Inspection on 17/10/06 for Thalassa Nursing Home

This inspection was carried out on 17th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Thalassa Nursing Home 15/12/05

Thalassa Nursing Home 16/08/05

Thalassa Nursing Home 05/10/04

Thalassa Nursing Home 23/06/04

Similar services:

Flint House

St Vincents

The Cotswold Home

Fairways

Newbeech House

Winton House

Treloar College

Rush Court

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

CARE HOMES FOR OLDER PEOPLE Thalassa Nursing Home 79 Western Way Gosport Hants PO12 2NF Lead Inspector Tim Inkson Unannounced Inspection 17th October 2006 09:30 X10015.doc Version 1.40 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 Thalassa Nursing Home DS0000042027.V314128.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. 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. Thalassa Nursing Home DS0000042027.V314128.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Thalassa Nursing Home Address 79 Western Way Gosport Hants PO12 2NF 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) 01923 828528 info.thalassa@tiscali.co.uk www.numadahealthcare.co.uk Numada Healthcare Ltd Daphne Serena Coleborn Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33), Physical disability (6), Physical disability of places over 65 years of age (33) Thalassa Nursing Home DS0000042027.V314128.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. All service users must be at least 55 years of age. Date of last inspection Brief Description of the Service: Thalassa Nursing Home is a care home providing nursing care for thirty-three residents over the age of 55 years. The home is a large converted and extended house in a residential area of Alverstoke, Gosport and is near local shops and amenities. The accommodation is over two floors, connected by a shaft lift; and consists of twenty-three single and five shared bedrooms and three communal rooms. The home has large grounds which are accessible to the residents and there is car parking space to the front and side of the home. Potential residents are invited to visit the home to visit the home to view accommodation but if they are unable to do so they are sent a detailed brochure/information pack. On admission to the home new residents are given a comprehensive service users guide. A copy of the guide is readily available in the hallway/entrance to the home as is a copy of a report of the last inspection made by the Commission of Social Care Inspection (CSCI) of the home. At the time of the fieldwork visit to the home on 17th October 2006, the home’s fees ranged from £513 to £600 per week. The fees did not include the cost of hairdressing, podiatry and newspapers and magazines. Thalassa Nursing Home DS0000042027.V314128.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site/fieldwork visit was unannounced and took place on 17th October 2006, starting at 09:00 and finishing at 16:20 hours. The process included viewing the accommodation, including bedrooms, communal/shared areas and the home’s kitchen and laundry. Documents and records were examined and staff-working practice was observed where this was possible without being intrusive. Visitors and staff were spoken to in order to obtain their perceptions of the service that the home provided. Residents who were able to hold meaningful conversations were spoken to in order to obtain their views about what it was like to live in the home. At the time of the inspection the home was accommodating 32 residents and of these 5 were male and 27 were female and their ages ranged from 68 to 99 years. No resident was from a minority ethnic group. At the time of this visit the home’s registered manager was unavailable, but the deputy manager was present throughout the visit and was available to provide assistance and information when required. Other matters that influenced this report included a pre-inspection questionnaire with documentation completed and provided by the registered manager. Also information that the Commission for Social Care Inspection had received about or from the home such as notices concerning incidents that had occurred e.g. deaths. What the service does well: Detailed records were in place that gave nursing and care staff information that enabled them to provide the help that residents’ needed. Residents felt safe and secure and happy that staff could look after them properly and treated them with respect. The home’s routines were flexible and it promoted the right of residents to make choices for themselves and exercise personal autonomy as far as was reasonably possible, including dealing with their own finances. Residents were positive about the food that the home provided and were pleased with the range of activities in which they could participate and the condition of the accommodation that they occupied. Management systems and procedures in the home worked well including quality monitoring and health and safety. Staff were recruited properly ensuring that residents safety and welfare was given proper consideration. There was a strong commitment to staff training and development to ensure that staff were able to fulfil their roles and responsibilities and meet residents needs. Thalassa Nursing Home DS0000042027.V314128.