Inspection on 11/08/09 for Thornlea Rest Home

This is the latest available inspection report for this service, carried out on 11th August 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

Thornlea Rest Home 06/02/07

Thornlea Rest Home 08/12/05

Thornlea Rest Home 23/06/05

Thornlea Rest Home 05/10/04

Thornlea Rest Home 05/04/04

Thornlea Rest Home 13/08/02

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 15/11/2009.

Key inspection report CARE HOMES FOR OLDER PEOPLE Thornlea Rest Home 308 St Annes Road Blackpool Lancashire FY4 2QP Lead Inspector Mrs Jackie Riley Key Unannounced Inspection 11th August 2009 09:00 DS0000009737.V377280.R01.S.do c Version 5.2 Page 1 This report is a review of the 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. 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 older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The 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. Thornlea Rest Home DS0000009737.V377280.R01.S.doc Version 5.2 Page 2 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 Thornlea Rest Home DS0000009737.V377280.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Thornlea Rest Home Address 308 St Annes Road Blackpool Lancashire FY4 2QP 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) 01253 345574 www.thornlearesthome.co.uk Mr Timothy Davies Wood Care Home 15 Category(ies) of Old age, not falling within any other category registration, with number (15) of places Thornlea Rest Home DS0000009737.V377280.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 categories: Old Age, not falling within any other category - Code OP The maximum number of Service Users who can be accommodated is: 15 Date of last inspection 25th September 2007 Brief Description of the Service: Thornlea is a large detached bungalow situated in a residential area of South Blackpool, on a main road, which is an advantage in respect of public transport and local amenities. The home is registered to accommodate a maximum of fifteen older people. The accommodation consists of 13 single bedrooms and one double bedroom, none of which have en-suite facilities. There are two lounges and a dining room. The bathing and toilet facilities are sufficient to meet the number of people accommodated. Sufficient information about the home is provided to all prospective residents in order that they can make an informed decision about the care and service provided. The home has a Statement of Purpose and Service User Guide containing information about the care provided, the qualifications and experience of the owner and staff and what services people can expect if they choose to live at the home. This information is displayed in the hallway of the home along with a copy of the last report for anyone to read. Information received (11/08/09) from the homeowner showed that the fees for care at the home ranged from £295.00 to £360.oo per week. Thornlea Rest Home DS0000009737.V377280.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 stars. This means the people who use this service experience good quality outcomes. A key inspection of the home was undertaken which included an unannounced visit to the service on the 11th August 2009 and lasted approximately 5 hours. We spoke to six people living there the owner and three staff members. The care records and other records relating to the care people receive were looked at. We also looked around the home with the manager and spent time talking to people living there. As part of the inspection process we looked at the rooms some people occupy, as well as looking at daily notes this is called case tracking. Every year the person in charge or manager is asked to provide us with written information about the quality of the service they provide, and to make an assessment of the quality of their service. This document is called ‘Annual Quality Assurance Assessment’ (AQAA). We use this information, in part, to focus our inspection activity. What the service does well: We found the home provides care in a flexible way, so that people have the opportunity to live their daily lives as they choose to. Comments included, I like it here because I can come and go as I please and get up and go to bed when I want to, The staff are really good they are always there for you if you need them. We saw staff speaking to people with respect and sensitivity, which people we spoke to said they liked. We saw staff making sure people’s needs are being met, so that they are comfortable. We talked to the staff team on duty who confirmed they have a good knowledge of the individual care needs, social and cultural needs of people living at the home so that they are not disadvantaged in any way. Comments included, many of the residents have been here for a long time and we know their needs. It’s nice to get to know the residents past life as they are all so different ands interesting. Thornlea Rest Home DS0000009737.V377280.R01.S.doc Version 5.2 Page 6 We found the way the home records peoples needs is good, so that their individual needs are identified and met. Staff we spoke to said they find it important to make sure issues are recorded so that they know at any one time what the needs of a person living at the home is. What has improved since the last inspection? What they could do better: We looked at training records for staff and found there is a range of training available to them relating to the needs of people living in the home, however the training record showed not all staff have received training in the area of safeguarding people. We spoke to the manager about this and were told it is not up to date and there are policies and procedures in place for staff and staff also receive information and training as part of national care qualifications. The training record should show which staff have received training in this area so there is a clear audit. Whilst all staff have received mandatory training there were some who needed to update their training so that their skills reflect current good practice, in areas of moving and handling. We found there are recruitment records for all staff employed in the home; however application forms should be requesting a full employment history with any gaps explained so that the information is complete. We saw the home has an induction checklist which the manager completes when a new employee commences work at the home. This checklist covers essential areas such as health and safety. The home should develop a record showing a carers competences in individual areas of their role, which is agreed with their manager as they gain more experience. Thornlea Rest Home DS0000009737.V377280.R01.S.doc Version 5.2 Page 7 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. Thornlea Rest Home DS0000009737.V377280.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 Thornlea Rest Home DS0000009737.V377280.