Care Home: Longley Park View Nursing Home

What the care home does well People receive the information they need to help them make a choice about the service. Before moving into the home people have there needs assessed and are able to visit the home if they wish. Each person had a care plan which detailed their health personal and social care needs. People`s health care needs were meet and the medication procedure protected people from harm. People told us they were treated with respect and our observations confirmed this. A range of activities were organised people were encouraged to keep in touch with family and friends and were encouraged to make choices wherever possible. People told us they were happy with the food provided and choices were offered. People told us they felt safe; staff received training on safeguarding adults and was able to tell us how they protected people on a daily basis. There were procedures in place to ensure infection control and staff told us they were provided with appropriate cleaning materials and equipment. People told us in the main there was always enough staff on duty. Staff were appropriately trained to do their job and received refresher training to make sure they were updated with good practice. The records checked showed that people were protected by the recruitment procedures; this included thorough checks of references and criminal records. The home is well managed and staff work in an organised and confident way to provide a good service to people. People told us they are able to comment on the way the service is run and examples were given of how they have effected change. There are safe procedures in place for the management and overseeing of people`s finances and people told us they were satisfied with the arrangements for this. Staff told us they received regular supervision; they were able to tell us the action they took on a daily basis to promote the health safety and wellbeing of the people they support and themselves. What has improved since the last inspection? Care plans have improved and include peoples social care needs and the records show that care plans are regularly reviewed. Medication received into the home is recorded appropriately and there are procedures in place for this to be monitored. There is a range of activities and and the home now employs two activities coordinators.There is a complaints procedure and records of complaints are appropriately recorded. Receipts for spending made on behalf of people using the service are kept and are available for inspection. What the care home could do better: CARE HOMES FOR OLDER PEOPLE Longley Park View Nursing Home 70 Longley Lane Sheffield South Yorkshire S5 7JZ Lead Inspector Shirley Samuels Key Unannounced Inspection 10th September 2008 09:20 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 DS0000021794.V371457.R03.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. DS0000021794.V371457.R03.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Longley Park View Nursing Home Address 70 Longley Lane Sheffield South Yorkshire S5 7JZ 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) 0114 242 5402 0114 242 5452 none None Longley Health Care Limited Susan Storey Care Home 67 Category(ies) of Dementia - over 65 years of age (38), Mental registration, with number disorder, excluding learning disability or of places dementia (11), Mental Disorder, excluding learning disability or dementia - over 65 years of age (18) DS0000021794.V371457.R03.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The numbers of care staff and qualified nurses on duty at any one time must be determined and provided according to the assessed needs of service users. Staffing levels must be maintained at at least those described in the document accompanying the variation application, reference number `JQ09/01/2003 confidential`. The building must be organised into the following groupings; 11 Mental Disorder (MD) - ground floor separate unit; 18 Mental Disorder for people 65 and over (MD/E) - ground floor separate unit; 38 Dementia for people 65 and over (DE/E) - first floor separate unit. The service may admit persons between the ages of 60 and 65 years into the Ecclesfield Unit MD(E). 14th September 2007 2. 3. Date of last inspection Brief Description of the Service: Longley Park View is a care home, which provides both personal and nursing care for up to 67 residents. Thirty- eight places are for older people (over 65 years of age), eleven places are for people who are under 65 years and who suffer from mental disorder and a further eighteen places for people in the same group but over 65 years of age. Longley Park View is a purpose built home providing accommodation at ground and first floor level. The home is sited in a residential area and is close to local shops and a bus route to the North of Sheffield city centre. The home is organised into four separate units, each having its own communal areas, which include a kitchen facility, a lounge and bathrooms and toilets. Longley Park View is owned and managed by Longley Health Care Ltd, which is part of Exemplar Health Care. The weekly fees charged at the home ranged from £485.00 to £2,500 This information was supplied to CSCI as part of the inspection process. The home has produced its statement of purpose and a service user guide, which gives further information about the service. Both documents and other information can be obtained by contacting the home manager. The inspection report is available in the entrance to the home and copies can be obtained on request. DS0000021794.V371457.R03.