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Thalassa Nursing Home DS0000042027.V314128.R01.S.doc Version 5.2 Page 7 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 Thalassa Nursing Home DS0000042027.V314128.R01.S.doc Version 5.2 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There were procedures in place to ensure that the home identified the assistance and support that potential residents needed before they moved into the home. EVIDENCE: The home had written policies and procedures about how it arranged the admission of new residents to the home. A sample of the records of 4 residents was examined that included those concerned with the actions that the home took to identify the help and care that people needed. There was evidence from these detailed “pre-admission records” and also from discussion with residents and visiting relatives, that admissions to the home of new residents were planned. Also that staff with the appropriate knowledge and skills visited potential residents in order to identify the help and support that they needed before they moved into the home. Thalassa Nursing Home DS0000042027.V314128.R01.S.doc Version 5.2 Page 9 Comments from residents and relatives indicated that registered nurses were the home’s personnel that identified the needs of potential residents and what was said about these procedures included the following: • “She was in hospital and S came to do an assessment” (relative). • “He was assessed at the hospital by F” (relative). • “The owner is good. When I came and looked around I did not like the colour of this room and so they redecorated it for me”(resident). • “They came to see me and took list of my medicines I was taking and things like that” (resident). The home’s pre-admission assessments were complemented by more thorough and comprehensive assessments of a resident’s needs when they actually moved into the home. There was documentary evidence that assessments of residents needs were reviewed regularly and revised as necessary when an individual’s circumstances had changed. The home does not provide intermediate care. Thalassa Nursing Home DS0000042027.V314128.R01.S.doc Version 5.2 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had systems in place to ensure; the personal and healthcare needs of residents were met; and medication was managed safely and effectively. Among other things staff working practice helped to ensure that residents’ privacy and dignity was promoted. EVIDENCE: The home had written policies and procedures that set out how the home would ensure that staff knew what help individuals needed and how they would provide the assistance and support that each person required. The procedures indicated that the home would take the following actions: • After pre-admission assessment of an individual’s needs a more in depth assessment of the person would be carried out. • Plans would be prepared and based on among other things the person’s daily routines; eating and meals; likes and dislikes; medication; personal hygiene; activities/occupation; links with the community and general health. • The plans would be reviewed and amended at three levels: daily; at the end of a 4-week trial; and formally on a monthly basis. Thalassa Nursing Home DS0000042027.V314128.R01.S.doc Version 5.2 Page 11 The care plans were examined of the same sample of 4 residents as in the section above at page 9. Among the sample was an individual who was receiving treatment for sores/wounds arising from ulcers. The documents examined were detailed and the plans were based on the initial assessments the home carried out in order to identify what help individuals needed (see pages 9 and 10). These assessments included a range of potential risks to residents e.g. pressure sores; falls; moving and handling; malnutrition; etc. Where a pressure sore assessment indicated that an individual was at risk it was noted in all cases that the corresponding plan of care for the person concerned referred to the use a pressure relieving aid. The plans examined set out clearly the actions staff had to take and what specialist equipment was needed to provide the support and assistance each person concerned required. This was illustrated by the instructions in one care plan based on a swallowing assessment that indicated that the person concerned required a soft/pureed diet and help feeding i.e. ““Sit upright – give small mouth full at a time – check mouth empty after meal - never leave R with food in her mouth”. The plans of care were readily available and in close proximity to the person concerned e.g. bedroom or in a cupboard in a communal area. This enabled staff to refer to the plans and record their actions or update them without delay. There was evidence from the documentation and discussion with residents and relatives that wherever possible individuals and/or their representatives had been involved in developing the plans and agreed with the contents. Comments about all these matters included: • “I agreed to the use of the bed rails as it’s the only way of keeping me in bed and not falling” (resident). • “The folder with my plan is in my cupboard but I don’t bother to look at it” (resident). • “I am very happy with the care that Mum is getting. I sometimes read her care plan. I was asked about the use