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is admission and assessment procedures in place to ensure the care needs of people are met. EVIDENCE: We looked at the records of two people living at the home. We saw they had assessment details in place from social workers, or healthcare professionals. The information showed the home is informed through these assessments of the needs of the person. Staff spoken to said they use this assessment information to determine the level of care people need. Comments received said, They came to see me at home before I came here, “We get all the information we can from social services or the hospital, but we also carry out our own assessment before anybody comes here so we know we can meet their needs”. Thornlea Rest Home DS0000009737.V377280.R01.S.doc Version 5.2 Page 10 There is up to date information about the home and what services it provides. This information has been given to people living there as well as their families or advocates, so that they know what the home can provide and make an informed decision. People we spoke to told us they know about the information the home provides them with, so that they know what to expect. Thornlea Rest Home DS0000009737.V377280.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Promotion of health is taken seriously, people’s welfare is monitored and health needs are met. EVIDENCE: Since the previous inspection the home has continued to develop its care planning records which are clear and easy to follow. The two care planning records we looked at were accurate and up to date. There was good information about individual healthcare needs as well as how those needs are going to be met. Staff we spoke to said the information is clear and they can follow the plans to maintain and support people who live in the home. A person living at the home told us they are always asking you about what you need and get the doctor is I’m not feeling well. Thornlea Rest Home DS0000009737.V377280.R01.S.doc Version 5.2 Page 12 The records we looked at show there are risk assessments in place for people, which highlight what the risk is, how it can be managed and what the outcome is for the person. Some people living at the home have lived there for some time and there has been little change, however there is evidence there are reviews taking place involving the person. One person we spoke to said I like to go out every day but they make sure I have a card on me with the name of the home and the number, and they always ask when I’m likely to be back. People we spoke to told us they are involved in the care planning, and this was included in the care planning records. By looking closely at the records we found there is a good link between the home and other healthcare professionals including, doctors and district nurses. We saw records of G.P. visits and District nursing visits to individual people. In addition we saw hospital appointment records with reasons for the appointment and the outcome. This information helps the staff to keep informed of any changes which may be necessary in a persons care. Staff spoken to said, we have a good relationship with the doctors and district nurses, we work well together. The way the home manages it medication procedures is very good. We saw evidence of the home working well with the pharmacist who provides regular information and updates relating to good practice. All staff responsible for medication administration have received training in this area. We saw there are good recording processes which are all up to date. We looked at two records and found them to be complete. We looked at how the home stores medication and found it to be in a locked purposeful facility, to ensure security. We saw people’s privacy and dignity is respected by looking at how staff talk to and respond to people. We found staff to be respectful and sensitive to individual needs throughout the inspection. Staff spoken to said, I always treat people with respect as I would expect to be done to me. Thornlea Rest Home DS0000009737.V377280.R01.S.doc Version 5.2 Page 13 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Social activities and meals provide daily variation and interest for people living in the home. EVIDENCE: We spoke to some of the people living at the home and staff about what routines there are. They said they are flexible and people can get up and go to bed when they choose. We saw some people using their rooms during the day. Other people were in both lounges. We saw people are free to move around the home when they choose to. The lunchtime meal was being prepared and seen to be wholesome and nutritious. People we spoke to said, they liked the meals and they liked the daily choices available to them. Some people eat in the dining room, but others choose to eat their meals in their own rooms or at tables by their chairs. Menus we looked at were balanced and the use of fresh produce is made available whenever possible. Staff members spoken to said they like preparing Thornlea Rest Home DS0000009737.V377280.R01.S.doc Version 5.2 Page 14 the meals for people, and that they know that due to the home being of a moderate size they know the likes and dislikes of individuals and they respect this. We saw in the care planning records there is reference to people dietary needs. Comments received included, “The meals are always nice and they know what I like and don’t like”, “I like to have my lunch here before I go out, it’s worth staying for”. We saw there are a range of activities available to people living there. We spoke to people who told us they like to go out independently, some like to sit in the two lounges, and others choose to use their own rooms. There is a garden area used by some people when the weather is nice. In addition there are organised activities including hand massage, board games and music and movement. This activity was going on during the inspection and we saw there were a number of people taking part and enjoying the activity. One comment told us I like to take part in what’s going on its fun. The staff told us the home is staff with additional staff so there is more time to do things with people. We spoke to a person who likes to go out daily and this is not seen as a problem to the staff. The person said they tell the staff when they are going out and what time they expect to be back. Staff said they know the routine and would be alert if the person was late for any reason. Thornlea Rest Home DS0000009737.V377280.R01.S.doc Version 5.2 Page 15 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints are handled well and taken seriously ensuring people feel listened to. Staff have access to safeguarding protocols to protect people. EVIDENCE: We looked at the homes complaints procedure. It is made available to people using the service. We were told by staff and a person living there, they are aware of the complaints procedures and how to use it. Comments included, I would talk to the owner if I was unhappy about something”. We found there have been no complaints made to the home or to the Commission since the previous inspection of the service. We spoke to the manager about how people are protected they told us most staff have training as part of gaining a care qualification. The training list we looked at showed only one member of staff has attended specific safeguarding training in the last few years. The manager also showed us the homes policies