Care Home: Langley House

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What the care home does well As part of the inspection, contact was made by phone with a funding authority that has responsibility for some residents accommodated in the home. They expressed no current concerns about the care being provided; and that issues raised were well received and acted upon accordingly. Good care was evidenced when observing staff interacting with residents and carrying out their duties. All staff were observed to treat residents with kindness and respect. Effective team working was observed throughout the inspection. The routines of daily living are flexible to suit the differing needs and preferences of all people living in the home. There is a relaxed atmosphere throughout the home and residents appeared unhurried and are given sufficient time and support in their everyday lives. All residents appeared clean, well groomed and dressed according to their individual expressed preferences, as recorded in their care plan. What has improved since the last inspection? What the care home could do better: The registered persons must ensure that all complaints made whether verbal, formal written; or expressions of concern or dissatisfaction, are recorded in the complaints log. This will enable the manager to review the number and nature of complaints made and should be used as part of the home`s quality assurance procedures in order to inform improvements to the service. Staff need to ensure that daily recordings are more in line with outcomes identified in the care plans, and also that the implications of the Mental Capacity Act are routinely taken into account in both care planning and daily recordings. It is strongly recommended that where a resident has an allergy to either medication or food; it is recorded more prominently and highlighted on the front sheet of the residents file and on the MAR chart. It is strongly recommended that ther are two staff signatories for all financial transactions made on residents behalf. This will provide safeguards for both residents and staff. CARE HOMES FOR OLDER PEOPLE Langley House 2 Oak Road Harold Wood Romford Essex RM3 0PH Lead Inspector Ms Gwen Lording Unannounced Inspection 2nd September 2008 10:15 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Langley House DS0000027917.V370497.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Langley House DS0000027917.V370497.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Langley House Address 2 Oak Road Harold Wood Romford Essex RM3 0PH 01708 381302 01708 381 641 ashokpabari@aol.com/info@homesupportservices.com Mr Ashok-Kumar Mohanlal Pabari Mrs Shobhna Ashok Pabari Hekmatullah Hareer Care Home 20 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (20) of places Langley House DS0000027917.V370497.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. No person with Dementia shall share a room. In the event that Langley House has referral of exceptional circumstances of two persons - relatives or a particular close friendship - wishing to share a room, and taking into account the Mental Capacity Act 2005, the registered person will have to apply to the Commission for a specific minor variation. 12th September 2006 Date of last inspection Brief Description of the Service: Langley House is a care home registered to provide personal care and accommodation for twenty older people, some of who may have dementia. It has been operating since 1988. The registered proprietors run other care services, including a local domiciliary care agency. The premises are a doublefronted detached property close to Harold Wood Station, and opposite a parade of shops. The home has a passenger lift and bedrooms are situated on the ground and first floor. It has eighteen single and one shared bedroom. There is a large main lounge with dining area, a smaller ‘quiet’ lounge and a conservatory extension. On the day of the inspection the range of fees for the home was between £450:00 and £500:00 per week. A copy of the Statement of Purpose and Service user Guide is made available to both residents and their families. Copies of the most recent inspection report are also made available. Langley House DS0000027917.V370497.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use the service experience good quality outcomes. This was an unannounced inspection which started at 10:15am and took place over five hours. The inspection was undertaken by Gwen Lording. The registered manager was available throughout the visit to aid the inspection process, and one of the registered proprietors joined us at the beginning of the inspection. This was a key inspection in the inspection programme for 2008/2009. Discussions took place with one of the registered proprietors; the registered manager; the cook and members of care staff. We spoke to a number of residents and where possible residents were asked to give their views on the service and their experience of living in the home. Care staff were asked about the care that residents receive and were also observed carrying out their duties. A tour of the premises, including all communal areas and the kitchen and laundry was undertaken. The files of several residents were case tracked, together with examination of other staff and home records. This included medication administration; staff training records; maintenance records; complaints; accidents/ incidents and staff recruitment files. Information was taken from an Annual Quality Assurance Assessment (AQAA); which was completed by the manager and returned to us prior to the inspection. This is a self-assessment process, which all providers are required to complete once a year. Additional information relevant to this inspection was also obtained from Regulation 26 monitoring reports and Regulation 37, notification of events. Surveys were sent out prior to the inspection for completion by staff and residents. As part of the inspection process the views of funding authorities that place residents in the home were sought and are commented on in this report. During the inspection we asked several people living in the home how they wished to be referred to. The majority expressed a wish to be referred to as ‘resident’, and this is reflected accordingly in the report. We would like to thank the residents and staff for their input during the inspection. Langley House DS0000027917.V370497.