Key inspection report
Care homes for adults (18-65 years)
Name: Address: Thomas Owen House Lees House Road Thornhill Lees Dewsbury West Yorkshire WF12 9BP The quality rating for this care home is:
two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Cheryl Stovin
Date: 0 1 0 7 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area.
Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection.
This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years)
Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC 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: Thomas Owen House Lees House Road Thornhill Lees Dewsbury West Yorkshire WF12 9BP 01924458017 01924488783 nurses@thomasowenhouse.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Thomas Owen Care Limited care home 39 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 39 The registered person may provide the following category of service only: Care Home with Nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following categories: Dementia Code DE, maximum number of places 39 Mental Disorder, excluding learning disability or dementia, Code MD maximum number of places 39 Date of last inspection Brief description of the care home Thomas Owen House care home is a detached, stone built property with enclosed central garden. It provides nursing and personal care for up to 39 people who are predominantly younger adults with a mental disorder. The majority of rooms provide single accommodation with spacious and comfortable communal accommodation. The home was a former private residence and was converted for care home use in 1989. It is situated in the Thornhill area of Dewsbury and is convenient for local bus services, Care Homes for Adults (18-65 years)
Page 4 of 27 Over 65 0 0 39 39 Brief description of the care home the church and pub. Shops and the Post Office are within walking distance of the home. The town centre of Dewsbury is a short bus journey away. Information about the home and the services provided are available from the home in the Statement of Purpose and Service User Guide. 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: This report brings together evidence of the key inspection of Thomas Owen House which included a visit to the service on 1st July 2009. During this visit a full tour of all of the building took place, we looked at records and talked to people living at the home and to management and staff. The visit was made by one inspector and a total of 7 hours were spent at the home. The purpose of this inspection was to assess the quality of the care and support received by the people who live at Thomas Owen House The last key inspection was in July 2007, no additional visits have been made to the home. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is Care Homes for Adults (18-65 years)
Page 6 of 27 considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The methods used to gather information included conversations with the people living at the home, the staff and visitors as well as looking at care plans and examining other records. We received the homes self-assessment questionnaire before the inspection visit. This all gave us useful information about the home and helped us plan the visit. The weekly charges made by the home range from five hundred pounds to thirteen hundred pounds, (as at 1st July 2009). The charges are subject to an individual assessment dependent upon the amount of care and support people require. Additional charges are made for hairdressing and personal toiletries. Care Homes for Adults (18-65 years) Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for 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. Peoples care needs are fully assessed to make sure that the home is suitable for them. Evidence: The care records of six people living at the home were people were looked at. These records confirmed that all peoples care and support needs are fully assessed to make sure that the home is suitable for them. The admission procedure is thorough and tailored to meet the individual needs of people moving into the home. People are encouraged to visit as many times as they like before making a decision to move in. This gives people the opportunity to meet the staff and other people living at the home and to sample the daily routine. If people have any specific needs that staff are unfamiliar with staff receive specialist training before people are admitted to Thomas Owen House.
Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: A contract is in place which details the services and facilities provided by the home. This makes sure that people know what is and is not included in the weekly charge. People are provided with written information about the services and facilities provided by the home. This makes sure that people know what to expect from the home. Care Homes for Adults (18-65 years) Page 11 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. The care planning system is easy to follow and peoples needs and goals are met. Evidence: The care records of six people living at Thomas Owen House were seen. The records show that peoples personal and health care support needs are assessed and care given in a way that people prefer. How the care is to be delivered is clearly set out in peoples care plans. The care plans are reviewed regularly and any changes needed to peoples care clearly documented. Risk assessments and care plans were in place relating to challenging behaviuour. From observation and discussions with staff and people living at the home, it was clear that the staff are aware of each persons needs and preferences. The staff make sure they provide the help people need in the way they prefer. Staff were seen to be providing support and care to people in line with their care plan and staff spoken to had a good understanding of what people require. People are
Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: encouraged, whever possible, to make decisions about their own lives. One person told us that the staff help me to live my own life. Care Homes for Adults (18-65 years) Page 13 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. People live active and varied lives and participate in a wide range of community activities. Evidence: People living at Thomas Owen House are encouraged and helped to live active and varied lives. The staff team have implemented new ways of working with people to make sure they maintain and develop their own interests. Social activities are very much part of peoples lifestyles. On the day of the visits people were out and about, one person was out shopping and others were out for lunch. One person particularly enjoys visiting the coast and this forms part of their care plan. A record is kept of social activities that people participate in. Records showed that people visit the cinema and theatre,attend concerts and regularly eat out. One person particularly enjoys using a computer which is provided for the use of people living at
Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: the home. Any specific events identified as a goal at their Person Centred Planning meetings were seen to have either been carried out or in the process of being arranged. People are actively encouraged to keep in touch with families and friends. Details of special occasions, for example, birthdays and anniversaries are recorded and their key worker assists them in buying gifts and writing cards. The home has an emphasis on healthy eating and people are encouraged to eat a balanced and nutritious diet. The time of the main meal varies according to what people are doing and is flexible. The main meal of the day during the visit was served at lunchtime and was: southern fried chicken, served with black peppered potato wedges, garden peas and a side salad, or stir fry with oriental vegetables followed by strawberries and ice cream or fruit cocktail. Snacks and drinks are freely available during the day. People said that they enjoyed the meals served at the home. Care Homes for Adults (18-65 years) Page 15 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. Peoples health care needs are met and personal care is given in accordance with their preferences. Evidence: There was evidence in the records seen that people receive the specialist health care they require and receive support from a wide range of health care professionals. Physiotherapists regularly visit the home and provide advice to the staff about maintaining peoples mobility. People are registered with a local GP practice before they move into the home, this makes sure that medical assistance is available immediately they move in. One visiting relative told us that they care for their relative in a wonderful way, and that the staff meet their needs exactly. The home uses a Monitored Dose System for the administration of medication and is held safely. Medication Administration Records were seen to be accurately completed and stocks
Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: held reconciled with records kept. There are guidelines in place for any as required (PRN) medication, which makes sure that the medication is administered in a consistent manner. A separate PRN medication record is held. No person living at the home currently handles their own medication. Facilities are provided for the safe storage of medication should anybody be able to do so. The home has a pharmaceutical waste contract in place to make sure that unused medication is disposed of safely. Care Homes for Adults (18-65 years) Page 17 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. Procedures are in place to make sure that people are protected from abuse and their welfare is protected. Evidence: The home has a complaints procedure which is produced in a format that people can understand. The staff told us that there had been no complaints or compliments since the last inspection. No complaints had been made directly to the Commission. All staff receive training in the Protection of Vulnerable Adults and staff spoken to had a good understanding of safeguarding procedures. The home also has a whistle blowing procedure for staff to draw attention to poor practice in a confidential manner. Finance records for some individuals were looked at as part of this visit. These were found to be accurately completed and receipts obtained for purchases. This makes sure that financial procedures are safely monitored. 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. People live in a safe and hygienic environment with equipment provided to meet their needs. Evidence: The home, a large Victorian property is situated in a residential area not far from the town centre of Dewsbury. There are shops and local facilities nearby. The accommodation is well maintained and since the last inspection redecoration and refurbishment has taken place and the accommodation is bright and welcoming. At the time of the visit a new roof was being installed, the work was being completed in a sensitive manner to minimise any disruption to people living at the home. All areas of the home were found to be clean and tidy and laundry facilities were good. Where it is needed, equipment required to help people move is provided, such as ceiling tracking in lounges and bedrooms. All bedrooms are well equipped and the majority have been personalised to reflect peoples individual interests and tastes. People are obviously proud of their rooms which are equipped to meet their needs.
Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: Communal areas are spacious and comfortable with sufficient space for social activities to take place. There is a smoking area provided in the home for those people who wish to smoke, additional ventilation has been installed in this area to make it more pleasant for people to use. There are attractive and safe outdoor garden areas. There is ample car parking space for staff and visitors. Protective gloves, aprons and disinfecting hand rub are available for staff to use when necessary, to support the homes infection control measures. 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. Peoples needs are met by a well trained and competent staff team and are protected by the safe recruitment practices. Evidence: There are sufficient staff on duty to meet peoples needs. There is always a Registered Nurse on duty and during the visits there were two nurses on duty. Seven support workers are also on duty during the day, two of which are dedicated to providing activities or outings. At night there are two support workers and a registered nurse on waking night duty. The staff work flexibly to make sure that people can attend social activities and get out and about. Staff spoken to showed a good understanding of peoples needs and used appropriate communication methods. Relationships between everybody appeared to be relaxed and friendly with appropriate use of informality and humour. People living at the home, who were able to, told me that the staff treated them well and assist them to live as independently as possible. Staff said the organisation places a high priority on staff training and development
Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: with a wide range of training opportunities. All staff undertake mandatory training which includes food hygiene, manual handling, fire safety, emergency aid and safeguarding practices. There is a programme of National Vocational Qualification (NVQ) in place and all of the support assistants are expected to complete the award, this makes sure that the staff are qualified to care for people. Over half of the care staff already hold the award. The homes recruitment procedures are thorough, making sure that staff are safe to work with the people who live at the home. Five staff recruitment files seen confirmed that all new staff complete an application form and provide two written references. Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) register checks are obtained and no new staff begin work until these checks have been completed satisfactorily. 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. People live in a well run and managed home with their health and safety promoted. Evidence: The Registered Manager of the home is qualified and competent to run the service. Staff said that the manager was very approachable and listened to what they had to say and actively encouraged suggestions and comments. There are regular meetings with people living at the home which makes sure that their views are fully taken into account as to how the home is run. A senior manager from the organisation visits the home regularly and compiles a report each month on their findings. The homes manager lets us know about any significant incidents that affect the well-being of people who live at Thomas Owen House. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: At present there are no people living at the home who are subject to a deprivation of their liberty authorisation, under the Mental Capacity Act 2005. We received the homes annual self assessment. It contained information about the home and the services that are provided, the improvements they have made and their plans for the coming twelve months. There are health and safety polices and procedures in place. All staff receive training in health and safety and safe working practices with regular updates. Health and safety records seen showed that all the required checks had been carried out. This means that peoples health and safety is promoted. 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 Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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 CQC 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!