CARE HOME ADULTS 18-65
Thomas House 70 Grove Park Calder Grove Wakefield WF4 3BZ Lead Inspector
Tony Railton Key Unannounced Inspection 30th April 2008 08:30 Thomas House DS0000062919.V363416.R01.S.doc Version 5.2 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 Thomas House DS0000062919.V363416.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 Adults 18-65. 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. Thomas House DS0000062919.V363416.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Thomas House Address 70 Grove Park Calder Grove Wakefield WF4 3BZ 01924 283445 01924 263312 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) K and M Care Mrs Maureen Preston Ms Katherine Barrick Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Thomas House DS0000062919.V363416.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 only - Code PC, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following category: Learning disability - Code LD The maximum number of service users who can be accommodated is: 3 2nd May 2007 2. Date of last inspection Brief Description of the Service: Thomas House is a spacious semi-detached property offering en-suite facilities within the 3 bedrooms, 2 spacious lounges, a large well-equipped kitchen and a garden to the rear of the property. This domestic property is situated in a residential area of Wakefield and the location allows for easy access to public transport and to local community facilities. The care and support provided is based on people who have learning disabilities living an ordinary lifestyle. People living in the home are encouraged and supported to access ordinary community based healthcare and leisure services. The operators of Thomas House (K&M Care) have experience of working with adults who have a learning disability and, in particular, those with Autism. The manager/proprietor informed the Commission on 30th April 2008 that the current range of charges for the home are from £1700 to £2300 per week. Details about the home are made available to prospective service users and their representatives via the Service User Guide and Statement of Purpose, both of which are available on request from the home. Details of the Commission for Social Care Inspection are included in these documents. Thomas House DS0000062919.V363416.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This service has been given a Two Star rating that means people living in the home experience good quality outcomes.
This visit to the home started at 08.30 and ended at 11.30. During the visit there was the opportunity to meet and speak to three people living in the home. There was also the opportunity to speak to the Registered Manager and two of the staff team. Three peoples files were seen and included assessments, care plans, reviews, daily, medical and financial records. Three staff files were also seen and included, application forms, references, Police and POVA (Protection of Vulnerable Adults List) checks, staff training and supervision records. Other information considered included three of the homes satisfaction surveys completed by those using the service, three relatives’ surveys, and two other surveys completed by others visiting the home. Information sent to the CSCI by the service providers was also considered as was the service history and previous inspection visit report. This was a very positive visit and a number of major improvements were noted. The inspector would like to take the opportunity to thank the people living in the home, the registered manager/owner and the staff team for their warm welcome and hospitality throughout the visit. What the service does well:
People were observed relaxing in a well decorated, well maintained home that is comfortable and clean. One person said they like living in the home as the “staff make them laugh”. The returned relatives satisfaction surveys show that they are very happy with the support and services offered. One says “Its like home from home”. Another writes, “Thomas House is spotless and very comfortable and the staff are very friendly”. Another writes, their relative “seems to be very happy, and is always ready to go back to Thomas House after a visit home”; they also say “all the staff at Thomas House do a great job, which I know is not always easy”. Another relative writes “Thomas House is like no other its like a home away from home”. They also say “staff have a very positive attitude” they go on to say “the difference in their relative is unbelievable, they will now interact with staff and other service users, eat their meals and no longer spends all their time in their bedroom”, they continue, “this is down to the care provided from day
Thomas House DS0000062919.V363416.R01.S.doc Version 5.2 Page 6 one, our relative experiences more, and their visits are more fulfilling at Thomas House than any previous respite”. One visitor to the home said, “Thomas House is a warm, welcoming and friendly place”. Another said, “staff are friendly and very professional”, and they go on to say, “There is a friendly and caring atmosphere, with homely surroundings of a very high standard”. One person using the service said they “like to make it rain in the garden and the staff make them laugh”. When asked if they dislike anything about Thomas House they said “nothing” They also said they can “choose their meals”, they “like their bedroom”, they also like “going shopping” and “help making meals”. They also said they like “swimming, walking, horse riding, going to the sea side and theme parks”. The daily records show that people do have choices and have a say in what happens to them on a day-to-day basis. The reviews show that people living in the home and their relatives are very happy with the care and support provided. What has improved since the last inspection? What they could do better:
For the benefit of people using the service, the registered manager said there are plans to introduce the LADAF, (Learning Disability Award Framework), and this is to be included as part of the induction training for new staff.
