Care Home: Langley Court

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What the care home does well The feedback we received from the people who live there was extremely positive. Comments included `we do as we like - a home from home`, `I`ve been in one or two this is the best`, `you can always rely on them`, `more than what you would expect` and `very very nice`. Feedback about the staff included `very friendly`, `fantastic`, `very nice` and `they give you anything you want`. The home is run well and people benefit from the ethos and leadership of the manager. She is clearly committed to ensuring high standards and person centred individualised care. The environment is comfortable, homely and clean. What has improved since the last inspection? A new more user friendly guide about the home has been produced using pictures and photographs. Care plans have been improved and now provide more individual information. Training for staff has been developed and each person now has a personal development plan. The manager has been proactive in accessing training through the Local Authority and Skills for Care. What the care home could do better: We think the home should continue to develop the service provided and to be achieving excellence in all areas. There is still scope for improvement within assessment and care planning and developing activity, occupation and engagement. The manager needs to register with the Care Quality Commission. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Langley Court 9 Langley Avenue Surbiton Surrey KT6 6QH     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: Jon Fry     Date: 2 2 0 7 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 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 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 Older People Page 2 of 24 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 Older People Page 3 of 24 Information about the care home Name of care home: Address: Langley Court 9 Langley Avenue Surbiton Surrey KT6 6QH 02083996766 02083992183 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) : Mrs Gita Dinesh Patel,Mr Dinesh Ambalal Patel care home 28 Number of places (if applicable): Under 65 Over 65 0 28 dementia old age, not falling within any other category Additional conditions: 28 0 The maximum number of service users who can be accommodated is: 28 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: Old age, not falling within any other category - Code OP Dementia - Code DE Date of last inspection Brief description of the care home Langley Court provides care for twenty-eight older people, three of whom may have dementia. The home is a large detached house situated in a quiet residential area of Surbiton. A copy of the homes Service User Guide and Statement of Purpose can be obtained on request. Care Homes for Older People Page 4 of 24 Care Homes for Older People Page 5 of 24 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 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: One inspector made an unannounced visit on the 22nd July 2009 and spent six hours in the home. We talked with sixteen people who live there, one visitor, the manager and two members of staff. We also looked at records including assessments, care plans, staff records and information that is provided to the people who live there. The manager sent us an Annual Quality Assurance Assessment (AQAA) when we asked for it. This is a self assessment that gives us important information about outcomes for the people who live there as well as some numerical data. Care Homes for Older People Page 6 of 24 Care Homes for Older People Page 7 of 24 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 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 Older People Page 8 of 24 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 9 of 24 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. Good information is available about the service provided. Peoples needs are assessed before they come to live at the home. Evidence: My doctor put me here - I needed company, my family came and visited for me, I had no choice - the other alternative was full and my relative chose it were comments from individuals about how they came to live at Langley Court. The manager told us in the AQAA that we encourage prospective service users and their relatives to visit the home and to spend as much time as they would like with us and all service users are assessed prior to and post admission to ensure their needs are identified. We looked at the care files for two people and both contained assessments completed Care Homes for Older People Page 10 of 24 Evidence: by the home before the person came to live there. We have recommended that the home continues to look at the assessment format in use to make sure that good quality person centred information is captured. This may help staff in writing care plans that are individualised and not task focussed. A guide about the service is made available in different formats including large print and photographs. This document has been improved since our last inspection took place in 2007. Care Homes for Older People Page 11 of 24 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care planning has improved but there is scope to further personalise these important documents. Evidence: Comments from the people living at Langley Court about the care provided included I like it, I thinks its very good, we love it, Im very satisfied and everybody is so friendly. The homes AQAA said that each of our residents has a personalised plan of care incorporating all aspects of their daily activities. The service additionally told us that its plans for improvements include continuing to improve the care plans and moving the formats over to ones as used by the Eden Alternative. This is a tool that aims to improve quality of life for people living in care homes. We looked at the care plans for two people. Both plans contained some good information about the individual and their support needs around areas such as eating Care Homes for Older People Page 12 of 24 Evidence: and drinking, sleeping, mobility and personal hygiene. The home should continue with its plans to develop the care plan format to be be more person centred. We saw examples where there were still generalised statements made and not enough detail recorded about who, what, when, where and how. Care plans also need to guide care staff to be consistent in responding to someone who has dementia. We have recommended that the manager looks at training around care planning around individuals expressing their sexuality. The manager told us that some staff are unsure about this area and what to record in each persons plan. Life stories are now being completed for individuals and the home is encouraging relative and friends to be involved with this important work. We strongly recommend that this important work continues. Medication is managed well for the people who live there. The records we looked at showed that people are receiving the right medication at the right time. Care Homes for Older People Page 13 of 24 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A good programme of activities is available for the people who live there. There is scope to further extend this