Inspection on 26/06/07 for The Thimbles

This inspection was carried out on 26th June 2007.

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

The Thimbles 23/01/06

The Thimbles 30/09/05

The Thimbles 06/01/05

The Thimbles 18/08/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 The Thimbles 80 Barnham Road Barnham Bognor Regis West Sussex PO22 0ES Lead Inspector Ms B Tye Unannounced Inspection 26 June 2007 09:00 The Thimbles DS0000014793.V338827.R01.S.doc Version 5.2 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 The Thimbles DS0000014793.V338827.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 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. The Thimbles DS0000014793.V338827.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Thimbles Address 80 Barnham Road Barnham Bognor Regis West Sussex PO22 0ES 01243 555808 F/P 01243 555808 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) None United Response Mr Matthew Jones Care Home 3 Category(ies) of Learning disability (3) registration, with number of places The Thimbles DS0000014793.V338827.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 3 persons in the category LD Date of last inspection 23rd January 2006 Brief Description of the Service: The Thimbles is a care home registered to provide accommodation and personal care for up to three residents with a learning disability, aged between eighteen and sixty-five. The home is a detached cottage located within the village of Barnham, near to local amenities and public transport. Residents share a lounge but all have single rooms on the first floor, one with en-suite. All areas of the home are accessible to residents including the small courtyard garden. Fees The Thimbles DS0000014793.V338827.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Prior to the inspection all relevant information and correspondence relating to the home was examined. This included a completed Annual Quality Assurance Assessment by the manager detailing changes and improvements to the service in the last 12 months. During the course of the visit the inspector spoke to the people living in the home, interviewed staff and spoke at length to the area manager. The registered manager was absent on the day of the visit. Take this out A tour of the premises was undertaken. We observed breakfast being served and daily routines within the house, including staff interaction with residents. Three care plans and staff files were examined alongside the homes records including, staff training and rotas, fire, incident and accident reports and all those relating to health and safety. The inspector was able to gain feedback from the residents about the service and four completed questionnaires were returned prior to the inspection. This is the first inspection of 2006/2007. This is called a key inspection and will determine the frequency of visits/inspections hereafter What the service does well: What has improved since the last inspection? Since the last inspection the service has implemented a full annual Quality Assurance review. This includes views of the residents, their families and interested parties. The outcome of this review assists senior management in developing the service in line with resident’s wishes and aspirations. Staff meetings are held on a regular basis, which enable staff to input their views about how the home is run. The Thimbles DS0000014793.V338827.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. The Thimbles DS0000014793.V338827.R01.S.doc Version 5.2 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 The Thimbles DS0000014793.V338827.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents and their families can be confident that current information regarding the home will be made available, their needs will be assessed and visits to the home encouraged. EVIDENCE: The Statement of Purpose and Service User Guide for the home are in place and accessible for prospective residents. All information is available in pictorial format to ensure the residents have a clear understanding of what is available in the home. One resident stated ‘I was given enough information before I moved to the home’. Files examined showed that each resident’s needs had been assessed in relation to all aspects of care. There have been no new residents admitted since the last visit. At that time pre-admission assessments and contracts were seen to be in place. The Thimbles DS0000014793.V338827.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Care plans and risk assessments detail the personal, social and emotional needs of each person. Residents know that their individual care plans reflect their assessed and changing needs as well as their personal goals. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a plan of care in place for each person living in the home and information is updated on a daily basis and reviewed frequently. The plans include any specific arrangements agreed with residents about their day-to-day activities and care as well as any specialist arrangements. Care plans seen include the individual resident’s consent to medication in addition to detailed risk assessments. Care plans, which include assessments of need, risk assessments, daily living plans and personal routines are very comprehensive although information could be better organised within the files. This would enable staff members to The Thimbles DS0000014793.V338827.R01.S.doc Version 5.2 Page 10 access information easily about the personal and background details of the people they are supporting. Detailed risk assessments held on each care file promote the residents independence in daily living within agreed limitations, to ensure their safety and welfare. All care plans and risk assessments seen were signed by the residents and their key workers. The members of staff spoken to show an awareness of the support needs of residents and any changes are communicated at shift handover times and through the daily communication sheets. Staff practice was observed; residents were treated kindly and with respect. It was clear that staff were knowledgeable about resident’s needs and how to communicate appropriately with them. The Thimbles DS0000014793.V338827.