Inspection on 16/05/07 for Thornfield

This inspection was carried out on 16th May 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

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Cranworth Close Registered Care Home

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

CARE HOME ADULTS 18-65 Thornfield 261 Highfield Road Idle Bradford BD10 8QY Lead Inspector Cheryl Stovin Key Unannounced Inspection 16th May 2007 11:00a Thornfield DS0000068182.V327995.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 Thornfield DS0000068182.V327995.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. Thornfield DS0000068182.V327995.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Thornfield Address 261 Highfield Road Idle Bradford BD10 8QY 01943 865654 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) Isand Ltd *** Post Vacant *** Care Home 6 Category(ies) of Learning disability (6), Learning disability over registration, with number 65 years of age (1) of places Thornfield DS0000068182.V327995.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection N/A Brief Description of the Service: Thornfield is registered to provide accommodation and care for seven people with a learning disability. The home is situated in a residential are in the Idle district of Bradford with easy access to the city centre. The home has been extensively renovated and refurbished. All bedrooms are for single occupancy and furnished and equipped to a good standard. All of the bedrooms have en-suite bathing facilities Communal areas are spacious and comfortable with well maintained, safe and accessible garden areas. The weekly charge made by the home is subject to individual financial assessment and set at the level of care required. Thornfield DS0000068182.V327995.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report brings together evidence gathered during the first key inspection of Thornfield. This included an unannounced visit I made to Thornfield on 20th May 2007 over a period of five hours. During this visit a full tour of the building was undertaken, records were examined and discussion took place with people living at the home and the staff. In addition to this visit comment cards were sent out to the people living at the home to give them an opportunity to share their views of the service with CSCI. Four out of the seven people living at the home returned their survey cards. The responses indicated that the people living at the home are happy there. This was the first inspection of Thornfield. No additional visits have been made to the home since it opened in February 2007. A pre-inspection questionnaire was sent to the home which was promptly returned which contained useful information. This was a very positive first inspection with only one requirement made. People living in the home said that they were happy there and that they enjoy their lifestyle. What the service does well: The home has a warm and welcoming atmosphere. All of the people that live at Thornfield have detailed and holistic individual support plans which ensures that they receive personal and health care support in line with their wishes. The home is furnished and fitted to a high standard. Individual bedrooms are highly personalised reflecting the people’s interests and tastes and fully equipped to meet their needs. People live active and varied lives and make use of a wide range of community social and recreational activities. The staff team is well trained and highly motivated and committed to providing a high standard of care and attention to the people using the service.. Relationships between staff and people living there were relaxed and friendly with appropriate use of informality and humour. Thornfield DS0000068182.V327995.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. Thornfield DS0000068182.V327995.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 Thornfield DS0000068182.V327995.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): 2, 3, 4 and 5 People who use the service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People’s needs are assessed before moving into the home and they are provided with written information about the services and facilities provided. EVIDENCE: People’s needs are fully assessed to make sure that the home can meet their needs. The assessment process is very thorough and is completed in conjunction with the person’s family and health and social care professionals. All of the people living at the home said in their survey cards that they were asked if they wanted to move into the home, and that they had received enough information to decide if it was the right place for them. People are encouraged to visit the home several times before making a decision to move in. This makes sure that people have the opportunity to meet other people living and working in the home and to sample the daily routine. One person commented in their survey card “came to visit on numerous occasions before moving in”. Everybody living in the home has an individual statement of terms and conditions. This details the rights and responsibilities of the organisation and Thornfield DS0000068182.V327995.R01.S.doc Version 5.2 Page 9 the people living in the home. The weekly charge is subject to individual assessment depending on the amount of care the person needs. Thornfield DS0000068182.V327995.