CARE HOMES FOR OLDER PEOPLE
Longwood Grange Nursing Home Longwood Gate Longwood Huddersfield West Yorkshire HD3 4UP Lead Inspector
Sally McSharry Unannounced Inspection 12th December 2005 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 Longwood Grange Nursing Home DS0000001120.V268762.R01.S.doc Version 5.0 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. Longwood Grange Nursing Home DS0000001120.V268762.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Longwood Grange Nursing Home Address Longwood Gate Longwood Huddersfield West Yorkshire HD3 4UP 01484 647276 01484 460208 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) Ancyra Health Limited Ms Rosemary Dyson Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Longwood Grange Nursing Home DS0000001120.V268762.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. Up to 6 service users - category TI and/or TI(E) Can provide accommodation and care for one named service user aged under 65 years 18th August 2005 Date of last inspection Brief Description of the Service: Longwood Grange is a care home providing personal care, nursing care and accommodation for up to 40 elderly service users. The home is also registered to care for up to six elderly service users requiring terminal care. The home is owned by Ancyra Health Limited, a private limited company. The accommodation was adapted from its former use as a school some years ago. It is situated on a steeply sloping site adjacent to a church in the centre of Longwood, a former village satellite of Huddersfield. The accommodation provided is located on two floors linked by a passenger lift. The ground floor providing the communal facilities, toilets, lounge and dining room. All the bedrooms are on the first floor most of which are for single occupation. There are no en-suite facilities in the home. Longwood Grange Nursing Home DS0000001120.V268762.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced and carried out on 12 December 2005. The inspector looked at a selection of the core minimum standards and followed up on the requirements and recommendations made after the last visit. Three service users’ care records were looked at; the inspector spoke to eleven service users, one visiting relative and some staff. Activities provided in the home were reviewed and the inspector saw the preparations for the home’s Christmas Party, which was due to take place later in the day. A brief tour of the building was carried out. Staffing levels, general staff training and NVQ training were reviewed. The management of the home and health and safety checks were also observed. What the service does well: What has improved since the last inspection? What they could do better:
Some work is still needed on the detail of information in care records. Staff should also ensure the daily record is completed on a daily basis. Ongoing training should be extended to include more topics appropriate to the work staff are carrying out. Action must be taken to ensure the fire safety systems in the home are tested weekly and clearly recorded.
Longwood Grange Nursing Home DS0000001120.V268762.R01.S.doc Version 5.0 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. Longwood Grange Nursing Home DS0000001120.V268762.R01.S.doc Version 5.0 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 Longwood Grange Nursing Home DS0000001120.V268762.R01.S.doc Version 5.0 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): EVIDENCE: None of these standards were inspected during this visit. Longwood Grange Nursing Home DS0000001120.V268762.R01.S.doc Version 5.0 Page 9 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 and 8. All service users have an individual care plan, which identifies their health and personal needs. Service users’ health care needs are being met in the home. EVIDENCE: All service users have an individual care plan, which identifies their health and personal needs. Risk assessments are in place and have been completed for service users recently admitted to the service. Risk assessment documentation now clearly shows how each score has been reached, as recommended in the last inspection report. Care plans and risk assessments have been reviewed monthly. Some care plans lacked some specific detail regarding the current pressure relieving equipment used by individuals. Daily records are not being made on a daily basis. It is recommended that a daily record is made of the actual care given and any outcomes to that care. There is clear evidence in service users’ records that other health care professionals are contacted if the staff at the home are unable to meet the health care needs of service users. Longwood Grange Nursing Home DS0000001120.V268762.R01.S.doc Version 5.0 Page 10 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 and 13. Appropriate activities are arranged for the service users. They are encouraged to be part of the decision-making process and make choices about their lifestyle. Service users are supported to keep contact with family and friends. EVIDENCE: A variety of activities, trips out and entertainment is offered in the home. Service users advised that some of them had attended the local British Legion social evening. Others were going Christmas shopping and some service users had been making Christmas decorations. One service user advised that although activities are offered they can choose whether to take part or not. Service users advised that they are able to receive visitors at any time and that links with the local community and churches are maintained. Longwood Grange Nursing Home DS0000001120.V268762.R01.S.doc Version 5.0 Page 11 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 and 18. Service users and relatives said they would be confident to raise any concerns. Training is provided to help protect service users from abuse. EVIDENCE: All service users who spoke with the inspector said that if they had any concerns they would raise them with the manager or another senior member of staff on duty. Service users were complimentary about the manager and felt she would address any issues. The complaints procedure is displayed in the home and is contained within the written information provided to service users about the home. All staff are given information about the abuse and the protection of vulnerable adults. The training and information provided helps protect service users. Longwood Grange Nursing Home DS0000001120.V268762.R01.S.doc Version 5.0 Page 12 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 and 26 The home is generally well maintained and there is an ongoing programme of redecoration. Longwood Grange is clean, pleasant and tidy. EVIDENCE: Some bedrooms have been redecorated since the last inspection. The redecoration programme is ongoing in the home. Bedrooms are individualised and personalised by service users. There is a maintenance programme and health and safety checks are carried out. There is one area on the first floor corridor where a leak has caused damage to the plasterwork. The area is drying out and due for repair soon. During this visit the home was clean and tidy and there was only one room noted to have an unpleasant odour. Longwood Grange Nursing Home DS0000001120.V268762.R01.S.doc Version 5.0 Page 13 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 and 30. There is sufficient staff to meet the needs of the current service users. Care staff are trained to NVQ level 2. Training is provided by the home. EVIDENCE: Following a requirement made in the last report staffing levels in the home have been reviewed and further staff provided during the daytime. Service users said that when they need assistance they ring the call bell and staff come to help them. NVQ training is promoted in the home and 73 of care staff have achieved NVQ level 2 with further staff working toward the award. This is a good level of training. General training is offered by the home and since the last inspection three staff have attended first aid training. Further staff are booked to attend first aid courses. Some staff have also attended training provided by the local hospital on oral care. It remains a recommendation that the variety of topics covered in training be expanded. Longwood Grange Nursing Home DS0000001120.V268762.R01.S.doc Version 5.0 Page 14 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 and 38. The manager is experienced and manages the home well. Some steps are taken to ensure the health, safety and welfare of service users and staff, however the registered provider must ensure all safety checks are carried out regularly. EVIDENCE: Mrs Dyson is a first level qualified nurse with experience in running a care home. She continues to maintain her professional registration and post registration development. Service users and staff reported Mrs Dyson to be approachable and effective. Since the last inspection further staff have attended first aid training as required after the last inspection. An up to date copy of the lift certificate was available at this inspection. Longwood Grange Nursing Home DS0000001120.V268762.R01.S.doc Version 5.0 Page 15 Although more regular fire alarm tests and checks have been carried out, the system is not being tested weekly as required, therefore it remains a requirement of this report that weekly tests occur and are clearly recorded. Longwood Grange Nursing Home DS0000001120.V268762.R01.S.doc Version 5.0 Page 16 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 X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X X X 1 Longwood Grange Nursing Home DS0000001120.V268762.R01.S.doc Version 5.0 Page 17 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 OP38 Regulation 23 Requirement The fire alarm system must be checked weekly. Time scale of 05/09/05 not met. Timescale for action 19/12/05 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 OP7 OP7 OP28 Good Practice Recommendations A daily record should be made of the care given to each service user that day and any outcomes to that care. Some care plans lacked some specific detail regarding the current pressure relieving equipment used by individuals. The variety of topics covered in training should be extended. Longwood Grange Nursing Home DS0000001120.V268762.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Brighouse Area Office Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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