Inspection on 19/08/05 for The Thorns

This inspection was carried out on 19th August 2005.

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 Thorns 14/10/08

The Thorns 10/10/06

The Thorns 13/01/06

The Thorns 27/01/05

The Thorns 22/06/04

The Thorns 29/08/02

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE The Thorns Coastal Road Hest Bank, Lancaster Lancashire LA2 6DW Lead Inspector Ajam Auckburally Unannounced 19 August 2005 10:00am th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. The Thorns F57 F09 S9876 The Thorns V232958 190805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Thorns Address Coastal Road, Hest Bank, Lancaster, Lancashire. LA2 6DW Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01524 822588 Morpress Properties Mrs Denise Audrey Shuttleworth CRH Care Home 15 Category(ies) of Op Old Age 15 registration, with number of places The Thorns F57 F09 S9876 The Thorns V232958 190805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th January 2005 Brief Description of the Service: The Thorns is situated in Hest Bank village in Lancaster and close to the Lancaster canal. The home is the converted family house of the owners and provides accommodation for a maximum of fifteen residents of both sexes who are 65 and over. Accommodation is provided in 11 singles and 2 double bedrooms. The double rooms are mostly used as singles, unless they are occupied by married couples who want to share a room. All the bedrooms except two have an ensuite facility. All the bedrooms are well furnished but service users can furnish their rooms with their own furniture if they wish. The home is situated away from the main road and although local shops and amenities are close by, they are not easily accessible for elderly frail people. The home is staffed around the clock and residents said that they are well cared for. There were twelve residents residing at the home at the time of the inspection. They all said that they are well cared for and that all the staff are kind and considerate. The Thorns F57 F09 S9876 The Thorns V232958 190805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the first of two statutory inspections to be carried out this year. The inspection was an unannounced one and took place on the 19th August 2005 and lasted for 5 hours. The inspection was carried out against the National Minimum Standards for Older People. The inspection despite being an unannounced one was carried out in a nice atmosphere and with the full cooperation of the manager, the staff and the residents. During the inspection, some records were looked at and several residents and staff were spoken to. The residents were very positive about the care they receive and the way the staff treat them. One resident said that “I am so glad I chose this home. The staff are so kind and they will do anything for you.” Comment cards received from the residents had very positive comments about the care provided. There were 12 residents living at the home at the time of the inspection and there were 3 care staff, 1 senior carer, 1 manager, and a cook on duty. The number of staff on duty was well above the minimum level recommended. The staff were observed to be polite and kind when talking to the residents. What the service does well: Since the home opened 15 years ago, the owners wanted to provide a high standard of care for the residents. The residents spoken to said that they live in a very nice home with high standard of care and facilities. The residents had high praises for all the staff and the manager. They said that nothing is too much trouble for them. The staffing level is usually well above the minimum recommended. The residents said that when you need anything, there is always somebody around to provide it. The staff said that there is usually an adequate number of them to do all the routine jobs and to also find to spend with the residents. The Thorns F57 F09 S9876 The Thorns V232958 190805 Stage 4.doc Version 1.40 Page 6 The residents said that they are well cared for by a team of good staff. This was evident by observing the good way the residents and the staff got on. There was a good atmosphere in the home and everyone seemed happy. The written records kept by the home on the residents showed that they receive good care which meets their individual needs. The physical standards of the home have been maintained to a good standard. All the bedrooms and communal areas are kept well decorated and there is a rolling programme for replacing carpets and furniture. 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. The Thorns F57 F09 S9876 The Thorns V232958 190805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection The Thorns F57 F09 S9876 The Thorns V232958 190805 Stage 4.doc Version 1.40 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 standard(s) 3 Pre admission assessments to meet the needs of new residents are good. New residents benefit from having their needs met. EVIDENCE: Every resident considering coming to live at The Thorns has a pre admission assessment done. This is done by different methods and the most common one is when a relative of a resident rings the home to see if there is a vacancy. If there is, then the person is asked some basic questions and given the option to visit the home. Where it is possible and practicable, a senior member of staff will visit the prospective resident in his own home. The manager said that prospective residents are encouraged to visit the home prior to admission; however in many instances it is a member of their families who would visit. During the visit a written assessment is done to decide whether the home can meet the needs of the resident. Questions will