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 two star. This means people who use the service experience good quality outcomes. “We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken.” This was a key inspection carried out on this service by Shirley Samuels on 10 September 2008 from 9:00am - 4pm. In the report we make reference to “us” and “we”, when we do this we are referring to the inspector and the Commission for Social Care Inspection. The inspector sought the views of five people using the service, six staff and the manager who assisted with the inspection. The operations director was at the home on the day of the visit and was present at the feedback session at the end of the visit. This visit was a key inspection and the inspector checked all the key standards. During this visit we looked at the environment, and made observations on the staff’s manner and attitude towards people. We checked samples of documents that related to peoples support, care and safety. These included three assessments and care plans, three medication records, and three staff recruitment files. On the day of the visit we received three questionnaires from relatives. The inspector looked at other information before visiting the home. This included the Annual quality assurance assessment (AQAA). This is a form completed by the owner and the manager of the service which tells us how they think the service is doing, what has improved and what further action they plan to take to develop the service. The inspector would like to thank everyone for their cooperation and welcome. DS0000021794.V371457.R03.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? Care plans have improved and include peoples social care needs and the records show that care plans are regularly reviewed. Medication received into the home is recorded appropriately and there are procedures in place for this to be monitored. There is a range of activities and and the home now employs two activities coordinators. DS0000021794.V371457.R03.S.doc Version 5.2 Page 7 There is a complaints procedure and records of complaints are appropriately recorded. Receipts for spending made on behalf of people using the service are kept and are available for inspection. 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. DS0000021794.V371457.R03.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 DS0000021794.V371457.R03.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): 1, 3 and 6 People using the service experience good outcomes in this area This judgement has been made using available evidence including a visit to this service. People have the information they need and are assessed before they move into the home. EVIDENCE: People told us they were given information about the home. On the day of the visit information was seen in the entrance to the home and in peoples bedrooms. This made sure people had information to help them make a decision about whether the home was right for them or not. In the AQAA the manager told us, thorough assessments are carried out and people have the opportunity to visit the home several times have lunch and stay over as guest if they wish. DS0000021794.V371457.R03.S.doc Version 5.2 Page 10 Staff told us that before people moved into the home they received information which helped them to make a decision about how they could met the persons needs. They said that in the main the information was sufficient and where there were gaps in information this was obtained as soon as possible. The home does not provide intermediate care. DS0000021794.V371457.R03.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): 7, 8, 9 and 10 People using the service experience good outcomes in this area This judgement has been made using available evidence including a visit to this service. People have a plan of care, health care needs are met and the medication Procedures are safe. EVIDENCE: In the AQAA the manager told us, care plans are maintained to a high standard and medical assessments take place and GP’s make weekly visits to the home. On each of the files checked there was a detailed care plan, which highlighted each area of a person’s need the action staff need to take, and details of the action taken. The records showed that care plans were firstly developed from the assessment at the time of admission then developed further as people settled in. People told us they were consulted and were able to contribute to their care DS0000021794.V371457.R03.S.doc Version 5.2 Page 12 plan the relatives confirmed this. Care plans were reviewed the staff told us they used the information detailed in the past months daily notes and activities to update care plans. The records showed that this system was working well and was being further developed. This made sure that care plans were centred on individual need and kept up to date. People told us there health care needs are met. The GP makes a ward round style visit each week and staff are also able to request more urgent visits were necessary. The records detailed appointments with health care professionals and the outcomes. This made sure that people’s health care needs were met. Staff responsible for the administration of medication recived training and refresher training. The medication procedures and practices are monitored annually by an outside pharmacy and a report on their findings is prepared and details recommendations for improvement. The last Audit at this service took place in April 2008 and only minor recommendations were made. On the day of our visit we checked the medication and records for three people, they were all correct. Medication was appropriately stored, and there was an internal monitoring system for checking stock and returning medication for disposal. This made sure that people were protected by the medication procedures. People told us their privacy and dignity was respected. We observed staff speaking to people in a respectful manner. One relative told us, “The staff treat people as individuals, recognising the need for one to one approaches”. DS0000021794.V371457.R03.S.doc Version 5.2 Page 13 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): 12, 13, 14 and 15 People using the service experience