Care Home: Langrigg House

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What the care home does well The manager makes sure that a full assessment of needs and capabilities is completed before an offer of accommodation is made. Prospective residents and their families are encouraged to visit the home to have a look around and meet some of those already living there. There is a statement of purpose and residents guide available, that gives information about the facilities on offer at the home. This is useful information for those who must decide if they want to move in. We found that all residents have a clear and detailed person centred care plan that outlines details of their likes and dislikes and health and social care needs. Residents and their families are involved in the development of the plans and staff are provided with all the information needed to meet the assessed needs. Some of the comments we received from people living in the home included; `The staff are lovely and I enjoy all my meals.` `I enjoy my meals, the lassies are lovely and the boss is great.` `I have made new friends since moving in to Langrigg House. ` `Good and cheerful carers`. `In the two weeks my mother has been placed in Langrigg all the staff have been fantastic. Nothing has been any trouble. They are all dedicated to their work. I feel confident that my mother is in the best place for her needs`. We spoke to staff during our visit and also received comments via returned survey forms. They told us; `We meet the service users` needs and have up to date information.` `Provides a good atmosphere to live in. I feel the home works well it is the best I have ever worked in.` Langrigg House is one of the best care homes and I am proud to work there. The manager is the best boss. I would be happy if a family member lived there`. Comments from healthcare professionals included; `Very good all round care for clients. One of the better homes. Good with palliative care.` `The home gives good care in all aspects`. We were able to speak to some visitors during our time in the home and that all praised the care and support given by the manager and staff. One lady told us how much better her aunt was since she moved into the home.We found that staff had been recruited correctly and safely with all the required legal checks completed prior to them starting work. They are supported in their role as carers through regular supervision and training. There are always sufficient staff on duty to meet the needs and expectations of those living in the home. Medication is manged safely and well and health and safety policies and procedures ensure those living and working in Langrigg House are safeguarded at all times. What has improved since the last inspection? Since our last visit to this service care plans have become even more person centred with staff having more personal information about the residents. This has meant that they now see the residents in a more holistic way. Staff training has resulted in more staff completing the NVQ qualification in care and training records have been improved. Internal decoration has been completed and the garden area has been refurbished with funding and staff provided by the Princes Trust. The manger has developed links with local schools and colleges which will mean more volunteers coming to the home. This development will continue in the future. What the care home could do better: There were no requirements or recommendations made as a result of this inspection. We believe, therefore, that the manager and staff will continue to provide excellent service to those living in Langrigg House. Key inspection report Care homes for older people Name: Address: Langrigg House Langrigg Road Morton Carlisle Cumbria CA2 6DX     The quality rating for this care home is:   three star excellent 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: Margaret Drury     Date: 1 5 0 4 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 28 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 28 Information about the care home Name of care home: Address: Langrigg House Langrigg Road Morton Carlisle Cumbria CA2 6DX 01228606391 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): eileen.muir@cumbriacc.gov.uk www.cumbriacare.org.uk Cumbria Care Name of registered manager (if applicable) Mrs Eileen Joy Muir Type of registration: Number of places registered: care home 40 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: 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. The maximum number of service users who can be accommodated is: 40. Date of last inspection Brief description of the care home Langrigg House is located in a suburb of SW Carlisle and is close to local amenities such as health centre, shops, Post Office and public transport. The home is owned by Cumbria Care, an internal business unit of Cumbria County Council, and operated on a daily basis by Mrs Eileen Muir. The internal layout had been redesigned to offer Care Homes for Older People Page 4 of 28 Over 65 0 40 40 0 Brief description of the care home accommodation in four smaller units, each having a sitting/dining room, and kitchenette. There is a separate 10 bedded dementia care unit and dedicated respite accommodation. These are both on the ground floor, each with its own separate lounge. The dementia care unit has a lounge and conservatory area, which can be used for private visits. The home has ample toilet and washing facilities, all of which are suitable for people with a disability. Thirteen bedrooms have en-suite facilities. Residents are able to move around the home independently with the help of passenger