Inspection on 27/09/05 for Red Thorn House

This inspection was carried out on 27th September 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 19/04/05

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 Norfolk PE14 7SD Lead Inspector Jenny Rose Unannounced Inspection 27th September 2005 14:30 Red Thorn House DS0000062819.V253190.R01.S.doc Version 5.0 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 Red Thorn House DS0000062819.V253190.R01.S.doc Version 5.0 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. Red Thorn House DS0000062819.V253190.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Red Thorn House Address Church Lane Terrington St John Wisbech Norfolk PE14 7SD 01945 880877 01945 881438 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) Hereward Care Services Ltd Miss Suzanne Mary Hollingworth Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Red Thorn House DS0000062819.V253190.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th April 2005 Brief Description of the Service: Redthorn House is a care home providing personal care and accommodation for eight 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 1960’s. 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/quiet room, kitchen and lounge. There are large, attractive gardens, which are secure, offering various areas for relaxation, space and activity as required by the service users. Red Thorn House DS0000062819.V253190.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, taking place on a weekday over a period of 3 and half hours. There were 6 service users in residence and there was one vacancy. The Deputy Manager, Mrs Pauline St Clair was in attendance throughout the inspection in the absence of the Manager who was on holiday. Preparation had taken place in the CSCI office; there was a tour of the building and records seen. Two members of staff were spoken to in private. All the service users were seen and three were spoken to. What the service does well: What has improved since the last inspection? * There have been two new admissions since the last inspection and the home operates as two discreet ‘units’, which are homely and domestic in character. * The building and refurbishing work is now complete to a high standard. * There is now a dining room/quiet room in the house. * The hallway has been redecorated. * There is now a senior carers’ staff room where staff can meet. * The manager’s office has been moved so as not to intrude into the domestic environment of the main house. * Secure, secluded and separate gardens have been made with access for service users. * Automatic door closers have been fitted to three downstairs doors Red Thorn House DS0000062819.V253190.R01.S.doc Version 5.0 Page 6 * There are plans to re-floor the kitchen with non-slip flooring and to carpet one of the lounges to give it a more homely character. . What they could do better: 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. Red Thorn House DS0000062819.V253190.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Red Thorn House DS0000062819.V253190.R01.S.doc Version 5.0 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 the following standard(s): 2 There is clear information, in a format comprehensible for prospective service users and their carers/advocates, to make an informed decision as to whether the home can meet their needs and aspirations. EVIDENCE: There have been two new admissions since the last inspection. There was evidence that prospective service users’ needs and aspirations are assessed in their former place of residence and that there are visits to the home prior to admission with carers and/or advocates before the service user is offered the opportunity to ‘test drive’ the home. A pre-admission assessment was seen for a new service user, which gave full details of communication and sleeping patterns and risk assessments regarding locks on doors. The new service users’ rooms in the house provided ample evidence that the service users and their families, where appropriate, had been involved in purchasing things for their rooms before moving in and that where appropriate, service users’ carers/advocates were closely involved in the preadmission process and continued to be involved. All service users are accepted for an initial probationary period of three months, giving the individual time to settle into their new surroundings and gel with the original service user group, when a review takes place to assess the accuracy of the information gained in the initial assessment. Red Thorn House DS0000062819.V253190.R01.S.doc Version 5.0 Page 9 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 the following standard(s): 6,7,8,9 The home is aware of the changing needs of service users and these changes are appropriately recorded in the care plans. Service users are supported to make choices about their lives as necessary and are able to take acceptable risks in order to maintain their independence as far as possible. EVIDENCE: Two care plans were seen and the Deputy Manager gave evidence that staff were being allotted time ‘off rota’ in order to develop the care plans, which was taking place at the time of the inspection for the care plan for one of the most recent service users. Care plans are comprehensive, contained photographs and each plan has a section for the individual expressed in a simple manner and in symbols where appropriate. They are reviewed regularly, with the service user and their carers, if appropriate. As on the first inspection, two key-workers and the senior change the care plans according to behaviour changes and/or preferences of the service user and there was evidence that the service users were actively involved in this process. Red Thorn House DS0000062819.V253190.R01.S.doc Version 5.0 Page 10 The care plan for a more established service user showed evidence that changes in her personal development had taken place and her individual programme of care had underpinned her growing confidence, particularly in getting on and off the home’s bus and taking part in activities outside the home. This is to be commended. There is a good risk assessment process and together with the care plans are reviewed on a monthly basis and explained to the service user, with prompt cards and sequence charts, if necessary, and to the service user’s carer/advocate, if appropriate. Red Thorn House DS0000062819.V253190.R01.S.doc Version 5.0 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 the following standard(s): 12,16 Service users are supported to take part in age, peer and culturally appropriate activities, which enhances their quality of life. EVIDENCE: There was anecdotal and photographic evidence that service users are supported to take part in appropriate activities for their age, or to continue activities in which they had been engaged before admission to the home. In addition, service users, if they wished were encouraged to use the Public Library, having lunch out and going to the local pub. Service users rights to decision making are recognised and for one of the most recent service users investigations were taking place to find the most appropriate help for developing his interest in computers. In the meanwhile he was receiving Day Care in the home, taking part in activities such as swimming, personal shopping as well as shopping for ingredients for chosen meals. One service user goes to church occasionally and three service users regularly visit families at home. Red Thorn House DS0000062819.V253190.R01.S.doc Version 5.0 Page 12 Service users’ rights in the issues of healthcare are respected, inasmuch as one service user had refused to have a ‘flu injection, and this was appropriately