Care Home: Longview

What the care home does well Each prospective resident is assessed to make sure the providers are able to meet their needs, preferences and choices. Each resident also has a care plan that summarises their needs and the care and support required. Wherever possible residents are encouraged to direct their own care and it is evident that trusting and meaningful relationships have been established between the residents and staff. Visitors are also positive about the standards of care and support provided and one described the care as wonderful. Residents health needs are well met and medical services are promptly accessed when required. Suitable arrangements are in place to manage prescribed medicines in order that residents health is promoted. Residents are offered a varied and stimulating lifestyle that reflects their preferences and choices. Visiting arrangements at the home are flexible and visitors commented staff always warmly welcomed them. A varied and nutritional diet is in place that reflects the individual residents preferences and choices and promote healthy living. Suitable arrangements are in place to deal with complaints and to protect residents from abuse. Residents and visitors said there are no barriers to raising any concerns. Any allegations or issues about abuse are taken seriously and referred to the statutory authorities for investigation. The home is maintained to the required standard and the furniture, furnishings and fitting are domestic in nature wherever possible. The home is regularly maintained and a programme of redecoration is in place. Residents and visitors said they were very satisfied with the facilities provided and all were very pleased about their individual bedrooms that are also maintained to a good standard. Many have also been personalised by the occupant. Residents and visitors stated good standard of hygiene and cleanliness are maintained at all times. The staff is well trained and good team work arrangements are in place. The staff said that good support arrangements are also in place and advice, guidance and assistance is readily available each day and night. Visitors and residents clearly have confidence in the staff and the manner in which they undertake their duties. Appropriate management arrangements are in place and the providers are suitably experienced. The registered persons also take an active part in the care and support provided. Visitors and residents had confidence in the management arrangements. A range of measures is in place to promote safe working practices and to minimise risks to residents and staff. What has improved since the last inspection? The providers have continued to improve and develop the care planning arrangements to make sure that staff are provided with good information about residents needs, preferences and choices. The providers have also developed the range of activities available to residents at the home in order maximise stimulation and a varied lifestyle. The providers have continued to improve and develop the quality assurance measures in order that they can reliably assess the quality of the services and facilities provided. All of the requirements listed in the previous report have been completed. Medication records are now to a good standard and automatic hot water control valves have been fitted to all taps. Evidence to indicate that a comprehensive induction training programme is given to all new staff was made available. What the care home could do better: Some general policies and procedures require an update to include the contact details of this Commission. Include the address of the Department of Adult Care and Support within the complaints procedure. When hand written entries are made to the medication administration record, these should be accompanied by two signatures to confirm accuracy. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Longview Rosehill Goonhavern Truro Cornwall TR4 9JX     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Michael Dennis     Date: 3 0 0 7 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Longview Rosehill Goonhavern Truro Cornwall TR4 9JX 01872573378 01872572375 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Longview Care Home Ltd care home 28 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home Longview provides care for twenty-eight residents. The home is registered to provide care for adults over 65 with mental disorder (excluding learning disability), or for adults with dementia. The home is located in a rural setting outside the village of Goonhavern. The nearest town is Newquay that offers a wide range of facilities and amenities. The home is a two-storey building that has three lounges and a dining room on the ground floor. The bedrooms are located on the two floors and the majority are for single occupancy. The home also has a lift. All external doors are locked and alarmed due given the need to safeguard residents. The home has attractive gardens 0 0 Over 65 28 28 Care Homes for Older People Page 4 of 26 Brief description of the care home that are accessible to residents. There is also good car parking. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: A planned unannounced key inspection took place on 30th July 2009. The purpose of the inspection was to consider the work that had been undertaken on the requirements and recommendations set at the last inspection on 6th August 2007 and to inspect other core standards. Therefore some of the key standards considered included assessment of residents needs, care planning, staffing arrangements and safe working practises. The registered providers, residents, staff and visitors were consulted about the services and facilities provided. The environment, records and documents were also considered. Care Homes for Older People Page 6 of 26 What the care home does well: Each prospective resident is assessed to make sure the providers are able to meet their needs, preferences and choices. Each resident also has a care plan that summarises their needs and the care and support required. Wherever possible residents are encouraged to direct their own care and it is evident that trusting and meaningful relationships have been established between the residents and staff. Visitors are also positive about the standards of care and support provided and one described the care as wonderful. Residents health needs are well met and medical services are promptly accessed when required. Suitable arrangements are in place to manage prescribed medicines in order that residents health is promoted. Residents are offered a varied and stimulating lifestyle that reflects their preferences and choices. Visiting arrangements at the home are flexible and visitors commented staff always warmly welcomed them. A varied and nutritional diet is in place that reflects the individual residents preferences and choices and promote healthy living. Suitable arrangements are in place to deal with complaints and to protect residents from abuse. Residents and visitors said there are no barriers to raising any concerns. Any allegations or issues about abuse are taken seriously and referred to the statutory authorities for investigation. The home is maintained to the required standard and the furniture, furnishings and fitting are domestic in nature wherever possible. The home is regularly maintained and a programme of redecoration is in place. Residents and visitors