Inspection on 17/01/07 for Thistledown

This inspection was carried out on 17th January 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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Thistledown 15/12/05

Thistledown 28/06/05

Thistledown 28/02/05

Thistledown 25/08/04

Thistledown 03/02/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Thistledown 33 Beach Road Hayling Island Portsmouth Hampshire PO11 0JB Lead Inspector Mrs D Peel Unannounced Inspection 17th January 2007 2:30 Thistledown DS0000011854.V323416.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 Thistledown DS0000011854.V323416.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. Thistledown DS0000011854.V323416.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Thistledown Address 33 Beach Road Hayling Island Portsmouth Hampshire PO11 0JB 023 9246 1282 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) Mr R Bagoban Mrs I Bagoban Mr R Bagoban Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Thistledown DS0000011854.V323416.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th December 2005 Brief Description of the Service: The home provides care for up to six people (aged 18-65). Four of the five residents currently at the home have lived there since 1984, whilst the fifth took up residence in 2002. Residents have single bedrooms on the ground and first floors. The home has a lounge with a dining area, a large lounge at the rear of the property, a kitchen, shower room and bathroom. It is within easy reach of local amenities. Residents have the benefit of transport to day centres and other locations in the owner’s minibus. The current scale of fees being charged at the home is from £319 to £401.52 per week. Thistledown DS0000011854.V323416.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit to Thistledown was carried out by Mrs Diane Peel on the 17th January 2007. During this visit the intended outcomes for 31 standards were assessed; these included the key standards for care homes providing a service to Young Adults aged 18-65. Prior to the visit the inspector reviewed feedback questionnaires returned by four of the five people living at the home, relatives comment cards returned to the inspector and the previous two inspection reports detailing the outcomes for service users at the visits carried out in June 2005 and December 2005. The inspector arrived at 2.30 pm and met with the owners of the home. A tour of the building was undertaken with all communal areas being viewed and three bedrooms where the doors had been left open by the service users whilst they were out at their day centres. A case tacking exercise was undertaken for one service user and the inspector met with all the service users on their return from their day centres to discuss their level of satisfaction with the standards of support and facilities provided at the home. What the service does well: Thistledown provides a stable family home for the people who live there, some who have been living with the owners, Mr and Mrs Bagoban for twenty years. The service users have much in common and see each other as part of their extended family. A lot of effort has been put in to ensure that the service users have active social lives, have opportunities for learning new skills and feel part of the community. Families are encouraged to be involved in the care package and they are consulted to ensure that their views are taken into account. Thistledown DS0000011854.V323416.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. The summary of this inspection report can be made available in other formats on request. Thistledown DS0000011854.V323416.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 Thistledown DS0000011854.V323416.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): 1,2,3,4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users needs have been assessed so that the home and each individual service user know that their needs can be met. EVIDENCE: There have been no new service users admitted to the home since the last visit by the Commission for Social Care Inspection (CSCI) in December 2005. Mr Bagoban told the inspector that it was unlikely that the vacancy at the home would be filled as the established group of people get on well together. Three out of the four service users returning questionnaires to the inspector reported that they thought that they had had enough information about the home before deciding if it was the right place for them. The other person couldn’t remember since they had lived at the home for twenty years. One person returning the questionnaire who had been helped by a relative to complete the questions reported that they had moved to the home 18 years ago and had spent a weekend there before moving in. Thistledown DS0000011854.V323416.R01.S.doc Version 5.2 Page 9 Mr Bagoban told the inspector that he keeps the Statement of Purpose and Service user Guide on a disk so that he can update it when needed. From speaking with the service users at the home it was clear that the home is meeting the needs of the current people who live there. Thistledown DS0000011854.V323416.R01.S.doc Version 5.2 Page 10 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): 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care planning systems could be further developed to ensure that they are regularly reviewed. Service users are included in decisions made about life in the home so that they have opportunities to exercise choice and have a fulfilling life style. EVIDENCE: Care plans are in place. The plans included information about health needs, personal goals, physical care and support needs and social needs. In reality only Mr and Mrs Bagoban and one weekend carer need to use them. Thistledown