Care Home: Langdon Park 18

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What the care home does well The acting manager, staff and organisation have worked hard to make improvements at the home and to make sure people living there are happy, well cared for and safe. They have worked with other agencies to develop the service and are continuing to improve. The provider has met the two statutory requirement notices regarding the managementof medication and finances. What the care home could do better: The provider needs to continue to make improvements to meet all the requirements made at the key inspection of 22nd June 2010. They need to make sure they can maintain compliance with the National Minimum Standards and Care Home Regulations. Random inspection report Care homes for adults (18-65 years) Name: Address: Langdon Park 18 18 Langdon Park Teddington Middlesex TW11 9PS zero star poor service 22/06/2010 The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Sandy Patrick Date: 1 7 0 8 2 0 1 0 Information about the care home Name of care home: Address: Langdon Park 18 18 Langdon Park Teddington Middlesex TW11 9PS 02089432255 Telephone number: Fax number: Email address: Provider web address: www.mst-online.org.uk Name of registered provider(s): Name of registered manager (if applicable) Metropolitan Support Trust Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 7 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 7 The maximum number of service users who may be accommodated is: 7 The Registered Person may provide the following categories of care 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 - Code LD Date of last inspection 2 2 0 6 2 0 1 0 Care Homes for Adults (18-65 years) Page 2 of 16 Brief description of the care home Langdon Park is a purpose built care home that provides care and accommodation for a maximum of seven adults with learning disabilities. Staffing is available to residents 24 hours a day. The service is managed by Metropolitan Support Trust. The home is situated in a quiet residential area close to local shops and public transport links. Each person has a single room with en-suite bathroom. Care Homes for Adults (18-65 years) Page 3 of 16 What we found: We made an unannounced visit to the home on the 17th August 2010. The reason for this visit was to check compliance with the two statutory requirement notices we issued to the service on the 8th and 9th July 2010 following a key inspection of the home. We met with the acting manager and discussed the work that had taken place to meet these requirements. We looked at records relating to these requirements and we looked at the storage of medication. We had a discussion with the acting manager about the other requirements we made at the key inspection and how these were being addressed but we did not look at any evidence relating to these. Compliance with these requirements will be checked at the next inspection of the home. We found that the home had met the statutory requirement notice relating to management of medication. We saw that new procedures and guidelines were in place and we saw evidence that the staff had read and understood these. We saw that the manager had set up a system for assessing each staff members knowledge and competency when handling medication. We saw that staff had been given additional training in this area. We saw that storage of medication had improved and that medication which had expired or was no longer required had been returned to the pharmacy for disposal. We saw that records relating to administration were accurate and were regularly checked. We saw that there was a system for regularly checking medication storage, records and administration by senior staff. We judged that the service had taken appropriate action to meet this requirement and that they had systems in place to make sure they continued to be compliant. We found that the home had met the statutory requirement notice relating to the management of people who live at the homes finances. We saw that systems were in place to make sure peoples money was managed safely. We saw that new procedures and guidelines were in place and that there was evidence that staff had read and understood these. We saw that regular checks on money held and records of this were made by senior staff. We saw that systems were in place to make sure peoples money was always used appropriately and that they were using their own money to meet their needs and requirements and not the needs and requirements of others or staff. We judged that the service had taken appropriate action to meet this requirement and that they had systems in place to make sure they continued to be compliant. We will look at the continued compliance in these areas and with the other requirements made at the key inspection of 22nd June 2010 when we next visit the home. The provider has given us a detailed improvement plan which shows what they are going to do to make sure all requirements are met and that people who live at the home are well cared for and safe. What the care home does well: The acting manager, staff and organisation have worked hard to make improvements at the home and to make sure people living there are happy, well cared for and safe. They have worked with other agencies to develop the service and are continuing to improve. The provider has met the two statutory requirement notices regarding the management Care Homes for Adults (18-65 years) Page 4 of 16 of medication and finances. 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 2. Care Homes for Adults (18-65 years) Page 5 of 16 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 6 15 The registered person must 23/07/2010 make sure support plans identify all of peoples needs and the support they require to meet these needs. The registered person must make sure the staff record evidence of how they have supported people and that these records are factual and not the opinions of the staff. Because these plans are a guide to tell staff how to care for each person and records need to show that people are having their needs met.. 2 6 15 Improve the standard of 30/10/2009 recording on support plans to demonstrate that service users receive appropriate support to achieve their goals. At the inspection of 22/06/10 there was limitted improvement to the recording in support plans. 3 7 12 Make sure that staff are aware of service users communication needs and are equipped with the skills to meet these needs. 30/10/2009 Care Homes for Adults (18-65 years) Page 6 of 16 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action At the inspection of 22/06/10 there was no evidence that staff have the skills or information to help them understand individual communication needs. Care plans did not describe individual needs or how these could be met. There was no evidence of training for staff in different communication techniques. 4 7 12 The registered person must 23/07/2010 make sure information is accessible to the people who live at the home and that it is accurate. Because people need to have accessible information to make informed choices about their care and every day lives. 5 9 13 The registered person must 23/07/2010 make sure risk assessments are in place and are accurate and personalised. Because the staff need thorough assessments to judge whether people are safe and to help people to make informed choices. 