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Inspection on 18/08/05 for Longwood Grange Nursing Home

Also see our care home review for Longwood Grange Nursing Home for more information

This inspection was carried out on 18th August 2005.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Two service users who were new to the home commented on the pleasant welcome they received when entering the home. Both service users felt they had settled in well and that staff were approachable. Information about the home is available to prospective service users. Preadmission assessments are carried out before a new service user is admitted to the home, to ensure the home and the members of staff at the home are able to meet the prospective service user`s needs.

What has improved since the last inspection?

Since the last inspection an activities organiser has been employed and now a variety of activities have commenced in the home; both service users and staff commented on the positive effect regular activities have had. A continuous redecoration programme helps keep the accommodation pleasant. Formal staff supervision has commenced and regular monthly management visits and reports are now carried out; monitoring the service provided.

What the care home could do better:

The occupancy of the home has increased since the last inspection and staffing levels during the day have not increased correspondingly. A further member of care staff must be provided during the day to meet the needs of the current number of service users.Care planning still needs work to ensure new service users are suitably assessed against any risks and ensure there is a daily statement regarding the care each service user receives and any outcomes to that care. Caution should be taken when introducing new care plan documentation to ensure new risk assessments enable monthly reassessment and clearly illustrate how the assessment score has been achieved. The variety of subjects covered in staff training should be widened and further staff must be trained in first aid. Fire safety checks and tests must be carried out on a weekly basis.