of bedrails. They let me know if she is unwell” (relative). • “I only have to mention something and they will get a doctor to visit. • I read his care plan occasionally (relative). Where care plans referred to the use of equipment or how a specific need was to be met this was observed to be available, provided or in place e.g. pressure relieving aid; Zimmer frame; hoist; provision of soft diet and help at meal times. The provision or use of equipment set out in care plans was also confirmed in discussion with residents and one individual said: • “I have a special mattress on my bed and a blue cushion on my chair”. Records indicated that care plans were reviewed at least monthly and daily notes referred to the actions taken by staff to provide the needs set out in those plans. Staff spoken to knew the needs of the individuals whose records were sampled and they were able to describe the contents of the care plans. Comments from Thalassa Nursing Home DS0000042027.V314128.R01.S.doc Version 5.2 Page 12 residents about the abilities of staff the care and support that they provided included: • “The staff are very attentive”. • “They are marvellous, they are so happy and willing to help. I can’t walk by myself, as I have had a stroke”. • “It is very nice and they are all so good to me. They could not do enough for me”. • “I need help getting out of bed and with washing and dressing. I feel very safe when they help me”. The records examined also indicated that a range of healthcare professionals visited the home and that arrangements were made for treatment for service users when it was necessary. Residents said that they saw and received treatment from among others, doctors and podiatrists and when required arrangements to attend specialist outpatient clinics were made by the home. One resident said: • “I have been to the hospital for transfusions since I have been here. I have my own doctor and he has been to see me 2 or 3 times. There was documentary evidence that when an individual had a wound/pressure sore that specific plans were implemented to manage the wound and monitor progress with healing. The home used the Malnutrition Universal Screening Tool (MUST) to help ensure that the nutritional needs of residents were identified and individuals’ health was monitored routinely and regularly by among other things recording their blood pressure and weight. The home had written policies and procedures concerned with the management and administration of medication. A range of reference material about medication was readily available including a relatively recent copy of the British National Formulary (BNF). Medication was kept in a locked and secured medicine trolley, cupboards and where required in a medical refrigerator. There was an appropriate storage cupboard/container for controlled drugs should they be required. All medicines were dispensed from their original containers and the only staff that dispensed and were responsible for the management and administration of medication on a day-to-day basis were registered nurses. Good practice noted during the fieldwork visit included: • Recording the temperature of the refrigerator used for storing some medication • Sample copies of the signatures of the Registered General Nurses that dispensed medication • Some sedative medication was treated as if it was a controlled drug Records were kept of the ordering, receipt, administration and the disposal of medicines and these were accurate and up to date. The home’s deputy manager said that new procedures had been implemented by the home following publication of paper/report by the Commission for Thalassa Nursing Home DS0000042027.V314128.R01.S.doc Version 5.2 Page 13 Social Care Inspection in February 2006, about medicines in care homes. Consequently the home now retained information leaflets about all medicines prescribed for residents. Although health care assistants were not responsible for the management of medication there was evidence that a number had attended courses in medicine management and the home had also arranged for regular reviews of residents medication. There was evidence from both discussion with staff and an examination of staff training records that all staff working in the home completed induction training that covered the fundamental principles that underpin social care, such as privacy and dignity. Most residents were accommodated in single rooms and shared rooms were provided with screens that were used to promote privacy and dignity and residents spoken to confirmed that staff working practice ensured that their privacy and dignity was promoted. Comments about these matters from residents and visiting relatives included the following: • “I generally leave my door open but they knock on it before they come in. Oh yes they shut the door and that sort of thing (resident). • “They are very polite. They call me M which is what I prefer. • I have my own room and I have an en-suite toilet ……. They always knock on my door before they come in” (resident). • “Staff always ask me to go outside if they change his bag or something to give him privacy”(relative). • “They generally knock on the door. I have seen the staff use the screen in here to provide privacy to the other lady or for Mum” (relative). Care plans