Inspection on 29/06/05 for Thistlegate House

This inspection was carried out on 29th June 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Thistlegate House 25/03/09

Thistlegate House 13/02/08

Thistlegate House 20/08/07

Thistlegate House 13/02/07

Thistlegate House 01/06/06

Thistlegate House 30/01/06

Thistlegate House 01/10/04

Thistlegate House 16/06/04

Thistlegate House 05/03/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Thistlegate House Axminster Road Charmouth Dorset DT6 6BY Lead Inspector Marion Hurley Unannounced 29 June 2005 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. Thistlegate House D55 S26880 Thistlegate House V230982 290605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Thistlegate House Address Axminster Road Charmouth Dorset DT6 6BY 01297 560569 01297 560569 thistlegatehouse@aol.com Mr John A Corney Mrs June P Webb 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) CRH - Care Home Only 18 Category(ies) of OP - Old age (18) registration, with number of places Thistlegate House D55 S26880 Thistlegate House V230982 290605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. One of the following rooms may be used as a double at any one time: 4, 15, 17, 27, 28, or 31 Date of last inspection 1 October 2004 Brief Description of the Service: Thistlegate House is an elegant listed graded II building. It stands in four acres of grounds and gardens and commands exceptional views of the surrounding countryside. The house is situated near to the seaside village of Charmouth and is approximately two miles away from Lyme Regis coastal resort. Mr J Corney and Mrs J Webb have owned and managed the home since 1994. The accommodation comprises a total of 17 bedrooms, mainly singles, spread over two levels (upper and lower ground and first floor). It includes a large lounge and a dining room and five bathrooms plus additional WCs; one single and one double-sized bedroom have an en-suite WC facility. There is no passenger lift in the home. For service users with limited mobility access to first and lower floor bedrooms is achieved by the use of a stairmatic chair with staff assistance. The gardens and grounds are extensive and landscaped with flower borders, lawns, roses, mature shrubs and trees. The most recent feature to be developed is a kitchen garden. Attractive garden furniture and potted plants compliment the paved patio area directly outside the lounge, which provides a relaxing place for service users to sit safely outside. Thistlegate House D55 S26880 Thistlegate House V230982 290605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection has been undertaken as part of the statutory inspection process legally required in accordance with the Care Standards Act 2000. Thistlegate House was assessed according to the Care Homes for Older People, National Minimum Standards. The inspection took place over ten hours, five of which were spent in the Home. During the course of the visit five staff were spoken with and the Registered Providers were available throughout the inspection. A total of seven residents were spoken with privately in their bedrooms and a further six joined in a general discussion. A partial tour of the premises was completed during the course of the visit. Records and documents relating to those standards assessed were examined and read. The inspector was grateful for the time and support provided by both residents and all the members of staff on the day of this inspection visit. The following standards were not assessed at this inspection and therefore any requirements from the previous inspection are carried forward and will be assessed at the nest inspection. (22,25,26,33,36) What the service does well: Thistlegate House provides a homely and comfortable environment. The Registered providers who live on site have over the years created and maintained a relaxed atmosphere balancing this informal approach with professionalism in the management of their business. All the bedrooms are individually decorated and comfortably furnished. Residents may bring their own furniture with them and the Registered Providers have always made arrangements to accommodate the extra items. Residents consistently said they appreciated the quality and experience of the “girls”(staff) “they are lovely”; “they look after us very well”. Prospective residents and or their representatives are always invited and encouraged to visit the home before making a final decision to move. Visitors are welcome to the Home and two were met during the course of this unannounced inspection both said they felt very welcome and “could just pop in anytime.” Thistlegate House D55 S26880 Thistlegate House V230982 290605 Stage 4.doc Version 1.30 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. Thistlegate House D55 S26880 Thistlegate House V230982 290605 Stage 4.doc Version 1.30 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 Thistlegate House D55 S26880 Thistlegate House V230982 290605 Stage 4.doc Version 1.30 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 & 5 • • Residents only move to Thistlegate House following an assessment of their needs and with the understanding that the home’s facilities and services can meet their needs. Prospective residents are invited to visit the home before making a decision to move. EVIDENCE: The records of a recently admitted resident were read. The assessment covered all aspects of the resident’s personal care, physical, social and emotional needs in addition to their current abilities and interests and social network. Staff from Thistlegate House completed the pre admission assessment with the prospective resident at their previous accommodation. Both the resident and their relative were able to confirm the admission process and in this case the close relative had taken the opportunity of viewing the home and the resident’s bedroom prior to the move. During this preliminary visit they had been provided with written information giving details of the services and facilities available at Thistlegate including the complaints policy and procedures. When asked about the admission process they said, “it was quite a difficult time which was well managed; they (staff from Thistlegate) looked after the details.” Thistlegate