Inspection on 22/08/06 for Longworth House

This inspection was carried out on 22nd August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Longworth House 30/10/07

Longworth House 21/03/06

Longworth House 17/06/05

Longworth House 03/12/04

Longworth House 16/06/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Longworth House Higher Ramsgreave Road Ramsgreave Blackburn Lancashire BB1 9DJ Lead Inspector Mrs Janet Proctor Key Unannounced Inspection 22nd August 2006 09:30 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 Longworth House DS0000009451.V303349.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Longworth House DS0000009451.V303349.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Longworth House Address Higher Ramsgreave Road Ramsgreave Blackburn Lancashire BB1 9DJ 01254 812283 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) Mrs Julie Elizabeth Hayes Mr Steven Michael Hayes Care Home 28 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (28) of places Longworth House DS0000009451.V303349.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service should employ a suitably qualified manager who is registered with the Commission for Social Care Inspection. The home is registered for a maximum of 28 service users to include: Up to 25 service users in the category of OP (over 65 years of age, not falling within any other category) 3 named service users within the category of DE(E) (Dementia over 65 years of age). Date of last inspection 21st March 2006 Brief Description of the Service: Longworth House is registered to provide personal care to 28 people from the age of 65 years plus. Three of these service user are also suffering from dementia. The registered persons are Mrs Julie Elizabeth Hayes and Mr Steven Michael Hayes. Mr Hayes undertakes the day-to-day management of the home. Longworth House is situated in a rural location, between Ramsgreave and Mellor, with general amenities being available in Brownhills, which is 5 minutes away by car or bus. More extensive facilities can be located in the local town of Blackburn, which is approximately 3 miles from the home. The property is detached, and stands in its own extensive, established and well-maintained grounds, with a panoramic view of the Ribble Valley from the back garden. Longworth House has increased the number of persons it can accommodate from 22 to 28. There have been 8 new bedrooms provided, all en-suite. An additional small lounge has also been created to supplement the communal space already provided in the existing two lounges and two dinning areas. Service users may use any of these facilities as required, and can use their own private bedroom as they wish. Prospective residents receive a brochure that has all the details necessary for them to make a decision about whether the home would be suitable for them. The fees charged at the time of the inspection ranged from: £315-00 per week to £360-57 per week. Longworth House DS0000009451.V303349.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Key inspection was unannounced and took place over 1 day on the 22nd August 2006. The previous inspection was done on 21st March 2006 and information on the findings of this can be obtained from the home or from www. CSCI.org.uk . No additional visits have been made since the previous inspection. On the day of the inspection there were 25 residents at the home. Information was obtained from staff records, care records, and policies and procedures. A tour of the building was also done. Information was also got from talking to residents, a visitor, the Deputy Manager, the Manager and staff members. Wherever possible the views of residents were obtained about their life at the home and their comments are included in the report. What the service does well: The manager and deputy manager ensured that residents were assessed before they came to live at the home. This meant that the staff at the home knew what care they needed and could ensure that everything was in place before they arrived. The resident received a letter telling them their needs could be met. This letter was ‘warm’ and ‘friendly’ in its tone and made a pleasant start to the relationship between the prospective resident and the staff at the home. There were good relationships between residents and staff and a friendly atmosphere at the home. Staff were seen to treat residents in a kind, considerate and patient manner. Residents spoken to were very complimentary about the staff. They said, “They’re very good with me, very gentle”, “They don’t rush me” and “I’m really happy here.” All of the residents spoken to praised the food at the home. They said, “The food’s very good” and “we get very nice meals”. They could request items that were not on the menu. They could also have their meals in their bedroom if they wished. Every resident was happy with the accommodation provided. They said “My room’s large and there’s a decent view – but the view from the garden’s magnificent” and “I’ve not got one of the biggest rooms but it has everything I want and need in it. It’s not too far from the lounge and dining room and there’s a toilet round the corner.” Longworth House DS0000009451.V303349.R01.S.doc Version 5.2 Page 6 The number of carers with the National Vocational Qualification in care was above 50 . This meant that a large number of staff had knowledge they needed to be able to do their work. What has improved since the last inspection? What they could do better: All residents who are admitted must have the full assessment process before coming to stay at Longworth House. If they have had a previous admission then the previous information must be reviewed to see whether the needs are still current. This is so that staff have accurate information to enable them to meet the resident’s care needs. The care plan should be written with the input of the resident if possible and then kept under review. This is so that