examined also indicated how some individuals’ privacy and dignity should be maintained with instructions how this could be done e.g. “Ensure curtains drawn and door closed when attending to her”. Thalassa Nursing Home DS0000042027.V314128.R01.S.doc Version 5.2 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home organised a range of social activities that provided stimulation and it also promoted residents self-determination, enabling residents to exercise choice about all aspects of their daily life. Residents were able to maintain links with relatives and representatives. The dietary needs of residents were well catered for with a balanced and varied selection of food available that met their tastes and choices. EVIDENCE: The home had a number of written policies and procedures that were concerned with the rights of residents and these included a general statement that said: “The only restrictions will be the legal and regulatory requirements necessary to protect the health and safety of the service users, relatives, visitors and staff, and to ensure that the proper level of care is provided”. There were also a number of specific policies and procedures about residents’ rights that included: “Provision of personal telephone facilities; expressing sexuality; selfmedication; advocacy; handling monies and valuables; access to personal files and case notes; voting and electoral register; pets within the home; making wills; worship in their chosen faith; opening personal mail; smoking and the Thalassa Nursing Home DS0000042027.V314128.R01.S.doc Version 5.2 Page 15 consumption of alcohol; making their own snacks; and laundering personal garments”. Residents spoken to indicated that the home’s routines were relaxed and informal and that they could exercise self-determination as far as was reasonably possible. • “There are no rules here, we can do what we want”. • “It is nice and I can stay in bed if I want”. Local clergy visited the home and there were regular services provided for those residents that wished to attend. The home employed a part time activities organiser and a range of social and other events were arranged in order to provide stimulation and interest for residents. A list of the activities that were organised was on display outside one of the home’s two lounges. Residents and relatives spoken to commented about the activities that were organised and all said that there were opportunities for individuals to participate in different things. • “I am quite content to sit here. I think that I am lucky to be in such a nice place. It is quiet if I want quiet or there are people to talk to if I want that (resident). • “The vicar came for the harvest festival”(resident). • “They have activities 2 or 3 times a week in the lounge but I don’t go. They try and do different things and get people in. recently someone celebrated their 65th wedding anniversary” (resident). • “They have activities, there is one lady who gives them things to do and someone comes in and plays music. They have cheese and wine (relative). • “They have parties and things, I know they have bingo and singers” (relative). The home had a written policy about visitors to the home. Residents spoken to confirmed that they were able to maintain contact with the families and friends and that there were no restrictions on visiting arrangements. There were pamphlets/leaflets in the entrance of the home and a poster outside one of the home’s two lounges with details about organisations that offered to provide independent advice, information and guidance that could be helpful to residents and their families. Most residents handed over the responsibility of the management of their finances to relatives or other representatives, but some continued to look after their own financial affairs. Residents were able to bring personal items into the home including furniture and during a tour of the premises it was noted that several individuals had taken trouble to personalise their bedrooms. The home had written policies and procedures about maintaining residents’ confidentiality and also about residents’ rights to access their personal files Thalassa Nursing Home DS0000042027.V314128.R01.S.doc Version 5.2 Page 16 and case notes. A number of residents spoken to were aware of the contents of their personal case notes/care plans. Residents and relatives spoken to were all complimentary about the food provided. Residents also confirmed that they had 3 meals a day and could have snacks and drinks at other times. The menus and records of food provided indicated that the food was nutritious and there was a wide range of meals provided with a selection of choices every day. In addition special diets and individual preferences and needs were catered for e.g. diabetic and soft or pureed meals. Residents could choose where to eat and a number preferred to eat in their rooms and they were able to select the meal that they wanted from a choice made available to them the day before. Individuals’ food preferences, dislikes and any food related allergies were recorded in their care plan documents and the details were also readily available in the kitchen. Comments from residents and relatives about the food provided included the following: • “The food is good …… They come