House D55 S26880 Thistlegate House V230982 290605 Stage 4.doc Version 1.30 Page 9 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) 7,8,&10 • • • The health & personal care needs of each resident at Thistlegate House are identified and met whilst living at the home. Personal care is individually provided based on an assessment of needs. This ensures staff provide and understand the support and care each person requires. Residents are treated with respect ensuring their personal dignity is maintained at all times. EVIDENCE: Throughout the inspection visit a total of three staff were observed working side by side with different residents. Irrespective of the tasks there was always positive comments and chatter overheard. All staff knocked on the resident’s bedroom doors before entering. The format of the written care plans is currently being revised and 50 of the resident’s plans have now been completed in the new style. The new format provides a more in depth picture of the person’s abilities and specific needs and preferences. e.g. one referred to the person’s restricted vision this was followed up with a statement “please ensure the floor is kept clear”. Thistlegate House D55 S26880 Thistlegate House V230982 290605 Stage 4.doc Version 1.30 Page 10 Records include details of the person’s daily needs, risk assessments, manual handling needs/plan, medical history, skin map and preferences for their management of personal hygiene. The risk assessments identify the hazard /risk, and an evaluation of the risk in relation to the resident’s abilities. The identified risks predominantly related to hot water temperatures and the surface temperatures of heaters. Diagrams of the position of furniture and the radiators were included with the records. Some residents had signed their own plans whilst representatives had signed others. At the time of this inspection not all plans had been signed and it is important to ensure that once all the records are completed in the new format they are individually signed and dated. Five residents were spoken with independently about their perception of the care they received and all stated they felt well cared for the following is a snapshot of comments received:“personal care is excellent, girls are very good, have a sense of humour, they help me to the bathroom for a good wash down , they always find my earrings, no grumbles” Thistlegate House D55 S26880 Thistlegate House V230982 290605 Stage 4.doc Version 1.30 Page 11 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 • Residents at Thistlegate House may choose to participate in a range of social and recreational activities. Staff endeavour to ensure any specific cultural or religious needs are met according to the wishes of the resident. Visitors are welcome at Thistlegate House enabling residents to maintain social contacts as they wish. • EVIDENCE: One member of the existing staff team has recently been appointed to work with the residents in developing a range of social activities they may wish to do either in groups or individually. Residents with the member of staff are “trying” different activities i.e. watching specially purchased historical videos, card and board games, and reminiscent sessions. One resident said they went on monthly social outings with a local community group. Another person goes out for Sunday lunch after Church. Often a social outing is combined with a visit to the GP or Dentist and this may then include a trip to a garden centre or a pub lunch. One person said “ I could chose if I really wanted to do something different, I like going downstairs for the company and my meals”. A total of six residents and two visitors were respectively asked about social activities and the arrangements for visiting. Each found no difficulties in “dropping in every day” and all the resident spoken to were quite happy with Thistlegate House D55 S26880 Thistlegate House V230982 290605 Stage 4.doc Version 1.30 Page 12 the social arrangements. The “activities organiser” was observed working with a group of residents who had first watched a favourite video which was then followed up with a lively discussion. The number of visitors to the Home was additionally confirmed by the frequent signings in the visitor’s book. The mid-day meal was served during the course of the visit and was attractively presented and looked to be an appetising and well-balanced meal. One resident said their meals “were important I love the food” (this standard was not assessed at this visit). Drinks were regularly served to the residents throughout the day. Thistlegate House D55 S26880 Thistlegate House V230982 290605 Stage 4.doc Version 1.30 Page 13 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 & 18 • • • Thistelgate House has a simple and clear complaints procedure. Residents and their representatives met on the day of the inspection were confident their concerns would be listened to and acted upon. The Providers protect residents from any form of exploitation or abuse. The recruitment procedures and staff training are thorough and there are policies and procedures for responding to any suspicions or allegations. The Dorset County multi- agency document “No Secrets” was available and this is based on the Department of Health National Guidance. EVIDENCE: The residents and two visitors spoken with during this inspection visit said they would be able to talk to any of the staff about “grumbles” and “they are approachable”(provider’s and staff). A total of five staff from the morning and afternoon teams were asked if they had any concerns or issues would they feel able to discuss these and all stated that they would either bring issues up during the daily staff meetings or privately with the Providers as and when they might need to. Thistlegate House D55 S26880 Thistlegate House V230982 290605 Stage 4.doc Version 1.30 Page 14 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) 19,20,23,24, &26 • • The location and layout of Thistlegate House is suitable to meet the needs of the residents currently residing there. All the bedrooms viewed met the minimum standards with reference to size and some were considerably larger. The bedrooms were well equipped and furnished and each had lockable