6 12 16 The registered person needs to make sure peoples individual wishes and social interests are assessed, recorded and they are supported to meet these. Because people who live at Care Homes for Adults (18-65 years) Page 7 of 16 23/07/2010 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action the home have different interests and needs and these should be valued. 7 12 16 The registered person needs 23/07/2010 to make sure the majority of social activities are planned and advertised so that people can make a choice about whether they wish to participate. Because people need to have time and information to make decisions about what they want to do. 8 14 16 Make sure that service users 30/10/2009 have the opportunity to take an annual holiday. 22/06/10 There was no evidence that people who live at the home have had a holiday since the last inspection. 9 14 16 Make sure that service users 30/10/2009 have access to a range of activities that reflects individual interests. At the inspection on 22/06/10 we found that peoples individual needs were not recorded and they were not supported to meet these needs. 10 14 12 The registered person must 23/07/2010 make sure people who live at the home are offered choices about music and other entertainment and that the Page 8 of 16 Care Homes for Adults (18-65 years) 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action staff value and respect their choices. Because people living at the home should have the entertainment they choose and not the choice of staff. 11 18 12 The registered person must 23/07/2010 make sure everyones health needs are properly identified, assessed, recorded and met using the support of other professionals where appropriate. Because people may be at risk if they are not given the support they need to stay healthy. 12 18 12 The registered person must 23/07/2010 make sure the staff supporting people have the skills and knowledge to meet their needs. Because people are at risk if the staff do not understand how to keep them healthy. 13 19 12 The registered person must make sure the staff treat people with respect for their privacy, dignity and wellbeing at all times. Because people have the right to be treated in this way. 14 22 22 The registered person must 27/08/2010 make sure people who live at the home know how to make Page 9 of 16 23/07/2010 Care Homes for Adults (18-65 years) 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action a complaint and who to speak to if they are unhappy about anything. Because people do not have clear accessible information about this and with a high turn over of staff and management they may not know who they should speak to. 15 24 23 The registered person must make sure the environment is well maintained and furnished and decorated appropriately. Because people should live in a well maintained environment which they have personalised. 16 24 23 The registered person must make sure equipment and rubbish are stored or disposed of appropriately. Because people should live in a well maintained environment which they have personalised. 17 30 23 The registered person must 23/07/2010 make sure the environment is kept clean, odour free and people are not exposed to risks of infection. Because people may be at risk if their environment is dirty or infected. 18 31 18 The registered person must 30/09/2010 Page 10 of 16 30/09/2010 23/07/2010 Care Homes for Adults (18-65 years) 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action make sure all staff have clearly defined job descriptions, contracts of employment and understand their roles and responsibilities. Because people may not get the support they need if the staff do not have this information. 19 33 18 The registered person must make sure the home has an effective staff team, with sufficient numbers and complementary skills to support peoples assessed needs at all times. Because people may not have their needs met if the staff team is not stable and appropriately skilled. 20 33 18 Recruit to the vacant posts to 30/10/2009 establish an effective team and to provide consistent support to service users. 22/06/10 the organisation has not recruited to establish an effective staff team. 21 34 19 The registered person must 23/07/2010 make sure the recruitment practices of the home ensure suitable staff are employed and that there is evidence of these recruitment checks within staff files. Because people may be at risk if unsuitable staff are Care Homes for Adults (18-65 years) Page 11 of 16 30/09/2010 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action working at the home. 22 35 18 The registered person must 30/09/2010 make sure the staff receive the training they need to meet the needs of the people living in the home and to keep them safe. This training must be recorded and updated as necessary. Because people are at risk if supported by untrained staff. 23 36 18 The registered person must 22/07/2010 make sure all staff (including regularly working temporary staff) have opportunities for formal, planned supervisions meetings regularly and that these are recorded. Because people may be at risk if staff are not appropriately supervised. 24 36 18 The Registered Person must 30/03/2009 ensure that all staff have supervision at least six times a year. Staff must receive regular supervision and support. We looked at a sample of staff supervision records during our visit on 22/06/10 and found that some staff had only had only had one supervision since June 2009 and some staff had not had any supervision meetings. 25 37 9 Address the situation 30/10/2009 Page 12 of 16 Care Homes for Adults (18-65 years) 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action regarding the management of the service and establish a consistent management team. 26 37 8 The registered person must make sure the manager applies to be registered with CQC and that management at the home is stabilised. Because the management changes and poor management have had a detrimental impact on the service people receive. 23/07/2010 27 38 10 The registered person must make sure the service receives the support, care and skill required to make improvements. Because the improvements needed are so great that the service manager needs additional support, resources and skill to make sure people are safe and their needs are met. 23/07/2010 28 39 26 The registered person must 23/07/2010 make quality monitoring checks at least monthly as described in Regulation 26 and must provide a copy of the report of their findings to CQC. This will provide evidence of the providers monitoring and committment to improving the service. Care Homes for Adults (18-65 years) Page 13 of 16 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 29 40 17 The registered person must 30/09/2010 make sure all required records are in place, and are accurate and clear. This will evidence the work at the home and the support given to people. 30 42 13 The registered person must make sure all parts of the home are free from hazards and that identified risks are reported and minimised. Because people are at risk if they do not live in a safe environment. 23/07/2010 31 43 23 The registered person must 23/07/2010 take appropriate precautions to assess the risks of fire and to detect, contain and extinguish fire. Because people are at risk from hazards in the current environment. Care Homes for Adults (18-65 years) Page 14 of 16 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, 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 15 of 16 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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