Inspection on 25/04/05 for The Longdens

This inspection was carried out on 25th April 2005.

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 19/05/06

The Longdens 23/08/05

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 The Longdens 7 Leopold Street Derby DE1 2HE Lead Inspector Jenny Thornton Unannounced 25th April 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Longdens C52 C02 S1987 Longdens V222474 250405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service The longdens Address 7 Leopold Street, Derby, DE1 2HE 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) 01332 346626 01332 298576 Keltie2054@aol.com Mr J & Mrs D Keltie Mrs Dorothy Keltie Care Home 16 Category(ies) of Older People registration, with number of places The Longdens C52 C02 S1987 Longdens V222474 250405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1. Age range of residents 65 years, with the option of admitting 2 persons aged 50 years and over. 2. Where residents under 65 years of age are residing in the home consideration is given to Younger Adults National Minimum Standards. 3. The registration includes the option of one day care place. This is in addition to the maximum number registered. Date of last inspection 07/10/04 Brief Description of the Service: The Longdens is a care home for sixteen poeople aged 65 years and over with mental health and learning disablity 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 centres shops and facilities are close by. The home has ten single and three shared rooms, two rooms have ensuite facilites. The first floor is accessed by stairs and a passenger lift. Two rooms on the first floor are accessed by several steps and a chair lift. Residents have acces to a large enclosed garden. The Longdens C52 C02 S1987 Longdens V222474 250405 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was un-announced and started at 9.15am. It took place over six hours. The Inspector spoke to eight residents, five members of staff, the manager and owner. A number of the residents had difficulties in expressing themselves in words and were unable to contribute directly to the inspection, but they were observed throughout the visit as to how well their needs were being met by staff. The Inspector looked around the home and examined various records. After the visit telephone calls were made to two care managers from Social Services involved with residents at the home. What the service does well: What has improved since the last inspection? What they could do better: Care plans need to be completed following a resident’s admission to the home to show how their needs are being met. The home provides social activities and takes residents out, although residents would benefit from further activities inside and outside the home. The Longdens C52 C02 S1987 Longdens V222474 250405 Stage 4.doc Version 1.20 Page 6 Full privacy screening needs to be fitted in shared rooms; the registered persons had ordered new curtain tracking. To safeguard residents the manager needs to obtain all the required information and documents for staff to work at the home. To ensure all new staff are trained to do their job they need to complete initial induction and foundation training within the first six months. Further staff needs to attend training on protecting residents. All items requiring repair or attention need to be reported to the manager at the time, so as ensure the home is well maintained and safe. 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. The Longdens C52 C02 S1987 Longdens V222474 250405 Stage 4.doc Version 1.20 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 The Longdens C52 C02 S1987 Longdens V222474 250405 Stage 4.doc Version 1.20 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) 2, 3 and 4 Progress has been made to ensure that resident’s needs are appropriately assessed on admission, although some essential information was not recorded. Resident’s interests were met through a contract of residence with the home, which sets out the services provided. EVIDENCE: Three care plans examined showed that resident’s relative or representative had been provided with a copy of the home’s terms and conditions, which sets out the services provided, or a contract if purchasing their care privately. The home’s contract did not state which room a resident occupied, although this information was clearly recorded in the home’s terms and conditions. Care plans checked contained a fairly detailed assessment of resident’s needs, although one care plan provided very little information about the person’s medical history or his mental health needs. Various written risk assessments had been completed, although a risk assessment for moving and handling had not been completed for a resident who was admitted to the home in November. The Longdens C52 C02 S1987 Longdens V222474 250405 Stage 4.doc Version 1.20 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9 and 10 Improvements have been made to ensure that residents care needs are set out in an individual care plan, although not all care plans were complete. Procedures relating to the receipt, checking and storage of medicines require reviewing in line with the required standards. EVIDENCE: Two resident’s care plans checked contained fairly detailed care plans, but had not been updated following changes in their needs. A care plan had not been completed for one resident who was admitted to the home in November, staff were therefore unable to show that the gentleman’s needs had been identified and were being met. The manager agreed to immediately complete a care plan for this resident. Staff completed a monthly general report on resident’s wellbeing. Staff said that care plans had been completed with involvement of residents and relatives where possible, although records did not show this. Information set out in care plans indicated that resident’s health and personal needs were well managed. Information relating to visits from health The Longdens C52 C02 S1987 Longdens V222474 250405 Stage 4.doc Version 1.20 Page 10 professionals such as G.P, dentist, chiropodist and optician were recorded in the daily log sheets, which did not provide clear information at a glance, as to when a resident were last seen. Records relating to ordering, receipt and disposal of medicines were kept in the home to ensure that medicines are appropriately handled. Medicines received in the home were checked against resident’s previous medication administration record, as