said they were very satisfied with the facilities provided and all were very pleased about their individual bedrooms that are also maintained to a good standard. Many have also been personalised by the occupant. Residents and visitors stated good standard of hygiene and cleanliness are maintained at all times. The staff is well trained and good team work arrangements are in place. The staff said that good support arrangements are also in place and advice, guidance and assistance is readily available each day and night. Visitors and residents clearly have confidence in the staff and the manner in which they undertake their duties. Appropriate management arrangements are in place and the providers are suitably experienced. The registered persons also take an active part in the care and support provided. Visitors and residents had confidence in the management arrangements. A range of measures is in place to promote safe working practices and to minimise Care Homes for Older People Page 7 of 26 risks to residents and staff. What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The providers undertake good needs assessment for each prospective resident. This is to make sure they can meet the persons needs and that staff are provided with clear information about the care and support required. Evidence: Prospective residents are supplied with information they need to make an informed choice about where to live. A Statement of Purpose and Service User Guide is given to the person and their representatives detailing information about the home. Each prospective resident is assessed to make sure the providers are able to meet their needs. The assessments identify the care and support required and the resident is invited to participate in the process wherever possible. The relatives and representatives of the individual are also consulted and the opinions of any specialist workers involved with the person are taken into account. Care Homes for Older People Page 10 of 26 Evidence: The assessments have improved following the last inspection and provide more information about the individuals needs, preferences and choices. Prospective residents and their families are given the opportunity to visit the home prior to admission. Trial periods of residency are operated Following admission contracts of care are issued and signed by all parties. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good arrangements are in place to meet and promote residents health needs and medicines are safely stored and managed by trained staff in order that residents health is not compromised. Evidence: Each resident has a care plan that outlines the care and support required and provides staff with information, direction and guidance. The care planning arrangements have continued to be improved to make sure good information is in place for the staff. The providers encourage residents to direct their own care as far as possible and where this occurs the information provided in the care plans is satisfactory. Where residents are unable to effectively direct their care more detailed information is provided. This helps to make sure that residents are provided with the care they require and need. Full and comprehensive life stories have been compiled for each resident. The care plans are regularly reviewed so that residents needs are met in the best way Care Homes for Older People Page 12 of 26 Evidence: possible. Visitors and relatives at the home were very positive about the care and support provided and clearly have confidence in the staff. One visitor described the care as wonderful. Residents were also complimentary about the care they receive and said that the staff were attentive to there needs and requests. The arrangements to meet residents health needs are good and health services are promptly accessed when required. Health professionals also have regular contact with the care home and during the inspection a General Practitioner visited a number of residents. Medication is held in secure facilities and residents are able to administer their own prescribed medicines providing it is safe to do so. At this time there are no self medicating residents. A suitable policy and procedure is in place and the staff maintain appropriate records. The staff administering medicines are suitably trained and reliable arrangements are in place to dispose of medication that are no longer required. A dedicated secure fridge is also provided for medicines that require refrigeration. The temperatures of this fridge are regularly recorded. There were three handwritten entries to the medication administration records. These entries should include two staff signatures to confirm accuracy. The care plans contain the wishes of each resident as to their required arrangements upon death. Care Homes for Older People Page 13 of 26 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. Residents are provided with a varied lifestyle that reflects their choices and preferences. A range of activities are regularly offered so that residents can have a varied and stimulating lifestyle. Residents are provided with a varied and nutritional diet that reflects their personal preferences and promotes good health. Evidence: Visitors said the routines of daily living are flexible and are determined by the residents or their needs and moods. There are no barriers to residents accessing the community when it is safe to do so and flexible visiting arrangements are in place. Visitors said they always receive a warm welcome from the staff and found that good communication took place. The providers have continued to improve the range of activities and leisure pursuits available to residents. Activities are provided each day and this occurs within small groups or on a one to one basis. Positive activities clearly benefit a number of residents many of whom have complex and changing needs. The providers have continued to develop this area of work. Care Homes for Older People Page 14 of 26 Evidence: A varied and nutritional meal is provided that reflects residents needs, preferences and choices. Residents said they were very pleased with the food and were provided with a choice at each mealtime. Visitors said that good food was provided that offered a healthy nutritional diet. The kitchen staff are suitably trained and the kitchen was found to be in good order. Suitable health and safety measures are in place and the equipment and services are regularly maintained and serviced. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Suitable arrangements are in place to deal with any complaints and to protect residents from abuse. Evidence: A suitable policy and procedure is in place to deal with any complaints, concerns or issues that are raised. Residents and visitors said there are no barriers to raising any issues of concerns and were confidant that all matters are dealt with promptly. The Providers or the Commission have received no complaints following the last inspection visit. A suitable policy and procedure is also in place to protect residents from abuse. The staff at the home have received training in this area and it is also included in the induction package for new staff members. Senior staff have also received training on the Mental Capacity Act and Deprivation of Liberty Safeguards. Where any allegations or concerns arise the matter is reported to the statutory authorities for investigation. A whistle blowing policy is also in place. This makes sure that staff can report any concerns about abuse to a third party if they do not feel able to disclose their concerns to the providers. Care Homes for Older People Page 16 of 26 Evidence: The complaints policy contains the addresses of those to whom complaints can be made. The contact details of the Department of Adult Care and Support should be added. Care Homes for Older People Page 17 of 26 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. A good standard of accommodation is provided that is homely and comfortable for residents. High standards of cleanliness and hygiene are in place at all times which promote residents health and welfare. Evidence: The home is maintained to a good standard and the furniture, furnishings and fitting are domestic in nature. The layout of the home is satisfactory, generally accessible and comfortable. The home is regularly maintained and a programme of redecoration is in place. A programme of refurbishment and redecoration is currently underway. Residents and visitors said they were very satisfied with the facilities provided and all were very pleased about their individual bedrooms that are also maintained to a good standard. Many have been personalised by the occupant. There are a number of toilets and bathrooms distributed throughout the home and within a reasonable distance of the communal areas and residents bedrooms. Two of the bathrooms have specialist baths and the providers make sure the equipment is regularly serviced and maintained to safeguard residents. Some of the bedrooms also have en-suite facilities. Since the last inspection the providers have installed automatic temperature control Care Homes for Older People Page 18 of 26 Evidence: valves to hot water outlets to ensure residents are safe from scalding. There is also a range of disability equipment so that residents independence is promoted. The equipment also promotes safe working practises and the residents health and well-being. Individual residents are also provided with suitable equipment when required and following a specialist assessment. Residents and visitors were also very satisfied with the standard of hygiene and cleanliness that is maintained. The home was totally free from any offensive odour. Suitable laundry facilities are also in place and residents and visitors consider the service operates to a good standard. A dedicated house keeping staff is employed who clearly work to high standards and maintain a positive environment that promotes residents health and well-being. The gardens are maintained to a high standard. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The providers make sure that sufficient numbers of staff are on duty during waking hours to provide the care and support required and to safeguard residents. The staff are well-trained and good recruitment, selection and vetting arrangements are in place. New staff complete an induction programme Evidence: A senior carer is on duty for all waking hours. In addition a minimum of three carers are on duty throughout the day. Additional staff are also employed during waking hours if required to meet the residents needs. Two waking staff are also on duty each night and the providers, manager or senior staff are on call to respond to any emergencies. The providers reside at the care home and are available to provide emergency assistance. During any provider absences senior staff sleep at the home to provide emergency cover. Positive arrangements are in place for staff to regularly attend training to make sure their skills and knowledge are up to date. In addition a good percentage of staff are trained to NVQ 2 standard. New staff members undertake a period of induction and the providers have adopted the Skills for Care induction package. Evidence presented indicates that improvements Care Homes for Older People Page 20 of 26 Evidence: have been made to the induction training provided, Staff that had recently started work at the home said they had been well supported and had undertaken a comprehensive induction. The staff generally commented upon the good support they receive and stated that advice, guidance and assistance was available when required. It is also clear that good teamwork is in place. Visitors and residents were complimentary about the manner in which staff undertake their duties. The recruitment, selection and vetting arrangements are robust and meet the required standards. This further protects and safeguards residents. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good management arrangements are in place and the two providers take an active part in service provision. Arrangements are in place to consult with residents, staff and stakeholders about the quality of the services and facilities provided. This is to help the providers to improve and develop the arrangements in place. A range of measures is in place to promote safe working practices and the providers continue to improve the arrangements so that residents health, safety and well being is protected. Evidence: The Registered Manager and the Responsible Individual take an active part in the dayto-day delivery of the care and support to the residents. The registered persons have suitable experience to manage the care home and both have completed the Registered Managers Award. Care Homes for Older People Page 22 of 26 Evidence: To assist in the management of the care and support provided the providers have appointed a number of senior carers who coordinate the work of the staff each day. The senior staff also provide direct support and supervision of the work undertaken. Residents, visitors and staff were very positive about the management arrangements and said there were no barriers to raising any issues or concerns. The providers have established reliable methods to undertake quality assurance measures. The feedback to date has been very positive from relatives, representatives and professionals. A range of measures is in place to promote safe working practises and staff are provided with appropriate guidance and direction from a range of policies and procedures. Staff are regularly supervised. Suitable risk assessment and risk management arrangements are also in place and each individual resident is risk assessed to make sure they are safeguarded. Suitable fire safety and prevention measures appear to be in place and the staff regularly undertake fire training. The fire authority visited in June 2008 and reported that all required works had been completed. Gas safety inspection completed in June 2009, Food Hygiene inspection in January 2009, Legionella inspection in July 2009. All were found to be satisfactory. A number of the homes policies and procedures were inspected and found to be appropriate and regularly updated. In some of these policies it will be necessary to amend the contact details of this Commission. Care Homes for Older People Page 23 of 26 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 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 3 9 16 37 Hand written entries to the medication administration records should contain two signatures to confirm accuracy. Add the address of the Department of Adult Care and Support to the complaints policy The contact details of this Commission requires updating on some policies and procedures. Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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