recorded. Evidence was seen of the preparation of a piece of garden specifically for one service user who enjoys flowers. Service users were supported to help clean their rooms, if appropriate and one service user likes to help with a number of household tasks. Red Thorn House DS0000062819.V253190.R01.S.doc Version 5.0 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 the following standard(s): 18,19 The home is committed to person centred planning in supporting service users to having a say in the way their personal care is delivered. EVIDENCE: From the care plans, discussion with staff and on the day it was seen that service users’ wishes and independence were taken into account. One service user was choosing the timing of his walk with his key-worker, on a one to one basis. It is also evident that the home is committed to person centred planning and staff gave a good account of how this is achieved. The Deputy Manager gave an account of how relatives are also involved in the service user’s personal care, as well as other healthcare professionals and social workers, if this is deemed appropriate. The care plans are in the process of being developed into Health Action Plans, with service users, their key-workers and carers/advocates, if appropriate, together with the Day Centre and other professionals. These are in a simple, comprehensive format. Eventually, if appropriate, these would be shared with the GP. These will cover such issues as smoking, Women’s Health, Injections, Blood Tests, Behaviour Recording, this is seen as good practice. The home gives high priority to their delivery of personal care support specifically to suit the individual and also to developing methods of Red Thorn House DS0000062819.V253190.R01.S.doc Version 5.0 Page 14 communication for individual service users. All members of staff in the next few weeks would have attended courses on Makaton, which is to be commended. One service user needed to have his routine for the next day explained in picture form every day. It was also evident that service users’ emotional needs were being met. This particular service user said, “I feel safe in my new Redthorn House”, and that staff are very aware of this aspect of personal care. Red Thorn House DS0000062819.V253190.R01.S.doc Version 5.0 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 the following standard(s): 22,23 Complaints procedures are in place in a form, which is meaningful to the service users and is explained by the key-workers, which ensure as far as possible that any complaints, or allegations of abuse, would be listened to and acted upon. EVIDENCE: The complaints procedure is in place as evidenced in the last inspection report and the Deputy Manager said there had not been any complaints. The policies and procedures are in place for Adult Protection and staff receive on going training in this area. Both members of staff spoken to gave a good account of the issues involved and were aware of the home’s Whistle Blowing Policy. Red Thorn House DS0000062819.V253190.R01.S.doc Version 5.0 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 the following standard(s): 24, 26, 28, 30 The refurbishment of the property and improvements to the surrounding gardens make for a safe, comfortable, clean and homely environment for service users. EVIDENCE: In addition to the lounge and the kitchen/dining room, soon to be re-carpeted and non-slip flooring laid, there is now another dining/quiet room, providing choice for service users. There have been improvements to the garden areas, which are safe, pleasant and accessible, providing space for barbecues in summer and football games, as well as an area in which service users can grow plants, if they wish. The three, new bedrooms in the main house are all en-suite, which promotes service users’ privacy and independence and they have attractive views across fenland. These bedrooms were all personalised; one service user had a trampoline in her room, where she could exercise when she wished. Another service user spoken to was pleased to show off her room, the bed linen she had chosen and her personal possessions and certificates she had gained at the Day Centre. All areas seen were clean and hygienic. Red Thorn House DS0000062819.V253190.R01.S.doc Version 5.0 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,34 There are clearly defined management roles, an efficient staff team, appropriately recruited and trained, which is beneficial for service users. EVIDENCE: On the day of the inspection, the Manager was on holiday, but it was evident from a senior member of staff that she was aware of the staff roles and responsibilities and referral was made to the Deputy Manager, who is very experienced, was well versed in all aspects of the management of the home. Two members of staff were spoken to and in discussion with them and the Deputy Manager it is evident that there is an effective and enthusiastic staff team. One member of staff said, “There is a good team spirit, …this is a nice place to work” and he also spoke of gaining much job satisfaction from working in the home. He spoke of good handovers at change of shifts and 6-weekly supervision, with either the Deputy or the Manager. Another more recent member of staff spoke of enjoying the job and finding the other members of staff, who were in the original staff group, very helpful to her, especially when she first started work at the home. This is seen to be good practice. She also spoke of the training opportunities she has and gave a good account of her work as a key-worker in supporting service users on a one-to-one basis. Red Thorn House DS0000062819.V253190.R01.S.doc Version 5.0 Page 18 Two staff files were seen and supervision notes were kept in the file in sealed envelopes. All the necessary recruitment information, including references and ID were in order. Red Thorn House DS0000062819.V253190.R01.S.doc Version 5.0 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39,42 This is a well run home, with clear management roles, which ensures that the best interests of the service users underpin development by the home. EVIDENCE: Various records pertaining to the health and safety of residents were seen to be in order, although embryonic at present, since much of the building and installation is new. The Deputy Manager reported that if there were any issues to be raised, the Directors were readily receptive to staff suggestions. She cited the example of the purchase of another design of ‘People Carrier’, specifically for safety reasons for one service user. She also reported that the re-siting of the staff and manager’s rooms had been well considered in terms of keeping the office away from the domestic environment in the main house. Red Thorn House DS0000062819.V253190.R01.S.doc Version 5.0 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. 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 X 4 x x x Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 4 4 4 4 x Standard No 24 25 26 27 28 29 30 STAFFING Score 4 x 4 x 3 x 3 LIFESTYLES Standard No Score 11 x 12 3 13 x 14 x 15 x 16 4 17 Standard No 31 32 33 34 35 36 Score 4 x 4 3 x x CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Red Thorn House Score 4 4 x x Standard No 37 38 39 40 41 42 43 Score x x 4 x x 3 x DS0000062819.V253190.R01.S.doc Version 5.0 Page 21 NO 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. 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. Refer to Standard Good Practice Recommendations Red Thorn House DS0000062819.V253190.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Norfolk Area Office 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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