staff did not receive a copy of the original prescription. The home does not have a separate lockable fridge for the storage of medicines requiring cold storage. Residents were prescribed several eye drops that required to be kept in a fridge; these were stored in the food fridge in the dining area, which was unlocked. The Longdens C52 C02 S1987 Longdens V222474 250405 Stage 4.doc Version 1.20 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 15 Efforts were being made to meet residents social needs and interests although residents’ would benefit from further activities inside and outside the home to fulfil their social needs. The home provides a good variety of home cooked foods, which residents enjoy. EVIDENCE: Daily routines were generally flexible, several residents preferred to get up later and have a late breakfast, which staff respected. The home had made progress in taking residents out on an individual basis and providing some planned activities in the home. Although records of social activities were brief and did not support that individual’s social needs and interests were fully met. Discussions with residents and staff identified the need for further activities inside and outside the home. A member of staff had recently taken on responsibility for arranging activities for residents. Residents were occupied in some activities during the inspection, and staff took three residents out for a drink in the afternoon. Three battery-powered wheelchairs have been purchased, which enables staff to take residents out more. One resident said that they did not want to join in with the activities and staff respected this. The Longdens C52 C02 S1987 Longdens V222474 250405 Stage 4.doc Version 1.20 Page 12 The radio was on in the dining area during the morning; the music being played was not considered age appropriate and in keeping with residents’ preferences. The manager agreed to address this issue with staff. Residents considered that the home provides a good variety of home cooked foods and that their dietary needs and preferences are met. New weekly planned menus had been produced which offered a good variety of foods and a balanced diet. The Longdens C52 C02 S1987 Longdens V222474 250405 Stage 4.doc Version 1.20 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 Procedures are in place to safeguard residents’ interests, however certain staff were not aware of the procedures and had not attended training on prevention of abuse. EVIDENCE: The home has a clear complaints procedure, which was displayed in the home and included in the service users guide, which residents and relatives had received a copy of. Complaints are generally dealt with at an informal stage, which results in the home receiving few formal complaints. The Commission has received no complaints about the service in the last six months. Care managers and residents spoken with, felt able to raise concerns they may have about the care and services and that issues would be acted upon. The home’s policy and procedure to safeguard residents from abuse linked with Derby City’s Adult Protection procedures. One staff questioned said that they were not aware of the home’s procedure. Discussions with the manager and records showed that over half of the staff had attended local Social Services training on prevention of abuse. The manager planned for the remaining staff to attend this. The home’s policy on smoking in the home was not followed. Staff were seen to smoke in the area next to the kitchen and in the conservatory, which residents used. The Longdens C52 C02 S1987 Longdens V222474 250405 Stage 4.doc Version 1.20 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 26 The home is generally well maintained and safe for residents, although certain areas required attention. EVIDENCE: Residents consider that the environment is comfortable and homely. Since the last inspection new bedroom furniture has been provided in several rooms, and the ground floor corridor areas were being redecorated. Unpleasant odours were present in the lounge and corridor areas at the time of the inspection. The manager confirmed that the lounge carpet had recently been cleaned, and that the ground floor corridor carpets were being renewed. Domestic staff worked five days a week in the home; care staff carried out some basic domestic duties at the weekend. Some staff spoken with considered that the domestic hours were not sufficient fro the needs of the home. On initial arrival to the home areas requiring cleaning, but these were later attended to by the domestic on duty. Several bottles of cleaning solutions, which would cause harm to residents, were present in the laundry. The laundry was unlocked. The manager took The Longdens C52 C02 S1987 Longdens V222474 250405 Stage 4.doc Version 1.20 Page 15 immediate action to remove the cleaning products, when the Inspector brought this matter to her attention. Full privacy screening was not provided in shared rooms; the manager had ordered new curtain tracking and planned to replace the curtains. The need for full screening was identified on the last inspection and a requirement was made to provide this. The registered persons work in the home most days and carry out the majority of repairs and maintenance. The home was generally well maintained, although the handles were missing off the chest of drawers and wardrobe door in Room 1, and the headboard was missing off one of the beds in room 2. Mr Keltie said that staff had not reported these issues to him, and he agreed to promptly carry out the repairs. The hot water temperatures to the baths and showers were regularly checked and a safe bathing procedure was displayed in the bathrooms. The ground floor bath was used to bathe residents during the inspection but staff failed to report to the registered person who was present in the home, that the hot water exceeded safe temperatures. Mr. Keltie took immediate action to regulate the hot water within safe temperatures, when the Inspector brought this matter to his attention. The Inspector was assured that the hot water safety value had been restored. Residents were able to access the garden and several residents enjoyed spending time in the garden. The Longdens C52 C02 S1987 Longdens V222474 250405 Stage 4.doc Version 1.20 Page 16 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, 29 and 30 The home is sufficiently staffed to meet residents’ needs. Care staff had attended various training, however, not all new staff had