CARE HOMES FOR OLDER PEOPLE Longwood Grange Nursing Home Longwood Gate Longwood Huddersfield HD3 4UP Lead Inspector Sally McSharry Unannounced 18 August 2005 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. Longwood Grange Nursing Home J51J01_s1120_Longwood Grange_v242886_180805.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Longwood Grange Nursing Home Address Longwood Gate Longwood Huddersfield HD3 4UP 01484 647276 01484 460208 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) Ancyra Health Ltd Ms Rosemary Dyson Care Home with Nursing 40 Category(ies) of Older People - 40, upto 6 people requiring registration, with number terminal care. of places Longwood Grange Nursing Home J51J01_s1120_Longwood Grange_v242886_180805.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Conditions of this registration are listed on the registration certificate displayed at the service. Date of last inspection 14 March 2005 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 J51J01_s1120_Longwood Grange_v242886_180805.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was an unannounced visit carried out on 18th August 2005. During the visit the inspector spoke with some service users and staff. A sample of service user records and medications were audited. A brief tour of the building was carried out. Other records checked during this visit include service users’ finances, staff training and recruitment records and maintenance records. What the service does well: What has improved since the last inspection? What they could do better: The occupancy of the home has increased since the last inspection and staffing levels during the day have not increased correspondingly. A further member of care staff must be provided during the day to meet the needs of the current number of service users. Longwood Grange Nursing Home J51J01_s1120_Longwood Grange_v242886_180805.doc Version 1.40 Page 6 Care planning still needs work to ensure new service users are suitably assessed against any risks and ensure there is a daily statement regarding the care each service user receives and any outcomes to that care. Caution should be taken when introducing new care plan documentation to ensure new risk assessments enable monthly reassessment and clearly illustrate how the assessment score has been achieved. The variety of subjects covered in staff training should be widened and further staff must be trained in first aid. Fire safety checks and tests must be carried out on a weekly basis. 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 J51J01_s1120_Longwood Grange_v242886_180805.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 Longwood Grange Nursing Home J51J01_s1120_Longwood Grange_v242886_180805.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 and 3. The company provides information about the home, which enables prospective service users to make a choice as to whether they wish to live at Longwood Grange. Where possible pre-admission assessments are carried out by a member of staff from the home to ensure the home is suitably equipped and staff appropriately trained to meet the prospective service user’s needs. EVIDENCE: Pre-admission assessments are carried out where possible, enabling staff to assess the service users’ health and welfare needs. This helps ensure Longwood Grange and the staff are able to care appropriately for the service user. Longwood Grange provides some respite care but does not have an intermediate care contract. Longwood Grange Nursing Home J51J01_s1120_Longwood Grange_v242886_180805.doc Version 1.40 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 standard(s) 7, 8, 9 and 10. Individual care plans identify service users’ health, personal and social care needs. Service users’ health needs are being met, but not all risk assessments are carried out for service users who are new to the home. Medications are clearly recorded and managed appropriately. Service users felt that staff in the home maintain their privacy and that they are respected. EVIDENCE: A sample of care records was audited. Service users have an individual care plan which clearly states their health, welfare and social needs and how they are to be met by the staff in the home. Some care plans include risk assessments which are reassessed monthly, however the care records of more recent service users admitted to the home have not had risk assessments completed and daily records have not been carried out daily. These must be done. Longwood Grange Nursing Home J51J01_s1120_Longwood Grange_v242886_180805.doc Version 1.40 Page 10 The company is introducing some new care plan documentation to the home. Some of the documents should be amended to show monthly reassessments and how the score have been achieved. Staff at the home assist service users to access the services of specialist health care professionals and NHS services. Medications audited during this visit show that a clear and organised system is in place. The sample of medications audited was found to be correct. Some service users spoke to the inspector during this visit. Service users commented on the kindness of staff and in particular the manager. Service users said they felt their privacy was respected and that they were able to make choices in the home. Service users also said that members of staff respected the choices they had made. Longwood Grange Nursing Home J51J01_s1120_Longwood Grange_v242886_180805.doc Version 1.40 Page 11 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 and 15. Service users said that life in the home met their expectations, with cultural, religious and social needs being met. Contact with service users’ families and the community is maintained and those service users who are able said they have choice and control over their lives. A wholesome and varied diet is provided at the home. EVIDENCE: Improvements have been made at the home with the introduction of an activities co-ordinator who organises and provides a variety of activities during the afternoon, five days a week. Service users are able to choose whether they join in activities or not. Some service users who spoke to the inspector said they preferred to watch what was going on rather than taking part. Links with the community and churches are maintained and one service user regularly attends services at their church. Service users confirmed that their families and friends are able to visit the home at anytime. Longwood Grange Nursing Home J51J01_s1120_Longwood Grange_v242886_180805.doc Version 1.40 Page 12 All those service users who spoke with the inspector complimented the meals provided at the home, making reference to the choice provided and the quantity served. One service user’s family regularly bring in food for her and she has a small refrigerator in her room to store items safely. Longwood Grange Nursing Home J51J01_s1120_Longwood Grange_v242886_180805.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 and 18. Service users 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 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 J51J01_s1120_Longwood Grange_v242886_180805.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 and 24 The home provides a pleasant well-maintained environment. Bedrooms are comfortable and service users are able to personalise their own space. EVIDENCE: Some redecoration has been carried out on the corridor area since the last inspection. Some bedrooms have also been redecorated, others are showing signs of wear. The manager has identified bedrooms for redecoration and the programme to address these continues. The worn armchairs identified at the last inspection have been removed. A programme to provide all bedrooms with a lockable drawer is ongoing. Some service users have personalised their rooms beautifully. Longwood Grange Nursing Home J51J01_s1120_Longwood Grange_v242886_180805.doc Version 1.40 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 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 and 30. Staff numbers must be increased to meet the needs of the current number of service users. Trained and experienced staff are employed to meet service users’ needs. Recruitment processes are thorough. Staff training is on going but the variety of subjects covered in training could be expanded. EVIDENCE: Since the last inspection the number of service users accommodated at the home has increased. The number of staff employed during the day has not increased and the registered provider must employ a further member of care staff throughout the day to ensure service users needs are fully met in the home. For guidance the registered provider should refer to the existing staffing notice issued by Calderdale and Kirklees Health Authority in August 2000. There is evidence that mandatory training is being provided in the home, however there is only one member of staff who is trained in first aid. Further staff must be trained in first aid with the aim being that there is a trained first aider on each shift. There is a limited range of subjects covered in staff training and the range of topics covered should be expanded. Longwood Grange Nursing Home J51J01_s1120_Longwood Grange_v242886_180805.doc Version 1.40 Page 16 Staff recruitment processes and procedures are good with necessary references and checks having been carried out. There was evidence that staff most recently employed had received induction training and that NVQ training is established in the home; with eight out of the nineteen care staff already having NVQ level two or above and further staff about to complete NVQ level two training. New staff are waiting to commence the course. Longwood Grange Nursing Home J51J01_s1120_Longwood Grange_v242886_180805.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) 33, 35, 36 and 38. Regular management reports help monitor the service; this assists the company to ensure the best interests of the service users are being met. Service users’ financial interests are managed appropriately. Formal staff supervision has commenced at the home. Generally the health, safety and welfare of service users and staff are being promoted and protected, however some lapses in weekly fire safety checks have occurred. EVIDENCE: Since the last inspection the company has ensured that monthly management reports required under regulation have been carried out and a copy of the report forwarded to the CSCI. Longwood Grange Nursing Home J51J01_s1120_Longwood Grange_v242886_180805.doc Version 1.40 Page 18 No one at the home acts as an appointee for any of the service users. Small amounts of personal spending money are held safely at the home for individuals. The records of the money held were audited and found to be correct and accounted for. Since the last inspection formal staff supervision sessions have commenced. Maintenance tests and checks are carried out to ensure service user and staff safety, however due to staff sickness the weekly fire alarm tests and checks have not always been carried out on a weekly basis, this must be addressed. During this visit the service records for the passenger lift were available, however a copy of the lift insurance certificate was not available at the home. A copy of this should be forwarded to the CSCI with the action plan required from the registered provider addressing items identified in this report. Longwood Grange Nursing Home J51J01_s1120_Longwood Grange_v242886_180805.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 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x 3 x x STAFFING Standard No Score 27 1 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x 3 3 x 1 Longwood Grange Nursing Home J51J01_s1120_Longwood Grange_v242886_180805.doc Version 1.40 Page 20 no 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 8 Regulation 13,14,15 and 17 Requirement Service users must be assessed in relation to risk. Where the assessment identifies a risk action must then be taken to minimise or eliminate the risk. All service users including new service users must be assessed for risk. There must be another member of staff provided during the day to help care for the current number of service users accomodated. Further staff must be trained in first aid. The fire alarm system must be checked weekly. Timescale for action 30.09.05 2. 27 18 15.09.05 3. 4. 28 38 13(4) 23 31.12.05 05.09.05 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. Refer to Standard 7 7 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. Risk assessments should be evaluated monthly. It is recommended that risk assessment documentation has an J51J01_s1120_Longwood Grange_v242886_180805.doc Version 1.40 Page 21 Longwood Grange Nursing Home 3. 4. 28 38 area to record the outcome of the assessment each month and show how the score has been acheived. The variety of topics covered in training should be extended. A copy of the passenger lift insurance certificate should be forwarded to the CSCI along with the action plan required from the provider which addresses issues raised in this report. Longwood Grange Nursing Home J51J01_s1120_Longwood Grange_v242886_180805.doc Version 1.40 Page 22 Commission for Social Care Inspection 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 © 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 Longwood Grange Nursing Home J51J01_s1120_Longwood Grange_v242886_180805.doc Version 1.40 Page 23 - 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. 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