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, 8 and 9 People who use the service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People’s needs and aspirations are assessed and recorded in their individual care plan. People living in the home make decisions about their lives and are fully involved in the day to day running of the home. EVIDENCE: The care records of all seven people living in the home were seen. All contained very detailed information. The individual care plans are drawn up with the people using the service. There are useful sections covering the likes and dislikes of the person, and details of ‘things I would like you to know’, ‘things I can do for myself’, ‘the support I need’ and ‘what I need to be safe and happy’. Thornfield DS0000068182.V327995.R01.S.doc Version 5.2 Page 11 The care plans contain detailed information about the persons’ previous life history and interests and hobbies. This helps the staff understand the person and any particular problems they may have. Any particular cultural and religious needs are identified and the care plans clearly states how these needs are to be met. The care plans are reviewed every month and any goals, aspirations or areas for development are recorded. Detailed risk assessments are in place which are reviewed on a regular basis. All people living at the home are encouraged to participate in the day to day running of the home and join in all activities of daily living. Staff and people living at the home appeared to be working together as a team, and regular meetings influence the way the home is run. Thornfield DS0000068182.V327995.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 and 17 People who use the service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People living at the home enjoy an active and varied lifestyle and are very much part of the local community. EVIDENCE: The atmosphere in the home was noted to be relaxed and homely and very welcoming. The people living at the home live active and varied lives and use a wide range of local facilities. People are encouraged to develop and maintain their own interests, with assistance given from the staff where necessary. One person living at the home has an interest in cooking and is attending college full time doing a National Vocational Qualification (NVQ) course in catering. Another person is a keen DJ and has all the up to date equipment and regularly plays the decks for the other people living at the home. Thornfield DS0000068182.V327995.R01.S.doc Version 5.2 Page 13 People’s cultural needs are identified and people are assisted to follow culturally appropriate social and leisure activities. One person living at the home regularly watches Bollywood DVD’s, listens to bhangra music, visits the Bombay Stores and cooks asian cuisine in the home. The staff and people living in the home work together in the day to day running of the home. All of the people living at the home said in their survey that they make decisions about what they do each day, each evening and at weekends. People are encouraged to maintain contact with family and friends, dates of birthdays, anniversaries and other important occasions are recorded in their records. This makes sure that staff can remind people of the special occasions and assist them to mark them. A monthly newsletter is produced which makes sure that everyone is kept up to date with what is happening in the home. The newsletter is displayed on the notice board. People living at the home assist with the preparation of meals and enjoy a varied and nutritious diet. There is an emphasis on healthy eating with plenty of fresh fruit always available. The main meal of the day is in the evening and on the day of the visit was roast chicken, roast potatoes and fresh vegetables, following by yoghurt or fruit. Any specific cultural or religious needs are met and one person is provide with halal meat. People said that they enjoyed their meals and also enjoyed helping to cook them. The people living at the home and the staff have recently planted a vegetable patch in the back garden and they are looking forward to enjoying home grown vegetables during the summer. Thornfield DS0000068182.V327995.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 and 20 People who use the service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People’s health and personal care needs are met and care plans are detailed and clearly show how their support is to be given and by whom. EVIDENCE: People’s personal, physical and emotional health care support needs are assessed and form part of their plan of care. All personal care is given in private and in accordance with their preferences. People’s physical and psychological health care needs are assessed and detailed in their personal support plan. A recognised health care monitoring document the ‘OK Health Check’ is completed for each person and a health action plan completed. People’s cultural needs are assessed and plans drawn up, in conjunction with the service user, to ensure that these needs are met. Thornfield DS0000068182.V327995.R01.S.doc Version 5.2 Page 15 To make sure that people living at the home access regular health care checks an annual planner is in place for each person. This planner shows when people are due for dental, optical, chiropody and other appointments. The home uses a Monitored Dose System (MDS) for the administration of medication. The medication is securely and appropriately stored and Medication Administration Records were accurately completed. Stocks of medication held reconciled with records kept. All staff receive training in the administration of medication to make sure people receive their medication safely. At the time of the visit nobody was handling their own medication. Each person takes medication has a medication profile which details what the medication is prescribed for and any possible side effects to watch out for. Thornfield DS0000068182.V327995.