Inspection on 10/05/05 for Thorndene

This inspection was carried out on 10th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Thorndene 15/02/07

Thorndene 04/01/05

Thorndene 07/09/04

Thorndene 08/04/04

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Insight - Eastchurch

Southfields

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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 Thorndene Canterbury Road Swingfield Dover, Kent CT15 7HZ Lead Inspector Wendy Mills Announced 10 May 2005 9:15 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Thorndene H56-H05 S23562 Thorndene V224520 100505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Thorndene Address Cantrbury Road, Swingfield, Dover, Kent, CT15 7HZ 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) 01303 892244 Thorndene Limited Mrs Patricia Ann Moore Care Home only 20 Category(ies) of Learning Disability x 18; Learning Disability registration, with number (over 65) x 2; Physical Disability x 3 of places Thorndene H56-H05 S23562 Thorndene V224520 100505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: .There are variations to conditions of registration to allow for two service users with a learning disability over the age of sixty-fivef and three service users with a learning disability and a physical disability. Date of last inspection Brief Description of the Service: Thorndene is a care home for up to twenty people with a learning disability. It is in a rural position in village of Swingfield. It is a not-for-profit organisation and is a large and well decorated and furnished, country house with a separate, smaller annex. Both units are set in extensive and well maintained grounds. Local shops are close by both in the village and nearby Hawkinge. There is easy access by road and public transport to the larger towns of Dover, Canterbury and Folkestone. The philosophy of the home is to encourage each resident to maximise his or her potential within a safe and supportive environment where respect and understanding for individual strengths and needs are paramount. The home offers spacious accommodation. It is clean, comfortable, homely, well furnished and has a good standard of décor. The registered manger, Mrs Pat Moore, ensures that there is a person-centred approach to a wide range of cultural, educational and recreational activities. The Home has consistenetly met, and frequently exceded, the National Minimum Standards. Thorndene H56-H05 S23562 Thorndene V224520 100505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection began at 9.15am and took seven hours. The inspector spoke with fifteen residents, two relatives, four members of staff and the registered manager. Detailed discussions were held in confidence with four residents, two relatives, a senior team leader, training co-ordinator, cook and the registered manager. There was a very good response to the CSCI survey, both from the residents and their relatives, and to the in-house questionnaire. All responses were very positive and demonstrated a high level of satisfaction. A tour of the Home was undertaken, key documentation inspected and sample care plans examined in detail. Both indirect and direct observations were made throughout the inspection. The home met and often exceeded the National Minimum Standards inspected at this visit. The residents and their relatives expressed a high level of satisfaction with the Home, the registered manager and all the staff. The home is very clean, tastefully furnished and decorated and homely. Several examples of exemplary care practice were evident. There are good staffing levels and a high level of person centred care. Staff training is linked to the needs of the residents, local and national policies and recommendations, and to staff supervision. What the service does well: The home is well run and provides a supportive and homely environment in which the residents are encouraged to maximise their independence and develop new skills. It is proactive and innovative in the way it meets the needs of the residents and organises training and development for staff. It provides exemplary person centred care. In particular, the way medication is managed and linked to nutrition and skin care. The way in which activities are assessed and provided is in line with best practice. The Home provides excellent support for families and enables the residents to maintain appropriate links with their families and friends. The internal long-term planning and quality assurance systems are excellent. The Home monitors the health needs of the residents very well and places a strong emphasis on health promotion. The way in which it promotes exercise, healthy diets, self fulfilment and spiritual well-being are exemplary. Thorndene H56-H05 S23562 Thorndene V224520 100505 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. Thorndene H56-H05 S23562 Thorndene V224520 100505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Thorndene H56-H05 S23562 Thorndene V224520 100505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,5 The Statement of Purpose and Service User Guide are excellent. The residents are aware of their roles and responsibilities in the Home and know that their independence will be maximised and promoted. The residents and their families know that their goals and aspirations will be supported by the Home. EVIDENCE: The Statement of Purpose and the Service User Guide are produced in a variety of formats such as plain English and Widget. No new residents have joined the Home since the last inspection. The residents said that the Home helps them live interesting and fulfilled lives and also helps them through their difficulties. Personal goals are reflected in the care plans and risk assessments are in place. Thorndene H56-H05 S23562 Thorndene V224520 100505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8,9&10 The