lifts, ramps, handrails and grab rails. There is also a day service for older people situated within the home. The fees for this service are in line with those set by the Local authority, with extra charges for newspapers, toiletries, outings and hairdressing. This home does not provide intermediate care. Care Homes for Older People Page 5 of 28 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: three star excellent 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: Prior to this inspection the manager was asked to complete an Annual quality Assurance Audit (AQAA). It is a legal requirement that this form is completed by every regulated service. It asks for details about that which has improved in the home in the past year and what the manager hopes to achieve over the next 12 months. The AQAA was fully completed and returned within the timescale set by the Commission. We also sent surveys out to residents, staff, relatives and healthcare professionals. There was a good response with all of the comments being very positive. Some of these comments are included in this report. We completed a tour of the building looking at the environmental standards within the home and chatted to residents, staff and visitors. Based on information provided by the manager, comments on the returned survey forms and our observations during a visit to the service we judged that Langrigg House Care Homes for Older People Page 6 of 28 continues to exceed the National Minimum Standards of the Care standards Act Care Homes for Older People Page 7 of 28 What the care home does well: The manager makes sure that a full assessment of needs and capabilities is completed before an offer of accommodation is made. Prospective residents and their families are encouraged to visit the home to have a look around and meet some of those already living there. There is a statement of purpose and residents guide available, that gives information about the facilities on offer at the home. This is useful information for those who must decide if they want to move in. We found that all residents have a clear and detailed person centred care plan that outlines details of their likes and dislikes and health and social care needs. Residents and their families are involved in the development of the plans and staff are provided with all the information needed to meet the assessed needs. Some of the comments we received from people living in the home included; The staff are lovely and I enjoy all my meals. I enjoy my meals, the lassies are lovely and the boss is great. I have made new friends since moving in to Langrigg House. Good and cheerful carers. In the two weeks my mother has been placed in Langrigg all the staff have been fantastic. Nothing has been any trouble. They are all dedicated to their work. I feel confident that my mother is in the best place for her needs. We spoke to staff during our visit and also received comments via returned survey forms. They told us; We meet the service users needs and have up to date information. Provides a good atmosphere to live in. I feel the home works well it is the best I have ever worked in. Langrigg House is one of the best care homes and I am proud to work there. The manager is the best boss. I would be happy if a family member lived there. Comments from healthcare professionals included; Very good all round care for clients. One of the better homes. Good with palliative care. The home gives good care in all aspects. We were able to speak to some visitors during our time in the home and that all praised the care and support given by the manager and staff. One lady told us how much better her aunt was since she moved into the home. Care Homes for Older People Page 8 of 28 We found that staff had been recruited correctly and safely with all the required legal checks completed prior to them starting work. They are supported in their role as carers through regular supervision and training. There are always sufficient staff on duty to meet the needs and expectations of those living in the home. Medication is manged safely and well and health and safety policies and procedures ensure those living and working in Langrigg House are safeguarded at all times. 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 9 of 28 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 10 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. All those wishing to move into Langrigg House have their personal, social and healthcare needs fully assessed before they are offered a place. This helps to ensure that the home will be suitable and able to meet their needs appropriately. Evidence: The home has a compehensve admissions process that ensures the procedure causes the least amount of trauma to the prospective resident and their family members. All those involved in the admission are invited to visit the home to look around, meet the staff and those people already living there. We met with a number of people during our visit who told us how kind the manager and staff were when they moved in and how much they appreciated this. Some of them said that they had made new friends since they came to live in Langrigg House. All prospective residents are fully assessed before an offer of accomodation is made. This is usually completed by the manager but if she is not available one of the Care Homes for Older People Page 11 of 28 Evidence: supervisors completes the assessment on her behalf. Also at the assessment is one of the moving and handling key workers who is able to assess what aids and equipment may be required to assisst the resident. The home also takes into account any information received