Inspection on 08/05/07 for The Longdens

This inspection was carried out on 8th May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Longdens 30/04/08

The Longdens 21/07/06

The Longdens 19/05/06

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 Key Unannounced Inspection 8th and 24th May 2007 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.V336256.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. Longdens, The DS0000001987.V336256.R01.S.doc Version 5.2 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.V336256.R01.S.doc Version 5.2 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. 21st July 2006 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.V336256.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key unannounced inspection and took place over seven hours. The inspector spoke with the Registered Manager, care staff and made a tour of the building. Records were examined relating to the two service users and the general operation of the home. Additionally, time was spent in preparation for the visit, looking at the preinspection questionnaire. Currently the home is caring for fifteen service users with one vacancy. No family or relatives were present during this visit. At the time of the inspection none of the service users are able to manage their own financial affairs and the Registered Manager is appointee for six service users’ financial affairs. All service users, who completed the “Have Your Say” questionnaire, stated they were quite settled at the home, good activities were provided, they liked the staff and they usually listened to them. The care staff assisted the service user in completing the form. The homes Statement Of Purpose and Service user Guide are displayed in the main entrance. However the last inspection report from the Commission for Social Care Inspection is not easily accessible, being kept in the main office. A number of the service users were able to contribute directly to the inspection and during the tour of the home spoke with the inspector about life at The Longdons and the activities they are involved in. What the service does well: What has improved since the last inspection? Longdens, The DS0000001987.V336256.R01.S.doc Version 5.2 Page 6 The home has made a number of improvements since the last inspection one being that there is now a younger service user group This has encouraged the management to offer a programme of activities; such as trips out into the community, lunch club, computer classes and a holiday to Blackpool. The home has now employed a deputy to assist with the management and day-to-day running of the home. A new chef has been appointed and new and different meals are being introduced. The majority of the requirements from the last inspection have been addressed and met. 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. The summary of this inspection report can be made available in other formats on request. Longdens, The DS0000001987.V336256.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Longdens, The DS0000001987.V336256.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 3. Standard 6 is not applicable to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements are in place to ensure that potential residents needs are fully assessed and met prior to admission. EVIDENCE: The records of two service users recently admitted to the home were checked. The majority of the service users who are admitted to the home have their needs assessed through the care management system. There was evidence on file to show that care needs assessments are reviewed on a regular basis by the referring agency. As discussed with the Registered Manager any areas of identified risk and specific care needs must be reviewed on a regular basis by the referring agency and risk assessments updated. Completed service user questionnaires and discussions with service users during the visit confirmed they were consulted about the home and were able to visit prior to moving in to the home. Longdens, The DS0000001987.V336256.R01.S.doc Version 5.2 Page 9 Longdens, The DS0000001987.V336256.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 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. There is a care planning and review system in place, however current practice leaves service users vulnerable. The residents privacy and dignity is respected and maintained EVIDENCE: Although the care staff had completed an assessment of need and care plans were in place these were too concise, had not always been signed and little evidence of them being updated and reviewed. The care staff stated that care plans are compiled with service users and their families wherever possible. , However, records did not reflect this practice. Information in care plans did not fully detail service users daily needs and personal care. Individual risk assessments on service users need to be complied and be incorporated into the service users care plans. The health needs of the residents were recorded in care plans. Information relating to visits from health care professionals such as G.P, dentists, podiatrists and opticians were recorded. Longdens, The DS0000001987.V336256.R01.S.doc Version 5.2 Page 11 The home operates and monitors all medication, as none of the service users are able to administer their own medication. The Registered Manager confirmed that only nominated staff who have received training on medication can administer medication. The home’s medication procedures have recently been inspected by the local pharmacy and found to be satisfactory. The arrangements for receipt, storage, administration and disposal of medication were also examined and found to be satisfactory. There was a clear audit trail of all prescribed medication used at the home. The homes medication policy has been updated to incorporated non-prescribed medication and homely remedies. However there was no clear audit trail or records for when this had been administered or medication held. A list of authorised staff signatures needs to be kept with medication records. The Registered Manager addressed this at the time of the visit. The staff were observed routinely knocking on service users bedrooms and bathrooms before entering. The service users spoken with considered that the staff working at the home were good and that their privacy and dignity was respected. Conversations between service users and staff were appropriate and respectful taking account of any communication difficulties the service users may have. Longdens, The DS0000001987.V336256.