residents know that their views are valued and that the Home will respect their confidentiality and maintain their records securely. There is a clear and consistent care planning process that the residents understand and in which they participate fully. EVIDENCE: The residents said that there are regular house meetings and that they can bring up any ideas for improving the home, new activities, holidays, ideas to help others and any other general concerns. They also said that they could always talk, in private, to the registered manager or the staff if their concerns were more individual. They all said that they know that information held about them will be kept in confidence. On the day of inspection five of the residents were helping out with household chores. All were clear about their responsibilities for these duties and were proud to talk about the way in which they contribute to the life in the Home. Residents said that they are involved in the review process and that they are always trying new things. Recently one resident has taken a great interest in patchwork and some others have started going to a local gym. All new Thorndene H56-H05 S23562 Thorndene V224520 100505 Stage 4.doc Version 1.30 Page 10 activities are reflected in the care plans and regularly reviewed. Appropriate risk assessments are place. Relatives said that the care and encouragement that the Home gives is excellent and responses to the CSCI questionnaires were all positive. Examples of comments made are: “We consider that the care at Thorndene remains exemplary”. “Pat Moore and her staff make every effort to involve individuals in their own decision-making”. Thorndene H56-H05 S23562 Thorndene V224520 100505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,14,15&16 The Home offers excellent opportunities for personal development and is innovative and proactive in its approach to all aspects of care planning. Appropriate family links are maintained. The Home fosters a strong culture of mutual respect and support. The meals are of excellent quality and offer both choice and variety, and cater for special diets. EVIDENCE: The residents spoke enthusiastically about the various leisure and educational activities in which they are involved. They were proud to show an extensive photographic record of their activities. Inspection of a fifteen percent sample of care plans and other documentation confirmed that each individual had been thoroughly assessed for and involved in, the choice, planning and review of these activities. Discussion with staff, confirmed that there is a wide and exciting range of activities on offer and that there are enough staff on duty to ensure that no activity is missed unless through illness of a resident or other valid reason, such as a cancellation. Records show that few activities are missed and when they are, the reasons for this are documented. Thorndene H56-H05 S23562 Thorndene V224520 100505 Stage 4.doc Version 1.30 Page 12 Positive feedback from relatives’ questionnaires included comments such as “****** continues to gain in social and personal skills”: “The Home gives the appropriate amount of choice and security”: “The residents’ quality of life is of highest priority with staff”: “The atmosphere in the house always seems to be happy and cheerful”. Inspection of documentation, a visit to the kitchen s and dining room, and discussion with the cook, the registered manager and residents, confirmed that nutrition is given a high priority. The home employs the services of a nutritionalist and many of the residents have diets tailored to their needs. Food supplies are plentiful and of excellent quality. Seasonal fresh fruit and vegetables are always available and residents said that they really enjoy their meals. A healthy eating programme is promoted and unhealthy foods discouraged. Thorndene H56-H05 S23562 Thorndene V224520 100505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19 ,20&21 Personal support is offered in a way that protects the privacy and dignity of the residents and promotes their independence. There are clear and comprehensive systems for the management and administration of medicines and the home promotes good health. EVIDENCE: The residents said that the staff respect their confidentiality and that they feel confident discussing personal issues with the staff. Indirect observation confirmed that personal care, when needed, was offered in a discreet and sensitive manner. In response to questionnaires, relatives said that the home works hard to promote the health of the residents and to look after them when ill. One respondent said, “Pat Moore was especially supportive in overseeing *****’s care during ill health …….and kept us in touch with decisions at all times”. Visiting health care professionals, in response to CSCI questionnaires, said that that the home supports their work with the residents and provides “a happy, healing, professional environment”. Inspection of the systems for the ordering, recording, storage and administration of medication and discussion with both the registered manager and a senior team leader confirmed that improvements have been made on Thorndene H56-H05 S23562 Thorndene V224520 100505 Stage 4.doc Version 1.30 Page 14 the already good practice. There is now an improved system for the recording and storage of “over the counter”(OTC) medicines such as paracetamol. A special file is held on OTC medicines and a printed record is attached to the MAR sheets. Controlled drugs are recorded separately and counter-signed. Special activities have been arranged for those residents who are now showing signs of aging. Conversation with residents about bereavement showed that they are well supported when dealing with their sadness at the loss of friends and family and that they are able to talk comfortably about their losses. Thorndene H56-H05 S23562 Thorndene V224520 