DS0000011854.V323416.R01.S.doc Version 5.2 Page 11 The care plan examined in detail had not been reviewed six monthly since the last visit by CSCI and Mr Bagoban told the inspector that he was aware that the care plans needed reviewing. A recommendation had been made that in addition to Care Management reviews Mr Bagoban reviews each care plan with the resident at least every six months. The five service users spoken with during the visit to the home explained that they live as a family. They are able to make ordinary every day choices and participate in the day-to-day running of the home. Risk factors are covered in the plan of care and identify how to minimise risks without taking away individual service users independence. One relative returning a questionnaire commented, “ Mr Bagoban maintains a good balance between advising the residents at Thistledown and giving them a choice.” Thistledown DS0000011854.V323416.R01.S.doc Version 5.2 Page 12 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): 11,12,13 14,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users living at the home take part in a variety of activities and have opportunities for personal development so that they feel valued and have opportunities to develop skills. Staff support service users to maintain contact with their families and friends so that they can maintain and develop relationships outside the home. Service users are offered a varied diet and can have alternatives if they wish. EVIDENCE: Four service users work at a horticultural day centre on a daily basis from Monday to Friday. The other person attends a day centre situated on Hayling Island. Thistledown DS0000011854.V323416.R01.S.doc Version 5.2 Page 13 Service users were keen to tell the inspector about what they do at the centres and all said that they enjoyed going. One service users spoke about the paper round which he does from the horticultural centre and his trips independently on the train to visit his mother. He explained how he had been supported to make the trip until he felt confident that he could do it alone. Service users also have activities which they take part in the evenings and at weekends. On the evening of this visit all five service users had returned home to get changed, have their meal and then go to a cookery class. They spoke about what they had been cooking in previous weeks and when asked what they would be making that evening it became apparent that a different person each week gets to make a choice of what to cook. Some service users at the home continue to be involved in the Special Olympics and have had a recent trip to Windsor to take part in events. Other activities which service users take part in include: line dancing, art classes and going to the pub. The service users returning questionnaire to the inspector had been assisted to complete them by various members of their families indicating that service users are encouraged to maintain relationships with relatives. Service users told the inspector that they went home for at least one at weekend every month and the majority had spent time with their families over Christmas. Relatives returning their own comment cards reported that the owners welcome them in the home at any time and that they can visit their relative living at the home in private if they wish. They felt that they were kept informed about important matters and consulted about their relatives care. Service users say that they like the food provided. That they can have something different if they don’t like what is being served. It was observed that there plenty were fresh fruit and vegetables in store at the home. A satisfaction questionnaire observed in a service users folder reported that the particular person was satisfied with the food provided. Thistledown DS0000011854.V323416.R01.S.doc Version 5.2 Page 14 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): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users receive personal support in the way that they want so that they can maintain individual levels of independence. A variety of healthcare professionals are involved in maintaining the physical and emotional needs of residents. Thistledown has demonstrated satisfactory medication handling. EVIDENCE: The support which service users require is detailed in their care records along with risk assessments which have been drawn up to avoid unnecessary harm. Through speaking with each service user during this visit it is clear that they are able to influence the level of support whish they need and can ask for extra support if they need it. Thistledown DS0000011854.V323416.R01.S.doc Version 5.2 Page 15 Service users told the inspector that they have a Doctor at the health centre and if they need to visit the Doctor Mr or Mrs Bagoban will go with them. Details in a care management review observed by the inspector during the visit recorded that that particular person visits the dentist six monthly for a check up and the opticians every two years. Two out of the five people living at the home have regular prescribed medication. Mr Bagoban told the inspector that there are no special arrangements for delivery of medication. It is dispensed by the chemist from a prescription like any family would in their own home. The medication is then stored in a medication cabinet, administered by Mr and Mrs Bagoban and the weekend carer. Records are kept of the administration. Thistledown DS0000011854.V323416.R01.S.doc Version 5.2 Page 16 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): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements are in place for service users and their families to make complaints if they are not satisfied with something. The registered person has arrangements in place to protect service