CARE HOMES FOR OLDER PEOPLE
Thorndene 107 Thorne Road Doncaster DN2 5BE Lead Inspector
Valerie Hoyle Unannounced Inspection 13th December 2005 09:00 X10015.doc Version 1.40 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 Thorndene DS0000007967.V269706.R01.S.doc Version 5.0 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 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. Thorndene DS0000007967.V269706.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Thorndene Address 107 Thorne Road Doncaster DN2 5BE 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) 01302 327307 327307 Mr Gerald Pickup Mrs Kathleen Pickup Mrs Kathleen Pickup Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22) of places Thorndene DS0000007967.V269706.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Total of 2 short-stay places within the overall registration. Date of last inspection 28th July 2005 Brief Description of the Service: Thorndene is registered currently for twenty-two service users falling in the older persons category. There is a large conservatory to the rear of the building and a paved seating area and this is accessed via the dining area, and conservatory. The accommodation is a Victorian property, which is situated close to the centre of Doncaster within easy access of all facilities including shops. The homeowners Mr. and Mrs. Pickup are involved in the day-to-day operations of the home, and work to enhance service users experience of residential care. Thorndene DS0000007967.V269706.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This is the second unannounced inspection of this inspection year. (2005/06) This unannounced inspection was conducted over 5.5 hours where a partial tour of the building was undertaken. The inspector examined three service users care plans and supporting documentation. Four staff and six service users were spoken to during the visit. Staff was observed interacting with residents (service users) in a positive supportive manner, enabling them to participate in daily living skills. The views of the two visitors and district nurse were also gained during this visit. The deputy manager was available throughout the visit and assisted while examining records and procedures. What the service does well:
The registered providers continue to provide good quality care and residents spoke highly of both Mr and Mrs Pickup. The registered providers have submitted plans to the local council to build an additional six beds and lounge onto the rear of the building. The inspector briefly examined the plans and Mr Pickup is to send copies to CSCI if planning permission is gained. The home continues to be well managed ensuring the safety and protection of service users. There is a stable staff group and a number have worked at the home for a good length of time. They spoke positively about their positions at the home. Staff have shown commitment to their own learning and should be commended for their efforts to obtaining NVQ qualifications, and they hope to reach their 50 qualified target in a few months. The staff at the home have achieved a quality kite mark ‘Investors In People’ that is recognition of their investment in training and developing the work force. The management and staff are commended for their efforts in achieving this award Service users care plans are comprehensively written to ensure staff can deliver appropriate care to those who live at the home. A number of service users commented that the staff were excellent, always willing to help and give support where needed. Service users are happy in their environment and particularly like the social interaction and friendships that they have formed. One resident described a party to celebrate her/his 100th birthday. She/he said it was a special topped with a lovely buffet provided by the owners of Thorndene. Thorndene DS0000007967.V269706.R01.S.doc Version 5.0 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 DS0000007967.V269706.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Thorndene DS0000007967.V269706.R01.S.doc Version 5.0 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 the following standard(s): 3 Service users are not admitted into the home without a full needs assessment undertaken by the registered manager, to ensure their needs are met. EVIDENCE: The placing authority provides information to the home prior to admission and the registered manager is able to make an initial judgement about the suitability of the service user, and assess if the staff are able to meet their care needs. Three assessment documents examined included sufficient information to ensure care needs can be met by the staff at the home. One new resident said that she/he had decided to move into Thorndene following a short stay at the home earlier in the year. She/he said that ideally she/he would prefer to live at home but said the staff made her/him feel settled. Thorndene DS0000007967.V269706.R01.S.doc Version 5.0 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 the following standard(s): 7, 8, 9 The care planning systems are sufficiently detailed to enable staff to deliver the care to service users who have specific identified needs. Arrangements for dealing with service users health issues are adequately met by staff at the home, with support from health professionals. Medication policies and procedures are well managed and staff have the necessary skills to administer the medication to service users, ensuring their safety and protection. EVIDENCE: Three care plans examined and these were comprehensively written with clear methods of staff intervention. There is sufficient evidence to confirm staff on a regular basis reviews the care plans and comprehensive risk assessments ensure residents can maintain their independence while remaining in a safe environment. Staff are comfortable with their abilities to meet the needs of residents and they are well informed and trained to deliver the care. One member of staff said that she enjoyed working at the home and wanted to provide the best possible care for the residents.