Thomas House DS0000062919.V363416.R01.S.doc Version 5.2 Page 7 To make sure the finances of people using the service are safer the records should be updated and two signatures obtained to check and say they are correct. The information gathered through the satisfaction surveys has not be put together or a report provided showing what people said and what changes have been made to the running of the home as a result of their comments. 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. Thomas House DS0000062919.V363416.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Thomas House DS0000062919.V363416.R01.S.doc Version 5.2 Page 9 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including this visit. To make sure the service can meet peoples’ care and support needs these are assessed before coming to live in the home. EVIDENCE: The manager said the new person centred plans show peoples personal and healthcare needs and are completed with the assistance of people wanting to use the service and their relatives. A sample of three peoples records show people and their relatives are involved and have a say in how they want to be cared for. The manager also said that people already have assessments completed by Social Services before they come to the home. They said that these assessments are also considered when deciding if people want to live in the home. The returned satisfaction surveys show that people and their relatives are fully involved in reviewing peoples’ assessments and judging if peoples’ needs are met by the service. The minutes of the reviews confirmed this. The assessments seen are very detailed and give staff lots of information about what they must do to make sure people receive the care and support they need and require. Thomas House DS0000062919.V363416.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including this visit. People and their relatives have a say in what happens to them and they make choices about how the live their lives. EVIDENCE: The person centred plans seen are very good and have lots of detail telling staff what they need to do to meet peoples care needs and how they like to be supported. The daily records are also good and contain words to describe and show peoples choices and preferences and how people want to be supported. The monthly reports show that peoples care needs are looked at regularly to see if there have been any improvements or any changes in how people are cared for. The risk assessments seen show that people are supported and encouraged to take risks as part of living an ordinary lifestyle and what action should be taken to minimise any risks to people in the home.
Thomas House DS0000062919.V363416.R01.S.doc Version 5.2 Page 11 The six returned satisfaction surveys show that people enjoy living the home and their relatives feel involved and that peoples care needs are met. The minutes of the six monthly reviews show people their relatives and other supporting professionals feel peoples personal needs are met and are happy with the care and support provided. One relative wrote, “Thomas House is like home from home”. One person using the service said they “like everything” about the home and would “not make any changes” Thomas House DS0000062919.V363416.R01.S.doc Version 5.2 Page 12 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including this visit. People are supported to live as ordinary a lifestyle as possible and have a say in what they do. They are also offered a varied and balanced diet of their choice. EVIDENCE: The daily records contain descriptive words to show and reflect peoples’ choices and preferences with regard to activities and choice of menu. Three peoples records show that there are opportunities for personal development both at local authority run Day Opportunities or Local Authority Special School. One person’s returned satisfaction survey says they enjoy, “Swimming, Arts and Crafts, Trips to the Sea side and Theme Parks”, they go on to say they also like “Shopping, Preparing and cooking food, and Gardening”. One person’s records contain Certificates of Achievement for Personal Awareness and ‘Life-skills’. The returned satisfaction surveys show people
Thomas House DS0000062919.V363416.R01.S.doc Version 5.2 Page 13 living in the home and their relatives are happy with the support provided and the way they live their lives. The reviews show that people, their relatives and others involved such as local authority day opportunities staff are happy with the lifestyle offered by the home. One satisfaction survey says their relative “enjoys the meals more at Thomas House than at home”. Another writes, “our relative is very fussy but they are always well fed”. Thomas House DS0000062919.V363416.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. People living in the home experience good quality outcomes in this area. We have made this judgement using a range of evidence including this visit. People receive care and support in a way they prefer and require and they are protected by the way medicines are dealt with. EVIDENCE: Peoples’ person centred plans, assessments and reviews show that they and their relatives and others are involved and have a say in how they are cared for. The minutes of the reviews show people, their relatives and others think the home meets peoples assessed needs and are happy with the support provided. Peoples’ medical and daily records show they are supported to use ordinary community based healthcare services. Records also show people are supported by hospital based consultants and the Community Learning Disability Team when required. The manager said the medication system has been changed and is better than before and the new system is simpler and safer. They also plan to train all staff in the safe administration of medicines. Three peoples medicines were checked and found to be correct. Staff training records show some staff have received training in how to give medicines safely and there are plans to train the others.
Thomas House DS0000062919.V363416.R01.S.doc Version 5.2 Page 15 The returned satisfaction surveys show that peoples’ relatives feel they are involved and have a say in how peoples healthcare needs are met. The minutes of the reviews show that relatives and other visiting professionals feel that peoples’ healthcare needs are met. Thomas House DS0000062919.V363416.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People living in the home experience good quality outcomes in this area. We have made this judgement using a range of evidence including this visit. People and their relatives know their comments will be listened to and acted upon and they are protected from abuse. EVIDENCE: The minutes of the reviews and the returned satisfaction surveys show that people and their relatives are fully involved in the running of the home and have a say in what happens. One relative writes “they speak to the manager on a regular basis”. The information sent before the visit shows the home has not received any complaints or Safeguarding Referrals. The manager confirmed this and said she speaks to relatives all the time and if there are any issues these are dealt with promptly. The manager said to make sure people know how to make a complaint a copy of the complaints policy is included in the Service User Guide and this is given to people and their relatives. The Service User Guide confirmed this. To make sure people using the service are protected the staff training records show all staff have POVA (Protection of Vulnerable Adults) training. Discussion with two support workers found they have a good understanding of the needs of people who have Learning Disabilities and confirmed they have had training in recognising and dealing with abuse. One relative’s satisfaction survey says they “find Thomas House to be safe and secure”.