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. There is a choice of activities available for residents to participate in. Residents are supported to keep in touch with family and friends. Residents have their nutritional needs assessed. The daily routines and house rules promote independence and individual choice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents are supported to pursue interests and hobbies in line with their care plans. They are encouraged to get involved in daytime activities but the final decision about participation is theirs. The three residents at the home all have a detailed weekly programme of activities, which include college and a work placement. Residents spoken to stated they enjoy living at the home and like the activities on offer. These include attending church, horse riding, eating out, and visits in the local area and attendance at community events. One resident The Thimbles DS0000014793.V338827.R01.S.doc Version 5.2 Page 12 is due to go on holiday for a week with his family, which he is very much looking forward to. Residents meetings are held on a weekly basis to involve them in the decisionmaking processes within the home. Minutes of these meetings are held on file. A community notice board in the kitchen area displays information about local community events and activities held in the home. There is access to a local advocacy service should the residents require it. Observation and feedback on the day of the visit reflected that there is a strong emphasis on independence and maximising choice for individuals. The kitchen/dining area provides a clean and homely environment for residents to sit and talk throughout the day. All residents have access to hot drinks and snacks as required. Menus were seen and these are planned on a weekly basis. The residents choose all meals a week in advance, but a choice is available if they change their minds on the day. One resident does all her own cooking and shopping in the home. Other residents assist with preparation of house meals and the weekly house shop as part of developing independent living skills. All residents are currently undergoing intensive assessment, as there are plans in place for them to move on to supported living accommodation in the next 18 months. The residents and their families have been fully involved and supported through the proposed changes and strong links are on going with involved professionals. This will ensure the resident’s needs are met in full during and after their transition from the home. The Thimbles DS0000014793.V338827.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Healthcare needs are met including access to a number of healthcare professionals. Medication is well managed in line with agreed risk assessments and staff members receive relevant training. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Healthcare needs are assessed and recorded in detail on residents care plans. These are reviewed on a regular basis and any issues can be discussed in their key worker meeting, once a month. There is evidence from records and from speaking to the staff team that the home works with a variety of healthcare professionals to meet residents healthcare needs. These include Community Psychiatric Nurses, Social workers and GP’s. Each resident has an assigned key worker who liaises with health professionals about on going care and reviews. Residents also have access to services such as dentists, opticians and chiropodists. Staff support residents to attend appointments as required. The Thimbles DS0000014793.V338827.R01.S.doc Version 5.2 Page 14 Support with personal care is undertaken in privacy and with dignity. Residents have a choice regarding their daily routines. Residents chose and buy their own clothes, and their appearance reflects their own choice and style. Residents are supported to take control of their own medications where appropriate. One resident self medicates. Detailed risk assessments have been undertaken in respect of medication and the agreed limitations. These risk assessments are held on file in conjunction with detailed medication plans for each resident. Medicines were seen stored securely in locked cupboards in residents’ rooms. Records are maintained to provide an audit trail from the time they are received until disposal. Staff receive annual refresher training in the safe handling of medicines. All medicine administration records seen were in good order with no gaps or errors. This confirms staff and residents are working in line with the homes agreed risk assessments, policies and procedures. The Thimbles DS0000014793.V338827.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Working practices and staff training are designed to protect residents from risk of abuse. Residents know how and to whom they should complain. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a complaints procedure in place, which is displayed within the home. A copy is also included in the Statement of Purpose and Service User Guide in pictorial format. The complaints book showed that no complaint s had been received since the last inspection. A resident said, “the staff are nice. If I’m not happy about something I can talk to them’ The home has a “whistle blowing” policy and staff members receive training in the Protection of Vulnerable Adults. Records show all staff undergo enhanced CRB and POVA checks prior to employment at the home. The arrangements for handling resident’s money include financial records of all transactions and safe storage of personal money and valuables. The Thimbles DS0000014793.V338827.