provision. Evidence: They do their best, we keep ourselves occupied, theres sometimes enough going on but not always, theres not really enough to do but its very difficult for them, Im not keen on bingo so would like some alternatives and we do plenty of things were comments from people about the activities provided. The home told us in the AQAA that we provide an excellent activities programme which includes art, crafts, quizzes, monthly outings, exercises and outside entertainers as well as a clothes shop. Activities taking place on the day we visited included word games, bingo and exercises. We saw that trips have been organised to the seaside and someone from the Pat a Dog scheme visits the service regularly. The lounge area has lots of artwork displayed that has been done by the people living there. The manager told us that they are trying to employ someone to provide activities more frequently and to provide Care Homes for Older People Page 14 of 24 Evidence: more occupation for people involving them in baking and gardening. We have recommended that the service continues to develop in these areas. Feedback from people about the food provided was generally very positive. Comments included very good, the food is good - just my sort, not too tarted up, Im very satisfied, very good - roast twice a week and its alright. We watched the mealtime when we visited and saw that this is a unhurried and relaxed social occasion. The tables are laid out in a homely fashion with condiments available. Care Homes for Older People Page 15 of 24 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 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 there feel able to voice any concerns or complaints. Staff receive training in Safeguarding vulnerable people. Evidence: I would tell the staff, Id go to the office, they listen, I have no complaints, If I was unhappy, Id yell and Id tell one of the carers were comments from people when we asked them what they would do if they had a concern or complaint. The home told us that it has not received any complaints in the last twelve months. We saw that the complaints procedure is included in the guide about the service. We have recommended that a picture format of the complaints procedure be displayed in the home to continue to help people know who to go to if they have any concerns. Staff have Safeguarding training that teaches them how to recognise and report abuse. Training records looked at for two staff members confirmed that they had received this important training. Care Homes for Older People Page 16 of 24 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 who live there are provided with a homely, comfortable and clean environment. Evidence: Comments from people who live there included my room is quite nice and airy, good, I like my bedroom because it is small, its kept spotless and very nice. We saw that the home is kept clean and provides a homely comfortable place to live. The bedrooms we saw were personalised with lots of photographs and ornaments. Hallways and communal also contain shelves with ornaments and things to look at. Photographs are used to help people identify their bedrooms and there are pictures to signpost the doors of bathrooms and toilets. A number of people we spoke to said they enjoyed accessing the garden in good weather. Two people said that they helped with the gardening sometimes. Care Homes for Older People Page 17 of 24 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live there are treated with dignity and respect. Staff have good access to training to help them support people effectively. Evidence: Comments from the people who live there included very helpful, on the whole theyll be there for you if they can, the staff are very friendly, they are very good and very nice. The people we spoke to felt that there were enough staff on duty and said that they were treated with dignity and respect. The AQAA told us that the home provides training opportunities on a wide variety of topics including moving and handling, fire safety and first aid. all staff have either completed or are in the process of completing their NVQ level two award. The staff members we spoke to felt well supported in their work and said that they had good access to training. The records we looked at showed that each member of staff has a personal development plan and training attended included a Skills for Care induction, manual handling, fire safety, first aid and Safeguarding. We looked at the recruitment records for two members of staff. These were well maintained and included important checks such as references and a Criminal Records Care Homes for Older People Page 18 of 24 Evidence: Bureau (CRB) check. Senior members of staff continue to update their own training and regularly attend courses run by the Local Authority. Future plans include staff accessing training around the Eden Alternative. Care Homes for Older People Page 19 of 24 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 home is managed well. Regular checks take place to help keep people safe. Evidence: The previous registered manager has now left the service and an acting manager is in post who has considerable knowledge and experience of the service. Feedback from the people who live there and staff members was very positive with comments including she is excellent, very easy to talk to and very nice. The manager told us that she will be applying to register with the Care Quality Commission. Formal meetings for the people who live there are held every three months but there is ongoing informal contact with the manager and senior staff. Minutes of the last meeting showed there was discussion about the food provided, activities and trips out. The staff we spoke to said they received regular supervision and records we looked at showed that 1-1 sessions were taking place. Staff meetings are held quarterly for staff Care Homes for Older People Page 20 of 24 Evidence: members to discuss issues and shift handovers take place each day. Health and Safety checks take place to help people keep safe. We saw records kept for gas safety, hot water temperature checks and weekly fire alarm tests. Care Homes for Older People Page 21 of 24 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 Older People Page 22 of 24 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 1 3 We recommend that the service keeps developing the assessment format in use. This may help in making sure that good person centred information is captured at the point of admission. Life story work should continue to be developed. Training in care planning around sexuality and older people should be accessed. Care plans should continue to be developed to include more detail about the persons support needs - who, what, when, where and how. Care plans need to include guidance for staff in consistently responding to someone with dementia. 2 3 4 7 7 7 5 6 12 16 We recommend that the home continues to develop and extend its activity programme. We recommend that a complaints procedure be displayed that includes pictures of key people in the service. Care Homes for Older People Page 23 of 24 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. Care Homes for Older People Page 24 of 24 - 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!