include such things as mobility, mental state, likes and dislikes, any idiosyncrasies and other needs which will help the staff provide the right care. The Thorns F57 F09 S9876 The Thorns V232958 190805 Stage 4.doc Version 1.40 Page 9 A full assessment is carried once the new resident is admitted and continues all the time and regular reviews are carried to ensure that the level of care provided is appropriate. The manager was advised to record all reviews in order that progress can be easily monitored. Some of the residents spoken to said that they visited the home and spent some time with the other residents before they decided to come and live at The Thorns. They said that they were made very welcome and were given verbal and written information about the facilities and services at the home. The written records of two residents were examined and they clearly show that pre admission assessments were done and these were followed up by full assessments and reviews. The Thorns F57 F09 S9876 The Thorns V232958 190805 Stage 4.doc Version 1.40 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 standard(s) 8 & 10 There is a good system in place to meet the health needs of the residents. Policies and training to care for the residents with respect are in place. Residents’ health needs are met and they are treated with respect. EVIDENCE: Two residents’ case files were examined and they clearly show that medical details of the residents are well listed. They include the name and contact of the GP’s. Other health professionals such as dentist, optician are also included if the resident has one. A brief medical history is recorded along with any medications the resident may be taking. If the district nurse is treating someone, this information is also written down. The district nurse keeps her own notes on the treatments she provides to the residents. The residents said that if they need a doctor, then one is sent for. They said that they prefer the doctor to visit them at the home as they are not fit enough to go to the surgery. The Thorns F57 F09 S9876 The Thorns V232958 190805 Stage 4.doc Version 1.40 Page 11 The staff spoken to said that they respect the privacy and rights of all the residents. They said that they always knock before entering a resident’s bedroom. The residents said that as far as they are concerned all their rights as people are respected. One resident said “ I can do what I want, my visitors can come when they want and the staff treat me well.” Four residents were in their rooms when the inspector went round the home. Of the four, three of them said that they spend most of their time in their rooms. They said that they prefer it this way and that the staff respect their choice to stay in their rooms. They added that the staff look after all their needs without infringing on their privacy. The manager said that all staff are given training to ensure that they care for the residents with dignity. Policies regarding residents’ rights, privacy and dignity are available in the home’s policy manual. The Thorns F57 F09 S9876 The Thorns V232958 190805 Stage 4.doc Version 1.40 Page 12 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 standard(s) 12 & 13 Policies and procedures to help residents maintain their social, cultural and religious needs are in place. Residents are able to practice their religious belief and maintain their cultural and social needs. EVIDENCE: The residents spoken to said that they are free to do what they want. They said that they can follow their religion and that priests and vicars visit the home on a regular basis. The manager said that if any resident wanted to attend church or other social event, then a member of staff would take them. The residents said that the staff are good and that they would take them shopping and for walks if they wanted to. One resident who goes out for short walks with other residents, said that she would like to go out on her own with the support of a member of staff. The manger said that she would help the resident do this. Some of the residents said that they prefer to spend part of the day in their rooms. Some of them were seen in their rooms when the inspector looked The Thorns F57 F09 S9876 The Thorns V232958 190805 Stage 4.doc Version 1.40 Page 13 around the home. They said that they like the privacy of their rooms and that all the staff respect their wishes. They added that the staff will bring them a cup of tea to their rooms if they want The manager said that the residents can practice their religions freely and priest and other religious leaders visit the home regularly. Holy communions are held monthly in the home and they are also attended by some local residents. The residents of the home said that they enjoy meeting the neighbours. The manager said that she tries and arrange as many activities as possible. Bingo is played twice weekly and prizes are provided by the home. Other activities include weekly Tai Chi and regular entertainments. The staff said they will try and accommodate any reasonable activity the residents may wish to do. They said that they arrange one to one shopping for the residents. Some of the residents are taken to the nearby shops when they want. The Thorns F57 F09 S9876 The Thorns V232958 190805 Stage 4.doc Version 1.40 Page 14 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 standard(s) 16 The policies and procedures to deal with complaints are good. Residents live in a safe environment and are able to speak their minds without fear of reprisals. EVIDENCE: The home has a detailed complaint procedure which explains what people should do if they have a complaint. It says that in the first instance, people should complain to a member