good outcomes in this area This judgement has been made using available evidence including a visit to this service. Activities are provided, contact with family and friends is encouraged, people are assisted to make choices and they are happy with the food provided. EVIDENCE: In the AQAA the manager told us there are trips out of the home for individuals on a one to one basis or in groups. Trips to the coast, out for meals and shopping take place on a regular basis. In the last 12 months the opportunity for people to visit allotments and engage in gardening craft and art activities has been developed. The home employs activities coordinators, a variety of activities are arranged and people are able to choice whether or not to take part. For those who are unable to express a choice the staff told us they made choices for them based on what they knew about them and from information in their care plans. DS0000021794.V371457.R03.S.doc Version 5.2 Page 14 Many of the people were able to go out of the home on regular occasions with relives or with staff members. This means people are able to take part in meaningful activities which they find stimulating and enjoyable. People are encouraged to maintain contact with family and friends and be part of the local community. People told us they were able to make choices about how they spent their day, who to spend it with, what time they got up and went to bed. Staff told us having good information, getting to know people, speaking to relatives and being observant were all ways they were able to help people who were less able to make choices. This showed a commitment by the staff to respond to people as individuals and meet individual needs. People told us they were happy with the food provided and were always given a choice. The records showed that people were offered a well-balanced and varied menu. Individualised diets and methods of preparation were catered for. Liquidised food was presented appropriately and details of peoples dietary requirements were detailed in peoples care plans. The management have identified that the dining experience for people could be made better by the relocation of dining areas. The plans for this and other building work are being examined by the management of the organisation and are due to commence shortly. This will give people more room and allow staff the opportunity to support people with eating much more comfortably. DS0000021794.V371457.R03.S.doc Version 5.2 Page 15 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): 16 and 18 People using the service experience adequate outcomes in this area This judgement has been made using available evidence including a visit to this service. There are effective procedures in place for managing complaints and protecting people from abuse. EVIDENCE: In the AQAA the manager told us “we deal with complaints promptly” “we provide abuse awareness training for staff and a whistle blowing policy which is explained as part of the training. In the AQAA the manager also told us since the last inspection there had been six complaints all were dealt with within 28 days, three of them were upheld. There have been two safeguarding referrals one of them resulting in an investigation carried out by the homes manager. The investigation resulted in further training relocation of staff within the home, increased supervision and a policy review regarding family members working together. This shows there are procedures in place to protect people from abuse and for investigating allegations when they are made. The home has a complaints procedure people told us they had written information about how to make a complaint. There were records seen at the DS0000021794.V371457.R03.S.doc Version 5.2 Page 16 home of complaints, details of investigations the outcome and a response to the complainant. There have been no complaints made to us about the home. DS0000021794.V371457.R03.S.doc Version 5.2 Page 17 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): 19 and 26 People using the service experience adequate outcomes in this area This judgement has been made using available evidence including a visit to this service. The environment is in need of redecoration and refurbishment. The staff worked in a way that promoted good hygiene standards. EVIDENCE: In the AQAA the manager told us that bedrooms are decorated according to peoples requests and regular safety checks are made. There is currently a programme of refurbishing bathrooms and improvement of other communal areas. The décor furniture and furnishings in the main are in a poor state of repair. Some areas of the home were cluttered and doors were damaged. The manager and the operations director showed us a plan of the refurbishment DS0000021794.V371457.R03.S.doc Version 5.2 Page 18 work to be carried out (mainly on the ground floor), which includes relocations of dining rooms refurbishment of bathrooms replacement of all doors furniture and furnishings. On each unit there was a smoke room the door had to be left open to allow staff to provide the supervision required. Extractor fans had been fitted since the last inspection to reduce the level of smoke drifting into the corridor areas. There was enough domestic staff employed. They were provided with appropriate cleaning materials, equipment and training to do their job. Staff told us they were provided with such things as aprons gloves and bacterial hand wash to help them promote infection control and to reduce the risk of infection. This promoted good hygiene standards. DS0000021794.V371457.R03.S.doc Version 5.2 Page 19 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): 27, 28, 29 and 30 People using the service experience good outcomes in this area This judgement has been made using available evidence including a visit to this service. There are enough staff who are trained and competent and the recruitment procedures protect