Inspection on 18/04/05 for Longworth House

This inspection was carried out on 18th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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.

Other inspections for this house

Longworth House 30/11/06

Longworth House 31/10/05

Longworth House 05/10/04

Longworth House 20/04/04

Longworth House 27/05/03

Similar services:

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

The Shelley

Springfield House

Sutton Lodge Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Longworth House 28 Eversfield Road Eastbourne BN21 2DS Lead Inspector Debbie Calveley Unannounced 18 April 2005 09:45 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. Longworth House Version 1.10 Page 3 SERVICE INFORMATION Name of service Longworth House Address 28 Eversfield Road, Eastbourne, East Sussex BN21 2DS 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) 01323 729700 Mr Aleem Siddiqi Mrs Marie Madigasekera Care Home with Nursing 20 Category(ies) of Old age, not falling within any other category registration, with number (OP) of places Longworth House Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum number of service users to be accommodated is twenty (20). 2. That service users must be aged sixty-five (65) years and over on admission. Date of last inspection 30 December 2004 Brief Description of the Service: Longworth house is a converted former family home situated in a residential area close to Eastbourne town centre. It has been adapted to accommodate twenty older people needing nursing care.The resident accommodation is situated on three floors and consists of twelve single rooms and four double rooms. Three of the top floor bedrooms are below the minimum size requirement. A lift provides level access to all areas of the home; there is a large lounge for the residents with a dining area at one end. A conservatory has been built, which has increased the communal day space. There is no onsite car parking, but there is unrestricted car parking outside the home, the train station is approximately ¼ of a mile away and local buses stop nearby. Longworth House Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on the 18 April 2005 at 0945 hours. There were eighteen residents in the home on this day, The methodology of the inspection included a tour of the building, inspection of documentation and records, the delivery of care for six residents and informal interviews with six residents, three relatives and three members of staff. What the service does well: What has improved since the last inspection? The décor and environment of the home is improving at every inspection. A full time maintenance person has also improved the working environment for the staff. Longworth House Version 1.10 Page 6 An activity programme is now in place and a part time co-ordinator has settled in well. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Longworth House Version 1.10 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 Longworth House Version 1.10 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) 3, 4 and 5. Standard 6 is not applicable to this service. The clear and comprehensive pre-admission assessment ensures that the home are able to meet the prospective residents needs. EVIDENCE: The manager undertakes all the pre- admission assessments, they are clear and contain the information as required in standard 3.3. They are signed and dated on the day they are completed which then acts as a baseline for their plan of care. The prospective residents’ are seen either in their home or hospital before admission and the manager confirmed that wherever possible the family or representative is involved. Two relatives confirmed that they were consulted about the pre-admission visit and were given the opportunity to attend. The manager was able to verbally demonstrate her knowledge and awareness of the different specialities required in the home and ensures that the Registered Nurses employed in the home have attended relevant courses to deal with the needs of the elderly and also specialised courses for certain diseases. Longworth House Version 1.10 Page 9 Trial visits to the home can be arranged. The manager confirmed that selffunding residents are invited to a trial period to ensure suitability of the home; this is clearly stated in the Statement of Purpose and in the statement of terms and conditions. This practice is not accepted by the social services when placing clients, but if a resident placed by social services is not settling in to the home it is reviewed and an alternative placement found. This had happened recently when the home felt that they could not meet the residents’ needs in full. One of the six service users spoken to, was able to remember her daughter visiting the home and then telling her all about it. The manager ensures that she personally meets all prospective residents and when asked all six residents knew who the manager was and of her role in the home. Longworth House Version 1.10 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 and 10. The care plans are clear and thorough and cover all the identified needs of individual residents. The care plans have been continuously developed and have been maintained to an exemplary standard. EVIDENCE: Six care plans were tracked from the initial pre-admission assessment to the formation of care plans and to the delivery of care. They clearly identify the individual needs of all residents and they are routinely reviewed on a monthly basis. The involvement of the resident or relative in the formation of the care plan is evidenced by a signature and date. A relative remarked that they were kept involved in all aspects of their mothers care and that they felt that if they had any concerns that the staff would act on them. There is evidence