of staff unless the complaint is about staff. The next step is to speak to the manager or one of the owners. If this does not resolve the complaint, then the complaint can be passed to the Commission for Social care Inspection (CSCI). A complaint book is used to record any complaint received. The home had received no complaints since the last inspection. The residents said that if they have any complaints, they would not hesitate to speak to someone about it. They said all the staff and the manager are very approachable and easy to speak to. The manager said that every resident or their families are given written information about the complaint’s procedure. A couple of the residents said that they were not sure about how to contact CSCI, but were very positive about having any of their complaints sorted out by the staff of the home. The Thorns F57 F09 S9876 The Thorns V232958 190805 Stage 4.doc Version 1.40 Page 15 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 standard(s) 19 There are good policies and practices to keep the home safe and well maintained. The residents live in a well-maintained and safe environment. EVIDENCE: During the tour of the building, the inspector found that the home was clean and well maintained. Some of the bedrooms have been redecorated in the past few months. New curtains are being chosen for the dining room. The manager said that the residents are going to be consulted about the final choice. There are plans to turn one single large bathroom into two ensuite for the two bedrooms adjacent to it. When this work is completed, all the bedrooms will have an ensuite facility. The residents said that they feel safe in the home and that there are no hazards which could inhibit their movements. The Thorns F57 F09 S9876 The Thorns V232958 190805 Stage 4.doc Version 1.40 Page 16 The manager said that the security of the home and the residents are important. She said that there is always a member of staff around to ensure the safety of all the residents. The front door is kept locked when staff are not around. The Thorns F57 F09 S9876 The Thorns V232958 190805 Stage 4.doc Version 1.40 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 & 30 The training of staff plays an important part in the home’s policy. Residents are cared for by a team of well-trained staff. EVIDENCE: The manager said that all new staff are given an induction training programme when they start work at the home. The induction training includes basic practices such as Moving and Handling, Food Hygiene and First Aid. The staff the inspector spoke to said that they have attended many training courses and found them beneficial. The manager said that it is a contractual requirement for new staff to attend training courses. They staff said that they have attended the following courses: Abuse Awareness Health and Safety Medications First Aid NVQ The Commission for Social Care Inspection (CSCI) has recommended that 50 of care staff achieved the National Vocational Qualification (NVQ) level 2 this year. The staff at The Thorns have achieved 61 . The Thorns F57 F09 S9876 The Thorns V232958 190805 Stage 4.doc Version 1.40 Page 18 The manager said that all the staff are committed to training and she hopes that several more staff will complete their NVQ training in the next few months. The residents said that the staff are very good and caring and they seem to know what they are doing. They said that all of them are kind and helpful and treat them with respect and dignity. The Thorns F57 F09 S9876 The Thorns V232958 190805 Stage 4.doc Version 1.40 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 & 35 The policy and procedures to protect the finances of the residents are good. The home is run to serve the best interests of the residents. The residents’ finances are safeguarded and they feel that the home is run for their benefits. EVIDENCE: The home has good policies and procedures to protect the finances of the residents. The records of monies held on their behalf were examined and they were found to be accurate and current. The manager said that residents and their families are encouraged to deal with their own finances if possible, and this seemed to be the preferred way for most of them. Fees due to the home are mostly paid by standing orders arrangements. The Thorns F57 F09 S9876 The Thorns V232958 190805 Stage 4.doc Version 1.40 Page 20 The monies held by the home on behalf of some of the residents are for those whose families live far away or for those who have no families. Those residents who are able to deal with their finances said that they are free to use their money as they like and if they need help, the staff will provide assistance. The Thorns F57 F09 S9876 The Thorns V232958 190805 Stage 4.doc Version 1.40 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x COMPLAINTS AND PROTECTION 3 x x x x x x x STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x x x x x x x The Thorns F57 F09 S9876 The Thorns V232958 190805 Stage 4.doc Version 1.40 Page 22 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 25 Regulation 23 Timescale for action All central heating radiators must January be fitted with low heat surface 2006 covers Requirement RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations The Thorns F57 F09 S9876 The Thorns V232958 190805 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection 2nd Floor, Unit 1 Tustin Court Port Way Preston. PR2 2YQ 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. Extracts may not be used or reproduced without the express permission of CSCI The Thorns F57 F09 S9876 The Thorns V232958 190805 Stage 4.doc Version 1.40 Page 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!