Thomas House DS0000062919.V363416.R01.S.doc Version 5.2 Page 17 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 People living in the home experience good quality outcomes in this area. We have made this judgement using a range of evidence including this visit. People live in a well decorated and well maintained home that is clean and comfortable and safe. EVIDENCE: One relative satisfaction survey say’s “Thomas House is like no other its like home from home”. Another say’s “Thomas House is spotless and very comfortable”. One visitors survey say’s “Thomas House is very warm and welcoming”. A tour of the premises found it to be well decorated and well maintained. Although people using the service cannot communicate verbally they appeared to be relaxed, comfortable and enjoying their surroundings. The manager said to make sure people are safe regular fire safety and health and safety checks are undertaken. The maintenance records confirmed this. To maintain a safe environment staff training records show they have Health and Safety, Food Hygiene and Infection Control training. A recent contractmonitoring visit by the Wakefield Local Authority did not raise any issues.
Thomas House DS0000062919.V363416.R01.S.doc Version 5.2 Page 18 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 People living in the home experience good quality outcomes in this area. We have made this judgement using a range of evidence including this visit. Experienced and trained staff meets peoples care and support needs, and they are protected by the way staff are recruited and selected. EVIDENCE: One professional visitors survey says, “All staff members have the clients needs as a priority. They work together as a good staff team”. One relatives survey says,” I thank all the staff at Thomas House they do a great job which I know is not always easy”. Another says,” Staff have a very positive and no nonsense approach which has helped in developing social interaction” for their relative. They go on to say “The difference has been unbelievable our relative will now interact with staff and other people using the service, They will eat their meals with others and no longer spends all their time in their bedroom. This is all down to the care you have provided from day one”. Discussion with two support workers found they have a good understanding of the care needs of people using the service and people were observed being treated with dignity and having their wishes respected.
Thomas House DS0000062919.V363416.R01.S.doc Version 5.2 Page 19 To make sure people live in a safe environment staff training records show they have induction, First Aid, Health and Safety, Infection Control, Moving and Handling and Food Hygiene training. The manager said to make sure staff have more insight into the needs of people who have Learning Disabilities, all staff is registered on National Vocational Qualification Training Level three. They also said there are plans to introduce the LADAF (Learning Disability Award Framework) training for all staff. Discussion with staff and the training records confirmed this. To protect people from any kind of abuse a sample of six staff records show that appropriate police and POVA (Protection of Vulnerable Adults List) checks are taken up before they are employed. To further protect people staff records show they all have Safeguarding training. Thomas House DS0000062919.V363416.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 People living in the home experience good quality outcomes in this area. We have made this judgement using a range of evidence including this visit. People live in a home that is well managed and is run in their best interest, and where they are safe. EVIDENCE: The three peoples records, including assessments, person centred plans, daily and medical records and reviews show the care management systems have improved. They show that people and their relatives and others ‘have a say’ in how people live their lives and are fully involved in the running of the home. Six staff records including training, and supervision records show the way they are managed has improved as staff are now more trained and the work they do is regularly supervised. Staff said they feel supported and have a say in the work they do. The quality assurance system is good and shows people using the service, their relatives and other professional visitors have a say and the opportunity to
Thomas House DS0000062919.V363416.R01.S.doc Version 5.2 Page 21 comment on the quality of care provided. The manager said they have not had the opportunity to put all the information gathered from the surveys and provide a report. Peoples’ finances are protected and well managed as they were checked and found to be correct. However, some are not checked properly as some records only have one signature. The health Safety and Welfare of people using the service is promoted and protected as staff training records show they have health and Safety training. The maintenance records also show the home is checked to make sure it is safe. The returned satisfaction surveys show that people and their relatives feel the home is safe and secure. Thomas House DS0000062919.V363416.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Thomas House DS0000062919.V363416.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action 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 YA35 Good Practice Recommendations To give staff more insight into caring for people who have learning disabilities the Learning Disability Award Framework training for staff should be introduced as soon as is practicable. To show peoples views on the quality of the care provided the information gathered through the satisfaction surveys should be collated and a report provided reflecting their views and any changes made to the way the home runs because of their comments To further protect peoples finances two staff signatures should be obtained for all financial transactions. 2. YA39 3 YA43 Thomas House DS0000062919.V363416.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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