from the hospital or social worker as this may reflect in the final assessment. All this information, together with the personal interaction with the resident, ensures the manager is as certain as possible that all the assessed needs can be met by the care and support provided at Langrigg House. Many of those living in the home have had periods of respite care prior to taking up a permanent placement. Care Homes for Older People Page 12 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using this service receive excellent care and support based on their individual nedds, wishes and expectations. Their rights, choices and independence are taken into account at all times. Evidence: During our visit to Langrigg House we checked a sample of 7 care plans and records kept in relation to the care and support provided by the staff. We also spoke to the staff and supervisors and observed some of the working practices. The care plan format within the home has recently changed again and all those we looked at were fully up to date. The supervisor on duty during our visit confirmed that much work had been done to ensure the plans were a relevant working document. Each resident had a written sheet - My story and gifts, giving a profile of life history, what support the resident needed and how it was to be delivered. This information gives the staff a chance to see the resident as a whole person with individual wishes and aspirations. One of the care staff we spoke to told us she liked the plans very much as they were easy to understand and work with. The manager has purchased a Care Homes for Older People Page 13 of 28 Evidence: book about personalised care planning written by a professional consultant that, she said, had helped with the preperation of the plans. All this information helped us to judge that the plans for the delivery of care were unique to the individual. During our visit we were able to speak to a group of residents that were just finishing their lunch. Everyone of them told us how kind and helpful the staff were and how they saw the manager several times a day and could speak to her about anything. We spoke to one gentleman in his room and he told us how happy he was living in the home. His sister lives next door to the home and visits on most days. He said My meals are very good, the lassies are lovely and the boss is great. Healthcare needs are met through visits from the GPs, district nurses and any other healthcare professionals requested when necessary. We spoke to one of the district nurses who told us it was a pleasure to visit the home as the staff are very helpful. She also told us there were never any problems to address when visiting. There are policies and procedures in place for the safe handling and administration of medication. Staff are required to read the policies and all must have completed the medication training organised by Cumbria Care before they can give out medication (supervisors) or act as second checkers (staff). We looked at some of the medication records and found them to be up to date and correctly completed. The manager audits the records on one unit each week and also completes an audit when she administers the medication herself. There are limited controlled drugs prescribed currently, but those that are in the home are recorded and administered correctly and signed in and out by two members of staff. There is also a seperate sheet to record any medication that may be received at a time separate from the normal monthly medication and can be used for any received mid month or brought in by residents coming in for respite care. We looked at a sample of completed forms and found these to be correct and up to date. Privacy and dignity is adhered to at all times in Langrigg House and this forms part of the induction programme and is discussed during staff supervision and meetings. Staff were seen to speak to residents in a warm and friendly manner whilst still preserving their dignity. Healthcare visits are in the privacy of the residents rooms. The residents looked well dessed with ladies having had their hair done and wearing footwear of their own choice. Family members we spoke to all confirmed that their relative was well cared for and always looked as nice as she did at home. The manager and staff at Langrigg House ensure that any resident who wishes can remain in the home for a long as they wish. They follow the Liverpool Pathway for end Care Homes for Older People Page 14 of 28 Evidence: of life care and the manager confirmed that no resident is moved on unless it is at the specific request of the family. If it becomes necessary she brings in staff from Hospice at Home to assist her own staff with the care. This has been much appreciated by family members and was evidence by letters received in the home. Training in end of life care is prepared and delivered by the home manager. Care Homes for Older People Page 15 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using this service are able to participate in a variety of social and religious activities whilst maintaining contact with families and friends. This helps to ensure they enjoy a lifestyle that is meaningful and comfortable. Evidence: Although this home does not employ a designated activities organiser the manager ensures there is enough staff on duty to provide activities for the residents to enjoy some part of every day. Staff lunch times have been re-organised so that there are more staff available between 2.30 and 4 each afternoon. This gives the staff and residents the opportunity to interact either in small groups or on a one to one basis. Good working relationships