Inspection on 18/09/08 for Thamesfield

This inspection was carried out on 18th September 2008.

CSCI found this care home to be providing an Excellent service.

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

Other inspections for this house

Thamesfield 18/09/06

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Thamesfield Thamesfield Nursing Home Wargrave Road Henley-On-Thames Oxon RG9 2LX     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sally Newman     Date: 1 8 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 24 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Thamesfield Wargrave Road Thamesfield Nursing Home Henley-On-Thames Oxon RG9 2LX 01491418133 01491575001 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Thamesfield Ltd Name of registered manager (if applicable) Mrs Diana Wendy Eltze Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Thamesfield Nursing Home is situated in Henley on the river. The nursing home is one part of a large house. The remainder of the house and outlying buildings are wardenassisted flats with support. The house is well decorated and furnished. There are large communal rooms and outside gardens, which are shared with the flats. The nursing home has 12 en-suite bedrooms all with a view of the river. The current fees are 1250 - 1400 pounds per week. There are additional charges for hairdressing, chiropody, physiotherapy, incontinence pads, papers and toiletries. 0 Over 65 12 care home 12 Care Homes for Older People Page 4 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The last inspection on this service was completed on 18th September 2006. This was an unannounced inspection that was conducted over the course of three days and included a visit to the service of 5 hours duration. Information provided by the service and a range of records were seen and were used to formulate the outcome of this inspection. In addition, time was spent with the manager, staff and service users. A visiting relative was spoken to in private. A tour of the premises was undertaken and observation of care practise was undertaken throughout the course of the visit. The provider has a range of polices and procedures relating to equality and diversity. Care Homes for Older People Page 5 of 24 From the evidence seen by the inspector and comments received, the inspector considers that this service would be able to meet the needs of individuals with various religious, racial or cultural backgrounds. No complaints about this service have been received by the Commission since the last inspection. This home continues to provide a good quality of care to the service users living there. Service users are satisfied and are confident their views will be listened to. No requirements or recommendations have been made on this occasion. Currently the fees range from 1600 to 2000 pounds per week. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 7 of 24 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are fully assessed prior to admission to ensure their needs can be effectively met by the home. Evidence: Admissions to the home only take place if the service is confident that staff have the skills, ability and qualifications to meet the assessed needs of the prospective resident. All prospective residents are fully assessed by the management of the home prior to admission. The documentation for four people who use the service was examined. The records evidenced that all necessary information about the users’ health and personal care needs were sought prior to admission. Care Homes for Older People Page 9 of 24 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Clear information is in place to enable staff to meet the health and personal care needs of residents. The arrangements for medication are robust and protect service users. Service users feel they are treated with respect. Evidence: A random sample of four care plans was seen. All contained comprehensive information about individual needs and provided staff with clear guidance on how those needs should be met. There was evidence of regular review and all aspects of a persons lifestyle including their personal, health and social care needs are considered. It was noted that the manager had recently called upon the advice of a Community Psychiatric Nurse so that the home could complete newly introduced mental capacity documentation for each service user. End of life care plans were in evidence and both staff spoken to and the manager felt that this was an area of particular strength within the home. There was evidence in care plans that a wide range of health care professionals are Care Homes for Older People Page 10 of 24 Evidence: called upon to meet the health care needs of individual service users. One relative spoken to confirmed that he is always kept informed of his mothers welfare and health care needs. There was also evidence that extensive mobility aids are utilised to assist service users and appropriate guidance is sought on their correct use. The arrangements for medication were discussed with the manager. She undertakes comprehensive 3 monthly audits of the system for the administration of medication. The last audit was undertaken on 1st September and provided scores for each outcome area. The Primary Care Trust carried out an inspection of the medication arrangements in the home recently and concluded that the standard was met. It was noted that one service user self medicates and a risk assessment in this regard was in evidence. All service uses spoken to indicated that staff were always respectful and their right to privacy was always upheld. The manager confirmed that staff induction addresses issues of privacy and dignity and it is an area she discusses periodically within one to one supervision. Care Homes for Older People Page 11 of 24 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A range of activities is offered that provide opportunity for mental and physical stimulation. Service users are encouraged to maintain contact with their family and friends and are able to have visitors at any time. The home provides a varied and nutritious menu designed to meet the needs of its service users. Evidence: It was clear from evidence seen, from discussion with staff and from talking with service users that the home provides a wide range of activities to meet the physical and intellectual needs of service users. There is a dedicated activities organiser who is clearly highly regarded by service users. There are at least two activities each day during the week and weekend trips are organised on a periodic basis. The home would like to provide more opportunities for service users to go out of the home but it was evident from discussion from some service users that they were not really interested in going out too often as it tired them out. The introduction of a new boat designed for disabled people was being planned locally and the home was already investigating this for the use of service users. Recent outside activities have included attendance at Ascot races, cinema trip and pub lunches. Care Homes for Older People Page 12 of 24 Evidence: One relative who visited the home was seen in private. This individual visits approximately weekly and usually takes his mother out for lunch in the nearby town centre if she is feeling up to it. Until recently there was an established and experienced chef who managed the kitchen and arranged the provision of food in the home. This individual was supported by two assistants who are currently running the kitchen until additional personnel are appointed. A sample menu was provided, which included a wide range of food and meal options. The inspector was informed that only fresh ingredients were used and the only food not prepared from scratch was bread. The Assistant Check spoken to was well