Care Home: Langdale View

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What the care home does well People spoken with told us that staff working at Langdale View were always kind and helpful. What has improved since the last inspection? Since the last inspection people living at Langdale View receive the supervision they require to keep them safe, staff are present in the lounge areas at all times to assist people with their needs and to ensure people are safe. Procedures for the management of medicines promote safety for people living at Langdale View. What the care home could do better: Staff must be aware of peoples individual needs and the actions they must take to meet peoples needs as stated in the care plan. Some staff were not fully aware of peoples needs and this puts people at risk. More staff training is required regarding caring for people with dementia and the management of challenging behaviour, this is to ensure that people have their specialist needs met and are protected from harm. More training is also required regarding safeguarding adults, this is to ensure that national policies are followed in the event of suspected abuse in order to protect people from harm. While people did have access to health-care services, staff need to ensure that treatment provided is assessed and reviewed by the appropriate health-care professional. While there were a range of recreational activities on offer, activities for people who have moderate to severe cognitive impairment were limited, staff should ensure that opportunities for recreational activities are meaningful and meet individual needs and preferences. Staff must receive training regarding the Mental Capacity Act and associated deprivation of liberty safeguards, this is to ensure that people do not have their freedom restricted unnecessarily. Key inspection report Care homes for older people Name: Address: Langdale View 590 Gypsy Lane Leicester Leicestershire LE5 0TB     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Debbie Williams     Date: 1 2 0 5 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 21 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 21 Information about the care home Name of care home: Address: Langdale View 590 Gypsy Lane Leicester Leicestershire LE5 0TB 01162762186 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Yasmin Kassam,Neemat Kassam Name of registered manager (if applicable) Type of registration: Number of places registered: care home 34 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 34 The registered person may provide the following categories of service only: Care home with nursing -Code N. To service users of the following gender:either. Whose primary care needs on admission to the home fall within the following categories: Old Age not falling within any other category - Code OP . Dementia Code DE Date of last inspection Brief description of the care home Langdale View is registered to accomodate 34 older people and is also registered to accomodate people with dementia and who need nursing care. The home is a converted older building on the outskirts of Leicester City. Accomodation is on three floors which can be accessed by a passenger lift. There are two lounges and a seperate dining room on the ground floor. Care Homes for Older People Page 4 of 21 Over 65 0 34 34 0 1 0 0 7 2 0 0 9 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: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This key inspection included a visit to the service. We visited the home on 12th of May 2010. The main method of inspection was case tracking which meant selecting three residents and tracking the quality of their care by checking records, discussion with them and with staff and observation of care practices. We also looked at the providers own assessment of the services they provide, which they sent to us, this is called the annual quality assurance assessment or AQAA. We checked all the standards which the Care Quality Commission have decided are key standards during this inspection. In some sections we have also checked additional standards, these will be detailed in the main report. Care Homes for Older People Page 5 of 21 What the care home does well: What has improved since the last inspection? 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 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 Older People Page 6 of 21 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 7 of 21 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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. People are able to make an informed choice before moving into Langdale View and have their needs assessed before moving in. Evidence: Prospective residents are provided with a Statement of Purpose, this sets out the facilities and services provided and enables people to make an informed choice before moving in. We made a recommendation that this document should stipulate the providers equality and diversity position regarding religion, ethnicity, gender, disability and sexual orientation. People have their needs assessed before they move in and this ensures that the service can meet their needs. We looked at assessment records, a full needs assessment is carried out and this includes risk assessment, social and cultural needs and preferences. One person spoken with told us the acting manager had met with them and assessed their needs before they moved in. Care Homes for Older People Page 8 of 21 Evidence: The service is registered to accommodate people who have dementia, not all staff had received training in dementia care but the providers told us that this training had been planned for all staff. Care Homes for Older People Page 9 of 21 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Health and personal care needs were mostly met but staff were not always fully aware of peoples needs. Evidence: We looked at care plans for the people we case tracked, care plans were in place for all assessed needs and where possible people living at the home were given the opportunity to be involved in planning their care. Care plans included peoples individual preferences and were reviewed on at least a monthly basis. We spoke with people about their care plans and to staff about peoples care needs. We found some instances where staff were not fully aware of peoples needs or what was in their care plan and this meant that people did not always have their health and personal care needs met. Risk assessments were in place for risk of malnutrition, falls, risk of developing pressure sores and other identified risks, however where risk was identified, staff did not always follow the action required to minimize risk. One person who was at risk of falling did not have a call bell that was easily accessible to them and was unaware of how to call for staff when alone in their private room and this Care Homes for Older People Page 10 of 21 Evidence: person had been identified as at risk of falling, the providers took action to remedy this on the day of this inspection. Nutritional risk was also identified and the care plan stated that high calorie snacks should be offered but some staff were unaware of this. People spoken with told us they could see their GP whenever this was required. We looked at care records and daily records and evidence was seen that people had good access to health care services but there were a few instances where people required a health care review. We observed interaction between staff and residents and found them to be positive,respectful and kind. People spoken with told us that staff were always kind and helpful. We looked at medication administration records and storage areas and found that safe procedures for the management of medication were being followed. Staff had received the training they required to manage peoples medication and people spoken with told us that staff managed their medication effectively. Care Homes for Older People Page 11 of 21 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Langdale View did not always receive a service that met their lifestyle expectations and preferences but staff were