residents have some say in what care they receive and the information in the plan is current and accurate. Some improvements are still needed to ensure that the management of medications fully protects residents. The procedures should be reviewed so that they give staff accurate information on what to do. The dosage on the medication administration recording charts must not be amended, or must be signed and witnessed. This is so that there is no confusion about what dosage the resident must receive. The range of activities on offer should be looked at to make sure that this is what residents want to do to occupy their time. This is in order that the social and recreational needs of residents can be met. Records should be kept of the activities that are done with residents. Records must be kept of fridge and freezer temperatures. This is to ensure that the food is stored at the correct temperature. Longworth House DS0000009451.V303349.R01.S.doc Version 5.2 Page 7 In order to ensure continued protection of residents all staff must receive regular training in the protection of vulnerable adults and be aware of whom to contact should such an incident occur. All new staff must have thorough induction Induction training. Training for all staff must cover health and safety, moving and handling and basic food hygiene. This is in order to ensure that all staff are competent to do their work and to protect residents and staff. The bedroom doors must be checked to ensure that they close properly into the frames. There is the danger of smoke entering the room in the case of a fire if the door does not close properly. Risk assessment must be done for health and safety so that the residents and staff are protected from unnecessary harm. The recruitment procedures for all new staff must be thorough. All necessary documents, for example references and Criminal Record Bureau clearances, must be recent. This is so that residents are safeguarded. There must be quality assurance systems so that the home can monitor its own performance. This is so that the Manager can identify areas that need attention and create an action plan to resolve these. The views of residents, relatives and staff must be sought through meetings or surveys. This is so that they can have some say into how the home is run. The care staff must also receive regular supervision. This is in order that their performance is monitored and they can raise queries about aspects of their work. 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. Longworth House DS0000009451.V303349.R01.S.doc Version 5.2 Page 8 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 Longworth House DS0000009451.V303349.R01.S.doc Version 5.2 Page 9 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): 1, 2, 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents received sufficient information about the home and a contract. They could be confident that the home could meet their needs as these were assessed before moving into the home and they received a letter confirming whether the home could meet these needs. EVIDENCE: Prospective residents received a brochure that gave them all the details about the home. This included the Statement of Purpose and the Service User’s Guide. This brochure would be handed to interested parties or posted out. A visitor spoken to confirmed that she had received a copy and a copy had also been sent to her brother who lived some distance away. Copies of a contract stating the home’s terms and conditions of residency were seen in the care plans examined. This meant that residents were aware of what they would receive and prevented any misunderstandings about this. Longworth House DS0000009451.V303349.R01.S.doc Version 5.2 Page 10 From the residents files viewed it was evident that a pre-admission assessment had been completed by the Deputy Manager before they moved into the home. She then made a decision about whether there was sufficient staff, equipment and other resources at the home to meet the needs of the prospective resident. Once this decision was made she wrote a letter to the prospective resident confirming that their needs could be met. This process of assessment and confirmation of meeting needs had not been followed for one resident who was on respite care. The staff were working from documents relating to a previous admission without evidence that these had been reviewed to state that the needs were still current. Intermediate care was not given at Longworth House. Longworth House DS0000009451.V303349.R01.S.doc Version 5.2 Page 11 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, 8, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The care plans gave good directions to staff on how to meet the personal, health and social care needs of residents. The lack of regular reviews meant that the information may not be fully accurate. The medication practices did not fully protect the health of residents. Residents were treated with respect and care was given in private. EVIDENCE: The care plan documentation had all of the personal, health and social care needs identified and directions were given to staff on how to meet these. The style of writing included the strengths of the residents as well as their needs and the plans were individual to each resident. This meant that the diverse needs of each resident was identified. There was a record sheet to show that the resident or their relative had been consulted about the plan of care. Not all of these were being completed and there was no rationale to show why not. The plans had not been reviewed monthly. One seen had not been reviewed from February 2006 until August 2006. One of the daily reports was written in Longworth House DS0000009451.V303349.R01.S.doc Version 5.2 Page 12 a judgemental way and did not show reassurance and support as directed in the plan of care. The care plans included details about the personal and oral hygiene needs of the