Care Home: Longridge Care Home Limited

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What the care home does well The newly registered service is progressing slowly. The admission of people to the home will increase the staffing levels and the ambiance of the home. Those people that use the service are very happy in the home and appear settled. Relatives spoken to were very complimentary about the service. The manager has many plans for the home, but is presently concentrating on the admission aspects of the home and staff recruitment. What has improved since the last inspection? This is the first inspection under the new registration. What the care home could do better: Several requirements and recommendations were left at this visit which will need to be addressed, however the management team do need some time to achieve their aims, and the manager has action plans to assist her to do this. Key inspection report Care homes for older people Name: Address: Longridge Care Home Limited Levedale Road Dunston Staffordshire ST18 9AL     The quality rating for this care home is:   one star adequate 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: Joanna Wooller     Date: 1 6 0 6 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 23 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 23 Information about the care home Name of care home: Address: Longridge Care Home Limited Levedale Road Dunston Staffordshire ST18 9AL 01785714119 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Longridge Care Home Limited Name of registered manager (if applicable) Type of registration: Number of places registered: care home 32 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is: 32 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, maximum number of places 32, Physical Disability - Code PD, maximum number of places 20 Date of last inspection Brief description of the care home 0 20 Over 65 32 0 Care Homes for Older People Page 4 of 23 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: one star adequate 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: The quality rating for this service is 1 star. This means that that people who use this service experience adequate quality outcomes. This unannounced inspection took place on 16th June by one inspector. The newly appointed Manager was in the home and she participated in the inspection process. The inspection included the following elements, a walk around the building, observation and inspection of records relating to provision of care, discussions with people, who use the service, case tracking whereby we select several people who use the service, chat to them and look at their care plans and lifestyle in the home. discussions with several of the staff members on duty, observation and sampling of other services provided such as catering and laundry, and an inspection of the managerial aspects such as staffing issues, training, recruitment and health and safety. Care Homes for Older People Page 5 of 23 We were made welcome in the home and all assistance was given to gain the evidence required for the report. We had dealt with no complaints since the current manager of the home had commenced. People who use the service told us The care team support me greatly. They manage my daily care and are very compassionate to me. I have formed great relationships with the care staff and I enjoy the social banter and interaction on a daily basis. The cook is the best, I receive a good healthy diet and there is a good choice. Care Homes for Older People Page 6 of 23 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details 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 7 of 23 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 8 of 23 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People moving into the home do so having had their needs fully assessed and assurances are given that they will be met. The Statement of Purpose and Service User Guide must be available in the home and reflect the current situation at the home. Evidence: The Statement of Purpose and Service User Guide had not been updated to reflect the current situation in the home and the managers details were not included. We were told that admissions to the home only take place if the manager is confident that her staff have the skills, ability and qualifications to meet the assessed needs of the prospective new admission. The manager considers the application before an agreement is given to families or social workers. We were told that people considering moving in to the home are given the opportunity to spend time in the home to help them see how the home is run and the facilities and Care Homes for Older People Page 9 of 23 Evidence: services available. One lady who was a new admission, told us that the staff had been very welcoming and friendly. She had received a hot meal on arrival and was settled in to her room. She told us she was using the home for respite but felt she would return to the home should she need assistance in the future. Care Homes for Older People Page 10 of 23 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People that use the service have their health, personal and social care needs set out in an individual care plan. They are able to make decisions about their care including the assistance required with medication administration. People living in the home feel that they are treated with respect and their right to privacy is upheld. Evidence: Through case tracking several people we saw that they do receive personal care and support using a person centered approach. One relative told us that dignity and respect are considered at all times. She went on to say The care here is excellent and the staff are very respectful to protect my husbands privacy and dignity. Nothing is too much trouble for the staff, they are marvelous. We saw that the care records had individually recorded personal care needs including dietary requirements. Care Homes for Older People Page 11 of 23 Evidence: We saw that the care records identified individual needs and preferences of people using the service. We saw that the delivery of personal care is individual and is flexible and person centered with choices being given. We saw that people are supported and helped to be independent and can take responsibility for their personal care needs if capable. Staff were seen to listen to individuals and give choices. People do have access to health care and remedial services. The health care needs of persons unable to leave the home are managed by visits from district nurses and local health care services. We saw that people do have the aids and equipment they need and these are well maintained to support them and staff in daily living. Staff access to training has been limited and the manager is planning updates for all the staff. There was evidence that the managers observe care practices to ensure the staff understand the importance of treating people as individuals with respect and dignity. The home needs to put in place a relevant medication policy which should be supported by procedures and practice guidance. Medication is handled by one trained nurses and senior carers only. We saw that medication records are fully completed, contained required entries, and are signed by the appropriate staff. Regular management checks are made to monitor compliance. People are given the support they need to manage their medication and if individuals prefer or where they lack capacity, the staff manages medication on their behalf. Storage of medication is in line with the regulations and safe storage and disposal is carried out. The manager observes staff to ensure each individual is competent to handle, record and administer medication appropriately. The home is currently going through a transition stage with the introduction of a new dispensing group being introduced to the service. Care Homes for Older People Page 12 of 23 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home find that their lifestyles match their expectations, they maintain contact with family and friends and have choice and control over their life. People receive a wholesome, appealing balanced diet in pleasing surroundings at a time convenient to them. Evidence: People that live in the service told us that they are given a choice of