Inspection on 18/02/09 for Longwood Grange Nursing Home

This inspection was carried out on 18th February 2009.

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

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.

Other inspections for this house

Longwood Grange Nursing Home 10/12/07

Longwood Grange Nursing Home 05/12/06

Longwood Grange Nursing Home 12/12/05

Longwood Grange Nursing Home 18/08/05

Longwood Grange Nursing Home 14/03/05

Longwood Grange Nursing Home 14/09/04

Longwood Grange Nursing Home 29/03/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Longwood Grange Nursing Home Longwood Gate Longwood Huddersfield West Yorkshire HD3 4UP     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Lynda Jones     Date: 2 5 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Longwood Grange Nursing Home Longwood Gate Longwood Huddersfield West Yorkshire HD3 4UP 01484647276 01484460208 manager.longwood@aermid.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Aermid Health Care (UK) Limited Name of registered manager (if applicable) Mrs Tracey Jane O`Hagan Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Can provide accommodation and care for one named service user aged under 65 years. The maximum number of service users who can be accommodated is: 40 The registered person may provide the following category of service only: Care Home with Nursing - Code N to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category - Code OP Up to 6 service users - category TI and / or TI(E) Date of last inspection Brief description of the care home Longwood Grange is a care home providing personal care, nursing care and accommodation for up to 40 elderly people. The accommodation was adapted from its former use as a school some years ago. It is Care Homes for Older People Page 4 of 27 0 Over 65 40 care home 40 Brief description of the care home 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. In addition to the fee there are extra charges for hairdressing, private chiropody, newspapers, sweets and personal toiletries. Information about the home and the services provided are available from the home in the Statement of Purpose and Service User Guide. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. The purpose of this inspection was to assess the quality of the care and support received by the people who live at Longwood Grange. The visit to the home was carried outover one day. The last key inspection was in December 2007. The methods used to gather information included conversations with the people living at the home, their relatives and the staff, as well as looking at care plans and examining other records. Care Homes for Older People Page 6 of 27 We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use the service are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforement action will be taken. We also sent surveys to a sample of people who live and work at the home and to health care providers who visit the home. We received 6 responses from people who live there, 3 responses from staff and 2 responses from health care providers. We have included some of their comments in this report. We received the homes self-assessment questionnaire before the inspection visit. This gave us a lot of useful information about the home and helped us plan the visit. We would like to thank the people who live at the home, their relatives and the staff, for their welcome and hospitality and for taking the time to talk and share their views during the visit. What the care home does well: What has improved since the last inspection? The area manager is visiting the home on a regular basis and reporting on the conduct of the home. Care Homes for Older People Page 8 of 27 New chairs have been purchased for the lounge. The home now has its own manual handling coordinator, they have invested in staff training and better equipment. The moving and handling plans are better which means that people are being moved safely. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive information about the home before they move in and they can visit to see if the service can meet their needs. People are assessed before they move in to make sure the home can meet their needs. Evidence: In the surveys people told us they were given information about the home and this helped them decide if it was the right place for them. People are invited to visit the home to have a look at the accomodation and meet people, sometimes relatives do this if their family member is unable to get to the home. We were told people can just turn up, they dont have to make an appointment. In the information we received from the home before the inspection, we were told people are encouraged to take their time about making the decision to move in. The staff recognise that it is a big decision to Care Homes for Older People Page 11 of 27 Evidence: take These are some of the comments we received: I visited the home after making a telephone appointmentand I liked what I saw. My opinion has not changed, I think I made the right decision They were very helpful at the viewing This was the best home by far We looked at some of the care plans and we could see that everyone had been assessed before they moved in. This is to make sure that each persons needs can be met and to ensure it is the right place for them. In the surveys everyone said they had a contract. They are also given a copy of the service user guide which includes the homes statement of purpose and information about the complaints procedure. The home does not provide intermediate care. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples personal and Healthcare needs are met. Staff ttreat people with respect, care and consideration at all times. People are protected by the homes medication administration systems. Evidence: We looked at a selection of care plans because we wanted to see what individual needs had been identified and what action staff are expected to take to meet those needs. The records indicate that people receive the medical and healthcare support they need and any concerns about peoples health are followed up. Detailed medical records are kept showing, for example, when the GP visited and the outcome, as well as any further healthcare suppport that is needed. People who require any other health services are referred, and then followed up. In the information provided to us the manager said We work alongside numerous Care Homes for Older People Page 13 of 27 Evidence: other health care professionals who bring their wealth of experience and knowledge to the home. We are only part of the bigger picture and we use the other services to ensure good care is given. G.P.S District Nurses, Care home liasion mental health team, Opticians, Dentists, Physiotherapists, Occupational Therapists, Speech and language therapists, Dieticians, Macmillian Nurses, Tissue Viability, Falls Practioner, Audiology, Chiropody, Pharmaceutical services, this list is extensive, although we may not acess them for every service user. The daily records could be improved. These records should provide evidence of the care that is actually delivered on a day to day basis. The records do not do justice to the quality of care that is delivered. They are repetitive and do not reflect the good care and support that the staff actually provide. The people we talked to told us that they receive the care and support they need. In the surveys people said they always receive the medical support that they need, they said the staff were always available when needed and they felt that they listened to what they had to say. One person wrote in the survey the staff and nurses are exceptional. The records show that systems are in place for people living at the home and their relatives to be involved in regular reviews of the care plans. This enables people to comment on the care they receive and to say if it can be improved in any way. We were told that this opportunity is rarely taken up. There is evidence that people are consulted informally but involvement in reviews should be encouraged so that people can have a say in their own care. The home has an Advance Care Plan for people whos health deteriorates. They told us this prompts the end of life arrangements, incorporating cultural and spiritual needs. This ensures that the death is as peaceful and dignified as it can be. In the information provided before the inspection the manager said the home has a policy on the reciept, recording, storage, handling, administration and disposal of drugs. Medication and care plans are audited on a regular basis by the manager and the area manager. We looked at a sample of medication records and these show that medication is administered as prescribed. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are activities on offer to keep people stimulated. Relatives are welcome to visit at any time. Evidence: Longwood Grange is a lively home, everyone is warm and friendly and they make visitors feel very welcome. The staff are pleasant and respectful; during the inspection they were busy but they always made time to talk to people as they carried out their tasks. People clearly get on well together one person said we have a laugh here. In the information provided before the inspection the manager said Longwood Grange is first and foremost the service users home and as such we try to be as flexible as we can. The staff recognise that peoples preferred routines are important. They have recorded some useful information in the care plans about when people like to get up and go to bed, if they like a rest in their room during the day etc; this helps them to support people to maintain their routines as far as they can when people move in. They also encourage people to bring some of their personal possessions with them and arrange their rooms to suit their needs. Care Homes for Older People Page 15 of 27 Evidence: During the day staff were always present in the lounge, asking people if they had everything they needed. They offered people a variety of drinks mid morning and one person went round to everyone asking what they would like for lunch from a range of options. The staff took time with people with dementia, carefully explaining what was available to make sure they could make a choice. From observing the staff at work it is clear that they know people well; they know what they like and dislike. If someone did not like what was on offer they came up with an alternative. The manager said the service users autonomy and choice is very important, we strive to give them as much control over their lives as posible. People told us the meals at the home are good and they are pleased with what is on the menu. Lunchtime was unhurried, people were served as they took their seats in the dining room. Relatives told us they are made to feel welcome when they visit. They said they are always offered a drink when they call and they said they can stay for a meal if they want to. One person had lunch with her relative during this visit. People told us that staff are always available to answer any questions they may have. In the surveys, we asked if there are any activities arranged for people to take part in if they want to. They answered always and usually. There is an activities coordinator who works 16 hours per week, she organises trips out, entertainment and in house activities. She also spends time individually with people who prefer not to join in organised activities. There are records of everything that takes place and of individual hobbies and interests. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People know how to make a complaint and are confident that any issues raised would be sorted out. Staff know about adult protection. This means that people in the home are being kept safe. Evidence: Everyone receives a copy of the homes complaints procedure when they first move in. It is also on display on the notice board in the reception area where visitors sign in. In the surveys people confirmed that they know how to complain and who to speak to if they are unhappy about any aspect of the service. One person told us I am never unhappy about my relatives situation. I know she is cared for and well looked after. A record is kept of any complaints that are made together with the outcomes of investigations. According to the information we received before the inspection, there have not been any complaints in the last twlve months. All staff have received adult protection training and are aware of their responsibility to protect people in their care. We were told some further training will take place within the next 12 months. The information sent to us by the home said The protection of our service users is paramount. All staff are aware that abuse in any form will not be tolerated. Care Homes for Older People Page 17 of 27 Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well maintained and is clean and comfortable throughout. Evidence: There are plans to totally refurbish the home, we were told the home is waiting for the head office to give the go-ahead for work to start. Bedrooms are personalised and people have a lot of their own possessions around them. The plans for the home include creating some en suite facilities which will be a big improvement. The communal areas are pleasant and comfortable, all the chairs have recently been replaced in the lounges. The home is clean and well maintained. In the surveys people said the home is always fresh and clean. In the information provided before the inspection the manager said The home is accessible, safe and well maintained. It is homely and has a programme of areas being continually maintained and decorated. The grounds are well kept, service users enjoy sitting out or having a stroll. The bulding comlies with all the local fire regulations. We have an housekeeper who ensures she works alongside the handyman and if anything requires attending to it is adressed. Care Homes for Older People Page 19 of 27 Evidence: While we were there a problem arose with one of the showers. This was reported and promptly dealt with. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are enough staff on duty to meet peoples needs. Staff are well trained and competent to do their job. Staff are properly checked before they start working in the home to make sure they are suitable and safe to work with older people. Evidence: Staff told us that that there are always enough staff on duty and if someone phones in sick the manager or nurse make sure that there is cover for that person. The manager said staffing reflects the dependency levels of our service users, and the size and layout of our home. Staffing is reviewed continually and will be increased if the dependency requires this. Recruitment procedures at the home are good. Staff files confirmed that the necessary checks are being completed to ensure the suitability of new staff. This means that staff are safe to work with older people. All staff have access to training to help them to keep their care practice up to date. 77.27 of care staff have NVQ 2 or above, with 3 other care staff currently undertaking it. When staff first start work at the home they commence with a full induction Care Homes for Older People Page 21 of 27 Evidence: programme, and are supervised throughout. The manager said once employed we encourage personal development and support all staff. We saw records of supervision planned in advance, this is provided for care staff by four of the qualified nurses. The catering staff have all relevant qualifications and the domestics, housekeeper and laundry staff also have NVQ qualifications. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and run in the best interests of the people living there. Evidence: The Registered Manager has worked in the home for over 2 years. She is a registered nurse and is currently undertaking her Registered Managers Award. The manager runs the home in a warm, friendly and open manner. In their surveys, the staff said the manager is well liked and does a good job, she works alongside the staff, provides them with support and she is available to talk to. The manager runs the home in a warm, friendly and open manner. People living in the home are consulted about the service and their views affect the way the home is run.The home uses the feedback they get from quality assurance questionnaires and meetings to assist them with this. They make sure people have information about the service , the previous inspection report is available in reception for people to read and can be copied if anyone wants to take it away to read. Care Homes for Older People Page 23 of 27 Evidence: We have been provided with information which tells us that equipment used in the home is serviced regularly to protect the health and safety of the staff and people living there. The manager ensures that all safety checks and relevant maintainence checks are in place. The homes insurance certificate is in reception. Some people deposit small amounts of money at the home for safekeeping. There are records of purchases made on behalf of anyone and receipts are always obtained. The manager and the homes administrator deal with personal finances. The manager ensures that the finances are safeguarded and strict procedures and policies are in place. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 Daily reports should clearly reflect how peoples needs have been met and how they have spent their day. Care Homes for Older People Page 26 of 27 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - 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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