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 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 home provides activities and stimulation in line with the wishes and preferences of the service users. The meals offer both choices, variety and cater for any special dietary requirements. EVIDENCE: Service users spoken with during the visit were very positive about living at the home. The daily routine is flexible and they were able to make decisions about how they spend their time during the day. The service users are encouraged to remain as independent as possible and are able to go out on trips, be members of local clubs and attend the local college for computer skills. The service users described the range of activities on offer and stated that the staff respected their wishes if they choose not to take part. The care plan of one service user showed that the home was supporting her to practice her chosen religion. The Registered Manager stated that service users had been on holiday last year to Blackpool and another on is planned for this year. The Registered Manager provided photograph evidence to support that service users were involved in a variety of activities. Longdens, The DS0000001987.V336256.R01.S.doc Version 5.2 Page 13 The home does not formally compile a daily programme of activities for service users and as discussed this is may be something the home could consider doing. There are no restrictions on contact with family and friends visiting the home however these need to be recorded in care plans. Family and friends call-in and maintaining links with family is given priority; evidence of this was seen in the visitors’ book. No family or friends were present at the time of the inspections. The residents are all encouraged to personalise their rooms as they wish and bring in their own possessions. The inspector observed lunch, which was a lively occasion as all service users sit together, promoting conversation. The Registered Manager stated that following consultation with service users the dinning room had been reorganised to reflect their wishes. Service users’ individual preferences were considered and condiments are routinely offered. Service users are made aware of menus, and have opportunity to comment on these. Catering staff indicated that they had sufficient knowledge to meet individual service users dietary needs Menu records were seen showing a balanced and varied diet, however not all meals provided by the home are recorded. The chef has introduced an international day were by the service users have an opportunity to try dishes from a round the world. Longdens, The DS0000001987.V336256.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements are in place to safeguard service users’ welfare and ensure that their concerns are listened to and acted upon. EVIDENCE: The home has its complaints procedure on display giving information too both service users and families. The procedure contains the current contact details address of the Commission for Social Care Inspection and informs the complainants that they are able to contact the Commission at any stage of the complaint if they wish to do so. From completed service user questionnaires and from discussions with the staff confirmed that the service users are fully informed about the complaints procedure and would have no hesitation in putting their concerns to the Registered Manager/owner. The Commission has received no complaints about the service since the last inspection. The homes policy on safeguarding adults is linked to Derby City’s Safeguarding Adults procedures. As discussed with the Registered Manager the policy requires updating to reflect the change of emphasis from abuse to safeguarding. The Registered Person stated that Adult Protection is linked to the staff induction programme. However newly appointed staff have yet to undertake training on safeguarding of adults. Longdens, The DS0000001987.V336256.R01.S.doc Version 5.2 Page 15 The Registered Person stated that staff attend the Social Services Department’s training on safeguarding of adults and staff have been registered with them for a place. From discussions with the Registered Manager and from records examined there has been one reported incident since the last inspection. This was investigated by Derby City Social Services Department under the Safeguarding of Adults procedures and found to be satisfactory. Longdens, The DS0000001987.V336256.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The overall standard of the environment was good providing service users with a safe, well maintained and homely place to live. EVIDENCE: There is evidence to support on going investment in the home. Several of the service users’ bedrooms have been re decorated, following the last inspection. Service users’ bedrooms contained personal belongings and reflected their individual preferences and wishes. On the day of the visit the home was clean and there were no unpleasant odours. There were sufficient rooms for a variety of activities to take place and an area were residents could meet family and friends in private. A tour of the home highlighted the areas were work is required; these were identified with the Registered Manager. 