Inspection on 19/05/06 for The Longdens

This inspection was carried out on 19th May 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

The Longdens 30/04/08

The Longdens 08/05/07

The Longdens 21/07/06

The Longdens 23/08/05

The Longdens 25/04/05

The Longdens 07/10/04

The Longdens 26/05/04

Similar services:

Hillside

Applegarth

Trevayler Residential Care Home

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

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

CARE HOMES FOR OLDER PEOPLE Longdens, The 7 Leopold Street Derby Derbyshire DE1 2HE Lead Inspector Nancy Bradley J Unannounced Inspection 19th May 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 Longdens, The DS0000001987.V288203.R01.S.doc Version 5.1 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. Longdens, The DS0000001987.V288203.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Longdens, The Address 7 Leopold Street Derby Derbyshire DE1 2HE 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) 01332 346626 Mr James Keltie Mrs Dorothy Jean Keltie Mrs Dorothy Jean Keltie Care Home 16 Category(ies) of Learning disability (0), Mental disorder, registration, with number excluding learning disability or dementia (0) of places Longdens, The DS0000001987.V288203.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Age range of residents 65 years, with the option of admitting 2 persons aged 50 years and over. Where residents under 65 years of age are residing in the home consideration is given to Younger Adults National Minimum Standards. The registration includes the option of one day care place. This is in addition to the maximum number registered. 23rd August 2005 Date of last inspection Brief Description of the Service: The Longdens is a care home for sixteen people aged 65 years and over with mental health and learning disability needs, with the option of admitting two persons aged over 50 years. The home is also approved for one-day care place. The home is a semi-detached house in the centre of Derby; the city centre shops and facilities are close by. The home has ten single and three shared rooms, two rooms have en suite facilities. Stairs and a passenger lift access the first floor. Several steps and a chair lift access two rooms on the first floor. The home has a large enclosed garden. Longdens, The DS0000001987.V288203.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over six hours. The inspectors spoke to the registered persons and members of staff on duty. A number of the residents had difficulties in expressing themselves in words and were unable to contribute directly to the inspection. The inspectors did observe throughout the visit as to how their needs were being met by the staff. The inspectors looked around the home and examined various records relating to the residents and the running of the home. What the service does well: What has improved since the last inspection? What they could do better: 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. Longdens, The DS0000001987.V288203.R01.S.doc Version 5.1 Page 6 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 Longdens, The DS0000001987.V288203.R01.S.doc Version 5.1 Page 7 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): Standard 3 Quality in this outcome area is adequate. This judgement has been made using the available evidence including a site visit. The assessment process requires further strengthening to ensure that all the required information’s is available so that the resident’s individual needs can be fully assessed and met. EVIDENCE: The records of two residents recently admitted to the home were checked. The majority of the residents who are admitted to the home have their needs assessed through care management. The assessments were limited and did not provide information relating to medical history, mental health needs, preferred daily routines and preferences. The risk assessment had been completed however and one risk assessment did not fully detail the resident’s mobility, nutritious requirements and the use of a “cocoon” for sleeping in. The resident had been admitted to the home with the “cocoon” with a three year old risk assessment from the Occupational Therapist. Longdens, The DS0000001987.V288203.R01.S.doc Version 5.1 Page 8 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): Standard 7,8and 9 Quality in this outcome area is poor. This judgement has been made using the available evidence including a site visit. Improvements to residents care plans are required, to enable care staff to meet individual needs. Policy and procedures relating to the receipt, checking and storing of medicines requires reviewing in line with the required standards. EVIDENCE: The care staff had completed an assessment of need and care plans were in place. Although these were brief in content, they were not always signed and little evidence of them being updated and reviewed. The care staff stated that care plans are compiled with residents and their families wherever possible. , However, records did not reflect this practice. Information in care plans did not fully detail one residents health and medication needs. Information relating to visits from health care professionals such as G.P, dentists, chiropody and optician were recorded. The records relating to the ordering, receipt and disposal of medicines were examined. However several discrepancies were highlighted relating to the administering of medication. Records showed that staff had signed out medication and this had not always been given to the residents. Longdens, The DS0000001987.V288203.R01.S.doc Version 5.1 Page 9 An Immediate Requirement was left following these findings. The Registered Manager stated that an audit of all medication prescribed and non-prescribed would be conducted immediately and report their findings to the Commission for Social Care Inspection by 23 May 2006. Following discussions with staff it was highlighted that some staff had not received appropriate training in medication and medicines. The homes policy on medication was examined and this needs to be revised. The policy needs to be inline with the guidelines set out in the Royal