that all residents receiving medication for hypertension, diabetes and pulse irregularities are monitored daily and recorded and available to the G.P if required. On admission all residents have baseline observations recorded and a pressure area assessment score, these are monitored regularly and reviewed. Pressure relieving equipment is available and was seen in place during the inspection; a system is in place to regularly check the settings on the equipment to ensure maximum benefit. Two care staff interviewed were knowledgeable about the Longworth House Version 1.10 Page 11 equipment used in the home and were able to demonstrate the use of lifting equipment. The home have a range of paperwork available to monitor tissue viability, and the prevention of skin breakdown, e.g. nutritional scoring, “waterlow” score, and monthly weights. These were seen to have been correctly completed and reviewed regularly. There are four double rooms and screens are available to ensure privacy whilst personal care is being given. Good practice by the staff was observed during the inspection ensuring that the residents’ dignity and privacy was respected at all times. The six residents spoken to said that they found the staff helpful and courteous and felt that they were treated with respect by the care staff. Three relatives stated that everyone was very friendly and helpful, Longworth House Version 1.10 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13 and 15. The home offer a life style which meets their expectations and preferences. The dietary needs of residents are well catered for and offer a balanced and varied selection of food that has been updated in line with the personal likes and choices of residents. EVIDENCE: Six residents and three relatives were spoken to in depth about the lifestyle experienced in Longworth House. Four residents spend the majority of time in their room and stated that it was their choice to do so. The residents said that they were able to choose how they spend their time, where they take their meals and what they eat. There is an activity programme in place and a part time activity co-ordinator is employed and feedback from residents and their families was complimentary about the music sessions, which are held weekly. There was little evidence of one to one sessions with residents restricted to their room due to poor health. One resident expressed that she would like to be able to try to knit or crochet again, this was relayed to the manager at feedback. Longworth House Version 1.10 Page 13 The routines of daily life are seen to be flexible and residents spoken to confirmed to the inspector that they have the choice of how to spend their day. The manager confirmed that there is open visiting and friends and relatives are welcome to come for lunch or tea, for a small charge. During the inspection four relatives visited and were observed being welcomed in to the home. The chef has recently been employed and was happy to be interviewed. He was knowledgeable about the likes and dislikes of the residents and keeps a daily record of the amount eaten and of the food returned. The menu was inspected and was seen to be well balanced and nutritional. The mid-day meal was seen to be well presented, seven residents received a pureed meal, which was also attractively served. The meal time observed was unhurried and staff were seen to give assistance to residents in a dignified and respectful manner. Two residents said that the food was always tasty, and one said the cooking was nearly as good as hers. Longworth House Version 1.10 Page 14 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. The complaint procedure is clearly detailed in the Statement of Purpose and Residents Handbook. Staff interviewed had a good understanding and knowledge of Adult Protection policies and procedures, which protect the residents from harm and abuse. EVIDENCE: The manager stated that they had not received any complaints since the last inspection. This was confirmed by viewing the complaint book. The CSCI have not received any complaints about the service. A complaint policy and procedure is in place and the staff spoken to were aware of the importance of documentation and of the timescale in investigating a complaint. One resident spoken to was unaware of the complaint procedure, but indicated she felt she could talk to the manager about any problems and that her son has all the information regarding the home. The home has policies and procedures in place for the Protection of Vulnerable Adults and Whistle Blowing. These are regularly updated. A copy of the East Sussex Multi-Agency Guidelines on the Protection of Vulnerable Adults was available in the home. Two members of staff were able to discuss the policy in detail and were aware of the importance of whistle blowing. The staff confirmed that they receive training in Adult protection. The home does not have any involvement in residents’ finances. Longworth House Version 1.10 Page 15 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, 20, 21, 22, 23, 24, 25 and 26. The provider has significantly improved the appearance of the home, creating a comfortable and safe environment for those living there and visiting. The standard of cleanliness has been maintained to a good standard. EVIDENCE: On this inspection there was evidence of new carpets, fresh painting and new double glazed windows. A maintenance man has been employed full time and is following a programme for repairs and decorating. The inspector entered all the rooms and noted that redecoration has been continued, in colour schemes that the residents interviewed said they chose. The residents’ bedrooms were found to be homely and comfortable and many were personalised. The home provides communal space that is both comfortable and homely. During