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? The current manager has been registered with the Commission. Generally the care plans were very detailed and gave a real sense of the individual resident. The activities programme has been reviewed, in consultation with residents where possible and their relatives/ friends. This is now more varied and flexible to suit not only individual’s preferences, but also more appropriate to the capacities of people living with dementia. Since the last inspection there have been a number of improvements to the environment including re-decoration of the exterior of the premises; replacement of vanity units in bedrooms; and improved signage and décor to aid in orientation for those people living with dementia. Langley House DS0000027917.V370497.R01.S.doc Version 5.2 Page 7 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Langley House DS0000027917.V370497.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Langley House DS0000027917.V370497.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 2, 3 & 5 People using the service experience good quality outcomes in this area. We have made this judgement using all available evidence including a visit to this service. A pre-admission assessment is undertaken for all prospective residents. Care plans are drawn up from the information in this assessment ensuring that the needs of the residents are identified, understood and met. The home does not offer intermediate care. EVIDENCE: Individual records are kept for each resident and a number of files were examined, including the records for the most recently admitted resident. It was evident from viewing these files, that a full assessment of needs had been undertaken by the manager, with the involvement of the resident where possible, and their relatives. Where appropriate, information provided by the placing authority was also included. Langley House DS0000027917.V370497.R01.S.doc Version 5.2 Page 10 There was a written contract/ statement of terms and conditions with the home on all of the files seen. Pre-assessment visits to the home by family/ friends and where possible the prospective residents are encouraged. This gives people an opportunity to talk to staff, residents and visiting relatives and assess the home’s facilities. Langley House DS0000027917.V370497.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9, 10 & 11. People using the service experience good quality outcomes in this area. We have made this judgement using all available evidence including a visit to this service. Residents health and personal care needs are set out in individual care plans and provide staff with the information they need to satisfactorily identify and meet residents needs. There are clear medication policies and procedures to follow, so as to ensure that residents are safeguarded with regard to medication. EVIDENCE: Individual care plans were available for each resident and a total of four residents were case tracked and their care plans and related documentation inspected. It was not possible to talk to some residents in a meaningful way due to their level of dementia. However, it was evident from viewing care plans and talking to staff and residents that individual health care needs were being met. Langley House DS0000027917.V370497.R01.S.doc Version 5.2 Page 12 There was evidence that residents are able to access GP, district nursing services, community psychiatric nurse, dental care, chiropody services, optician and other specialist medical services as necessary. Care plans were reviewed being on a monthly basis however, the manager must ensure that reviews are undertaken in a meaningful way and do not become a mechanical exercise with “no change” being automatically recorded. Staff also need to ensure that daily recordings are more in line with the outcomes identified in the care plans. For example, the care plan for one resident around meeting the individuals personal care needs stated: “Make bath time and personal care an opportunity for (the resident) to have quality 1:1 contact”. However, the daily recording just stated: “had general bath”. Also that the implications of the Mental Capacity Act 2005 are taken into account in both the care planning and the daily recordings. This was discussed with the manager during the inspection and we also left a copy of the Commission’s guidance on the Mental Capacity Act 2005. Some care plans contained details around ‘end of life’ wishes and needs, but this is an area which still requires further development. However, we are confident that residents and their families receive, care in accordance with their wishes in a caring and sensitive manner. Risk assessments are routinely undertaken on admission for all residents around nutrition, manual handling, continence, risk of falls and pressure sore prevention. Risk assessments are being regularly reviewed and updated accordingly. Weights are recorded monthly, including weight loss or gain. Where concerns are indicated there is evidence that appropriate action is take, with an initial referral to the GP. We were able to speak to a district nurse who was visiting the home during