Pharmaceutical Society regulations on the Administration and Control of Medicines in Care Homes and Children’s Services. Longdens, The DS0000001987.V288203.R01.S.doc Version 5.1 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 13 and15 Quality in this outcome area is good. This judgement has been made using the available evidence including a site visit. The home gives importance to maintaining contact with family and friends and ensuring residents maintain links with their community. The home should look to providing residents with different options and variety at meal times. EVIDENCE: It was clear from discussions with staff and observations that residents are supported to maintain contact with family and friends. No relatives were present at the time of the inspections, however they can visit at any time. Evidence of this was seen in the visitor’s book. Several residents regularly go out for the day with their families. Although the residents considered the home provided a good variety of home cook meals, there was limited choice at lunchtime and staff commented that teas were repetitive. Resident’s individual preferences were not considered. There was no vegetarian option; salt/ pepper and sauces were not routinely offered. The main lunchtime meal was prepared shortly after the inspectors had arrived and was on the side for up to three hours. The cook needs to follow food hygiene procedures for the storing and serving of meals. It was also noticeable that the staff are not following current guidelines on how and when to liquidise food and its presentation. Longdens, The DS0000001987.V288203.R01.S.doc Version 5.1 Page 11 The weekly menus were seen, and the Registered Manager stated she was considering making changes to these. Any variations to the menus need to be recorded. Longdens, The DS0000001987.V288203.R01.S.doc Version 5.1 Page 12 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): Standards 18 Quality in this outcome area is adequate. This judgement has been made using the available evidence including a site visit. Procedures are in place to protect and safe guard adults from abuse, however several staff are not fully aware of the produces and require training on safeguarding adults. EVIDENCE: The homes policy on safeguarding adults is linked to Derby City’s Safeguarding Adults procedures. The Registered Person stated that Adult Protection is linked to the staff induction programme. However, several staff still have to undertake training on adult protection. The Registered Person stated that some staff have attended the Social Services Departments training course. Longdens, The DS0000001987.V288203.R01.S.doc Version 5.1 Page 13 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): Standards 19 and 26 Quality in this outcome area is adequate. This judgement has been made using the available evidence including a site visit. The home needs to continue with its improvement programme to ensure the residents live in a clean, safe and well-maintained environment. EVIDENCE: Several of the resident’s bedrooms have been re decorated, following the last inspection. Resident’s bedrooms contained personal belongings and reflected their individual preferences and wishes. The following improvements have been carried out: • The outside garden area and patio with new outside chairs on order • Several bedrooms have had new furniture, carpet and curtains • Dinning room floor has been replaced. . A tour of the home highlighted the following issues. • An unpleasant odour in the corridor area at the time of arrival. • The use of a “cocoon” in a resident’s bedroom. • The carpet in one bedroom was stained in areas, although this had been regular cleaned. Longdens, The DS0000001987.V288203.R01.S.doc Version 5.1 Page 14 • Pillows on several beds were flat. • In one bedroom prescribed creams were on the side. In discussion with the Registered Manager one resident had been admitted to the home and the Occupational Therapist assessments stated the use of “cocoon bedding,” which they brought this with them. The inspectors examined this and found it to be a form of restraint. The staff had had no training in its use and no new assessment of need had taken place in the three years the resident had been there. The Registered Manager was asked to look into the matter immediately The registered persons Mr and Mrs Keltie are present most days and carry out the majority of the repairs and maintenance. Mr Keltie stated he carries out repairs promptly when reported to him. The home had effective infection control procedures in place. Although the laundry was left unlocked no harmful solutions were on view. Longdens, The DS0000001987.V288203.R01.S.doc Version 5.1 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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): Standards 29 and 30 Quality in this outcome area is adequate. This judgement has been made using the available evidence including a site visit Current recruitment procedures and practices need to be strengthened to ensure the safety and protection of the residents. EVIDENCE: The recruitment files of four staff were looked at as part of the site visit, two of which were the most recently employed staff at the home. Although the files contained some of the essential information, these did not fully meet Schedule 2 of the National Minimum Standard, Care Homes for Older People 2001. The Registered Person has employed two overseas workers’ and needs to check and obtain any relevant information from the appropriate authorities. This has been highlighted in previous inspection reports. The following information was not evident on staff personal files: • Full employment history • Gaps in employment history were not recorded. • Information about the people’s pervious experience and skills. • Record of interview on which to determine the person’s fitness to be employed at the home. • References request did not seek verification of the reason why the person had ceased to work in a position involving children or vulnerable adults. • A signed health declaration to determine a worker’s physically and mentally fitness. Longdens, The DS0000001987.V288203.R01.S.doc