with local schools means that work place students visit the home regularly to carry out activities or just chat to those living in Langrigg House. A member of staff from another home within Cumbria Care visits the home to conduct a sing, dance and smile class each week and this is proving to be very popular. There is now a greenhouse in the garden for anyone who wishes to use it and the external area of the home has been greatly improved with funding and staff from the Princes Trust completing the work. The external space is now well laid out, beautifully Care Homes for Older People Page 16 of 28 Evidence: kept and much more pleasant for the residents to enjoy. Routines within the home are as flexible as the residents wish, with no set times for retiring at night or getting up in the morning. Some residents visit their friends in their bedrooms and one of the ladies told us I have made new friends since coming in to Langrigg House. There are church services held for those that wish to join in and Communion is also arranged by visiting clergy. During our visit to the home we inspected the kitchen area and spoke to the cook who told us she was very happy working at the home but would like more hours if possible. She said that, Langrigg House is the best place I have ever worked in and all the staff work together as a team. There is a four-week menu in place that provides a wide choice of varied and nutritious meals. The people with spoke to during our visit all said they enjoyed their meals and could choose another meal if they didnt like either of the choices available on that day. Meals are served in the lounge/diner on each of the units with staff serving from heated containers. Lunchtime was relaxed and unhurried with residents chatting among themselves whilst eating their meal. We noticed that the tables were nicely set with tablecloths and matching crockery. Care Homes for Older People Page 17 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using this service can voice their concerns if they wish. There are policies and procedures in place to help them do this and to ensure they are protected from the risk of harm or abuse. Evidence: There are clear policies and procedures in place to deal with any complaint raised. Every resident has a copy of terms and conditions of residency that outlines their legal rights and this, together with the complaints procedure, ensures that all know how to make a complaint. There is a complaints log in place but there have been none to record for some considerable time. When we spoke to some of the residents during our visit they all told us they have never had cause to complain formally as, if there was anything wrong, they would speak to Eileen (manager) because they saw her every day anyway. There are regular residents meetings which are also a forum for those living in the home to voice any concerns they may have. We, the Commission, have not received any complaints about this service from residents, families or external agencies. Staff on duty during this inspection were aware of their roles and responsibilities with regards to the protection of vulnerable adults. All staff have completed training organised by Cumbria Care and the manager prepares regular refresher courses using external materials. There is also a copy of Cumbrias policy available in the home. This Care Homes for Older People Page 18 of 28 Evidence: information and the completed training ensures staff working in Langrigg House are aware of the importance of keeping those living in the home safe at all times. There was a recent incident that was reported under adult protection that is currently being dealt with. We were informed by the manager, who had reported the incident to social services and ensured that the correct procedure was followed. The manager has arranged for voting papers to be prepared for all those residents who wish to take part in the forthcoming elections and arrangements will be made for them to cast their votes. Care Homes for Older People Page 19 of 28 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. This home is generally maintained to a good standard and people living at Langrigg House are provided with a warm, safe and comfortable environment in which to live. Evidence: Langrigg House is a two storey, purpose built building with access to the upper floor by passenger lift. It is situated in a residential area not too far from the centre of Carlisle. There are shops and a post office close by. The home can accomodate up to 40 residents in single rooms, 6 of which are designated for respite care. There is also a day centre at the front of the building that is not currently regulated. The building is reasonably well maintained and the manager works closely with Cumbria Cares accomodation manager to ensure the property remains in as good condition as possible. During our visit we toured the building and spoke to residents about their accomodation. They all said they were very happy with their own room and some like to spend quiet times there after lunch. Some of the rooms are quite small but they were all personal to each resident with pictures, ornaments and photographs. Residents also have their own television sets and radios and we saw that at least one room had a personal computer. Care Homes for Older People Page 20 of 28 Evidence: All the bathrooms are of a good size and staff are able to use mobility aids to assist residents when they take a bath. Two of them had recently been decorated, which ensured the residents are able to enjoy the bathing experience. Communal toilets are situated in all parts of the home and they are all suitable