completed induction and foundation training to the required standard, to ensure they are trained to do their job. EVIDENCE: Staff and residents spoken with considered that sufficient staff were provided to meet residents needs. The home continues to have a low turnover of staff and does use agency or relief staff support, which results in residents receiving care from staff they know well. Residents said that they had formed good relationships with staff. The deputy manager had recently left; the manager was looking to replace her role and the duties that she carried out. The files of two members of staff last employed to work in the home showed that the majority of the required information and documents had been obtained to safeguard residents, with exception of the following: Staff files did not contain a copy of the person’s birth certificate, and one person’s file did not contain a full employment history. Discussions with staff and records showed that care staff had attended various training, including external and distant learning courses. All care staff with the exception of one member of staff had either completed, or were undertaking a The Longdens C52 C02 S1987 Longdens V222474 250405 Stage 4.doc Version 1.20 Page 17 national approved qualification (N.V.Q), so as to ensure staff are trained and competent to do their job. Several staff had attended first aid training, and further training was planned. Records were not available to show that two care staff last appointed to work in the home had completed the home’s induction training programme. The manager said that one member of staff had their induction programme with her, and that the other member of staff had not completed this, as she had commenced national approved training (N.V.Q). The manager said that care staff did not complete a foundation-training programme, following completion of the home’s induction training. The manager did not consider this necessary as care staff tended to commence a national approved qualification within six months of them working in the home. . The Longdens C52 C02 S1987 Longdens V222474 250405 Stage 4.doc Version 1.20 Page 18 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 The manager closely supervises staff in their work and had introduced regular supervision meetings with senior care staff, but had yet to establish regular meetings for all care staff. EVIDENCE: The manager works in the home most days and closely supervises staff in their work. Discussions with staff and records showed that the manager had recently carried out one to one supervision meetings with senior care staff to show that they are appropriately supervised. A further three senior members of staff had completed training to carry out staff supervision, which will enable all care staff to receive regular planned supervision. Records of staff supervision did not cover training and development needs. The Longdens C52 C02 S1987 Longdens V222474 250405 Stage 4.doc Version 1.20 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. 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 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 2 x x x x x x x STAFFING Standard No Score 27 3 28 x 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x x x x x 2 x x The Longdens C52 C02 S1987 Longdens V222474 250405 Stage 4.doc Version 1.20 Page 20 Yes 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 3 Regulation 13 Requirement A moving and handling risk assessment must be completed followign a residents admission to the home. This must be regularly reviewed. Assessment of residents needs must include information relating to the person’s medical history and mental health needs. A care plan must be promptly completed following a resident’s admission to the home. Care plans must include all resident’s needs, and kept updated following changes in their needs Care plans must be completed with involvement of residents and relatives, where possible. The home must provide a separate lockable fridge for the storage of medicines requiring cold storage. Social activities provided must meet resident’s needs. Care plans must include residents social needs. All staff must be aware of the home’s procedure on prevention of abuse and have received C52 C02 S1987 Longdens V222474 250405 Stage 4.doc Timescale for action 31 July 2005 2. 3 14 31 July 2005 31 July 2005 31 July 2005 31 July 2005 30 September 2005 31 July 2005 3. 4. 7 7 15 15 5. 6. 7 9 15 13 7. 12 16 8. 18 13 31 July 2005 Page 21 The Longdens Version 1.20 training on this 9. 19 23 All areas must be kept clean and free from unpleasant odours. Privacy screening in shared rooms must provide privacy for personal care. All items requiring repair or attention must be promptly reported to the owner. All cleaning products that may cause harm to residents must be stored securely when not in use. The manager must obtain a copy of a person’s birth certificate and a full employment history for all persons working in the home. The manager must make arrangements for the training of staff in first aid All staff must receive induction and foundation training in line with national training requirements 31 July 2005 31 July 2005 31 July 2005 31 July 2005 31 July 2005 31 July 2005 30 September 2005 10. 11. 12. 24 19 26 12 23 13 13. 29 19 14. 15. 30 30 13 18 16. 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 2 8 9 19 26 Good Practice Recommendations The home’s contract with residents should state which room they occupy To aid communication all visits from health professionals should be recorded on a separate health sheet Medicines received in the home should be checked against resident’s previous medication administration record and a copy of the original prescription. The manager should ensure that all staff follow the home’s smoking policy. The manager should review the domestic hours to ensure C52 C02 S1987 Longdens V222474 250405 Stage 4.doc Version 1.20 Page 22 The Longdens 6. 36 all parts of the home are kept clean All care staff should receive formal supervision at least six times a year. Records of staff supervision should cover training and development needs. The Longdens C52 C02 S1987 Longdens V222474 250405 Stage 4.doc Version 1.20 Page 23 Commission for Social Care Inspection 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 The Longdens C52 C02 S1987 Longdens V222474 250405 Stage 4.doc Version 1.20 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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