people from harm. EVIDENCE: In the AQAA the manager told us that all new staff attend a five-day induction. Wherever possible existing staff are used to cover shortages this minimises the need to use agency staff. The manager also told us “As an incentive to staff an employee of the month scheme has been introduced”. People told us in the main there was enough staff on duty Staff told us there were effective arrangements in place to cover for staff absence. Every effort is made to cover with existing bank staff. Agency staff were only used as a last resort. This provides continuity for people using the service. There have been some staff turnover since the last inspection one relative said “it takes new staff time to get used to the residents whilst training, however DS0000021794.V371457.R03.S.doc Version 5.2 Page 20 after training staff appear to be competent” and added staff appear to do their best to interpret individual needs. On the day of the visit staff responded promptly to peoples request for help. People assessed as needing one to one supervision received this level of support and supervision. Staff were organised and worked well together. This made sure people received the support they needed. In the AQAA the manager told us the home employs 50 care staff and that 19 were trained to National Vocational Qualification (NVQ) level 2 and 8 care staff were working towards achieving this. Three staff files were checked. They included all the information required and included taking up references from previous employers, checking employment history, identifications; right to work in the country and criminal record checks. This made sure the people using the service were protected by the homes recruitment procedures. Staff received essential training on health safety, moving and handling, first aid, food hygiene, and infection control and fire safety. Refresher training was provided to make sure staff kept up to date with good practise. Staff also received training regarding specialist needs of the people they support. This made sure that staff received the training they needed to respond appropriately to people’s needs. DS0000021794.V371457.R03.S.doc Version 5.2 Page 21 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): 31, 33, 35 and 38 People using the service experience good outcomes in this area This judgement has been made using available evidence including a visit to this service. The home is well managed and there are procedures in place to promote health and safety. EVIDENCE: In the AQAA the manager told us “we ensure that our service users are cared for to the best of our ability and that the home is pleasant, relaxed and safe environment to live in”. She added, “We would improve teamwork to help staff feel more motivated and enthusiastic”. DS0000021794.V371457.R03.S.doc Version 5.2 Page 22 The home is well managed, since the last inspection a new manager has been registered at the home. The people using the service relatives and staff speak positively about he manager and told us she was approachable and made herself available. People told us they were able to comment on the service and were asked to complete quality surveys. The results were communicated to people their relatives and the staff. Staff told us they to were able to comment on the standards, regular meetings were held and they felt they were able to contribute to the way the home was run and gave examples of action being taken following feedback from them. This means that people’s views are listened to and taken into consideration. People told us they were satisfied with the arrangements for the management of their finances. People’s records were checked. Details were kept of income and expenditure. Money was stored safely and was checked and found to be correct against balance sheets. Receipts were kept for money spent on behalf of people and savings deposited in an interest baring account. This made sure that peoples financial interest were safeguarded. Staff told us they had received health and safety and moving and handling training. The training records supported this. Observations were made of safe manual and mechanical methods of handling. Staff carried these out competently and confidently. Hazardous substances were safely stored and maintenance records showed that regular safety checks were made to such things as, gas, electrics, hoist, fire systems lifts and wheelchairs. Staff were able to tell us the actions they took on a daily basis to promote the health and safety of themselves and the people they support. This made sure that the health safety and welfare of people using the service and staff was promoted and protected. DS0000021794.V371457.R03.S.doc Version 5.2 Page 23 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 3 x x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 1 x x x x x x 2 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 x x 3 DS0000021794.V371457.R03.S.doc Version 5.2 Page 24 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 OP19 Regulation 23 Requirement To make sure people live in a safe well-maintained environment. All areas occupied by people using the service must be reasonably decorated equipped and furnished. Timescale for action 01/01/09 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 5. Refer to Standard OP15 OP19 Good Practice Recommendations Plans to improve the dining facilities should be implemented to make sure that people have a more comfortable mealtime experience. Steps should be taken to make sure that the smoke drifts from ‘smoking rooms’ are contained in and extracted from these areas, to comply with the new smoke free regulations and best practice. DS0000021794.V371457.R03.S.doc Version 5.2 Page 25 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 DS0000021794.V371457.R03.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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