Thorndene DS0000007967.V269706.R01.S.doc Version 5.0 Page 10 Records examined and discussion with the staff confirmed service users healthcare needs are met. District nurses give advice and support staff to ensures service users healthcare needs are met. Service users are escorted to medical appointments by staff and comprehensive records are completed ensuring information is shared with those who care for the individual. The district nurse visiting two residents during this inspection said staff were always available to assist and had the necessary skills and knowledge with regard to the health care needs of residents. Several residents said they had been given a choice about having the flu injection given by the district nurse. An audit of medication stocks and records was examined and were found to be correct ensuring the health and safety of service users. All senior carers have undertaken accredited medication training to ensure they have the required skills and knowledge. Thorndene DS0000007967.V269706.R01.S.doc Version 5.0 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 the following standard(s): 12, 13 Social activities are arranged by the home and residents are able to participate if they wish, to enhance their lifestyle experience. The home has clear visiting policies and procedures to ensure residents can maintain contact with their family and friends. EVIDENCE: There is a lively atmosphere at the home and residents choose where and with whom they want to spend their time. The conservatory is an area used by Residents who enjoy a quieter area and the residents chatted about life at the home, and the friendships they have developed. One resident described a party to celebrate her/his 100th birthday. She/he said it was a special topped with a lovely buffet provided by the owners of Thorndene. Several residents said they were looking forward to the Christmas party on the 19th December and some said that they were going to spend Christmas with relatives while others preferred to spend it at the home. Visiting relatives said they were always made to feel welcome and staff were very caring. The staff at the home encourages relatives to play an active part in the home and they are invited to social events and outings. Relatives
Thorndene DS0000007967.V269706.R01.S.doc Version 5.0 Page 12 described a recent Christmas fayre where all the staff worked hard to raise funds for the residents. Thorndene DS0000007967.V269706.R01.S.doc Version 5.0 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 the following standard(s): 16, 18 Service users and their relatives are provided information to enable them the raise concerns about the home and their care. Adult protection Policies, procedures and training of staff ensure the protection of service users from abuse. EVIDENCE: There is a complaints procedure that is available to residents and visitors. The procedure is also referred to in the service users guide, identifying the stages to follow; this includes the time scales to respond to complaints. The address and telephone number of the Commission for Social Care Inspection is included in the procedure. There is a comprehensive Adult Abuse and Whistleblowing and staff follow the procedures to those standards. The registered manager would investigate fully any allegations of abuse and would follow the necessary procedures if any were substantiated. The registered manager holds discussions with staff to talk over issues and how to recognise different forms of abuse. Thorndene DS0000007967.V269706.R01.S.doc Version 5.0 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 the following standard(s): 19, 26 The registered provider continues to improve the décor and furnishings at the home creating comfortable and safe environments for residents. The home is clean and free from odours and there is sufficient domestic staff to maintain good hygiene standards. EVIDENCE: The registered providers continue to make improvement to the fabrics and furnishings at the home. The home is situated close to the town centre of Doncaster and has lawned gardens to the rear of the building. The registered providers have created a paved seating area to the side of the building and they have put up a large Christmas tree fitted with outside lights. The home was clean and free from offensive odours and service users said that their bedroom was always kept clean and tidy. The domestic staff are commended for their efforts in maintaining the cleanliness of the home. One of the domestic staff said she enjoyed working at Thorndene and liked spending time talking to the residents.
Thorndene DS0000007967.V269706.R01.S.doc Version 5.0 Page 15 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 Staff have the skills and knowledge to fulfil their roles within the home, and a stable staff group ensures continuity of care by staff that knows the service users. Recruitment policies are followed ensuring the safety and protection of service users. EVIDENCE: Staff rotas examined demonstrated there is sufficient staff to meet the needs of service users. Staff continues to work towards attaining NVQ qualification although they do not meet the requirement of 50 NVQ qualified staff. The registered manager is hoping that most staff will obtain the qualification within the next six months. A number of staff recruitment files were examined, and there is evidence that all the required employment checks have been undertaken prior to commencing work at the home, ensuring the safety and protection of residents. Thorndene DS0000007967.V269706.R01.S.doc Version 5.0 Page 16 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 The registered manager is skilled and experienced to manage the home to ensure the safety and protection of the service users. Procedures are in place to ensure the financial interests of residents are safeguarded. The registered provider is able to demonstrate that she actively seeks the views of residents. Staff and residents follow health and safety procedures and records provide evidence of servicing of essential equipment EVIDENCE: The registered manager has a wealth of experience and knowledge and is able to demonstrate her ability to manage the home. She holds the required management and care qualifications and she is also a qualified nurse. She operates an open door policy to ensure she is accessible to staff and residents. Residents spoke highly of the manager and said she was very caring.
Thorndene DS0000007967.V269706.R01.S.doc Version 5.0 Page 17 Staff and group meetings ensure that staff are informed about training opportunities and the day to day running of the home, they are also encouraged to be involved in decision making. Recent meeting minutes showed staff had been consulted about sickness procedures and ideas for the Christmas period. Quality assurance systems have been developed using a survey to gain the views of residents. Residents meetings are also used to ensure they play an active part in making decisions about how the home is run. Although staffing levels have increased to enable staff to have more time to spend on activities the quality assurance surveys reflected that residents would like more and varied activities. The manager and staff are working hard to address this. Residents are able to manage their own finances, although most prefer the manager to assist with dealing with their personal allowances. Residents are issued with invoices and receipts to show how their money is spent. Accident reports are analysed by the manager to ensure risk assessments are developed where required. Maintenance and service records examined were up to date and current to the services provided. The manager has the required Health and Safety policies and procedures and displays the relevant notices. Fire safety procedures are in place and service records were examined and were current, ensuring the safety of service users. Thorndene DS0000007967.V269706.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 3 Thorndene DS0000007967.V269706.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP28 Good Practice Recommendations The home must work towards providing a minimum of 50 of staff who are NVQ level 2 qualified in 2005 Thorndene DS0000007967.V269706.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Doncaster Area Office 1st Floor, Barclay Court Heavens Walk Doncaster Carr Doncaster DN4 5HZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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