and tell you what the menu is. There is always a choice. If you don’t like the choice, you can have something different” (resident). • “The food is very good, sometimes there is too much of it. I am not a big eater and there is ample. There is always a choice” (resident). • “The food is very nice. We three meals, we have breakfast, lunch and dinner and we have tea in the middle of the afternoon” (resident). • “The food is quite good, they always give him a choice” (relative). Thalassa Nursing Home DS0000042027.V314128.R01.S.doc Version 5.2 Page 17 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home had a clear and satisfactory complaints procedure to address the concerns of residents and relatives/representatives. Procedures were in place to protect service users from the risk of abuse but they need to be more robust. EVIDENCE: The home had a written policy and procedures about how complaints could be made about the service that it provided. A copy was displayed on a notice board outside one of the home’s two lounges. All residents and relatives spoken to were confident about raising any concerns with the home’s manager. The home kept records of complaints that detailed the issue, and set out any agreed action to remedy the matter and its outcome. There had been no complaint made to the home since the last inspection on 15th December 2005 and the Commission for Social Care Inspection (CSCI) had received no complaints about the home during that time. The home had written procedures available with adult protection. These were intended to provide guidance and ensure as far as reasonably possible that the risk of residents suffering harm was prevented. Staff spoken to said that they received training about protecting vulnerable adults and an examination of staff training records confirmed this. Staff spoken to were also able to demonstrate an awareness of the different types of abuse and the action they would take if they suspected or knew that it had occurred. Thalassa Nursing Home DS0000042027.V314128.R01.S.doc Version 5.2 Page 18 Where as the result of the assessment of an individual’s needs it was considered necessary for that person’s safety to use bed rails consent for their use was obtained from the individual and/or their representative and this was recorded. Earlier in the year a member of staff had been suspended from duty pending an investigation because an allegation had been made that she had abused a resident. She subsequently resigned before the investigation took place. As a result the home overlooked the requirement to contact the local adult services department of the local authority, which is the statutory agency responsible for co-ordinating adult protection investigations. The home also should have reported the incident to the Department of Health in accordance with Section 82(2)(b) of the Care Standards Act 2000. The home’s deputy manager was reminded of the need to take this action despite the fact that the person concerned had resigned. Thalassa Nursing Home DS0000042027.V314128.R01.S.doc Version 5.2 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s environment was safe and well maintained. There was an infection control policy and procedures in place and staff practice ensured that as far was reasonably possible residents were protected from the risk of infection. EVIDENCE: There was evidence from reports provided by the local fire and rescue service and the local environmental health officer that the home took action to comply with their respective requirements in order to ensure that the premises was kept safe. Work identified by the fire and rescue service had been done to improve fire safety precaution in the home and the environmental health officer had awarded the home the “Shipshape Silver Award” for food hygiene. At the time of the fieldwork visit the exterior and interior of the premises, its décor, furnishings, fittings and equipment were in good repair Thalassa Nursing Home DS0000042027.V314128.R01.S.doc Version 5.2 Page 20 The home employed maintenance personnel and staff dedicated to cleaning and residents and relatives commented on how well decorated, maintained and clean the home was. • “ It is kept beautifully clean. The cleaner comes in my room every day and they have 2 handymen running around the place” (resident). • “My room is nice, I have everything, a nice bed, nice cupboards, and a toilet and sink. Every morning it is cleaned right through” (resident). • “I come every day and what I like about it is, is that there is no smell and it is always tidy and clean ….. There is always someone painting and decorating” (relative). • “It always seems nice and clean and well kept ….. Not long ago they decorated all the bedrooms” (relative). The home had comprehensive procedures in place concerned with infection control. It was noted that in accordance with best practice. Written instructions about effective hand washing were on display and alcohol gel hand sanitizers, liquid soap and paper towels dispensers (that were full and working) were in all communal WCs that were seen. Protective clothing was readily available and staff were observed using gloves and aprons appropriately. The home was clean and odour free at the time of the fieldwork visit and residents and