the inspection. She told us: “The home is much better under the new manager. I have no current concerns about the care”. Good care was evidenced when observing staff talking to residents and carrying out their duties. All staff were observed to treat residents with kindness and respect, and there was a positive level of interaction between residents and staff. They understood the need to promote dignity through practices such as the way they addressed residents and were seen knocking on bedroom doors and toilets doors before entering. Staff were seen to be very gentle when undertaking moving and handling tasks and offered explanation and reassurance throughout the activity. All residents appeared clean, well groomed and dressed according to their individual expressed preferences, as recorded in their care plan. For example, the care plan of one resident recorded, “likes to wear trousers”, and this preferred style of dress was evidenced during the inspection. Langley House DS0000027917.V370497.R01.S.doc Version 5.2 Page 13 An audit was undertaken for the handling and recording of medicines within the home, and a random sample of Medication Administration Record (MAR) charts were examined. Discussions with staff and the review of medication records show that staff are following policies and procedures, so as to ensure that residents are safeguarded with regard to their medication. Where a resident had an allergic reaction to either medication or food this was recorded on the (MAR) chart and in the care plan. However, it is strongly recommended that where such an allergy has been identified; it is recorded more prominently and highlighted on the front sheet of the resident’s file and on the (MAR) chart. We spoke to a number of residents and asked about the care in the home. They all said that staff were kind particularly when attending to their personal care needs. Residents spoken said: “I have been here for two years and I am very happy. It is a nice comfortable home. I just have to ask if there is anything I need”. “The girls (carer’s) are very nice. If I have any problems I let them know and they sort it out for me”. Langley House DS0000027917.V370497.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 & 15 People using the service experience good quality outcomes in this area. We have made this judgement using all available evidence including a visit to this service. There is a varied programme of activities available within the home, which suits individual needs, preferences and capacities. Visiting times are flexible and people are made to feel welcome in the home so that residents are able to maintain contact with their family and friends. EVIDENCE: The home does not employ an activity co-ordinator however; additional care staff are designated to undertake activities on a daily basis. There has been a review of the general activities programme, in consultation with residents where possible and their relatives/ friends. This is now more varied and flexible to suit not only individual’s preferences, but also more appropriate to the capacities of people living with dementia. There is a very limited programme of activities outside the home and the manager has identified this in the AQAA as an area for improvement. Langley House DS0000027917.V370497.R01.S.doc Version 5.2 Page 15 The home will be celebrating its 20th anniversary next month and a party is being organised to celebrate this. From observation and talking to several residents it was evident that the routines of daily living are flexible to suit the differing needs and preferences of all people living in the home, especially around getting up in the morning and having breakfast. For example, we observed that some residents were still enjoying breakfast when we arrived at 10:15am. Throughout the visit we observed staff allowing time for residents to express their wishes and supporting individuals to make choices in their everyday lives. Individual residents are also involved in the day-to-day activities of the home dependant on their capabilities, preferences and interests. For example, potting plants for the garden, helping with drying dishes. Clearly those residents spoken to gain satisfaction from continuing to be involved in activities that they previously undertook at home. We observed that staff generally interacted well with residents, and had a good understanding of the differing needs of people living with dementia. Visiting times are flexible and relatives/ friends are encouraged to visit. A visit was made to the main kitchen and we were able to discuss the storage and preparation of food, and menus with the cook. There is a daily menu and a record is maintained of what each individual chooses to eat. A full cooked breakfast is available at weekends but residents can choose to have cooked eggs every morning, for example boiled, fried, scrambled. We observed the lunchtime meal being served and tables were nicely laid with tablecloth, napkins, cutlery, glasses and flowers. Meals appeared appetising and well presented with residents being given choices. Sufficient numbers of staff were on hand to give the necessary and appropriate level of assistance required by the individual. Langley House DS0000027917.V370497.