and procedures in place for protecting people. We advised the manager staff training records should show who has received training in this area there is evidence they have the knowledge and skills to act upon any suspicion of abuse. Thornlea Rest Home DS0000009737.V377280.R01.S.doc Version 5.2 Page 16 Thornlea Rest Home DS0000009737.V377280.R01.S.doc Version 5.2 Page 17 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the 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 suitably adapted, clean, comfortable and pleasant surroundings. EVIDENCE: We toured all areas of the home and found it to be clean and free from offensive odours. The home is generally well furnished and decorated; however as rooms are becoming vacant they are being decorated so that the environment is maintained to a good standard throughout. People we spoke to said they liked their rooms and the home in general. I like my room and the things I have brought to put in it make it feel homely. The owner told us there is an ongoing maintenance programme and recommendations for improvement in the laundry system has included cover for staff who need to Thornlea Rest Home DS0000009737.V377280.R01.S.doc Version 5.2 Page 18 access the laundry in poor weather. An additional drying facility is also in place. There are two communal lounges which are very comfortable with a range of seating for people with a variety of mobility issues. In addition there are suitable adaptations including walking aids, wheelchairs and hoists so that people with limited mobility are assisted. A dining room is available to some of the people living in the home. There is an enclosed rear garden available to people, which has a decking and seating area used in good weather. People we spoke to said they liked sitting there as its private and a quiet area. Comments included, I like to sit outside when the weather is fine. A range of plants and flowers might enhance the area and provide interest for people using the garden. Thornlea Rest Home DS0000009737.V377280.R01.S.doc Version 5.2 Page 19 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the 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 procedures for recruiting staff are good, ensuring the safety and protection of people. Training and deployment of staff is being developed so that they are meeting the needs of people using the service. EVIDENCE: We looked at the duty rotas and discussed staffing levels with the manager. The home has a consistent staff team in sufficient numbers with various skills and experience to meet the needs of people living there. Staff we spoke to said they were happy with the way they are supported and how they work in the home. Comments included, Some of us have worked together for a long time and we work well together as a team. We looked at the homes training records and saw staff have access to various levels of training including national training care qualifications of which over 50 of staff have achieved at various levels. There is also access to mandatory training including moving and handling, first aid, and health and safety. Some staff need to update their qualifications in these areas as well as staff gaining training in safeguarding people so that they are protected. Thornlea Rest Home DS0000009737.V377280.R01.S.doc Version 5.2 Page 20 We looked at two staff files. The files showed us staff are recruited safely using procedures which take into account full information about them including application records and references, Criminal Record Bureau (CRB). Protection of Vulnerable Adults (POVA) checks to make sure they are safe to work with people who may be vulnerable. We did suggest to the manager that whilst they ask for a ten year employment history this should be extended to a full employment history with any gaps explained so that the owner and manager have all the information they need to make a decision about employing a person to work in the home. Thornlea Rest Home DS0000009737.V377280.R01.S.doc Version 5.2 Page 21 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the 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 is managed well with systems and policies in place for the safety and protection of residents. EVIDENCE: We saw the home is being run in the best interests of people using the service including staff. Comments included, we always feel supported by whoever is in charge, I feel I can discuss things I am not sure about, “there is always someone to talk to, and they make sure we are all looked after”. The manager demonstrated a very good level of knowledge and skills in the day to day management of the home. They have good systems in place which the staff team know about and have good access to. Thornlea Rest Home DS0000009737.V377280.R01.S.doc Version 5.2 Page 22 We looked at how the home gains the views of people using the service and found there are staff and resident meetings taking place which have agendas, and records of issues discussed and action taken in areas which have required some action. Staff told us they feel listened to in order to improve the quality of service. Comments included, “We share information all the time so we know what is going on at any time”. Staff were able to follow clear instructions in the records for the health and welfare of people living at the home. We saw there is a clear line of management responsibility and that staff communicated well with the manager and owner throughout the inspection process. By looking at records we saw regular tests and servicing of essential equipment including, gas, electric and fire were up to date. The previous inspection in February 09, required the home to cease from wedging fire doors open. We made observations in this area and found the practice has ceased. Thornlea Rest Home DS0000009737.V377280.R01.S.doc Version 5.2 Page 23 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 4 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 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Thornlea Rest Home DS0000009737.V377280.R01.S.doc Version 5.2 Page 24 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. 2. Refer to Standard OP18 OP30 Good Practice Recommendations The staff training record should show who has attended training in safeguarding people so there is a clear audit. The training records show some staff should have received updates in mandatory training in areas of moving and handling so they are compliant to health and safety guidance. The home application forms should show a full employment history with any gaps explained so that the owner can identify suitable applicants for the job role. To ensure newly appointed staff have gained essential knowledge in their roles the induction process should be developed to include evidence of staff meeting individual competences so the manager knows they are suitable for the work they are undertaking. DS0000009737.V377280.R01.S.doc Version 5.2 Page 25 3. 4. OP29 OP30 Thornlea Rest Home Care Quality Commission Northwest Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: 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). 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