resident. Health assessments were done for: moving and handling; risk of falls; and nutrition. Risk assessments for the risk of pressure sores were not being done by the staff at the home due to their lack of confidence in using the form. This meant that a referral would only be made for District Nurse input once a problem with the skin had occurred. A relative was heard to tell a member of staff that a resident’s bottom was “red raw” and the staff member promised to inform the District Nurse. This may have been prevented if a pressure sore risk assessment tool had been used, as the resident may have been identified as being at risk and action to prevent skin deterioration put in place. Continence needs and any aids to be used were noted. Arrangements were made for residents to be seen by GPs, District Nurses, Chirpodists and other specialists. There were some aspects of good practice in respect of medications. Each plan of care examined had a declaration signed from the resident about whether they wished the home to take control of their medications. There was also a list of the residents’ current medication, when it was to be taken and what side effects there were. Patient information leaflets were now available so staff and residents could look up information. There was a signature list of staff who give medication and a photograph of the resident for identification purposes. The policies and procedures for staff to follow about the control of medications had not been revised. This meant they were not specific to Longworth House. The medications and Controlled Drugs were stored securely. The records of Controlled Drugs were checked against the medications and found to be correct. The book in which they were recorded had numbered pages. There were no means of measuring or recording temperature of the storage cupboard. Records were kept of medications ordered, received, administered and returned to the Community Pharmacy. There were no criteria for when as required medications would be given. The records of medications for one resident were unclear as to what dosage she should receive. The amendments made had not been signed and witnessed by members of staff. The amendments could not be tracked as documents were missing that covered the period the amendment had been made. The Deputy Manager telephoned the GP’s surgery and confirmed the dosage at the time of the inspection. Residents were treated with respect. All care was observed to be given in private. There was screening in the double rooms. Residents could use the Longworth House DS0000009451.V303349.R01.S.doc Version 5.2 Page 13 cordless phone for private telephone calls. Their preferred term of address was noted in the care plan. Longworth House DS0000009451.V303349.R01.S.doc Version 5.2 Page 14 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, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The routines of daily life met the preferences of residents. The range of activities on offer needs to be extended to ensure that they satisfy residents’ social and recreational needs. Residents were satisfied with the meals at the home. EVIDENCE: The daily routines were flexible. Residents could choose when they got up and went to bed. They could use their rooms as and when they wished. They could have their meals in their rooms if they wished to. A resident said, “My leg aches today so I’ve spent the morning in bed. They’ll bring my dinner up here for me”. Staff said that they always asked residents what they wanted to do and paid attention to their wishes. The social interests of residents were noted in their plan of care. There was no formal programme of activities. Staff members spoken said that they chose the activity to do on the day after asking residents what they would like to do. There was a book to record when activities had been done and who had attended. These records were not detailed and it could not be seen what activity had been done by a specific resident. Residents spoken to did not Longworth House DS0000009451.V303349.R01.S.doc Version 5.2 Page 15 seem to have any particular complaints about the lack of activities. They said, “I’ve been out for a walk around the grounds. I try to do that every day for exercise” and “I play dominoes sometimes but really like to just sit and watch goes on. I’ve spent a lot of time sitting out in the garden when the weather was nice. I really enjoyed that.” Arrangements had been made for a half day of craft activities each week from September. Visitors were welcome and residents could see these in their room if they wished. There was a three-week rota of menus. The day’s menu was displayed on a board in the hallway so that residents knew what was for the meals. Alternatives to the menu were available. Records were kept of any food choice other than what was on the menu. Drinks were served at meal times and inbetween. The kitchen had recently been renewed with stainless steel fittings and a new floor. It was stocked with sufficient supplies of food and there were fresh vegetables available for residents. The records of the fridge and freezer temperatures were unclear as they were not dated and showed a consistent temperature each day. Longworth House DS0000009451.V303349.R01.S.doc Version 5.2 Page 16 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents were confident that their concerns would be taken seriously and acted upon. The written procedures and lack of training in Protection of Vulnerable Adults meant that residents were not fully safeguarded. EVIDENCE: There was a complaints procedure displayed in each bedroom and on the notice board. This gave clear directions on who to make a complaint to and that a response would be made within 28 days. The procedure also had the address and telephone number of the Commission. A record of complaints made was kept at Longworth House. One had been recorded since the previous inspection. No complaints had been