aware of the dietary needs of the current service users. It is the practise that all service users are individually asked for their preference for that days meals. However, this is not rigidly adhered to when considering individuals capacity for remembering their choice. The kitchen was flexible enough to be able to provide an alternative when a service user changed their mind on the day of the planned meal. Currently the kitchen also provides meals for the adjacent flats and their services are purchased by the care home. The Assistant Chef confirmed that a recent food safety inspection had resulted in their getting a four star rating that equates to highly commended. This certificate was not immediately available on the day of the visit. Care Homes for Older People Page 13 of 24 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a complaints procedure, which is clear and accessible. Service users views and comments are listened to and acted upon. Service users are protected from abuse and exploitation by well-trained and competent staff who demonstrate knowledge of the homes abuse of vulnerable adults and whistle-blowing policies. Evidence: There is a robust corporate complaints policy and associated procedures that service users are encouraged to utilise. There had been a number of complaints made by service users that concerned food and state of furniture. All had been appropriately dealt with and the outcome was clearly recorded. It was apparent from evidence obtained on the day that service users are actively encouraged to voice there views and concerns and those spoken to were confident that their opinions and observations are taken seriously. There was evidence in staff files that all staff receive training in the abuse of vulnerable adults as part of their formal induction and NVQ training in which it is a core module. Refresher training courses are also offered at regular intervals. Those staff spoken to confirmed that they had attended protection of vulnerable adults and were able to demonstrate sound understanding of the principles and the action they should take if an allegation is made to them or they witness abuse. Care Homes for Older People Page 14 of 24 Care Homes for Older People Page 15 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a safe, homely and well-maintained environment for service users. The home was clean, tidy and hygienic throughout. Evidence: The house was well presented, being clean and tidy with good decoration and furnishings. It was noted from some complaints from service users that the decor and furnishings had been allowed to deteriorate although were still of a good quality. The inspector was informed that the new owners of the home were planning a complete refurbishment but no date was yet known. The gardens are extensive and well maintained. There is seating around the garden as well as by the river. There are plenty of parking spaces available. The communal areas are shared with the flats. There is a large dining room that is also used for concerts, shows etc. The lounge has a bar area and the bar is open prior to lunch. Service users socialise with other occupiers of the site. There are dedicated cleaning staff and two laundry assistants. All cleaning materials are kept locked away when not in use. There is a full-time housekeeper whose responsibility it is to maintain COSHH materials and to order new stocks including some service users toiletries. This individual also takes new staff through induction and is herself qualified to NVQ level 2. Care Homes for Older People Page 16 of 24 Evidence: The NHS Berkshire West Health Authority recently conducted an infection control audit. They provided a comprehensive report detailing the areas to be addressed and will be providing staff training and a further evaluation of the infection control systems within the home. Care Homes for Older People Page 17 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff recruitment procedures are robust and protect service users from harm. Staffing levels are appropriate to meet the needs of the service users. Service users benefit from a well trained and competent staff team. Evidence: This service benefits from a longstanding and consistent staff team. Staff reported that the team work closely together and support each other. Service users reported that there are always enough staff on duty but there are of course busier times of the day. Staff were described as kind, approachable and friendly. The manager confirmed that there is always at least one Registered nurse on duty at all times. All staff are encouraged and supported to undertake National Vocational Qualifications. The care staff member spoken to confirmed that she had completed her NVQ 2. A rolling programme of training is provided for the service. The manager confirmed that Infection Control training was taking place next week and Protection of Vulnerable Adults training is planned. A recent fire lecture had also been held. In addition Mental Capacity Act training was planned for all staff. Staff spoken to considered the training provided was of a good standard and any special requests for training were always considered. A care staff member who was spoken to advised that she had recently attended dementia training that she had found useful. Care Homes for Older People Page 18 of 24 Evidence: Two staff files were seen. Both contained all the required documentation and provided evidence that the service has a robust recruitment procedure. The manager stated that she had audited all staff files within the last week. Care Homes for Older People Page 19 of 24 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from a well managed home and their views and those of their relatives are actively sought and acted upon. The systems for managing service users monies and for health and safety are robust and protect service users. Evidence: The manager is well established in the home and is well regarded by staff and service users. Since the last inspection she has obtained her Registered Managers Award and a certificate in End of Life Care. Staff described her as approachable and knowledgeable. She was also considered to be calm in a crisis. The manager indicated that she felt well supported by the organisation and finds regular attendance at meetings with other managers particularly useful. The provider organisation delegates monthly checks of the service utilising Regulation 26 reports that are undertaken by the Regional Care Manager. Feedback about the home and the service is sought through the regular service user review process and Care Homes for Older People Page 20 of 24 Evidence: through the use of surveys to service users and relatives. The results of a recent exercise have yet to be collated. The manager confirmed that currently no annual service review or development plan is undertaken for the home but she will investigate the benefits of such as exercise. The manager confirmed that there is a comprehensive audit system in place for managing service users monies. Only very small amounts of money are maintained within the home. The system as a whole is audited monthly my the Regional Care Manager. There are comprehensive health and safety systems in place. Since the home was taken over the manager now has to undertake extensive regular audits of all aspects of health and safety matters. A range of checks are undertaken including fire safety equipment, portable electrical appliances, gas safety and hot water temperatures. Care Homes for Older People Page 21 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 24 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 23 of 24 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 24 of 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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