Inspection on 09/05/08 for Longview Residential Home

This inspection was carried out on 9th May 2008.

CSCI found this care home to be providing an Adequate service.

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 15/05/07

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 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Longview Residential Home 66/68 Plymouth Road Plympton Plymouth Devon PL7 4NB Lead Inspector Kim Fowler Unannounced Inspection 9th May 2008 08:00 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.V364464.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.V364464.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 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.V364464.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named service user of the MD(E) category. Date of last inspection 15th May 2007 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.V364464.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. The inspection was unannounced and took place between 8.10am and 1:20pm on 9th May 2008. The Registered Providers, Mr and Mrs Underhay were present. The inspector made a tour of the building and spoke to most the people living at the home and the staff on duty at the time of the inspection. Documentation relating to the care planning process and the management of the home were examined. . Any comments are in the relevant section of the report. What the service does well: What has improved since the last inspection? What they could do better: All Care Plans must be in place and regularly reviewed to ensure that all staff are aware of the current needs and changing needs of people living in the home. All medication recorded clearly, particularly Controlled drugs, would protect people living at the home. Longview Residential Home DS0000003482.V364464.R01.S.doc Version 5.2 Page 6 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.V364464.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.V364464.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): 2/6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The completion of pre-admission assessments ensures that any prospective new admission’s needs are known prior to admission. EVIDENCE: The files examined for people living at home show that all admissions had a completed pre-admission assessment carried out and that people admitted to the home have been assessed. One file examined showed the placing authorities care plan supports these assessments. This ensured that the care staff were aware of peoples needs. Several staff were spoken with during the inspection and were fully aware of the needs of each persons currently living at the home. Longview Residential Home DS0000003482.V364464.R01.S.doc Version 5.2 Page 9 One person living at the home was spoken to and confirmed that they had visited the home before they were admitted. Another person was able to state that there relative had been to the home before they were admitted. Longview Residential Home does not provide Intermediate care. Longview Residential Home DS0000003482.V364464.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): 7/8/9/10/11. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People living at this home receive consistent health and personal care as appropriate All care plan completed would enable staff to meet the health and welfare needs of people living at the home. The home’s poor practices relating to medication administration place people living at the home at risk. EVIDENCE: Three files of people living at the home were examined and two contained an individual care plan based on care needs and how the home would meet these needs. The daily care plans are easy assessable for staff on duty and risk assessments are held on individual files for the protection of all people living at the home. Longview Residential Home DS0000003482.V364464.R01.S.doc Version 5.2 Page 11 These care plans give detailed instructions to all staff as well as information to new staff to ensure intimate personal care is being provided in a manner that meets with the approval of people receiving the care. This is particularly important where people are unable to express themselves verbally. However one care plan was not completed and no care plans had been regularly reviewed or updated by the home. All care plans should be completed and reviewed to enable staff to be aware the changing needs of people living at the home at all times. Evidence was recorded into individual files that people living at the home are referred to the District Nurse team and the Mental Health team after monitoring by the homes care staff. Recorded onto an individual care plan was that a CPN (community psychiatric nurse) was due to visit one person living in the home and carry out a reassessment of their care needs. All people living at the home have access to all health care services and this information was recorded into individual files examined. These files recorded that there was input from other professionals including GP’s, CPN, chiropodist and consultants based at the local hospital. The medication system was examined and showed that the home uses the blister pack system to dispense medication and staff were observed administering medication. One blister pack showed that one person’s medication was signed for but had not been administered. When discussed with the Registered owner, evidence showed that this person had gone out for a visit without taking the medication with them nor was it administered on their return. It was also evident that for 5 days no staff member had carried out the correct procedure of contacting the GP to inform them that one person had missed their medication dose. The Controlled drug records were examined and it was found at the time, to have errors in the administration of two medications. The home held 2 bottles of medication for one person and the controlled drug book held 2 records. The records and the amounts held did not match. Following the inspection Mr Underhay, the Registered Provider forwarded subsequent records relating to the above errors. Mr Underhay states that there was no error, however the records during the inspection were not clear and indicate their maybe errors and were misleading. The MARS (Medication Record Sheets) showed changes in medication hand written onto these sheets, however there was no signature or date of the person who recorded these changes. Longview Residential Home DS0000003482.V364464.R01.S.doc Version 5.2 Page 12 Several staff members were questioned about medication and it was confirmed that no staff had received formal medication training. The inspector spoke to most people living at the home and some were able to comment directly about their experiences of living at the home. All clearly stated that they were well cared for. The inspector observed those residents with confusion being treated respectfully by the care staff, staff knocking on bedroom doors and staff assisting people with meals. Several people said they were assisted promptly. It was observed that people who chose to wander freely through the home were able to. One person said, “The staff are lovely”. The owners confirmed that any people living at the home who develop a terminal illness are able to remain at the home if the staff team and the District Nurse Services are able to continue to meet individual’s needs. Longview Residential Home DS0000003482.V364464.R01.S.doc Version 5.2 Page 13 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): 12/13/14/15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people living at Longview can be confident that the home offers good meals. The home welcomes and encourages families and friends to visit. EVIDENCE: The homes daily diary recorded visits by a guitarist and singer and a visit from a therapist who carried out a relaxation class. The Registered Providers also stated that activities are offered as much as possible either by themselves or one of the care staff: those people who were able to confirmed that activities are carried out in the home. Some activities aren’t always planned as people can request and chose from board games, quiz, Bingo, listening to music or watching a film. Visitors are welcome at any reasonable time and can visit their friend/family in the privacy of their own room. Several family visits had been recorded into either individual care plans or the home daily diary. On person said, “My daughter visit and I go out with them”. Longview Residential Home DS0000003482.V364464.R01.S.doc Version 5.2 Page 14 During discussion with people about food they said it was “very good” or “fine”. One person was able to comment that they were able to make a choice on the food. Most people living at the home that were able to made positive comments about the food provided. The menus were displayed for all and one of the staff cooks the lunchtime meal. One person cooking the meal was spoken with during the inspection and confirmed that the food budget was fine and there was always plenty of food available in the home including a choice of fresh vegetable. The meal served that day was Fish Fingers, Potatoes and vegetables. Longview Residential Home DS0000003482.V364464.R01.S.doc Version 5.2 Page 15 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): 16/18. 