made direct to CSCI in this period. Residents spoken to said that they’d no complaints about the way they were looked after. The procedures for reporting abuse should be made more specific. This is in order that staff are aware that they must in all cases of allegations, suspicions or incidents, inform the Social Services and the Commission for Social Care Inspection before taking any in-house investigation. No training in Protection of Vulnerable Adults had been given to staff since the previous inspection. Longworth House DS0000009451.V303349.R01.S.doc Version 5.2 Page 17 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, 23 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents were very happy with their accommodation at the home and lived in a safe, clean, and well-maintained environment. EVIDENCE: The home was very clean, well decorated and well maintained. The furnishings were very homely. Residents could bring in items of own furniture if they wished to and evidence of this was seen in some rooms. Residents could call for staff assistance from each bedroom, bathroom and toilet. Since the previous inspection a new en-suite toilet had been created to a double room and the kitchen had been refurbished. Only two bedrooms were double rooms. There was screening in these so that care could be given in private. A protocol to demonstrate the discussions and actions when a place became available in a shared room had not yet been Longworth House DS0000009451.V303349.R01.S.doc Version 5.2 Page 18 completed. This meant that there was no formal understanding as to what would happen in this situation. Two bedrooms had water damage from a tap being left on. These were in the process of being redecorated and refurnished. The problem with cleaning and odour control in one bedroom and the possibility of alternative flooring was discussed. The door to one bedroom was not closing properly into the frame. This meant that the fire safety was reduced. There was a separate designated laundry room with washable floor and walls. This had a washer with a sluice programme. The dryer was emptied of lint daily, which reduced the risk of fire. There was a sink, liquid soap and gloves available for dealing with soiled items. Care staff did the laundry duties. Residents spoken to were satisfied with the way in which their clothes were laundered. Longworth House DS0000009451.V303349.R01.S.doc Version 5.2 Page 19 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, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There were sufficient numbers of staff on duty to meet the needs of the residents. The recruitment practices were not always thorough enough to ensure that residents were safeguarded. The amount of staff training was not sufficient, which may place residents at risk of harm or result in their needs not being met. EVIDENCE: There was a duty rota for the home that showed the name of the staff and the hours they worked. There was one senior and 2 carers on duty during the day and at night-time there were 2 carers and a senior person on sleep-in. The Deputy manager had some hours each week to enable her to concentrate on administrative duties. Liquid paper was still being used on the duty rota. As the duty rota is a legal record any additions or amendments should be clearly identifiable. There was a Cook on duty each day. A domestic was on duty during the week-days and an additional six hours had been provided. The files for three new staff members were examined. Two showed that a through recruitment procedure had been followed. However, in one file all of the employment documentation was dated July 2005. This was when the person first applied for employment but did not take this up. When she reapplied in 2006 all her previous documentation was used. This meant that there was no evidence of what this person had being doing in the meantime. Longworth House DS0000009451.V303349.R01.S.doc Version 5.2 Page 20 The recruitment procedures needed to be up dated to reflect the current practice. A short Induction was done at the beginning of employment. This covered fire safety and other important issues. Some staff had been on a Learn Direct Induction Course. The home had a copy of the Skills for Care 12 week Common Induction Standards but was not yet using this. Staff were not receiving initial training and annual updates in a variety of subjects that they needed to be able to do their work. 55 of the care staff had NVQ level 2 or above. Longworth House DS0000009451.V303349.R01.S.doc Version 5.2 Page 21 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, 33, 35, 36 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents’ finances were well managed. There were no quality assurances systems to show that the home was well run and whether this was being done in the best interests of residents. All staff had not yet received training in mandatory subjects. This meant that the health, safety and welfare of residents and staff might not be fully promoted and protected. EVIDENCE: The day- to-day management of the home was done by one of the registered persons. The Deputy Manager was doing the NVQ level 4 in care with a view to becoming the registered manager for the home in the future. The home had the Investors in People award. There were no formal auditing systems in place. The lack of formal audits meant that there were no records Longworth House DS0000009451.V303349.R01.S.doc Version 5.2 Page 22 to show effective self-management. There were no ways of identifying their own shortfalls and of plans to remedy these. Recent survey forms had not been issued to residents and the previous information obtained had not been analysed and made available. A compliments book had been started. This contained some very nice comments about the staff and the home itself. Regular residents meetings were not held. There was day-to-day contact by the manager and the Deputy and anyone could approach