meals and the meals are always nice and appetising. The kitchen has been awarded a 5 star rating in the Environmental Health - Rate My Place system. Some people were seen to need assistance with feeding and they were given the choice as to where they prefer to eat. Some people were eating in the pleasant dining room and others were eating their meal on a small table in the lounge. One relative confirmed that the meals are always home cooked, hot and appetising. She told us the staff are compassionate to those that need assistance. The manager told us that the activities are carried out, as time allows at present but with only nine people in the home the care staff can entertain them and spend time on a one to one basis with them, however she plans to recruit an activity organiser as the occupancy increases. Care Homes for Older People Page 13 of 23 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People that use the service are confident that their complaints will be listened to, taken seriously and acted upon. People are protected from abuse, however the staff do require training updates. Evidence: We looked at the homes Complaints Procedure that was displayed in the hallway and contained in the Service Users Guide and Statement of Purpose. The home had received no complaints under the new management team. We talked to two people that use the service who told us they knew how to make a complaint, and how to tell of their concerns. We talked to one person using the service who told us they knew who to talk to if they were unhappy about something. We observed staff talking to people and discussing different options and choices. The manager confirmed that the newly formed training matrix identified that all the staff were in need of completing training in safeguarding, Deprivation of Liberties and the Mental Capacity Act. The manager confirmed that there are policies and procedures in place for managing abuse but she feels they need to be updated and further personalised to the home. Care Homes for Older People Page 14 of 23 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People that use the service live in a safe, well maintained environment that is clean, pleasant and hygienic. The home are required to employ a domestic to ensure the cleanliness remains at a good level and outbreaks from infections is avoided. Evidence: The home was generally clean and tidy, however we were informed that the home does not have any domestic cover at present and the care staff are maintaining the hygiene of the home. The management team must address this at the earliest opportunity. The environment was warm and homely and the people that use the service told us they liked the communal rooms and their own bedrooms. Bathrooms and clinical areas were clean and tidy and when asked the staff had a good understanding of the importance of using protective clothing to prevent the spread of infection. People that use the service and relatives told us the home is generally tidy and always clean. Care Homes for Older People Page 15 of 23 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People that use the service have their needs met and are kept safe by the number and skill mix of staff. The homes recruitment policy and practices protect the people living in the home. The staff are trained and competent to do their jobs, however mandatory training updates are required. Evidence: We saw that care staff levels were appropriate for the nine people using the service. The manager is presently recruiting to allow for further admissions of new persons. Staff training has been overlooked in recent times and the manager confirmed that she has now developed a training matrix to identify the individual staff needs. This document was not in the home at the time of the visit as it had been given to the provider, Mr Green. All mandatory training was in need of being given to the staff to refresh the their knowledge. Plans were being made to do this in the next few months. The staff on duty were familiar with the people using the service, they knew their likes and dislikes and were able to give them time to complete tasks. Care Homes for Older People Page 16 of 23 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home which is managed by a person of good character. The home is run in the best interests of the people living in it and their financial interests are safeguarded. The health, safety and welfare of people who use the service and the staff are promoted and protected. Evidence: The manager has been in post for eight weeks and has yet to submit her application for registered manager to the CQC. She holds an NVQ 4, a management course and has previous history of managing care service for many years. The manager plans to undertake satisfaction surveys as part of the homes quality assurance system, however she is able to talk to all the people that use the service and their families on a daily basis at present. She plans to carry out essential audits within the home and set up a quality file with the relevant policys and procedures. The manager told us that the fire alarms are sounded weekly and one person that uses the service confirmed this. The manager told us that fire drills were yet to be recorded but had been carried out. Staff spoken to told us the alarms are sounded and staff attend a Care Homes for Older People Page 17 of 23 Evidence: central point but no records or signatures of this are recorded. The manager told us that environmental and equipment checks are completed by herself and the provider. The staff training was to be addressed as soon as possible to ensure safe working practices. No accidents had been recorded in the home, however the home does need to purchase the official accident book to use alongside the homes own accident log. The manager has plans to put in place many risk assessments for the home, including the building, general environment and all outside areas. Care Homes for Older People Page 18 of 23 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 19 of 23 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 1 1 4 An up to date Statement of Purpose and Service user Guide must be available in the home. These documents assist the persons moving in to the home to make an informed choice about where they live. 17/08/2010 2 7 15 Care plans must be 17/08/2010 evidenced and signed by the person using the service or their next of kin. The care plan must be signed to by the appropriate person to ensure that the care is agreed and the needs are identified. 3 9 13 The home must have a medication policy and procedure in place. To assist with the safe administration of medicine the staff must follow the 16/07/2010 Care Homes for Older People Page 20 of 23 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 homes current medication policy and procedure document. 4 18 13 Staff must receive up to date safeguarding training. To protect people that use the service the staff must receive up to date training on safeguarding issues and reporting of incidents. 5 30 18 Staff must be trained 16/07/2010 appropriately to do their job. Staff must receive annual updates of mandatory training to ensure they are able to carry out their duties safely and follow current practice. 6 38 13 The manager must ensure that staff are trained to adhere to safe working practices. Fire Drills must be documented and signed and fire training must be completed to ensure staff are competent. 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 16/07/2010 16/08/2010 1 8 The manager must consider using other ways of measuring Page 21 of 23 Care Homes for Older People 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 persons weight if weighing scales are not an option, such as girth measurements. 2 3 4 8 26 38 Care records should be clearly labeled for ease of finding relevant documentation. The management team must organise domestic cover at the earliest opportunity. The management must purchase an accident book to appropriately log accidents in the home. Care Homes for Older People Page 22 of 23 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © 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. Care Homes for Older People Page 23 of 23 - 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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