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 & 18 People using the service experience good quality outcomes in this area. We have made this judgement using all available evidence including a visit to this service. The manager and staff make every effort to sort out problems and concerns However, all complaints made whether verbal or formal written must be recorded. This will ensure that any trends are identified and that residents and their relatives can be confident that their complaints are listened to and will be acted upon. All staff working in the home have received training in safeguarding adults to ensure that there is a proper response to any suspicion or allegation of abuse. EVIDENCE: The home has a written policy and procedure for dealing with complaints and the log inspected indicated that no complaints had been received since February 2007. In discussion with the manager, and inspection of the complaint record maintained, it was evident that only formal written, or serious complaints were being logged. We discussed with the manager as to what constituted a ‘complaint’ to be logged. This must include verbal complaints via telephone or face to face, and any expressions of concern or dissatisfaction with any element of the service. This will enable the manager to review the number and nature of complaints made and should be used as part of the home’s quality assurance procedures in order to inform improvements to the Langley House DS0000027917.V370497.R01.S.doc Version 5.2 Page 17 service. A notice of how to complain and to whom is prominently displayed throughout the home. Those residents spoken to were aware of how to complain, who to and that they would complain if they had need to. One resident told us: “If I have an issue I speak to one of the staff and it gets sorted out”. Another said: “The manager is here every day – so I would speak to him first”. All staff have undertaken training in safeguarding vulnerable adults and this is included in the induction training for all newly recruited staff. This was evidenced on staff files and the training schedule. Those staff spoken to were able to demonstrate a good understanding of the organisation’s policy and procedure in this area and knew what action to take if they had concerns about the safety and welfare of residents, or if they witnessed any suspected abuse. Staff were also knowledgeable about the different types of abuse and the common indicators of abuse. There is a policy on whistle blowing and challenging bad practice at work. Langley House DS0000027917.V370497.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19, 29, 24 & 26 People using the service experience good quality outcomes in this area. We have made this judgement using all available evidence including a visit to this service. The home provides a physical environment that is appropriate to the specific needs and particular lifestyle of the people who live there. Overall the home is welcoming, clean, well lit and tidy. The scheduled, planned replacement of carpets throughout the home will add to the quality of the living environment. EVIDENCE: We did a tour of the premises, at the start of the visit, accompanied by the manager and all areas were visited later during the day. Odour control and cleanliness throughout the home was good. One resident commented: “Cleanliness has improved due to the efforts of the new manager”. Langley House DS0000027917.V370497.R01.S.doc Version 5.2 Page 19 Since the last inspection there have been a number of improvements to the environment including re-decoration of the exterior of the premises; replacement of vanity units in bedrooms; and improved signage and décor to aid in orientation for those people living with dementia. We were told that the planned replacement of carpets throughout the home is scheduled to commence the following week. There is an ongoing decoration and refurbishment programme. The garden area is well maintained and enjoyed by many of the residents. Some bedrooms were seen by invitation of the resident, whilst others were seen because the doors were open or rooms were being cleaned. All of the bedrooms seen were very personalised, well maintained and reflective of the occupant’s culture, religious and personal interests. There is a large lounge/ dining room, another small lounge/ quiet area and a conservatory. These shared areas provide a choice of communal space for residents to sit quietly, meet with family/ friends or be actively involved with other people living in the home. We visited the laundry and this was found to be clean, with soiled articles being stored appropriately pending washing. Hand washing facilities are prominently sited and staff were observed to be practising an adequate standard of hand hygiene. Langley House DS0000027917.V370497.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 & 30 People using the service experience good quality outcomes in this area. We have made this judgement using all available evidence including a visit to this service. Staffing levels are satisfactory and the effective deployment of staff ensures there are sufficient staff on duty to meet the individual assessed needs of the residents. The procedures for the recruitment of staff are robust and provide safeguards for people living in the home. EVIDENCE: We inspected staff rotas and the staffing levels were sufficient to meet the assessed care needs of the residents. The home currently employs a cook five days a week and a domestic four days a week. In the absence of the cook and domestic additional designated care staff undertake these duties. The home does not employ anyone specifically to undertaken activities or laundry, and again additional care staff are designated to undertake activities and laundry duties. The staff rota is planned so that there are more staff being available during peak times of activity. The manager must indicate more clearly on the duty rota the specific role care staff are undertaking on a daily basis; for Langley House DS0000027917.V370497.R01.S.doc Version 5.2 Page 21 example kitchen and domestic duties. Staff were being effectively deployed to ensure that residents choosing, or needing to remain in their bedrooms were being cared for appropriately. Effective team working was observed throughout the inspection, staff