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: Some of the people living at Longview were able to confirm that the Registered Providers were approachable and could discuss any concerns. One person said, “ Will always put things right if anything is wrong”. Neither the home nor the Commission has received any complaints 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. One staff was not fully aware of the process, however did state that they would pass information onto senior staff of the Registered Providers. Mr. and Mrs. Underhay, the Registered Providers, stated that they are in the home most days and would deal with any issue raised straight away. The Commission would recommend that one of the Registered Providers receive the Local Authority’s Adult Protection training. Longview Residential Home DS0000003482.V364464.R01.S.doc Version 5.2 Page 16 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): 19/21/25/26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Continued improvements to the environment are necessary to protect the people who live at Longview from the risk of injury. EVIDENCE: A tour of the building confirmed that the home was very clean and tidy, with no offensive odours. All 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. There is access to the rear patio area via the lounge and dinning room and this leads to a 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.V364464.R01.S.doc Version 5.2 Page 17 The call bell system had previous been renewed and can 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. A previous requirement made in the last full inspection was for radiator covers to be fitted. A tour of the premises showed that many radiators are now covered and help protect people at risk from burns. Information received after the inspection from Mr Underhay, the Registered Provider states that, the two radiators without covers are high up the wall in the ground floor bathrooms and present little if any risk from scalding. The Registered Provider confirmed that all baths had been fitted with controls and plans are in place to fit controls to all washbasin, with some already fitted. No staff had completed the infection control training. Longview Residential Home DS0000003482.V364464.R01.S.doc Version 5.2 Page 18 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): 27/28/29/30. 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: Many of the care staff employed at the home are long serving staff members having worked at the home for a number of years therefore have a great deal of experience working with older people. Some of the people living at Longview were able to state that the care received is very good. Nine of the Thirteen staff employed hold an NVQ certificate, 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. On the day of the inspection there were 3 care staff on duty during the morning until 1pm and 2 in the afternoons and evenings. The Registered Providers confirmed that they are on the premises most days. One of the care staff on duty undertakes the cleaning and the meal preparations. Several people living at the home were able to comment that the help they receive is Longview Residential Home DS0000003482.V364464.R01.S.doc Version 5.2 Page 19 prompt and when they require assistance it is available without waiting. During the night time there are 2 staff on duty, 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 nighttime needs and none had been identified as at risk from wandering at night. Three 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. Several staff members were interviewed during this inspection and none had completed Adult Protection, Infection control, Medication or Dementia training. All staff would benefit from regular updated training. Longview Residential Home DS0000003482.V364464.R01.S.doc Version 5.2 Page 20 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): 31/33/35/38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Registered Providers of this home has the respect of people living at the home. The health and safety of the people who live at Longview is placed at risk by failure to address health and safety issues. EVIDENCE: The Registered Providers have owned and managed the home for many years and have experience in running the care home, and are well thought of by those who live and work at Longview. Both the staff and some of the people living at the home were able to confirm that the providers are in the home most days. Longview Residential Home DS0000003482.V364464.R01.S.doc Version 5.2 Page 21 There is no formally recorded quality assurance process at Longview to enable the Registered Providers to demonstrate how they consult with people living at the home about the quality of services provided. Those who were able to stated that the Registered Providers, who are in the home most days, do check with them that their needs are being met and to look for ways to improve their quality of life. The providers stated that the care staff receives informal supervision daily and staff stated that they felt well supported in their role. The staff went onto say that the Registered Providers are approachable and available at any time to talk about the care needs of the people who live in the home. The money held for people living in the home was checked and a clear record of income and expenditure with a signature in place either by staff member of the person whose money it belongs. All money is held in the homes safe. 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 home has a designated maintenance book so staff are able to record any repairs that the owner carries out himself. All fire systems are checked regularly and the home had a new boiler fitted late last year. A clinical waste contract was in place. Longview Residential Home DS0000003482.V364464.R01.S.doc Version 5.2 Page 22 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 X 3 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 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 3 3 X 3 X X X 3 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 X 3 X 3 X X 3 Longview Residential Home DS0000003482.V364464.R01.S.doc Version 5.2 Page 23 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 OP7 Regulation 15 Requirement All care plans must be in place and reviewed regularly to ensure service users needs in respect of his health and welfare are met. The home must make arrangements for all recording of medication, in particular controlled drugs, to be clear. Timescale for action 31/08/08 2 OP9 13 31/08/08 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 3 Refer to Standard OP18 OP30 OP33 Good Practice Recommendations The Registered Provider should complete the Local Authority’s Adult Protection training. All staff should have regular updated training in Medication, Dementia and Infection control. The Registered Providers should formally record their consultation with regard to the quality of the services provided at Longview. Longview Residential Home DS0000003482.V364464.R01.S.doc Version 5.2 Page 24 Longview Residential Home DS0000003482.V364464.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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.V364464.R01.S.doc Version 5.2 Page 26 - 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!