Care Home: Longwood Lodge Nursing & Retirement Home

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What the care home does well The manager makes sure that people`s needs are assessed before they move into Longwood Lodge, this is so that she can be certain that the staff and facilities can provide the care and support required. The manager makes sure that health care is provided promptly. Staff interaction with residents is respectful, caring and they support people to reach a very high standard of personal grooming. The manager ensures that activities and outings are provided that promote good relationships between the residents, which keeps them motivated and interested in life. The manager ensures that relatives, friends and other visitors to the home are made welcome. The manager ensures that meals and snacks are plentiful and meet the needs of the majority of people living at Longwood Lodge. The manager ensures that complaints are listened to and dealt with fairly. The environment at Longwood Lodge is clean and, in the main, accessible for the people who live there. People are given the opportunity to comment on the quality of the care provided. What has improved since the last inspection? Since the last inspection the manager now ensures that changes in care plans are recorded. Since the last inspection risk assessments for nutrition, moving/handling and falls have been put in place. Since the last inspection the time for giving out medication in a morning has been changed to 08:30 so that people are not woken up too early and the instructions given by the doctors can be followed. Since the last inspection the percentage of care assistants who have completed NVQ level 2 training has risen to 63%.New recruits now complete the "Skills for Care" Common Induction Standards course, which is provided by Oldham Borough Metropolitan Council. A training matrix has been produced which shows the training staff have received and shows any training gaps. What the care home could do better: The registered person should make sure that assessments and care plans provide more detail about people`s emotional and communication needs. Information that is provided, such as social profiles and interests, should be used in care plans so that the activities and other services provided are more person centred. The manager needs to make sure that staff always work in accordance with the care plans. The manager needs to ensure that any method for recording the administration of medication is as failsafe as possible, this will help to ensure that people are always given the correct medication. CARE HOMES FOR OLDER PEOPLE Longwood Lodge Nursing & Retirement Home 61-63 Queens Road Oldham Lancashire OL8 2BA Lead Inspector Michelle Haller Unannounced Inspection 14th October 2008 09:30 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 Longwood Lodge Nursing & Retirement Home DS0000067233.V371018.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Longwood Lodge Nursing & Retirement Home DS0000067233.V371018.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Longwood Lodge Nursing & Retirement Home Address 61-63 Queens Road Oldham Lancashire OL8 2BA 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) 0161 627 5868 F/P 0161 627 5868 Eaglecrest Care Management Ltd Mrs Maureen Edith Ward Care Home 43 Category(ies) of Old age, not falling within any other category registration, with number (43), Physical disability (43) of places Longwood Lodge Nursing & Retirement Home DS0000067233.V371018.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home with nursing: Code N, to people 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; Physical disability: Code PD. The maximum number of people who can be accommodated is: 43. 15th October 2007 Date of last inspection Brief Description of the Service: There are 43 beds in total at Longwood Lodge; the home is registered to provide nursing and residential care. Longwood Lodge is a detached Victorian property that has been extended. It stands in pleasant gardens overlooking Alexandra Park. An open seating area at the front of the building allows service users to enjoy the view in a safe and peaceful environment. Accommodation is provided over two floors and consists of 31 single rooms and six double rooms, all with en-suite facilities. Access to the first floor is provided by two lifts. Within the home there are also a number of communal rooms in which service users can socialise, dine and participate in activities. Fees for accommodation and care at the home range from £350 to £539.91 per week. The price is dependent upon whether residential or nursing care is provided, the provision of double or single rooms and whether the person is being funded by the Local Authority or paying privately for their care, in which case higher fees are charged. Additional charges are also made for hairdressing and chiropody services, newspapers, dry cleaning and personal toiletries. Further details about the services the home provides are available in its statement of purpose and service user guide, both of which are provided on request and displayed in the reception area of the home. A copy of the most up to date inspection report is displayed in the reception area. Longwood Lodge Nursing & Retirement Home DS0000067233.V371018.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This was a key inspection that included an unannounced visit to the service. This means the manager did not know in advance that we were coming to do an inspection. During the visits we looked around the building, talked to residents, relatives and staff, including the deputy manager and registered provider. We observed the interactions between people living at Longwood Lodge and examined care plans, files and other records concerned with the care and support provided to people in the home. As a result of the site visit a request for a Commission for Social Care (CSCI) Pharmacy inspection was made. We also looked at all the information that we have received or asked for since the last inspection. This included: The annual quality assurance assessment (AQAA) that was sent to us by the manager. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. Information we have about how the manager at Longwood Lodge has managed any complaints and any adult protection issues that may have arisen. What the manager has told us about things that have happened in the home through ‘notifications.’ Three resident and five staff Commission for Social Care Inspection (CSCI) surveys were returned to us. There has been one protection of vulnerable adult investigation since the previous inspection. The case concerned the general support provided to one person; it was fully investigated by Oldham Metropolitan Borough Council Social Services department, and the outcome was all the allegations were unfounded. Longwood Lodge Nursing & Retirement Home DS0000067233.V371018.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? Since the last inspection the manager now ensures that changes in care plans are recorded. Since the last inspection risk assessments for nutrition, moving/handling and falls have been put in place. Since the last inspection the time for giving out medication in a morning has been changed to 08:30 so that people are not woken up too early and the instructions given by the doctors can be followed. Since the last inspection the percentage of care assistants who have completed NVQ level 2 training has risen to 63 . Longwood Lodge Nursing & Retirement Home DS0000067233.V371018.R01.S.doc Version 5.2 Page 7 New recruits now complete the “Skills for Care” Common Induction Standards course, which is provided by Oldham Borough Metropolitan Council. A training matrix has been produced which shows the training staff have received and shows any training gaps. 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. Longwood Lodge Nursing & Retirement Home DS0000067233.V371018.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Longwood Lodge Nursing & Retirement Home DS0000067233.V371018.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (standard 6 is not applicable) Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. All service users who move into Longwood Lodge have their needs assessed before admission so the manager is confident staff have the skills to meet the identified needs. EVIDENCE: During the site visit the assessment records for five people were examined. Each contained detailed information about people’s health, physical and personal care needs. Assessments in place had been provided by the referring agency, such as social workers and nurses from the Primary Care Trust (health service). The Matron (registered manager) or Deputy Matron had also completed assessments of people’s needs prior to accepting the admission. This was so that they could be sure that the facilities, staffing levels and skills available at Longwood Lodge could fully meet people’s needs. Longwood Lodge Nursing & Retirement Home DS0000067233.V371018.R01.S.doc Version 5.2 Page 10 The assessments varied in depth, in that, those provided through Health and Social Services were very detailed, while the admission assessment completed at Longwood Lodge was more basic. The information included specific health needs, such as care following a stroke, nutritional need, such as special diets or methods of feeding, oral health, mobility and medication. The information was used to develop detailed care plans and risk assessments to ensure that people were safe and remained well for as long as possible. Mental health, mood and communication skills were not always assessed in depth. It is important to do this in respect of providing support and ensuring that staff can be provided with clear instructions in how best to communicate with people and promote good mental health and a sense of wellbeing. The manager stated that social profiles were completed, however these were not used to plan care and there was little reference to this information in the assessments or care plans. People who returned surveys mostly felt that they had received enough information about the home before admission, and each confirmed that they had received a contract. All the staff who returned surveys confirmed that they always received enough information about people to meet their needs. Longwood Lodge Nursing & Retirement Home DS0000067233.V371018.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. People at Longwood Lodge usually have their identified health needs met, personal care is completed to a high standard and people are treated with dignity and respect. EVIDENCE: The care plans for five people were looked at. The care plans provided instructions that were clear and detailed about how people’s health needs must be met. Documents including signed review sheets and updated care plans confirmed that care had been reviewed to make sure that changes to care happened when necessary. Risk assessments concerning pressure area care, nutritional screening, falls, continence care and catheter care had been completed and those that were looked at provided detailed information about what staff should do reduce risks identified in these areas. Longwood Lodge Nursing & Retirement Home DS0000067233.V371018.R01.S.doc Version 5.2 Page 12 Staff were observed throughout the day as they used moving and handling equipment. This task was carried out safely and in keeping with instructions given in the care plans. The care plans, records of professional visits, letters and other correspondence confirmed that specialist and routine health care was made available when needed. Health professionals involved in