Inspection on 19/04/05 for Red Thorn House

This inspection was carried out on 19th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Red Thorn House 24/05/07

Red Thorn House 27/09/05

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Red Thorn House Church Lane Terrington St John Wisbech PE14 7SD Lead Inspector Jenny Rose Announced 19 April 2005 14:00 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 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 Stationary 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. Red Thorn House Version 1.10 Page 3 SERVICE INFORMATION Name of service Red Thorn House Address Church Lane Terrington St John Wisbech Norfolk PE14 7SD 01945 881294 O1945 880877 redthornhse@btconnect.com@ Hereward Care Services Ltd Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Miss Suzanne Mary Hollingworth Care Home 5 Category(ies) of Learning Disability (5) registration, with number of places Red Thorn House Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection First Inspection Brief Description of the Service: Redthorn House is a care home providing personal care and accommodation for five adults who have a learning disability. The facilities are provided by Hereward Care Services Ltd. The home stands in a very rural area about one mile from the centre of the village of Terrington St John, which offers shops and a public house. The home was opened in 2004. It is an extended detached house built in the 1960s. Unit One is a purpose designed, self-contained extension comprising 5 single bedrooms on the ground floor, 3 with an en-suite facility. There is a shared bathroom for the remaining two rooms, a kitchen/dining area and reception room. This area is fully wheelchair accessible. Unit Two consists of 3 first floor bedrooms with en-suite facilities, a dining room, kitchen and lounge, to be opened shortly. There are large attractive gardens offering various areas for relaxation, space and activity as required by the service users. Red Thorn House Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, taking place over 4 hours. Preparatory work had been undertaken beforehand and two comment cards had been received in the CSCI office. A tour of the premises was undertaken; records, policies and care plans examined. Ms Suzanne Hollingsworth, Manager, was present during the inspection and several members of staff were spoken to. Mr Mark Hubble, Line Manager for the Home attended for the conclusion of the inspection. Opportunity was taken to communicate with three of the service users. What the service does well: What has improved since the last inspection? What they could do better: On this occasion, there are no comments to be made in this area. Red Thorn House Version 1.10 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Red Thorn House Version 1.10 Page 7 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 Standards Statutory Requirements Identified During the Inspection Red Thorn House Version 1.10 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4,5 Clear information is available for all prospective service users and their carers and advocates to make an informed decision as to whether the home is suitable for them and the pre-assessment process assures that their needs will be met. EVIDENCE: Prospective service users and their family and friends are provided with a comprehensive statement of purpose and service users’ guide, which is simply and clearly written, together with an individual written statement of terms and conditions which is also reproduced in Symbols. Prospective service users’ aspirations and needs are assessed in their former place of residence and visits to the home prior to admission with carers and advocates, before the service user is offered the opportunity to ‘test drive’ the home. The preadmission assessment is thorough, covering environmental, behavioural and training needs for the service user. The Manager reported that the three, new, prospective service users and their families have met at the home and the day centre and together with the staff at the home are purchasing things for their new rooms. She also said that it was intended to take photographs for the new service users to show to family and friends before moving in. This is seen as good practice. Red Thorn House Version 1.10 Page 9 All service users are accepted for an initial probationary period of three months. giving the individual time to settle into their new surroundings and an opportunity to assess the accuracy of the information in the initial assessment. Red Thorn House Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8,9 It is evident that there is a strong commitment to base the service provided on the needs and choices of the service users, which results in providing a high quality of life for the service users. EVIDENCE: Care plans are comprehensive and each service user’s plan has a section for the individual explained in a simple manner and in symbols, where appropriate. These are reviewed regularly, with the service user and their carers, if appropriate, and include activity plans: night and behaviour observation plans. Two key-workers and the senior change the care plans according to behaviour changes, explaining this to the service user with prompt cards and sequence charts, if necessary. It was observed that service users were encouraged to take part in the daily routines of the home, according to their capacities. One person was helping with taking in the washing. Another service user demonstrated his enjoyment of cooking, by sign language and with the finished result of a loaf of bread. There was a risk assessment in his care plan for this activity, also for other risks in daily routines, to provide as much autonomy as possible for service users. Red Thorn House Version 1.10 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,13,17 Much work has been undertaken to ensure that there are opportunities for the personal development of the service users and that they are part of the local community. This, together with a healthy diet, to which the service users can contribute in preparation, enhances the quality of life for the service user. EVIDENCE: Attendance at the Day Centre is organised on an individual basis for each service user, if appropriate, and it was observed that service users are encouraged to be as independent as possible with their self-help skills. The service users are known at the local amenities and there are opportunities for walking with staff, including wheelchair-users, along the lanes near to the home. It was also observed that service users were supported in listening to the music of their choice and playing a game in the sitting room. The bedrooms seen were personalised to the interests and preferences of the individual service user. Red Thorn House Version 1.10 Page 12 One service user needed support with choosing a healthy diet, and this has been managed by the introduction