R01.S.doc Version 5.2 Page 21 8. OP33 24 The Registered Providers must introduce a formal quality assurance system. This requirement has been included in previous reports and the timescale has been extended. 30/09/06 9. OP38 13 & 18 Care staff must receive training in health and safety and the control of infection. This requirement has been included in previous reports and the timescale has been extended. 31/12/06 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. Refer to Standard OP1 Good Practice Recommendations The Registered Provider should expand the Statement of Purpose to more accurately reflect the quality of the services provided, the recent qualifications obtained by staff and the experiences of those living in the home. Care staff should receive training relating to the protection of vulnerable adults. 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 provide induction training to newly appointed staff that meets the National Training Organisation’s specifications. Care staff should have an individual training and development assessment and profile. Care staff should receive formal supervision at least 6 times a year. 2. 3. 4. OP18 OP24 OP30 5. OP36 Longview Residential Home DS0000003482.V292803.R01.S.doc Version 5.2 Page 22 Longview Residential Home DS0000003482.V292803.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: 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 Residential Home DS0000003482.V292803.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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