users from being placed at risk of harm or abuse. EVIDENCE: All service users returning questionnaires to the inspector reported that they knew how to make a complaint and who to speak to if they if they were not happy. The two relatives returning questionnaires/comment cards reported that they were aware of the homes complaints procedure but had never had to make a complaint. No complaints have been received by the manager or CSCI about the home since the last visit in December 2005. Mrs Bagoban told the inspector that there had been no adult protection issues come to their attention at the home. The weekend carer had been on an Adult Protection course and they keep themselves up to date with adult protection Thistledown DS0000011854.V323416.R01.S.doc Version 5.2 Page 17 matters via e-mails and communication from the Hampshire Care Homes Association. Thistledown DS0000011854.V323416.R01.S.doc Version 5.2 Page 18 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): 24,25,26,28,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Thistledown provides a comfortable clean home for service users to enjoy living in. Shower facilities on the ground floor do not maximise privacy and dignity. At this time it is not of a serious effect on service users but a clear policy would enhance matters for service users. EVIDENCE: The property is in keeping with the local community and offers access to the local amenities and community services. There is a large garden to the rear with a patio area. Thistledown DS0000011854.V323416.R01.S.doc Version 5.2 Page 19 As a family home each service user has access to all communal areas and their own bedroom. Mr and Mrs Bagoban live on the premises with the service users and share their facilities with them. Mrs Bagoban told the inspector that since the last visit by CSCI, new sofas and new dining tables and chairs had been purchased for the lounge/dining room. The floor surface in the lounge/dining room had also been replaced by wooden flooring, which could easily be cleaned. Each service user has a single room, which they have personalised. The inspector viewed three bedrooms, which had been left open by the service user. They were all clean and demonstrated the individual personalities of the residents. All service users spoken with were pleased with their rooms and reported in their returned questionnaires that the home was always clean and fresh. None of the bedrooms have en suite toilets and showers. There is a shower room on the ground floor with which has two individual showers. There is a lock on the external door but the double units are not in keeping with maximising privacy and dignity. There is also an adjacent toilet. A requirement has been made in this report that there must be a clear policy to be followed which must maximise the privacy and dignity of residents using the down stairs shower room The bathroom on the upper floor has separate toilet facility next door. Thistledown DS0000011854.V323416.R01.S.doc Version 5.2 Page 20 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): 32,34,35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported by a stable staff group who they have been able to form a long-term relationship with. EVIDENCE: Mr and Mrs Bagoban are the main carers for the people living at Thistledown. They are assisted at weekends by one carer who has worked at the home since 1994. Mr and Mrs Bagoban are trained nurses in the area of learning disability and told the inspector that they keep themselves up to date via the internet and information provided by Hampshire Care Homes Association. Mr Bagoban told the inspector that he, Mrs Bagoban and the other carer all have CRB and POVA clearance. He was also aware that should he need to recruit further staff that he must carry out a POVA first checks. Thistledown DS0000011854.V323416.R01.S.doc Version 5.2 Page 21 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): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from the ethos ,leadership and management of the home, giving them and their relatives the confidence that the home is run in their best interests. EVIDENCE: Mr and Mrs Bagoban have been the owners of the home for many years and are both qualified nurses in the field of learning disabilities. The home is run as a family home and service users benefit from care and support from a service, which does not fit neatly into the National Minimum Thistledown DS0000011854.V323416.R01.S.doc Version 5.2 Page 22 Standards for Adults. Service users and their families are in no doubt that the home meets their needs. Mrs Bagoban told the inspector that the relatives of service users meet together to discuss with the themselves and provide feedback on how the service is run. Documents requested to be seen at this inspection were provided and were seen to be in good order. Thistledown DS0000011854.V323416.R01.S.doc Version 5.2 Page 23 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 3 2 3 3 3 4 3 5 X 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 1 28 3 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Thistledown DS0000011854.V323416.R01.S.doc Version 5.2 Page 24 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. 1 Standard YA27 Regulation 12.4(a) Requirement There must be a clear policy agreed maximise the privacy and dignity of residents using the down stairs shower room. Timescale for action 01/03/07 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 Thistledown DS0000011854.V323416.R01.S.doc Version 5.2 Page 25 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. Extracts may not be used or reproduced without the express permission of CSCI Thistledown DS0000011854.V323416.R01.S.doc Version 5.2 Page 26 - 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!