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. Longdens, The DS0000001987.V336256.R01.S.doc Version 5.2 Page 17 The home had effective infection control procedures in place. Although the laundry was left unlocked no harmful solutions were on view. Longdens, The DS0000001987.V336256.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27,28,29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has recruitment and selection procedures in place that ensure the safety of services users. This will be further enhanced with the implementation of the new personnel strategy. EVIDENCE: The staff rotas seen confirmed that staffing levels were being met. From completed service user questionnaires, direct observation and discussions with the care staff confirmed there were sufficient staff in the home to meet the needs of the service users. Information received from the pre inspection questionnaire shows that the home has a total of eleven care staff. Currently the home has one registered nurse, four staff holding a NVQ level 2 or above and four working toward a NVQ level 2. The home has recruitment and selection procedures in place to protect service users from potential harm. Several staff recruitment records were examined and these were in line with Schedules 2 and 6 of the National Minimum Standard. As discussed with the Registered Manager when gaps in employment are investigated this should be formally recorded on interview minutes. The Registered Manager and deputy have attended a personnel-training course and are looking to adopt a more unified approach when employing staff. Longdens, The DS0000001987.V336256.R01.S.doc Version 5.2 Page 19 From discussions with the Registered Manager and from examination of records the home is providing good training and development opportunities. Details of staff training together with training planned were provided by way of the pre inspection questionnaire. The home has registered with a local training company who can deliver both induction and on going training needs. All staff have a personal development Plan. Longdens, The DS0000001987.V336256.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31,33,35 36 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was generally well managed, with staff seeking the views of the service users on the running of the home. Arrangements are in place to safeguard service users’ financial interests and the handling of their money. EVIDENCE: The Registered Manager/owner is suitably qualified and has a number of years experience running this home. The Registered Manager /owner works in the home most days, and closely supervise the staff. The Registered Manager has a NVQ level 4 in management Following the last inspection a deputy manager has been appointed giving the staff a clear line of accountability during the Registered Manager absence. Longdens, The DS0000001987.V336256.R01.S.doc Version 5.2 Page 21 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 service users and their families. A resent survey on mealtimes was shown to the inspector during the site visit, which had resulted to changes in the dinning room. The Registered Manager acknowledged that quality assurance procedures could be improved with further consultation being undertaken with stakeholders. The home has policies and procedures in place relating to the management and safeguarding of service users finances and monies. The Registered Manager stated that several families manage service users finances and at present she is the appointee for six service users personal allowances. Service users’ 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. Discussions with care staff during the visit confirmed that they received regular supervision. A sample of service/maintenance records was examined (including gas and electricity services) and there was confirmation that all the equipment and services had been properly maintained. Systems were in place for the monitoring and maintaining the hot water temperatures. Longdens, The DS0000001987.V336256.R01.S.doc Version 5.2 Page 22 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 3 X 3 Longdens, The DS0000001987.V336256.R01.S.doc Version 5.2 Page 23 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 Requirement A detailed care plan must be promptly completed following a service users admission to the home. Care plans must include all service users needs, and kept updated following changes in their assed need. Care plans must be completed with involvement of residents and relatives, where possible. Care plans must be reviewed regular intervals. Detailed risk assessments must be complied on all service users following admission to the home. Risk assessments must be regularly reviewed to reflect changes in service users care. There must be a clear audit trail of all medication administered. The audit trail must include prescribed and none prescribed medication The home must consult with stakeholders as part of its’ review into the quality of care DS0000001987.V336256.R01.S.doc Timescale for action 31/07/07 2. OP7 15 31/07/07 3. OP7 15 31/07/07 4. 5. 6. 7. 8. 9. OP7 OP7 OP7 OP9 OP9 OP33 15 15 15 15 15 24 31/07/07 31/07/07 31/07/07 31/07/07 31/07/07 31/07/07 Longdens, The Version 5.2 Page 24 provided. 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. Refer to Standard OP7 OP12 OP18 OP33 Good Practice Recommendations The service user or their representative should sign the care plan. The home should consider compiling a formal activities programme. The homes policy on adult protection must be updated to reflect the emphasis of safeguarding of adults. The home polices and procedures should be reviewed annually. Longdens, The DS0000001987.V336256.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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.V336256.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!