100505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22&23 Staff have excellent knowledge and understanding of Adult Protection issues and how to protect the residents from all forms of abuse. The residents know that their concerns will be listened to and acted upon. EVIDENCE: The residents said that they feel comfortable talking to any of the staff or the registered manager about any concerns they may have. Records show that there are regular residents meetings and day-to-day comments, concerns and complaints are noted and acted upon immediately. Inspection of staff training records, discussion with the training co-ordinator and other staff demonstrated a high level of commitment to staff training. In addition, there are good systems in place for staff supervision. Thorndene H56-H05 S23562 Thorndene V224520 100505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27&30 The standard of the environment within the Home is very good and provides the residents with an attractive and homely place to live. EVIDENCE: A tour of the Home was undertaken. All areas are tastefully decorated and comfortable. Furnishings are of good quality and families of the residents have provided artwork to help to make an area where essential work is being carried out more attractive. The residents said they are pleased with their rooms. All rooms are personalised and reflect the individual interests and tastes. All areas of the Home were very clean and hygienic on the day of inspection. One respondent to the relatives’ questionnaire said, “I am always impressed by the cleanliness, atmosphere and care.” Thorndene H56-H05 S23562 Thorndene V224520 100505 Stage 4.doc Version 1.30 Page 17 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,35&36 Staff morale is high and there is an enthusiastic workforce that positively promotes improvement in the quality of life of the residents. The arrangements of staff induction and further training and development are excellent and staff demonstrate a clear understanding of their roles. Training and development is clearly linked to the needs of the residents, identified staff need, national policies and procedures and to best care practice. EVIDENCE: The Home had a dedicated member of staff whose main role is to co-ordinate training and development. Discussion with both the registered manager and the training co-ordinator showed a clear direction for staff training and development. Records show that a high level of training has been undertaken and staff said that they valued the training opportunities. The Home has accessed external support in order to establish more structured and regular supervision. One-to-one supervision is now firmly establishes and work has begun on a system for “on shift” supervision that will check competencies. Thorndene H56-H05 S23562 Thorndene V224520 100505 Stage 4.doc Version 1.30 Page 18 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,39,41,42&43 The Home is well managed and provides a caring and supportive service that promotes the independence, health, safety and welfare of the residents. EVIDENCE: There is a written forward plan for the coming year and a clear vision for the direction of the Home. The CSCI has received regular comprehensive written reports in accordance with Regulation 26 and there are excellent internal quality assurance systems in place. The registered manager, Mrs Moore, is well supported by the directors and the senior staff. She is a qualified nurse who has maintained her continuing professional development. The residents benefit from an open and inclusive management approach and have the opportunity to express their opinions at regular meetings. However, Mrs Moore is experiencing some difficulty in obtaining the appropriate funding for some residents with very complex needs due to the reluctance of some contract managers to acknowledge the need for adequate funding. Thorndene H56-H05 S23562 Thorndene V224520 100505 Stage 4.doc Version 1.30 Page 19 The Home achieved the Investors in People (IIP) award on the first assessment without IIP making any recommendations or needing to make a second visit. Respondents to questionnaires said, “It’s a brilliantly run, wonderfully staffed residential home”: “I particularly commend the leadership of Pat Moore”; “Thorndene provides consistent quality care”; “The staff are extremely hard working and friendly and have good relationships with the residents”: “Thorndene is one of the most professionally run homes I attend”. Thorndene H56-H05 S23562 Thorndene V224520 100505 Stage 4.doc Version 1.30 Page 20 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 4 3 x x 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 4 4 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 x x 3 Standard No 11 12 13 14 15 16 17 4 4 3 4 4 4 4 Standard No 31 32 33 34 35 36 Score 3 3 3 x 4 4 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Thorndene Score 3 4 3 3 Standard No 37 38 39 40 41 42 43 Score 4 4 4 x 3 3 3 H56-H05 S23562 Thorndene V224520 100505 Stage 4.doc Version 1.30 Page 21 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 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. 1. Refer to Standard 43 Good Practice Recommendations The registered providers and registered manager should continue to pursue contract managers to obtain appropriate funding for those residents with more complex needs. The registered manager should inform CSCI, in writing, of any occassion when a refusal to provide appropriate funding is encountered. 2. 43 Thorndene H56-H05 S23562 Thorndene V224520 100505 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford, Kent TN23 1HU 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 Thorndene H56-H05 S23562 Thorndene V224520 100505 Stage 4.doc Version 1.30 Page 23 - 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. 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