Version 5.1 Page 16 Although some staff had completed induction training, records of induction training were not available. Longdens, The DS0000001987.V288203.R01.S.doc Version 5.1 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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): Standards, 33 35 and 36 Quality in this outcome area is good. This judgement has been made using the available evidence including a site visit. Residents are given an opportunity to express their views on the running of the home. Arrangements are in place to safeguard the residents’ financial interests and handling of their money. The manager supervises staff in their day-to-day care of the residents, however supervision could be further developed. EVIDENCE: A quality assurance policy is provided, which sets out the standards and procedures for reviewing the quality of care and services provided by the home. This is based on a programme of self-review and consultation with residents and their families. Several recently completed questionnaires where shown to the inspectors during the site visit. Comments were generally very positive. Longdens, The DS0000001987.V288203.R01.S.doc Version 5.1 Page 18 The manager acknowledged that quality assurance procedures could be improved and with further management support this may be achieved. Currently there is no deputy manager in place. The home has polices and procedures in place relating to the management and safeguarding of residents finances and monies. The manager stated that resident’s relatives manage their finances and at present the Registered Manager is appointed for 5 residents personal allowances. Resident’s monies were checked against the records held and found to be correct. The home keeps appropriate records on computer and records are audited. All monies are kept secure. The Registered Manager works in the home most days and closely supervises the staff in their care of the residents. Records examined showed that some progress has been made to establish one to one supervision meetings with care staff to ensure consistency of care. Although supervision records covered aspects of practice and care of residents, records did not highlight training and developmental needs. Longdens, The DS0000001987.V288203.R01.S.doc Version 5.1 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 1 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 X 28 X 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 2 X X Longdens, The DS0000001987.V288203.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP3 Regulation 14 Requirement Assessment of residents needs must include information relating to the persons medical history and mental health needs. A moving and handling risk assessment must be completed following a resident’s admission to the home. This must be regularly reviewed A risk assessment must be completed on the use of a cocoon for sleeping. A care plan must be promptly completed following a residents admission to the home. Care plans must include all residents needs, and kept updated following changes in their needs Care plans must be completed with involvement of residents were possible or their representative. . Care Plans must be reviewed regular or when there is a change of circumstances. Residents must receive their required medication as prescribed by their GP. DS0000001987.V288203.R01.S.doc Timescale for action 30/06/06 2. OP3 13 30/06/06 3 4. 5. OP3 OP7 OP7 13 15 15 30/06/06 30/06/06 30/06/06 6. OP7 15 30/06/06 7. 8. OP7 OP9 15 13 30/06/06 23/05/06 Longdens, The Version 5.1 Page 21 9. OP9 13 10. 11 12. 13. 14 OP19 OP9 OP19 OP19 OP29 13 13 23 23 19 Schedule 2 18 15. OP30 A record of all medication administered must be maintained, and this should be checked against the records maintained by the home. . The home must review it’s policy on medication Staff handling medication must receive accredited training on medication. All areas must be kept clean and free from unpleasant odours. All part of the home where residents have access should be of a good standard The manger must obtain all the relevant documentation as required under Schedule 2 National Minimum Standard for Older People 2001 All staff must receive induction training and foundation training in line with National Minimum Standard 23/05/06 23/05/06 23/05/06 31/05/06 30/06/06 30/06/06 31/07/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5 Refer to Standard OP3 OP3 OP3 OP9 OP9 Good Practice Recommendations A copy of the care management assessment should be kept on each resident’s file The resident or their repersenative should sign all care plans. The assessment should include all the areas listed in Standard 3.3 Medicines received in the home should be checked against residents previous medication administration record and a copy of the original prescription Prescribed creams should be kept in a locked cupboard and only used for the person to whom they were prescribed. DS0000001987.V288203.R01.S.doc Version 5.1 Page 22 Longdens, The 6. 7 8 9 10 11 13 14 15 OP15 OP15 OP13 OP29 OP29 OP29 OP29 OP30 OP9 Resident’s individual preferences at mealtime should be taken account of and recorded. Variations in menus should be recorded. No one resident should be subject to any form of physical restraint, unless this is a means of securing his or her welfare. All record of interviews with staff should be kept to ensure consistency and to assess standard. Staff applications forms should be updated to request a full employment history and provide sufficient space to record this information. Staff applications forms should allow sufficient space for the applicant to records any medical history. Any gaps in employment should be accounted for and outcome recorded. Records of staff supervision should cover training and development needs. Prescribed creams should be kept in a locked cupboard and only used for the person to whom they were prescribed. Longdens, The DS0000001987.V288203.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Longdens, The DS0000001987.V288203.R01.S.doc Version 5.1 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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