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. The home’s premises are suitable for its stated purpose, accessible, safe and well maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The house is a listed building yet suitable for it’s stated purpose. It is in a good location for shops, public transport and other amenities and is accessible to all residents. It is well furnished and maintained. Residents have their own bedrooms, which they said they liked. They are all of a good size and well furnished in ways, which reflect individual personalities. All residents have their own key to their room. One room has an en-suite bathroom and there is a communal bathroom and separate toilet. Both are fitted with suitable locks. The Thimbles DS0000014793.V338827.R01.S.doc Version 5.2 Page 17 There is separate accommodation for staff that sleep on the premises. Laundry facilities are provided away from food preparation areas. The home was clean and tidy throughout. The Thimbles DS0000014793.V338827.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Residents in the home are supported by a committed, caring and well-trained staff team. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are sufficient staff to meet the assessed needs of the current service users in the home. At present one staff member supports three residents, with more staff available if required. There is always a manager on call should an emergency arise. The staff member on duty was kind and caring in his dealings with residents and was seen supporting people to be as independent as possible and offering choice. Residents stated that the staff team were kind and caring, one person said, “they are all good to us” New staff undertake an induction at the start of their employment in addition to the completing the annual training programme offered at the home. The Thimbles DS0000014793.V338827.R01.S.doc Version 5.2 Page 19 Staff spoken with said that they enjoyed working in the home and were observed speaking to the residents in a manner, which showed they had a good understanding of each resident’s needs and communication skills. Relationships between staff and residents appeared to be very relaxed and there was a happy and warm atmosphere in the home. Team meetings are held regularly and include a fixed agenda, which reviews concerns and needs of residents and staff. It was recommended long term agency workers who cover the full time post be invited to these meetings to contribute their views. Staff spoken to stated they were clear about their roles and responsibilities and receive clear direction and support from the manager. Staff presented as being well motivated and committed to providing the best possible care for the residents. The Thimbles DS0000014793.V338827.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. A competent manager is in place, staff are well supported and records are up to date. The safety and welfare of the residents is paramount within the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The current registered manager, is studying for National Vocational Qualification (NVQ) Level 4. He was absent on the day of the visit but the inspector spent time with the area manager and a long standing staff member. There is now an Annual Quality Review plan for the home, which incorporates the views and aspirations of residents and their families. The views of visiting professionals or others involved in the home are sought as part of the annual review process. The Thimbles DS0000014793.V338827.R01.S.doc Version 5.2 Page 21 In addition, some residents belong to a self-advocacy group which feeds back to the home, informing any changes which may be needed. A senior manager from United Response carries out a monthly visit on the conduct of the home. Training is provided for staff in areas such as safe lifting, first aid, food hygiene and fire safety. Good systems and records are in place for the maintenance of equipment, monitoring water temperatures and maintenance of the premises. All health and safety records were viewed during the visit and found to be up to date. A suggestion was made that the files and paperwork systems could be made more accessible to staff if they were better organised. One resident manages her own money and the others do so with some assistance. All financial transactions are recorded and signed for. Risk assessments on all aspects of the premises are carried out and all accidents are recorded. Residents spoken to were familiar with and confident about the fire procedures. Each resident is involved in assisting with the health and safety checks within the home, on a monthly basis. Overall, the inspector concluded the running of the home and supported administrative systems were in good order and best served the interests and welfare of the resident and staff group. The Thimbles DS0000014793.V338827.R01.S.doc Version 5.2 Page 22 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 Standard No Score 1 X 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 4 3 3 LIFESTYLES Standard No Score 11 X 12 4 13 3 14 X 15 3 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 3 X The Thimbles DS0000014793.V338827.R01.S.doc Version 5.2 Page 23 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 The Thimbles DS0000014793.V338827.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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