of a Healthy Eating Box, personalised for her particular choice of healthy foods. Service users choose to eat with whomever they feel comfortable and there are flexible routines. Those, who wish to, are encouraged to help with the preparation and clearing away of the meals and staff eat with the service users at homely tables in the kitchen area. All service users, except one, go shopping for their particular food preferences, which they can indicate by the use of photographs before going shopping. There is a dedicated vehicle so that trips and leisure activities can be undertaken outside the home and enabling service users to participate in community activities. Methods of communication with service users are given a high priority by management and staff. It was observed and noted that staff are trained in Makaton, make use of symbols and sequence cards to elicit service users’ wishes and computer software used provides clear information for service users. This is good practice. Red Thorn House Version 1.10 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20, Much attention has been paid to service users being actively involved in all aspects of their personal care and support, to maintain as much autonomy as possible. The home’s medication policies and procedures, together with the staff training, offer protection the service users. EVIDENCE: It was observed that service users’ wishes and independence were respected and taken into account, not only in the care plans, but, on the day, one person, it was observed, changed her mind about going out and therefore plans were changed and she returned to her room. The Manager reported that there is good liaison with local health services, from the GP, Community Nurse, Physiotherapist, Speech and Language team, Psychiatrist, Occupational Therapist, Dietician and Social Workers. It is intended to develop Care Plans into Health Action Plans, with service users, their key-workers and carers/advocates, the Day Centre and other professionals, if appropriate to share with the GP. The Community Nurse has been involved in training staff in the administration of certain medications. There were no service users are able to administer and control their own medication. Red Thorn House Version 1.10 Page 14 Red Thorn House Version 1.10 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 Complaints procedures are in place in a form, which is meaningful to the service users and explained by the key workers, ensuring that views are listened to and acted upon. The staff are well trained to protect the service users from abuse, neglect and self harm. EVIDENCE: The complaints procedure is explained in a simple form in the Guide for Service Users and within the care plan, in symbols, completed with the key-worker. All service users/family/advocates, as well as staff, are made aware of this and its use. A letter is sent to the family of the service user informing them how to make a complaint. Service users’ personal monies held by the home were checked at random and found to be correct. There are clear policies and procedures in place for Adult Protection and the staff well trained in this area. Red Thorn House Version 1.10 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,28,30 There has been much improvement to the property and the fittings and furnishings to ensure that the home is a comfortable, clean and safe environment in which to live. EVIDENCE: The communal rooms are homely, bright and clean and the bedrooms seen were personalised and as homely as possible, providing privacy and room for personal possessions of the service user’s choice in a safe environment. It was observed that service users’ privacy and dignity was respected by staff, who knocked on doors before entering. Three bedrooms had en-suite facilities. The whole area is wheelchair accessible. The home is surrounded by a pleasant garden and attractive views across the fenland. Red Thorn House Version 1.10 Page 17 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 34, 35 Opportunity has been taken to build a strong, bonded staff team, well trained to meet the individual service user’s needs and also those of the group. EVIDENCE: Three members of staff were spoken to, in addition to the Manager and Deputy Manager. All had undertaken training in many areas, particularly in Communication and Makaton, Musical Activities, Behaviour Management, as well as specialised health aspects, such as Epilepsy, Medication, Autism, in addition to the statutory training for care homes. Two members, in particular, had many years of experience in this area of care. All staff spoken to, were enthusiastic and creative in their approach to their work. One, in particular, felt that the location of the home in a rural area lent itself to developing new activities for service users; one, in particular, had not heard birds in his former residence. She felt that the atmosphere in the home was “like a breath of fresh air”. There has been time, before the arrival of the service users to build a strong staff team. All staff spoken to felt that this had been an excellent opportunity for the team to gel and learn to work together. Staff feel well supervised and supported the Management. Red Thorn House Version 1.10 Page 18 Red Thorn House Version 1.10 Page 19 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 39, 42 The home is well run and its ethos, leadership and management promote the interests of the service users. EVIDENCE: The staff feel well supported by the Management and the Directors, and the ethos is open and inclusive. There is a quality assurance system in place, which is designed to provide a vehicle for continuous improvement based on service users’ needs. The health, safety and welfare of both service users and staff are protected by the policies and procedures in place. The Accident Book and all service records seen were in order and up to date. Red Thorn House Version 1.10 Page 20 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. Where there is no score against a standard it has not been looked at during this inspection. 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 4 4 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 4 4 4 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 4 x x 3 x 3 Standard No 11 12 13 14 15 Red Thorn House 4 x 4 x x Standard No 31 32 33 34 35 36 Score x x 4 3 4 x Version 1.10 Page 21 16 17 x 4 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x 4 3 x Standard No 37 38 39 40 41 42 43 Score 4 x 4 x x 3 x Red Thorn House Version 1.10 Page 22 N/A Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 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 Good Practice Recommendations Red Thorn House Version 1.10 Page 23 Commission for Social Care Inspection 3rd Floor, Cavell House St Crispins Road Norwich NR3 1YF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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