Longwood Lodge included general practitioners, district nurse, podiatrist, dietician, speech and language therapists, dentist and opticians. In relation to pressure area care, positioning charts kept by night staff were seen and these confirmed that people were aided to move their position at night. However, during the day, turns and positional changes were not recorded. On the day of inspection one person whose care plan stated that they required repositioning to assist with pressure area care was observed for a number of hours. It was noted that this persons’ position was not substantially changed during this period. This matter was brought to the attention of the matron who agreed to implement positioning record charts during the day for those who needed it. When asked, the matron stated that at the time of this inspection no-one living at Longwood Lodge had pressure ulcers. During the same observation period it was noted that people were not assisted with drinks in a timely manner, or missed out on drinks completely. The kitchen staff gave out the drinks but care staff did not always come and support people who needed assistance to actually consume the drink. People with swallowing difficulties have been assessed by the speech and language therapist who has prescribed thickened fluids. This helps to prevent fluid going into the lungs, which can then cause chest infections. During observation it was noted that an un-thickened drink was left when it should not have been and staff began to serve this drink, only stopping because it was considered too hot. This matter was brought to the attention of the manager who immediately dealt with the situation and discussed changes that would prevent this mistake been repeated. The way in which medication was administered was observed and the records examined. Longwood Lodge Nursing & Retirement Home DS0000067233.V371018.R01.S.doc Version 5.2 Page 13 Medication is administered by nurses who have received the training to do this safely. Discussion with the manager confirmed that since the last inspection the time that the medication round starts has changed to 8:30. This is so that people are not woken too early, and so that medication is given with food if necessary. It would appear that the medication round still takes a long time because people were still being given morning medication at 09:30 when the inspection started and while the building tour was conducted some time later. The sheets used for recording the administration of medication were examined and it was noted that instead of signing against the name of the medication that has been given, a code is used to represent the prescribed medication. This was discussed with the matron as, in the process of transferring the information, it is possible that an error may occur. The matron agreed to look at making the medication record sheet more fail-safe. Medication is checked in and signed for by two trained nurses. All the medication sheets examined had clear photographs of the residents which helped with identifying who they were and so prevent medication errors. Controlled medication was received and managed safely. The matron needs to confirm that the current controlled drug medication cabinet meets new Pharmaceutical standards. All medication had been entered in a controlled drugs book and the numbers were accurate. During the inspection the interaction between staff and people living at Longwood Lodge was observed for the majority of the day. People were well dressed and groomed. They were fully dressed, wearing tights or stockings and socks and slippers or shoes. Professionals attended the home without hindrance and it was clear that the management had good working relationship with the doctors, social workers and other health and social care professionals. Random checks confirmed that people had their own clothes returned to them. The hairdresser was working in the home on the day of inspection, and many of the ladies had their hair washed and set. In the main, staff took time with people, speaking to them quietly, waking them gently and encouraging them to assist in procedures by explaining what was going on and waiting for them to respond. Communication would be aided further however if the assessment and care plans provided details about how to help people to communicate depending on their individual needs. Longwood Lodge Nursing & Retirement Home DS0000067233.V371018.R01.S.doc Version 5.2 Page 14 Daily records were examined and were written using respectful language. The information did not always relate to the care plans and neither did the information describe what had happened for a person from day to day. This means that it was not always possible to fully monitor a person’s progress and response to the care provided. Care plans and daily records are held separately and so the care plans are not used as a constant reminder about the support required. In the information she returned the manager identified that, in relation to health and personal care, one of the strengths of the service is that they: ‘Treat any potential problems quickly and effectively.’ People who were spoken to were very satisfied with health care provided in the home. One relative said ‘We can’t praise them enough.’ And a resident commented, ‘Yes if I’m poorly they get the doctor to visit quickly.’ All three people who returned surveys held different opinions from ‘always’ receiving support and health care needed to ‘sometimes’. The only comment in this area however was from the person who was most satisfied, they stated: ‘The care for my aunt is second to none - I couldn’t wish for better.’ Longwood Lodge Nursing & Retirement Home DS0000067233.V371018.R01.S.doc Version 5.2 Page 15 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People at Longwood Lodge experience a lifestyle, and have access to recreational activities, which meets their general needs and expectations. EVIDENCE: There are two activities co-ordinators or diversion therapists working at Longwood Lodge each day in the afternoon. The activities record and photographs on display in Longwood Lodge confirmed that activities included quizzes, arts and crafts, regular outings and entertainers. The activities co-ordinators kept daily diaries that showed what people had joined in with and enjoyed. The diaries also showed that people who remained in their rooms were offered one to one attention. The records also confirmed that people were encouraged to discuss topics of interest to them. Both the activities co-ordinators were observed as they worked with people. They were friendly and most of the time encouraged people to participate in a manner that was acceptable. Longwood Lodge Nursing & Retirement Home DS0000067233.V371018.R01.S.doc Version 5.2 Page 16 The afternoon activities were observed and included a beetle drive, game of ball and karaoke. This involved 15 service users. Most people were able to participate as the organiser adapted the games as she went around each person. For example, people were encouraged to throw the ball if they couldn’t kick it. People who were observed thoroughly enjoyed the activities that were offered, people talked to each other, gave encouragement and laughed at what occurred. One person who was interviewed said happily ‘Yes I enjoy bingo, quizzes and the staff dancing. And the Priest visits me.’ Another person, who prefers to spend time in their room, said ‘I’ve no worries whatsoever, it’s nice as staff sit and speak to you.’ Staff stated that, in the main, they leave activities to the co-ordinators, however one described her role as key-worker to include: ‘We have to keep people socialised by putting together pictures and sending cards or writing letters to family.’ This area could be further improved if the information gathered when social histories were assessed were included in the care plan and used to plan one to one activities. This should include activities that related to people’s specific cultural background and interests. Visiting hours at Longwood Lodge are flexible and there are no restrictions. People said they were made welcome in the home and that ‘Staff are always friendly’ and ‘I always feel welcome.’ People who returned surveys mostly felt that activities ‘usually’ met their needs, and people did not write any comments. In the information returned to us the manager said the home promoted positive relations between residents, staff and family through: ‘Unrestricted visiting of family members and their pets, a good programme of diversional therapy and evenings to promote fund raising and improve relationships with family members and staff.’ The food and meals provided at Longwood Lodge were varied and enjoyed by people living at the home. For breakfast people could have whatever they wanted, including a cooked breakfast. Lunchtime was a choice of beefsteak pie or chicken curry and rice. There was also a vegetarian option of vegetable curry and rice. The dessert was rice pudding. The meals looked very appetising and people were observed enjoying their meals. People who needed assistance were supported in a dignified manner. Longwood Lodge Nursing & Retirement Home DS0000067233.V371018.R01.S.doc Version 5.2 Page 17 The menu was examined and meals offered are a choice of traditional foods such as rag pudding, roast meat stews and pies, as well as less traditional foods, including curries and meats with sauces. One person who was interviewed did not eat meat but was complementary about the food offered so far, saying ‘The fish pie I had was delicious.’ During the afternoon most people were offered homemade cakes to have with their tea, people who were observed who were on soft diets were not offered an alternative. It would be good practice to make sure that people on soft diets are offered mid-morning and afternoon snacks so that they are treated the same as other residents. Lunch and teatime meals were observed for short periods. There are a number of dining areas, all were clean and the tables set for each meal. Both mealtimes were calm. The weight records confirmed that people put on weight when they move into the home and steps are taken to make sure that people receive adequate nutrition, by meals and snacks provided or supplements that are given as prescribed. People who commented stated that the food was good and said ‘the food is lovely - I’m a plain eater, I like straightforward food and I’m always full when I’ve eaten’ and ‘I think it’s good food. I like the meat pie.’ Longwood Lodge Nursing & Retirement Home DS0000067233.V371018.R01.S.doc Version 5.2 Page 18 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. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. People at Longwood Lodge can be confident that the manager will listen to and take actions to remedy concerns and complaints, and steps are taken to protect them from abuse. EVIDENCE: The complaints policy was looked at. This provided information about how people can make a complaint and the amount of time by which a complaint would be investigated. A copy of the complaints procedure was seen in the foyer of the home. People who were spoken to said that they were confident that concerns would be taken seriously. The complaints record was examined and showed that information was passed on to the manager and that she dealt with issues in a manner that was fair and transparent. The home now uses a complaints form, which makes it easier for the manager to record any follow-up action she has taken. These forms are also in keeping with confidentiality legislation, as they only contain information about one person and can be stored in their individual files. Comments included ‘If I had any concerns I would talk to matron, she’s very, very nice and she’s a person you can talk to.’ Longwood Lodge Nursing & Retirement Home DS0000067233.V371018.R01.S.doc Version 5.2 Page 19 Each person who returned a survey confirmed that they felt listened to by staff and that they knew who to approach if the had any concerns. The training calendar indicated that the majority of staff have received Protection of Vulnerable Adults (POVA) training. Of staff spoken to, training in this area was outstanding for the maintenance person. This matter was discussed with manager and she was reminded that POVA training should be provided to all staff working in the home. Staff who were interviewed were clear about the actions that could be considered abuse and were clear about the actions they would take if they had any concerns. People who were interviewed indicated that they felt safe living at Longwood Lodge and said: ‘I’m alright, everything here is fine.’ Longwood Lodge Nursing & Retirement Home DS0000067233.V371018.R01.S.doc Version 5.2 Page 20 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. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. People living at Longwood Lodge benefit from living in a home that is spacious, comfortable and clean. EVIDENCE: As a part of the inspection process a tour of the shared and private parts of Longwood Lodge was made. The reception area is welcoming and warm. All the rooms that were seen were pleasantly decorated and the majority of bedrooms had been personalised with items people had brought from home; these reflected their interests, such as love of sport, following a faith or family life. Longwood Lodge Nursing & Retirement Home DS0000067233.V371018.R01.S.doc Version 5.2 Page 21 People were observed mobilising around the home safely, either escorted or unescorted. Aids and adaptations, including heightened toilet seats, handrails and rise and fall baths chairs, were in place. The lounge areas were clean; carpets and furniture were free from unsightly marks or stains. Some bedroom doors had name labels, as did the bathroom and toilets. The home was clean, fresh and free from malodours. Kitchen and food hygiene is managed under the Local Authority’s scheme ‘Safer food, Better Business.’ This was last inspected in July 2007. The laundry room was not looked at during this inspection, however, there have not been any concerns in this area and maintenance records confirmed that the machines had been serviced and passed as safe to use. Staff used aprons to support people with personal tasks. The manager has employed a maintenance worker and health and safety appointed person who have charge of the health and safety aspects and maintenance within the home. People who commented said ‘The home is absolutely spotless. My aunty and room kept immaculate.’ Longwood Lodge Nursing & Retirement Home DS0000067233.V371018.R01.S.doc Version 5.2 Page 22 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. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. People at Longwood Lodge are offered support from a stable staff group who are well trained and recruited using a robust and effective recruitment and selection process. EVIDENCE: On the day of inspection there were 40 people residing at Longwood Lodge nursing home and the staff on duty were the registered manager, deputy matron and nursing sister, seven care staff; domestics, a chef and two kitchen assistants. In the main, people who returned surveys felt that there were usually enough staff on duty to meet people’s needs. The manager stated that if staff went off sick then existing staff were asked to provide cover. One staff member commented on this and said: ‘The home has enough staff but if somebody falls sick or is absent there is shortage. Nurses on duty will ring up duty staff to cover but sometimes it is not possible.’ Longwood Lodge Nursing & Retirement Home DS0000067233.V371018.R01.S.doc Version 5.2 Page 23 The training matrix and certificates confirmed that staff are given training opportunities so that they can be competent at their jobs. Nursing and care staff have completed training courses and lectures that have been provided by through the local Primary Care Trust (health service), the local fire service, and organisations that provide equipment. The manager is a Movement and Handling facilitator and provides this training to staff. The training records at Longwood Lodge confirmed that, since the last inspection, staff had completed a variety of courses. These included lectures about dealing with cerebral vascular accidents (strokes), resuscitation, fire safety, food hygiene, health and safety, infection control, nutrition, skin care, palliative care, protection of vulnerable adults and Parkinson’s’ disease. Three new members of staff had completed the home’s induction process. The induction checklist covers topics that are specific to the home. The manager stated that staff complete the Skills for Care common induction training during a two-day course that is run by Oldham Metropolitan Borough Council. She said that staff completed workbooks, which they kept. She also said that carers had to have completed this course before being enrolled onto the NVQ level 2. In the information returned by the manager confirms that 63 of staff have achieved National Vocational Qualification (NVQ) in social care level 2. The manager said that three care staff were due to enrol on the course with Oldham College. Nursing staff who returned surveys confirmed that they were supported to update their knowledge. One person commented ‘I have been working in the home for five years and attended many training sessions and lectures during this period.’ All staff who returned surveys felt that they were well prepared for the jobs they did and kept up-to-date with new ways of working. The files of the three most recent recruits were looked at, two held a copy of a completed Criminal Record Bureau check and three held verification that POVA first checks had been carried out. In each file there was also a completed application form, proof of identity and references that had been verified when necessary. Staff who were interviewed enjoyed working at Longwood Lodge and one wrote: ‘We have a good workforce and management.’ Longwood Lodge Nursing & Retirement Home DS0000067233.V371018.R01.S.doc Version 5.2 Page 24 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. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. People at Longwood Lodge benefit from an ethos that aims to promote safety and wellbeing and take account of the opinions of all who are involved in the home. EVIDENCE: During the inspection time was spent discussing the running of the home with the registered manager (matron) and the deputy matron; both are Registered Nurses. The manager continues to update her knowledge and skills, she said that she had recently completed the moving and handling facilitator’s course and a management course. Longwood Lodge Nursing & Retirement Home DS0000067233.V371018.R01.S.doc Version 5.2 Page 25 Discussion with the managers indicated that though keen to listen to staff they had high expectations of the standard of care and support provided, and this took priority. Quality assurance includes separate service user and professional body questionnaires. The home’s quality assurance looks at accommodation, staff including friendliness and helpfulness, meeting needs such as being treated with respect; the information is analysed and used to influence developments in the home, such as the menu and activities. The outcome from these surveys was looked at and responses in all areas confirmed that people felt the quality of the services in the home was either good or very good. The information returned by the manager stated: ‘Staff morale is positive, atmosphere in the home is good. We get good feedback from relatives and our home’s clients. We have acted upon positive feedback from “outsiders” or staff members.’ As a part of the inspection service users’ finances were looked at. The home employs an administrator who manages service users’ finances. Service users, their relatives or representatives are invoiced for money that is spent. There is a clear audit trail that includes receipts, invoices and bank statements. Steps are taken to enable staff to deal with health and safety issues effectively at Longwood Lodge. The training records confirmed that staff have received moving and handling, fire safety and infection control training. Cleaning materials were handled safely. The maintenance manual and records held certificates that confirmed that all gas and electrical appliances and equipment had been serviced in keeping with the relevant legislation. According to the information provided, the six monthly service for manual hoists was overdue. The manager was aware of this at the time of the inspection and remedial steps were taken. Accidents and incidents were recorded and there was also an analysis of accidents completed by the manager commonalities are identified, and steps taken, through risk assessment and risk management plans, to prevent a repeat. Staff identified that the management Longwood Lodge allowed for ‘People to be cared for, both residents and their families, for people to be treated as individuals, staff to keep to the philosophy and aim for a good atmosphere in the home.’ Longwood Lodge Nursing & Retirement Home DS0000067233.V371018.R01.S.doc Version 5.2 Page 26 And that at Longwood Lodge: ‘All residents are looked after with respect, staff try their best to make them happy - social activities and outside visits are arranged on a regular basis and residents’ choices are highly respected in this home.’ Longwood Lodge Nursing & Retirement Home DS0000067233.V371018.R01.S.doc Version 5.2 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 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 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Longwood Lodge Nursing & Retirement Home DS0000067233.V371018.R01.S.doc Version 5.2 Page 28 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 OP9 Regulation 13 Requirement The registered person must make sure that the medication record clearly shows what medication people have been given and by who. Timescale for action 30/10/08 Longwood Lodge Nursing & Retirement Home DS0000067233.V371018.R01.S.doc Version 5.2 Page 29 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP7 Good Practice Recommendations The registered person should make sure that care plans accurately reflect each person’s emotional and communication needs. This so that people receive support which help them to be content and settled at Longwood Lodge. The registered person needs to make sure that all staff work in line with the instructions detailed in care plans, this is so people receive care that will keep them healthy and reduce any risk of harm. The registered person should make sure that all information provided, such as social profiles and interests, is used in care plans so that the activities and other services provided are individualised. At least 50 of care staff working at the home should have achieved NVQ level 2 or above training. 2 OP7 3 OP7 4 OP28 Longwood Lodge Nursing & Retirement Home DS0000067233.V371018.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection NW Area Office Unit 1, 3rd Floor Tustin Court Port Way Preston PR2 2YQ 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 Longwood Lodge Nursing & Retirement Home DS0000067233.V371018.R01.S.doc Version 5.2 Page 31 - 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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