visitors spoken to were all very positive about these aspects. There were sluice disinfectors available on both floors of the home and the home’s laundry was appropriately sited and equipped. Effective procedures were in place for the management of soiled laundry items. Thalassa Nursing Home DS0000042027.V314128.R01.S.doc Version 5.2 Page 21 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There was an appropriate and satisfactory level and mix of staff that ensured the needs of residents were met. The home had clear staff recruitment, training and development procedures that ensured that service users were protected and supported. EVIDENCE: The care team working in the home comprised, 11 registered first level nurses and 21 health care assistants. Out of the latter 10 (i.e. 48 ) had obtained a qualification equivalent to at least National Vocational Qualification (NVQ) at level 2. At the time of the fieldwork visit the care staff rota setting out the minimum number and skill mix deployed in the home was as follows: 08:00 to 14:00 2 5 7 14:00 to 20:00 2 4 6 20:00 to 08:00 1 3 4 Registered Nurses Health Care Assistants Total Apart from registered nurses and health care assistants the home employed other staff and these comprised. • Activities organiser • Chefs Thalassa Nursing Home DS0000042027.V314128.R01.S.doc Version 5.2 Page 22 • • • • Kitchen assistants Cleaners Laundry assistant Maintenance/gardening personnel In addition to the staff employed to work in the home the company that owned it and three other care homes in the area, provided support through a director of care and training co-ordinators. Comments from residents, relatives and staff about the sufficiency and competency of the care team included the following: • “I feel safe here but not when I am in hospital ….. The matron chooses the right sort of people …. They are quick if I use the buzzer” (resident). • “I need help getting out of bed and with washing and dressing. I feel very safe when they help me ….. They give me insulin” (resident). • “They help me with anything that I want”(resident). • “From what I have seen there is always plenty of staff (relative). • “The staff are efficient and kind. They are approachable …. I think that there are enough staff on duty” (relative). • “I don’t think you would ever have enough staff in any home, but there is always someone around” (relative). Staff comments about staffing levels in the home included: • “I would say that our staffing levels are good. There are always two registered nurses on during the day, which is good for support. There is also a good balance of experienced and other less experienced staff. There is no problem planning shifts” (registered nurse). • “Staffing levels are OK, providing everything goes alright” (healthcare assistant). Records were examined of 5 staff that had been employed to work in the home since the last inspection of the establishment on 15th December 2005. All statutorily required information and pre-employment checks had been obtained and conducted before they had started work in the home. Here was evidence from staff training records and discussion with staff that were on duty at the time of the site visit/fieldwork that all new staff received comprehensive induction and that health care assistants completed a programme that satisfied the requirements of the training body for the social care workforce i.e. Skills for Care (previously the Training Organisation for Personal Social Services [TOPSS]). The home’s deputy manager said, “All new staff do 2 days induction training before they start work in the home”. Thalassa Nursing Home DS0000042027.V314128.R01.S.doc Version 5.2 Page 23 There was evidence from the records examined and talking to staff that the home and the company that owned the home was committed to ensuring the staff acquired the knowledge and skills needed to meet the complex needs of the residents accommodated and promoting on going staff training and professional development. Comments from staff about these matters included the following: • “I have done courses about dementia and Parkinson’s disease and other courses apart form the mandatory health and safety ones. I have done the Liverpool care pathway” (health care assistant). • “There are always plenty of courses to go on. If there is one you want to go they will try and arrange it. There are NVQ assessors in one of the other homes”(health care assistant). • “I am doing a mentorship course and we have lots of training courses offered to us. Registered nurses supervise carers and we have an adaptation nurse. I have to plan the lessons so it keeps me up to date with current practice. The company encourages mentorship, which is good. We are liaising with Bournemouth University and 2 nurses completed their adaptation at the end of the summer” (registered nurse). • “I keep up to date by going on study days and also reading” (registered nurse). • “I have done abuse training, which is mandatory. I have also done health and safety, infection control and do refreshers every year. I have just done the principles of care, also I have done CoSHH (Control of Substances Hazardous to Health) and fire which is mandatory”(cleaner). • “I have done fire managers training and I am an accredited moving and handling