Inspection on 08/05/09 for Red Thorn House

This is the latest available inspection report for this service, carried out on 8th May 2009.

CQC found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Red Thorn House 27/09/05

Red Thorn House 19/04/05

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Paradise Lodge

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Newton Court (1-2)

Kings Lane (32)

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Extracts from inspection reports are licensed from CQC, this page was updated on 07/08/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Red Thorn House Church Lane Terrington St John Wisbech Norfolk PE14 7SD     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: Brenda Pears     Date: 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 Adults (18-65 years) 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 Adults (18-65 years) Page 2 of 27 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 Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Red Thorn House Church Lane Terrington St John Wisbech Norfolk PE14 7SD 01945880877 01945881438 redthornhouse@herewardcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Hereward Care Services Ltd care home 8 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: Date of last inspection Brief description of the care home 8 Red Thorn House is a registered care home provided by Hereward Care Services Ltd. The home provides personal care and accommodation for eight adults who have a learning disability. The home is situated in a rural area close to the centre of the village of Terrington St John which is near Wisbech. There are 5 single bedrooms on the ground floor, 3 with an en-suite facility. There is a shared bathroom for the remaining two rooms, a kitchen/dining area and reception. This area of the home is fully wheelchair accessible. There are 3 first floor bedrooms with en-suite facilities. There are a number of communal areas including a dining/quiet room, kitchen and two lounges. There are large, attractive gardens, which are secure, offering various areas for relaxation, space and activity as required by the residents. Fees are individually calculated following a full assessment of needs. Copies of CSCI inspection reports are made available to residents and their relatives upon request. Care Homes for Adults (18-65 years) Page 4 of 27 Care Homes for Adults (18-65 years) Page 5 of 27 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 Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This was an unannounced inspection undertaken on the 8th May 2009 and started at 10.00am. The focus of this inspection was on the previous requirements, on the core national minimum standards and on the quality of life for people who receive support in the home. The methods used to complete this inspection consisted of looking at the care a resident receives and the records that support this. Information was provided to us by the home on an assessment form known as an Annual Quality Assurance Assessment Care Homes for Adults (18-65 years) Page 6 of 27 (AQAA). During the visit to the home we spoke to the deputy manager, undertook observations and interacted with individual residents. The manager was not on duty on the day of this inspection and the deputy manager assisted with this inspection in a professional manner. These methods and previous findings all inform the outcomes of this report. 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 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 Adults (18-65 years) Page 8 of 27 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 27 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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 home does assess the needs of any new resident to make sure individuals can be fully supported before an agreement is undertaken. Evidence: A full assessment is undertaken before support is agreed and appropriate staffing levels are allocated. Time is agreed for each person when first moving into the home and a further review is carried out to enable the person to decide if they wish to move in permanently. A review of records and discussions undertaken at this time confirmed this. Care Homes for Adults (18-65 years) Page 10 of 27 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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. Care plans contain appropriate information that enables staff to support residents in the way they choose. Evidence: We looked at two care plans and these confirmed the information in the AQAA that stated that the care plans and risk assessments are regularly reviewed. The care plan format has detailed sections of information that shows both doctors and district nurses provide support and other healthcare services are accessed when necessary. Care plans include areas for allergies, guidance on aggitated behaviour and de escalation techniques, history of physical needs and a health book. Appointments and outcomes of these are recorded for dietician, optician and hospital. Staff have previously confirmed that they play an active part in supporting residents when care plans are reviewed and any person chosen by the resident to attend their Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: review is invited to do so. People were being treated with dignity and addressed appropriately throughout this inspection and people were included in this process as much as possible. Care Homes for Adults (18-65 years) Page 12 of 27 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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. Service users are actively encouraged and supported to be in control of their own lives and undertake a variety of social events and daily routines. Evidence: People living in the home are supported to take part in a range of leisure activities and to maintain contact with family and friends. Clients are offered a variety of healthy meals that they have chosen. It was explained by the deputy manager on duty at this time that residents do have their regular outings or attend day care and other choices are made on the day and according to how each person is feeling. For instance, two residents would usually have been swimming on the day of this inspection, but both had cancelled and were being supported by staff in the home. Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: Records and discussions confirmed that family, friends and visitors are encouraged to keep contact and are included in as much of the events in the home as possible. There are regular daily activities undertaken by those choosing to attend day care centre and weekends are filled with chosen activities and trips to places of interest. These include allotment gardening, horse riding, cinema, bowling and meals enjoyed out. Key workers deal with allocated residents and support them to choose and undertake what they wish. This provides individual interaction that enables the person to speak freely and be enabled to develop their own goals using symbols where needed. One person has a boyfriend who visits regularly and on a special occasion a cake was made by the resident and the home celebrated with them. Daily activities are encouraged and supported to develop independence and responsibility for household duties. Care Homes for Adults (18-65 years) Page 14 of 27 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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. The home respects the privacy of residents and stores and dispenses medication appropriately. Evidence: Medication records and storage were found in line with requirements and we were told that there are only rare incidents of refusal of medication. Medical administration records (MAR) sheets were clearly completed and up to date in all areas. Discussions were undertaken regarding medication storage and new guidance that will soon be in force. The home works closely with their local pharmacy and training is ongoing and refresher training is due to be completed. Medication administered when needed is on the medical record sheet and prescribed for the individual person. There is a policy and procedure in place regarding the administration of medication and these are currently being reviewed. Records and care plans show that healthcare and appropriate support is accessed Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: outside the home. Records sheets showed that specific behaviours that may arise and develop challenging behaviors are fully discussed and actions agreed in the best interests of the resident. Guidance describes step by step behaviours and clear actions to be carried out by staff to prevent such escalation where possible. Care Homes for Adults (18-65 years) Page 16 of 27 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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 home encourages individual discussion as much as possible, providing the opportunity for residents to express any concerns. Evidence: The Commission and the home have received no complaints, only some concerns when adjoining building work was being undertaken. During this time the home provided a separate area of the garden for residents to use and the environment, both internally and externally, does allow for various areas of activity. The key worker system provides one to one time for each resident and supports discussion and expression of any concerns. Pictures and other prompts are used by the home when needed. Regular contact with family and friends also provides an avenue of information sharing and support for each resident. Residents were asked if their rooms could be seen and two people were very happy to show their room and share their photos with us at this time. There are robust procedures in place to support residents handling their own finances. A sound audit trail is in place and access is limited to certain staff only. Records were seen and balances checked on the day of this inspection. Care Homes for Adults (18-65 years) Page 17 of 27 Care Homes for Adults (18-65 years) Page 18 of 27 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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 home provides a safe, clean, comfortable environment for residents and offers spacious accommodation to meet their needs. However, the bathroom seen at this inspection requires attention as this is currently quite shabby. Evidence: The home is in spacious grounds set in the countryside and provides a homely and relaxed environment. Pictures and paintings are on display around the home that show special events that have been enjoyed. Internal and external areas are, in the main, well maintained. However, the bathroom is currently in need of attention as areas are quite scuffed and this does not provide an inviting place for residents to use. There is an ongoing redecoration programme that provides an opportunity for each resident to choose the colours for their rooms. Rooms seen were comfortable with personal belongings and favourite hobbies and outings were depicted around the rooms. One person spends time on the river with their family and this past time was evident by the photos on display. Two residents were relaxing in the home as they felt a little under the weather and later joined others for a trip out. The design of the home offers some quiet areas for Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: relaxation and quiet space when needed. Furnishings are bright and homely, providing a comfortable environment that continues to be upgraded with new soft furnishings and furniture. Care Homes for Adults (18-65 years) Page 20 of 27 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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 supported by a staff team that is recruited appropriately and undertakes regular training. Providing an appropriate staff team to support residents. Evidence: We examined records for two members of staff and these were found to be in good order with all the appropriate safety checks in place. These included a criminal records check, copies of identification and completed references. Regular supervision is undertaken and a wall chart showed that future dates are booked for this to continue to be completed. Staff on the day of this inspection included seven staff from 7am to 3pm, six staff on duty from 3pm to 8pm with two waking night staff. Weekend staffing usually consists of seven staff on all shifts to cover for additional activities. The staff team has been fairly stable with agency staff only being used when necessary. Agency staff will be regular people who are known to the resident and people who know the needs of people living in the home. Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: The training records continue to evidence that staff undertake comprehensive and relevant training to the specific needs of the service users. Training undertaken to date includes positive intervention, food hygiene, manual handling, first aid and autism awareness. A work shop for communication co-ordination has also been booked. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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 live in a home that is run in their best interests and by an appropriate staff team. Evidence: The current manager is undergoing the registration process and the deputy manager assisted with this inspection. All staff were professional and supported residents in an appropriate manner with due consideration for the individual, providing choices. There are regular quality checks undertaken for the home but some discussions were undertaken about providing a more indepth record for this quality review as this is currently limited. There are fire risk assessments on record and all service certificates seen at this time were up to date and included wheelchairs and hoists. The Commission has been kept fully informed of any notifiable incidents that have Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: occurred in the home in line with their registration requirements. Care plans show that the well being and individual needs of residents are considered and supported by practices in the home. Care Homes for Adults (18-65 years) Page 24 of 27 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 Adults (18-65 years) Page 25 of 27 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 40 The current quality monitoring system would benefit from being more indepth and provide fuller information about each area of the home. This would then ensure that all areas are reviewed over time and none are overlooked. Care Homes for Adults (18-65 years) Page 26 of 27 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). 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. Care Homes for Adults (18-65 years) Page 27 of 27 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!