the inspection it was observed that the residents used the communal space to entertain family, to enjoy the company of other residents and to attend the planned activities. There is a dining table to one end of the lounge area whilst the other end is furnished with comfortable chairs. Longworth House Version 1.10 Page 16 Whilst the home has not been formally assessed by an occupational therapist, the nursing staff are aware of equipment available for the needs of their residents and of where and how to procure them. Air mattresses, hoists, raised toilet seats and grip rails were found in use to meet the assessed needs of the residents. The equipment is serviced regularly and was clean on the day of the inspection. The maintenance man records the hot water temperatures weekly; all bath water is tested before use. Records were available. Random outlets were tested and found satisfactory. The home was found to be well lit and was at a comfortable temperature at the time of this inspection. The home was also found clean, hygienic and free from offensive odours. There are policies and procedures in place to encourage good practice and infection control and this was observed during the inspection. The care staff when asked were able to discuss infection control procedures. Supplies of gloves and aprons are freely available and were seen appropriately used. Longworth House Version 1.10 Page 17 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. The staffing levels in place on the day of the unannounced inspection were adequate to meet the assessed needs of the residents. Robust recruitment procedures address the protection of the residents. Staff are provided with training pertinent to the needs of the residents. The arrangements for the induction of staff are good with the staff demonstrating a clear understanding of their designated roles. EVIDENCE: The staffing levels on the day of the announced inspection were found to be adequate for the needs of the residents. The manager regularly assesses the staffing levels and adjusts them in accordance to the staffing levels set by the Health Authority. At present an extra carer is employed to assist the day staff at the busiest times, 0700-0900hours and 2000-2100 hours. The staffing rota was viewed. One relative mentioned that he had noticed that the amount of staff was consistent and that he had noticed that agency staff were not used and he felt reassured that his wife was being cared for by regular staff. The manager confirmed that they have not had the need to use agency staff. All care staff employed in the home have a qualification equivalent to the NVQ level 2. Three staff files were examined and it was proven that rigorous recruitment procedures are in place and these demonstrate that correct employment practice and legislation is adhered to. Longworth House Version 1.10 Page 18 The training file was seen and there was evidence of the continuing training sessions that cover a wide variety of subjects. The manager is very pro-active of accessing external courses for her staff. Longworth House Version 1.10 Page 19 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) 36 and 38 All staff receive formal supervision at least six times a year. The environment and working practices of the staff protect and promote the residents health, safety and welfare needs. Fire safety legislation was not being adhered to in regard to the improper use of door wedges. EVIDENCE: The manager has worked hard to produce a training programme that is suitable for her staff and for the needs of the residents. A copy has been provided for the CSCI. The majority of training is now provided in-house and the manager has the relevant qualifications to teach her workforce. The manager has a teaching qualification and conducts training sessions within the home on a regular basis; she also accesses courses through the local hospital and other venues. The staff training files were seen and displayed a wide variety of training for the staff. Longworth House Version 1.10 Page 20 The home has a comprehensive set of policies and procedures, which govern the running of the home. Staff are supported by the manager on a daily basis and more formally through supervision. Staff spoken to confirmed they received supervision and annual appraisals. They are in a written format and copies are kept in the staff files. The manager confirmed and the staff training records show that all staff are kept updated on the Health and Safety policies, the manual is available to all and clearly defined. Staff again were able to discuss the training they received and said that the manager kept them up to date with changes to policies in connection with their job description. The staff are issued with certificates yearly for Manual Handling, twice yearly for Fire Safety and Food and Hygiene. All relevant legislation and procedures are in place in respect of Health and safety. Longworth House Version 1.10 Page 21 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 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 Standard No 16 17 18 Score 3 x 3 x x x x x 3 x 2 Longworth House Version 1.10 Page 22 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 38 Regulation 23(4a-c) Requirement That advice is sought from the fire service regarding the use of door wedges. Timescale for action 18/04/05 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. Refer to Standard 12 Good Practice Recommendations That one to one activities are explored for those residents confined to their room. Longworth House Version 1.10 Page 23 Commission for Social Care Inspection exIvy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Longworth House Version 1.10 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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!