trainer I renew my accreditation next month”(health care assistant). Thalassa Nursing Home DS0000042027.V314128.R01.S.doc Version 5.2 Page 24 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s manager provided effective leadership There were systems and procedures in place for monitoring and maintaining the quality of the service provided and promoting the safety and welfare of everyone living and working in the home. EVIDENCE: The home’s registered manager had been responsible for the day-to-day functioning of the home for some twenty years and she is a registered nurse. Although she was unavailable at the time of this site/fieldwork visit, from discussion with residents, relatives and staff it was apparent that she was perceived as: having high personal standards; providing clear leadership; supportive; and caring. Comments about her qualities and management approach included the following: • “Matron is wonderful” (resident). Thalassa Nursing Home DS0000042027.V314128.R01.S.doc Version 5.2 Page 25 • • • • • “Matron is very thorough. She is nice and she has standards and that is what makes the home what it is” (staff member). “I would say the matron is approachable and friendly. A skill that she has that is important is an honest respect for clients. She has a really good attitude that influences staff. I don’t want to appear derogatory but she is old style and that is right because you need to go back to basics (staff member)”. “She is thoroughly committed to her job and is very caring and very dedicated. She knows all the ins and outs. She does 3 shifts when she spends a lot of time on the floor each week and 2 in the office (staff member). “Matron is fantastic and she is the main reason I have stayed for so long. She is all for the clients and treats staff well, equally” (staff member). “Matron is great and really cares for them”(relative) The home and the organisation that owned it had implemented a systems to monitor the quality of the service that the home provided that included the use of questionnaire to obtain the views of residents and relatives. Audits were done every 2 months of among other things; the homes management systems such as pre- admission assessments and care plans, management of medication and accident analysis. Responses to questionnaires that were used to obtain the views of the views of residents and relatives were collated the outcomes were published in the home’s newsletter. The results of survey for June 2006 were seen. Out of 35 questionnaires only 6 had been returned. There were 4 rating levels for respondents to indicate the quality of the service in a number service provided by the home and they were; excellent; good; fairly good; and poor. All the responses were either excellent or good. Comments from; residents about living in the home; visitors about the care their relatives received; and staff about working in the home; included: • “I would say it was tops, I am very happy” (resident). • “I think that I am lucky to be in such a nice place” (resident). • “We are definitely satisfied with the care that she is getting” (relatives). • “I am very happy with the care that Mum is getting”(relative). • “It is very nice, there is a nice atmosphere, the staff and clientele are nice. The new owner has done wonders and treats the staff fantastically” (staff member). • “It is like an extended family, a nice environment to work in. We keep our staff a long time” (staff member). The home had a range of written policies and procedures that staff could refer to for instruction or guidance and they were updated and amended to reflect changes in legislation and/or practice. Staff comments about them included: - Thalassa Nursing Home DS0000042027.V314128.R01.S.doc Version 5.2 Page 26 “The policies and procedures definitely helped me with NVQ. They tell us if there are new ones. During your induction you have to read them and sign to say you have”. Records examined indicated that the home’s equipment, plant and systems were checked and serviced or implemented at appropriate intervals i.e. passenger lift and hoists; fire safety equipment portable electrical equipment; hot water system; etc. Staff said that they attended regular and compulsory fire and other health and safety training. There was a fire risk assessment for the premises and regular risk assessments of the premises and working practices were undertaken. Guards covered all radiators in the home and all windows above the ground floor were fitted with restrictors. A member of staff working in the home was an accredited manual handling trainer and there were hoists and other equipment in the home that promoted safe working practices. Thalassa Nursing Home DS0000042027.V314128.R01.S.doc Version 5.2 Page 27 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 3 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 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Thalassa Nursing Home DS0000042027.V314128.R01.S.doc Version 5.2 Page 28 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. Refer to Standard Good Practice Recommendations Thalassa Nursing Home DS0000042027.V314128.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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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