making improvements in this area. Evidence: People spoken with told us they could choose how to spend their day, what time to get up and what time to go to bed and they could choose to spend time in their rooms or in one of the lounges. There were a range of organized activities on offer but activities were not planned to meet the specific individual needs of people who have cognitive impairment. The providers statement of purpose told us that there were no restrictions on visiting and people spoken with confirmed this, their visitors were made to feel welcome and could be seen in private. Staff had not received training in mental capacity or deprivation of liberty safeguards, this is required so that where people lack capacity to make a decision and their freedom is restricted in order to protect them from harm then policies and procedures are in place to ensure freedom is not restricted unnecessarily. Care Homes for Older People Page 12 of 21 Evidence: We observed the lunchtime meal and this appeared appetizing and nutritious. A range of special diets and culturally appropriate diets were also provided. A choice of cereal and toast was on offer for breakfast and a main meal provided at lunchtime. The evening meal choice was somewhat limited to sandwiches soup and salad. Menus were not planned to maximize a balanced healthy diet. However, the acting manager was in the process of planning a menu that would meet the nutritional needs of people living at Langdale View and a new cook had recently been employed, the providers told us that the tea time menu would offer more choice and include a hot option once the new cook began working at the home. Staff told us they had access to the kitchen at all times and could provide snacks and drinks to people living at Langdale View at anytime. People spoken with were satisfied with the quality and quantity of meals provided. Care Homes for Older People Page 13 of 21 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Langdale View were mostly protected from abuse but more staff training in this area was required. Evidence: People spoken with said they would feel comfortable speaking to staff if they had any concerns. The providers have a complaints policy which is included in the statement of purpose which is given to people before they move into the home. Staff had received some training regarding safeguarding adults and protecting them from harm. Staff spoken with were not fully aware of the policies and procedures they should follow in the event of suspected abuse. Procedures in place for the management of peoples personal money minimized the risk of financial abuse. Care Homes for Older People Page 14 of 21 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, 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. 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 living at the home were provided with a clean, comfortable and homely environment. Evidence: People spoken with said the home was always clean and fresh. On the day of this inspection we found all areas of the home to be clean and fresh. There were two lounges on the ground floor and a separate dining room and conservatory. People were able to personalize their rooms with their own things such as photographs, pictures or items of furniture. An Environmental Health Officer visited the home earlier in the year as part of a routine visit and awarded the home with 3 stars. All routine tests and maintenance required by the local Fire Authority were being carried out in order to protect people living in the home. Staff had received infection control training and were aware of the procedures to follow to minimize the risk of cross infection. Care Homes for Older People Page 15 of 21 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were cared for by staff who had received training to meet their needs but more training was required. Recruitment polices and procedures minimized risk for people living at Langdale View. Evidence: People spoken with told us there were enough staff on duty and they were not kept waiting for staff to attend to them. The service provides nursing care so there is at least one trained nurse on duty at all times. Recruitment policies and procedures minimized risk for people living at the home by ensuring that all staff employed undergo relevant checks regarding their suitability. A staff training and development programme was ongoing, all staff receive induction training when they first commence employment. Not all staff had received the training they required to carry out their jobs but the providers told us that this training had been planned. Care Homes for Older People Page 16 of 21 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. 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 service was managed in the best interests of people living there. Evidence: At the time of this inspection the service was being managed by an acting manager who was applying to the Care Quality Commission to become the registered manager. A quality assurance programme was in palce and this included seeking the views of people living at the home and their families. Policies and procedure in place for the management of peoples personal money minimized the risk of financial abuse. Staff had received mandatory health and safety training such as moving and handling, first aid, fire and food hygiene. The providers told us that more health and safety training was planned. Care Homes for Older People Page 17 of 21 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 12 12 People living at langdale 29/01/2010 View must be given opportunities for occupation and engagement in recreational and social activities and be encouraged to exercise choice and autonomy over their lives. This is so that people have their needs and expectations met and live fulfilling lives. 2 18 13 Staff must receive training in 30/01/2010 caring for people with dementia and the safe management of challenging behaviour. This is so that people have their specialist needs met and are kept safe from harm. 3 18 13 Staff must receive training in 29/01/2010 safeguarding vulnerable adults. This is to minimize risk for people living at the home and ensure that appropriate referrals are made where necessary. Care Homes for Older People Page 18 of 21 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 1 7 14 Staff must be fully ware of peoples needs and how to meet them. This is to ensure people have their needs met. 30/06/2010 2 8 12 People must have access to appropriate health-care professionals. This is to ensure people receive the care and treatment they require. 30/06/2010 3 12 12 Appropriate and meaningful recreational and social activities must be offered to people living at Langdale View. This is to ensure that people are stimulated and experience a good quality of life. 05/07/2010 4 14 12 Staff must receive training 30/06/2010 in mental capacity and deprivation of liberty. Where Care Homes for Older People Page 19 of 21 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 liberty is deprived a referral must be made to the deprivation of liberty team. This is to ensure peoples capacity to exercise choice and autonomy is maximized. 5 18 13 Staff must be made aware of the correct policies and procedures to follow in the event of suspected abuse. This is to protect people from harm. 6 30 18 All staff must receive training in caring for people with dementia and the safe management of challenging behaviour. This is to ensure that people have their specialist needs met and are protected from harm. 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 30/06/2010 30/07/2010 1 1 The providers Statement of Purpose should stipulate the providers equality and diversity position regarding religion, ethnicity, gender, disability and sexual orientation. Staff should attend the Local Authorities training in safeguarding adults. 2 18 Care Homes for Older People Page 20 of 21 Helpline: Telephone: 03000 616161 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 21 of 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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