interacted well, both with each other and the residents. The AQAA stated that 70 of care staff are qualified to National Vocational Qualification (NVQ) level 2 or above, and two members of staff are currently working towards this qualification. We looked at the current training records and saw that staff have received training in essential areas such as fire safety, food hygiene, moving and handling, health and safety and safeguarding vulnerable adults. Other staff training has included dementia care; first aid; death, dying and bereavement; and safe handling of medication. There is an in house training programme for all staff on the Mental Capacity Act 2005, and its implications on the delivery of care to vulnerable people. There is a designated fire marshal, health and safety officers and appointed first aiders. We inspected a sample of staff files and these were found to be in good order with necessary references, enhanced Criminal Records Bureau (CRB) disclosures and application forms duly completed. All elements of recruitment are accurately recorded and all required documentation is obtained prior to the commencement of employment. The organisation is able to demonstrate that they operate a proactive recruitment procedure in line with equal opportunities. Langley House DS0000027917.V370497.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35, 36 & 38 People using the service experience good quality outcomes in this area. We have made this judgement using all available evidence including a visit to this service. The manager has the necessary experience and qualification, and residents benefit as the home is run in their best interest. Monitoring visits are undertaken by the registered providers to monitor and report on the quality of service being provided in the home. EVIDENCE: Mr Hareer worked at the home for a number of years as a part time carer, whilst he was undertaking nurse training. He qualified as a registered nurse in 2007 and continued to work at the home. He was registered as the manager Langley House DS0000027917.V370497.R01.S.doc Version 5.2 Page 23 by the Commission in August this year. He is scheduled to commence training for the Registered Managers Award this month. He is very resident focused and is well supported by the registered providers, who maintain a high profile in the home. Mr Hareer has a clear understanding of what further improvements are needed and the key areas which need further development. The AQAA clearly identifies the plans for improvement to the service over the next year. In discussions with staff it was evident that they felt well supported both by the manager and the registered providers. Comments made by staff in surveys about what the service does well included: “Good communication with management”. “Well managed”. “Excellent Management”. Currently the manager does not act as an appointed agent for any resident. Residents’ financial affairs are managed by the individual resident, or their relatives/ representatives. The home has responsibility for the personal allowances of several residents. Secure facilities are provided for the safekeeping of money and valuables held on behalf of residents with written records being maintained. However, it is strongly recommended that there are two staff signatories for all financial transactions made on residents behalf. This will provide safeguards for both residents and staff. From viewing staff records and talking to staff it was evident that there is a formal supervision process and staff receive regular supervision. This could include observational and peer supervision, as well as 1:1 sessions. A representative of the organisation undertakes monthly Regulation 26 monitoring visits to monitor and report on the quality of the service being provided to people living in the home. A copy of the report is made available to the Commission. A wide range of records were looked at including fire safety, emergency lighting, water safety temperature checks, portable appliance testing, emergency call system, and lift/ hoist maintenance. These records were found to be in good order and up to date. Langley House DS0000027917.V370497.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 3 X X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Langley House DS0000027917.V370497.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP16 Regulation 22 Requirement The registered persons must ensure that all complaints made whether verbal, formal written; or expressions of concern or dissatisfaction, are recorded in the complaints log. This will ensure that any trends are identified and residents and their relatives can be confident that their complaints are listened to and acted upon. Timescale for action 02/09/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP7 Good Practice Recommendations Staff need to ensure that daily recordings are more in line with outcomes identified in the care plans, and also that the implications of the Mental Capacity Act are routinely taken into account in both care planning and daily recordings. It is strongly recommended that where a resident has an allergy to either medication or food; it is recorded more DS0000027917.V370497.R01.S.doc Version 5.2 Page 26 2. OP9 Langley House 3. OP35 prominently and highlighted on the front sheet of the residents file and on the MAR chart. It is strongly recommended that ther are two staff signatories for all financial transactions made on residents behalf. This will provide safeguards for both residents and staff. Langley House DS0000027917.V370497.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Langley House DS0000027917.V370497.R01.S.doc Version 5.2 Page 28 - 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. 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