facilities. Those bedrooms viewed had been personalised with ornaments, photographs and pictures and some residents had chosen to use their own furniture in their bedrooms. The range of bedrooms met the varying needs and wishes of the individual residents The premises were clean and tidy on the day of this unannounced inspection and decorated to a high standard throughout. • EVIDENCE: A partial tour of the premises was completed followed by discussions with some of the residents and the Providers. It was evident considerable work has been completed since the last inspection. The redecoration work has now been finished and the ground floor is very attractively decorated throughout. Thistlegate House D55 S26880 Thistlegate House V230982 290605 Stage 4.doc Version 1.30 Page 15 The communal areas are brightly decorated and the large lounge and separate dining room are very attractively furnished with a variety of chairs and fine furniture. The lounge was in use throughout this inspection with some residents being helped and others independently walking to and fro. Radiator guards are being fitted over all the radiators/ heaters. At the time of this inspection the heating was not required. Various covers have been tried and the Providers are now satisfied they have the most suitable. These are now in production and are currently being specially treated and painted. In the interim risk assessments are completed. It will still be important that these risk assessments are reviewed even when the covers are all fitted. A range of aids, hoists, assisted toilet seats are installed which are appropriate to meet the needs of the residents. In addition many residents have their own mobility aids. All call bells were positioned within comfortable reach for residents choosing to remain in their bedrooms. There is a large garden and residents spoke of enjoying time with staff walking in the grounds. On the day of this unannounced inspection the home was found to be clean and safely maintained A full time employee works on maintaining both the gardens and premises. Thistlegate House D55 S26880 Thistlegate House V230982 290605 Stage 4.doc Version 1.30 Page 16 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) 27,29 & 30 • • Thistlegate House employs a sufficient number of staff some of which have formal qualifications whilst others have many practical years work experience. Recruitment policies provide safeguards and the duty rota indicated the number of staff was in proportion to the needs of the residents and the safe running of the home. EVIDENCE: During the course of this inspection visit a total of 5 staff were met and were observed working well together as a staff team to compliment the Providers who were also present. Since the last inspection the Provider’s have successfully recruited additional Care Staff. The records of one newly recruited member of staff were read plus one other set of staff records. Both contained all the required information demonstrating good recruitment practises. The files contained terms & conditions (signed), references/statutory checks including dates sent and received, notes from the interviews, completed training evaluations, performance reviews & self assessments, and key standards, policies & procedures. Training information was in each file and this confirmed the information provided from discussion with the staff. A comprehensive record of staff training showed the variety of courses staff have attended including: - Protecting Vulnerable Adults ( Dorset County Council,) Stroke Education, Managing diabetes, food hygiene infection control and health & safety in the workplace. Thistlegate House D55 S26880 Thistlegate House V230982 290605 Stage 4.doc Version 1.30 Page 17 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) 31 & 38 • • Thistlegate House is managed by the Registered Providers who lead an experienced staff team. The health & safety of the residents and staff are protected by the policies and procedures followed at Thistlegate House. EVIDENCE: Both the Registered Providers are completing the required qualifications to fully meet the requirements specified (NMS 31) however both have many years working knowledge of running and managing Thistlegate House. On the day of this unannounced inspection all records relating to health & safety issues were checked and there was sufficient evidence from these records that safety tests were being carried out within recommended timescales Thistlegate House D55 S26880 Thistlegate House V230982 290605 Stage 4.doc Version 1.30 Page 18 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 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x COMPLAINTS AND PROTECTION 2 3 x x 3 3 x x STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x x x x x x 2 Thistlegate House D55 S26880 Thistlegate House V230982 290605 Stage 4.doc Version 1.30 Page 19 Yes 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 7 Regulation 15(2) Requirement Timescale for action 31:10:05 2. 3. 7 25 13(4) & 14(2) 13(4) 4. 38 13(4) The Registered Person/s must evidence that the Care Plans are written with each resident and provide the basis of care to be provided. Please note at the time of this inspection all the care plans were being reviewed and written in a new format and those already completed had been signed by the resident or their represenative. Risk assessments must be 31:10:05 specific to the individual and regularly reviewed Remedial action must be 31:10:05 completed to lower the hot temperature to outlets accessible to residents. Please note at the time of this inspection work is in hand to meet this requiremnt Risk assessments must be 31:10:05 completed in respect of all windows above ground floor. Please note the Environamental health office West Dorset District Council is advising on this matter Thistlegate House D55 S26880 Thistlegate House V230982 290605 Stage 4.doc Version 1.30 Page 20 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 Thistlegate House D55 S26880 Thistlegate House V230982 290605 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Unit 4 New Fields Business Park Stinsford Road Poole Dorset BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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