Care Home: 34-36 Langstone Road

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Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 34-36 Langstone Road 34-36 Langstone Road Russells Hall Estate Dudley West Midlands DY1 2NJ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Christine Lancashire     Date: 2 6 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: 34-36 Langstone Road 34-36 Langstone Road Russells Hall Estate Dudley West Midlands DY1 2NJ 01384234510 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : langstoneroad@mailauth.co.uk Langstone Society care home 8 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 8 The maximum number of service users who can be accommodated is: 8 The registered person may provide the following category of service only: Care Home Only (Code PC); To service users of the following gender: Either; Whose primary care needs on admission to the home are within the following categories: Learning disability (LD) 8 Date of last inspection Brief description of the care home Langstone Road is a residential care home registered for eight people with a learning disability. Originally two semi-detached properties, it maintains a similar appearance to other residential properties in the area and is situated close to local shops and public transport links. The Registered Provider is Langstone Society which is a Registered Charity who rent the premises from the Churches Housing Association of Dudley District Limited (CHADD). Facilities include 7 bedrooms, kitchen, dining room, 2 sitting rooms, and sufficient numbers of bathrooms and toilets. Car parking is available at the front of the property with gardens at the rear. Care Homes for Adults (18-65 years) Page 4 of 27 Brief description of the care home A statement of purpose and service user guide are available to inform residents of their entitlements. The fees are available on application to the home. Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: We carried out this inspection in order to check that the home had met the requirements of the last report. We also measured the performance of the home against the key National Minimum Standards. We arrived at this home on a weekday morning without telling anyone that we would be visiting that day. We toured the building and some of the people living there invited us to see their rooms. We talked to people who live in the home, to staff and the manager. We ate a meal with staff and people at the home. We looked at information provided to us by the manager before the inspection and we examined a sample of records about the people in the home, the staff, health and safety and quality monitoring. We looked at the records of the administration of medication. We had sent out questionnaires before the inspection. Staff, people who live in the home and Care Homes for Adults (18-65 years) Page 6 of 27 relatives completed these and we read their comments. We used our findings to write this report. What the care home does well: What has improved since the last inspection? Since the departure of the previous manager, the home has been managed by the registered manager of another home run by the same organisation. He has made many improvements to the environment and the systems for the benefit of the staff and people who live in the home. Several areas of the home have been decorated and newly furnished. There are new systems for recording peoples needs and how staff need to provide support. Care plans and risk assessments are now more detailed. All people in the home now have communication passports. There are new systems to make sure that staff are properly supervised and supported and have good opportunities for training. People who live in this home are now more involved in making decisions about their lives. People now take part in more activities and make more use of community facilities. There is now a system for making sure that the high standards are maintained and improved. Care Homes for Adults (18-65 years) Page 8 of 27 What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 27 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs and aspirations are fully assessed prior to coming to this home. Evidence: The home has a Statement of Purpose and service user guide which provide useful information about the home for people considering moving in and their relatives. There have been no recent admissions to this home but we looked at a sample of two files, including that of the last person to be admitted. We saw that they contained the necessary assessments before the person was admitted and copies of letters offering a place and saying that the home would be able to meet their needs. The information from the assessments was used to form the basis of the care plans which help staff to know what support to provide to each person. Care Homes for Adults (18-65 years) Page 11 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs and personal goals are reflected in their care plans. They are encouraged to participate in decisions about their lives and are supported to take risks as part of an independent lifestyle. Evidence: We looked at sampled files and found that care plans have been developed using the information gained through the assessments. These are detailed and provide staff with clear information about how to support individuals. The plans contain evidence that people have been involved in forming their own plans and have been consulted when changes have been made. Plans are reviewed on a monthly basis. Each person has a quality assurance folder which contains details of their preferences, how they like to be supported and what they have done. There are pictures in these records. Everyone living at the home also has a communication passport. Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: People told us that they like living at this home. Relatives told us that the staff provide a good standard of care. One told us X is always well looked after by the staff. Staff provide people with choices about their lives and decisions are recorded in files. People make decisions about the menus and activities. People are asked about their preferences by staff and also have monthly meetings to discuss issues. The manager provided examples of changes which had been made as a result of listening to people in the home. These include obtaining a tree and plaque in memory of someone who lived in the home and died. We saw risk assessments on files and these show how people are supported to take reasonable risks so that their ability to have new experiences is not restricted unnecessarily. There are records of the measures taken in various circumstances, such as when there are trips outside the home, to minimise the risks to each person. Staff demonstrated a commitment to enabling people to participate in a range of activities of their choice. Care Homes for Adults (18-65 years) Page 13 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to take part in appropriate activities and to maintain links in the local community. They have appropriate relationships and their rights are respected. They are supported to have a healthy diet and enjoy their mealtimes. Evidence: We sampled the files and found that people are supported to take part in a variety of activities, such as concerts, meals outside the home and shopping trips. People told us about activities which they had enjoyed. An activity worker visits the home once a month and helps people to undertake different interests such as making cards. One of the people showed us the card which she had made for her mother. Peoples quality assurance folders contain photos of them participating in outings. People attend day centres on various days of the week, which leaves some days free for people to spend quality time with their key workers. Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: People are encouraged to maintain friendships and relationships with family members and other people in the community. They use local facilities such as the hairdresser. The files contain details of people who are important to each person and staff explained how people are supported to have visitors. Staff make sure that each person follows a routine of their own choice. They provide support when this is needed but they also respect peoples privacy and encourage people to develop skills so that they can be as independent as possible. The menus show a variety of meals which meet the needs and preferences of the people in the home. People told us that they enjoy the food. Staff prepare the meals and people are encouraged to assist when possible. People help to set and clear tables. Staff are aware of the principles of healthy eating and the need to encourage some people to change their weight so that they are more healthy. Use has been made of relevant health professionals to provide advice to staff. Staff have rearranged the dining room so that there are small tables instead of one large one. This means that there is a less intimidating atmosphere for people when eating their meals. Care Homes for Adults (18-65 years) Page 15 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive personal support in the way they prefer and require so that their physical and emotional needs are met. They are protected by the homes practices in dealing with medicines. Evidence: We saw records in the daily notes which show that staff provide personal care when needed and prompt people who do not need physical assistance in this area. People are supported to choose their own clothes and style of presentation and their cultural and religious preferences are respected. The files contain details of peoples health needs and how these need to be met. Each person has a health action plan. Staff weigh people on a monthly basis. There are records of involvement with various health professionals and staff accompanied people to appointments on the day of the inspection. Each person in the home has an annual medication and health check. The manager plans to develop more education for people in the home so that they are more aware of the importance of good health care. Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: There are suitable arrangements for the storage of medication and risk assessments to find out whether or not people are capable of administering their own medication. Staff are trained to administer medication and we saw that the records are appropriately completed. There is good information for staff about the medication which people need to take and the doses which are needed. This includes instructions for when people may need to take medicines which do not have set times. The homes pharmacist visits every six weeks. Care Homes for Adults (18-65 years) Page 17 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This home has systems to ensure that the views of the people who live there are listened to and acted upon, giving assurance that people are well protected. Evidence: There is a complaints procedure, which is also in a pictorial version and details of how to complain are included in the Statement of Purpose and service user guide. Comment cards are also given to all people in the home and their relatives. The manager told us that people are also reminded at regular intervals about how to make a complaint. The home is involved with Dudley voices for choices and staff are committed to making sure that people are able to express their views about the care they receive. There is a system for recording complaints but there have been none since the last inspection. There are procedures for protecting people from abuse and whistleblowing. The records show that all staff have been trained in recognising the signs and symptoms of possible abuse. The manager has attended an advanced course and plans to make sure that all staff complete this training. People told us that they feel safe in this home. Care Homes for Adults (18-65 years) Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people at this home live in a homely, clean, safe and comfortable environment which is well maintained and where there are good arrangements for infection control, but the first floor would benefit from decoration. Evidence: There have been many improvements to the environment since the last report was written. The ground floor has been decorated and there is new furniture in both lounges. All areas downstairs are light and homely, with new flooring. The bath, which was mentioned in the last report as in need of repair or replacement, has been replaced and there are now accessible, walk in shower facilities in a pleasant environment. One person showed us their bedroom and this was personalised with items of interest to the person who occupied the room. The upstairs of the house is in a reasonable state but would benefit from decoration so that it is in keeping with the high standards seen on the ground floor. The manager showed us quotes which he has obtained for this work. Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: All areas of the house were clean, with no unpleasant odours on the day of the inspection. All staff undertake cleaning and people told us that they help to keep their rooms tidy. The garden has a lawned area which is raised and difficult to access. There is also a patio and decked area which is more accessible, but not ideal for people who may not be agile. People in this home can presently access areas in the home. However, the manager is aware of the possible difficulties which may arise in the future when people age and is seeking suitable long term solutions. Staff receive training in infection control and there are suitable policies and procedures in this area. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by adequate numbers of appropriately trained and competent staff so that their needs are met. They are protected by the homes recruitment practices. Evidence: The manager told us that staff are recruited through a standard process which includes taking up references and checks through the Criminal Records Bureau and the Protection of Vulnerable Adults list. There were interviews for new staff on the day of the inspection. People applying for jobs are encouraged to meet the people who live in the home and their views are taken into account when appointments are made. New staff receive induction training in basic areas such as first aid and infection control. Staff who has most recently been employed told us that they had received a good and helpful induction to their role. Checklists show what subjects have been covered. The training records for the home show that all staff have NVQ level 2, 2 staff have level 3 and one has level 4. In addition, staff have attended training in additional areas such as autism and the Mental Capacity Act. The records show plans for training in dementia and other relevant areas. Staff told us that they have good access to training and are encouraged to develop their knowledge, skills and confidence. They displayed great enthusiasm for working at this home and a good knowledge of the needs and Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: preferences of the people who live there. The rotas show that there are sufficient numbers of staff on duty at all times. We saw minutes which show that staff are supported by regular supervision and team meetings. Staff told us that they feel very well supported by the manager, who is always available to provide advice. No use has been made of agency staff and this means that the people in the home area supported by people they know and trust. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live in this home benefit from from a well run home where their views underpin self monitoring, review and development. Their health, safety and welfare is promoted and protected. Evidence: This home is being managed by the manager of a well run home in the same company. He is well qualified and experienced to undertake the role. Staff told us about the many improvements which have been put into practice since he started at this home. The inspection revealed many areas of development since the last report was written. Several policies and procedures have been reviewed and updated, including the policy for the management of peoples money. The records are well organised, plans are person centred and staff and people in the home are well supported. There are systems for making sure that the standard of care of monitored and Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: improved. These include visits by a representative of the company and regular checks on records by the manager. We saw records which show that people in the home are consulted about how the home is run. We saw staff asking people what they wanted to do. The manager told us that he plans to develop the quality assurance system further. The manager provided us with details of the checks which have been carried out on equipment in the home, such as fire detection equipment. We checked a sample of these and found that they were up to date. On the day of the inspection, the fire alarm went off due to smoke in the kitchen. Staff and people in the home remained calm and followed the correct drill. We also saw risk assessments for people, tasks and the environment. This means that there are good arrangements to make sure that people using the building are kept safe. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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