them at any time they were in the home. The last staff meeting was in November 2005 and staff said that they felt that they would benefit from regular meetings. Residents were able to control their own money if willing and able. There were safe keeping facilities and money was kept for a number of residents. There was a record to show the transactions and the balance. Three of these were chosen at random and were checked against the cash held and found to be correct. If any valuables or money was given in for safekeeping a receipt was given. Staff spoken to said that they had not had supervision for some months. The manager had a place on a course about risk assessments. Following this he would complete the health and safety and work based fire risk assessments. All appliances and equipment was serviced as required. Additional staff had done the first aid course so that there was always one person on duty with this qualification. From the training records seen it was evident that not all staff had received an annual update in: manual handling; Protection of Vulnerable Adults; and basic food hygiene. Longworth House DS0000009451.V303349.R01.S.doc Version 5.2 Page 23 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 3 3 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 X X X 2 X X 3 STAFFING Standard No Score 27 2 28 4 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 1 X 3 2 X 2 Longworth House DS0000009451.V303349.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action 1 OP3 14 The full assessment process 31/08/06 must be done for every admission to the home. If the resident has been admitted previously there must be evidence to show that the previous assessed needs are still current. 2 OP7 15(2)(b) The plan of care must be kept 30/09/06 under review. (Previous timescale of 17/10/05 not met.) 3 OP8 15(1) The health care needs of all 30/09/06 residents must be assessed and identified in the plan of care. This should include the risk of developing pressure sores. Where risks are identified there must be directions in the plan of care on how to reduce or manage these. (Previous timescale of 17/10/05 not met.) 4 OP9 13(2) Staff must ensure that the 31/08/06 directions for the dosage of medications are clear and unambiguous. A new recording chart must be requested or a second member of staff witness all amendments on the Medication Administration Record chart. 5 OP15 16(2)(j) Appropriate records relating to 31/08/06 the storage of food items must be kept. Longworth House DS0000009451.V303349.R01.S.doc Version 5.2 Page 25 6 OP18 13(6) 7 OP19 23(4)(c) (i) 19 8 OP29 9 OP30 18(1)(c) (i) 10 OP33 24 11 OP33 24 12 13 OP36 OP38 18(2) 12(1) 13(4) 14 OP38 18(1)(c) All staff must receive training in Protection of Vulnerable Adults. (Previous time scale of 17/08/05 not met.) Bedroom doors must close properly into their frames to ensure that fire safety is not compromised. All staff must have on file evidence of their full employment history and reasons for leaving, a current CRB and recent references from their last employer before starting work at the home. All new staff must have a through Induction programme that meets the standards set down by Skills for Care in the 12 week common induction programme. There must be quality assurances systems that enable self-auditing of the home and the services it provides. That a document that includes the findings of the most recent service users survey is produced. This information must be made available to current and prospective service users, their representatives and the Commission for Social Care Inspection. (Timescale of 28/02/05 not met) Care staff must receive regular supervision. The registered persons must carry out risk assessments for all safe working practice topics, with findings being recorded. (Time scale of 31/12/04 not met) All staff must receive training in: manual handling; Protection of Vulnerable Adults; and Basic Food Hygiene. 31/12/06 31/08/06 31/08/06 30/09/06 31/12/06 31/12/06 30/11/06 31/12/06 31/12/06 Longworth House DS0000009451.V303349.R01.S.doc Version 5.2 Page 26 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 OP7 Good Practice Recommendations Wherever practicable the resident or their representative should be consulted about the details in their plan of care. If this cannot be done there should be a record made of why not. The daily reports should be written in a non judgemental manner. The medication policies and procedures should be reviewed in line with Royal Pharmaceutical Society of Great Britain guidelines to cover all aspects of medicines management. The criteria for the administration of when required and variable dose medication should be clearly defined and recorded for all service users prescribed such items. Medicines should be stored at the appropriate temperature. A record of temperature should be maintained for all areas where medicines are kept (fridge should be monitored daily) The range of activities on offer to residents should be extended. A record should be kept of the activities actually provided and the residents involved in these. The procedure for Protection of Vulnerable Adults should be made more explicit for staff. A protocol to demonstrate the actions and consultation undertaken when a place in a shared room becomes available should be developed. Liquid paper should not used on official documents and records. The policies and procedures for recruitment should be amended to describe current practice. The person undertaking day-to-day management of the home should obtain NVQ level 4 in care and management. 2 3 OP7 OP9 4 5 6 7 8 9 OP12 OP18 OP23 OP27 OP29 OP31 Longworth House DS0000009451.V303349.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB 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 DS0000009451.V303349.R01.S.doc Version 5.2 Page 28 - 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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