for people who may have a mobility problem. The home employs domestic staff who now work to a planned domestic cleaning programme to ensure a high standard of cleanliness and hygiene. External cleaners also work 30 hours during the week to clean the bedrooms. The home was exceptionally clean on the day of our visit. There is a plentiful supply of protective clothing and cleaning materials that ensures there is very little, if any, cross infection. Care Homes for Older People Page 21 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in Langrigg House are supported by staff that are experienced and trained to a high standard. There are always sufficient staff on duty to ensure all residents have their needs met in an appropriate and timely manner. Evidence: The manager told us that she ensures staffing levels are always maintained and we saw evidence of this when checking the staff rotas for the current month. When we arrived at the home there were 7 staff on duty plus the supervisor and manager. The manager uses her allocated care hours in the best way possible to benefit the residents and running of the home and her deployment of staff is excellent. People told us that there were always staff around to meet their needs and requirements. We observed extremely good interaction between the staff and residents with lots of light hearted chat and laughter. We spoke to several visitors who told us how much they appreciated the care and support given to their relatives and all remarked how kind the staff were. Comments on returned survey forms included, Good cheerful carers and All the staff are fantastic and dedicated to their work. There are 3 members of staff on during the night but the manager would increase this number in the short term if this was necessary. Staff training is considered by the manager to be very important and there are Care Homes for Older People Page 22 of 28 Evidence: currently over 75 of the care staff qualified to NVQ level 2 in care, with others working towards the award. She prepares a training gap analysis each year end to see where there are gaps in the completed training. This makes certain that all staff complete across the board training which means all are able to meet the needs and requirements of those living in the home. The manager did tell us that places are sometimes hard to come by and she does prepare some training herself to ensure staff do not miss out. Training courses include, equality and diversity, person centred care planning, protection of vulnerable adults, communication, bereavement, dignity in care, manual handling, activities and infection control. Care Homes for Older People Page 23 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Excellent management and quality monitoring help safeguard people using this service and this, together with the policies and procedures in place ensures that the health and safety of the residents is met in a way that is appropiate and acceptable. Evidence: Langrigg House is effectively managed by a well experienced and qualified manager. She has worked for Cumbria Care for a number of years and has considerable experience in the care of older people. She works very hard to ensure that the home is run in an open and positive atmosphere and continually has an open door style of management. Residents and visitors alike told us during our visit that she was very approachable and always available for help and advice. Residents told us that she was always about the home and they saw her every day. Managers within the organisation are given targets they must meet and a recent audit of the home showed that Langrigg House had met all of them. Care Homes for Older People Page 24 of 28 Evidence: We looked at the way in which servie users personal monies are kept and managed and although there are no great amounts held, the correct records were in place with each entry signed by 2 members of staff. These records are audited on a regular basis to ensure everything is in good order. Staff follow the procedures and guidelines in this matter. Annual quality audits are completed by the manager with survey forms sent to residents and their families. Because the manager speaks to residents and visitors on a daily basis this also forms part of the internal quality audit system. Residents meetings are held which also gives a forum for suggestions about running the home and the opportunity for residents to voice any concerns. The manager showed us a copy of some minutes that indicated residents were not afraid to voice any concerns they might have. Staff are supported in their work by regular supervision by their line manager and the records evidenced that all staff supervision was up to date. This was another target that had been met. The manager always notifies the Commission of any events or incidents in the home through regulation 37 notifications and this ensures we are always up to date with what is happening in the home. Fire training is up to date and there is a fire risk assessment in place. There are a number of fire wardens amongst the support workers. All equipment is maintained under annual service level agreements and there is an annual health and safety audit completed by the organisations health and safety manager. All records that comply with safe working practices and relevant legislation are kept up to date and available for inspection Care Homes for Older People Page 25 of 28 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 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 27 of 28 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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