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 and 23 People who use the service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People are protected by the policies, procedures and practices in the home. EVIDENCE: The home has a complaints procedure which is given to people who live at the home and their relatives. The document clearly states the procedure to follow and the contact details of all the people to approach if they are unhappy about anything in the home. A complaints log is held which details any complaints received and the outcomes. All of the survey cards received from people who use the service stated that they knew who to speak to if they were unhappy about anything in the home. The home has an adult protection policy and all staff have received Protection of Vulnerable Adults (POVA) training. Staff were aware of the procedure to follow if they suspect or witness that abuse is taking place. Thornfield DS0000068182.V327995.R01.S.doc Version 5.2 Page 17 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, 27, 28 and 30 People who use the service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People live in a well maintained and hygienic environment. EVIDENCE: The home is situated in a residential area of Idle within easy reach of the city centre of Bradford. A full tour of the building was undertaken which showed that the home is well maintained throughout. All people have single bedrooms which were seen to be well furnished and equipped, and all highly personalised reflecting their occupants’ interests and hobbies. People living at the home are obviously very proud of their own rooms and were keen to show me their own personal space. All bedroom doors are fitted with locks and a lockable facility is provided for people to keep their belongings safe. Thornfield DS0000068182.V327995.R01.S.doc Version 5.2 Page 18 Communal areas are spacious and comfortable and furnished in a contemporary style to suit the needs of the people living in the home. The home was noted to be clean and hygienic throughout. All people who returned a survey card said that the home is always fresh and clean. Well maintained gardens and patio areas are provided, which can be used for those service users wishing to smoke. The laundry facilities are well equipped and comply with regulations. People are encouraged, wherever possible, to undertake their own laundry tasks. Thornfield DS0000068182.V327995.R01.S.doc Version 5.2 Page 19 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): 31, 32, 33, 34 and 35 People who use the service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People’s needs are met by a well trained and competent staff team, and are protected by the rigorous recruitment practices. EVIDENCE: There are enough staff on duty at all times to meet the needs of the people living at the home. Staff rotas seen indicate that there are five care staff, plus the manager, on duty during the daytime and evening. During the night there are two waking night staff. Staff said they felt that the staffing levels were “just about right” with enough time to perform their tasks and chat to people. One member of staff felt that the staff team was “ good and strong”. People living at the home described the staff as “very good staff”, “they help you” and “everybody is ok”. The staff work flexibly to make sure that the people living in the home are able to access social and recreational activities. Thornfield DS0000068182.V327995.R01.S.doc Version 5.2 Page 20 The relationships between staff and people living in the home was noted to be good with lots of banter and appropriate informality and humour. All people who returned a survey card felt that the staff treat them well and that the carers always listen and act on what they say. There is a commitment to staff training in the home with all staff required to undertake training to LDAF (Learning Disability Award Framework) specification. There is an induction training programme in place, and mandatory training for staff includes, managing violence and aggression,, fire awareness, first aid, health and safety, food hygiene, moving and handling and safe handling of medication (for senior staff). There is a programme of NVQ training in the home. Only three members of staff, however, hold the award. A further five are working towards the award. The Proprietor was reminded of the standard that states 50 of care staff must be qualified to NVQ II or equivalent. The staff recruitment files of five support workers were seen. All of the files contained CRB (Criminal Records Bureau) and POVA (Protection of Vulnerable Adults) disclosures. Two written references, an application form and proof of identity were also in place. People living at the home are actively involved in the recruitment process. Thornfield DS0000068182.V327995.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, 38, 39, 40 and 42 People who use the service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People live in a well run and managed service. People’s health and welfare are protected by the home’s health and safety practices. EVIDENCE: The acting manager of the home is experienced and competent to run the home. An application has been made to the Commission for Social Care Inspection to be registered as manager of the home. Thornfield DS0000068182.V327995.R01.S.doc Version 5.2 Page 22 An open and positive atmosphere is prevalent in the home with people living at the home and staff being encouraged to contribute to the decision making process. All people have their own bank accounts and everybody has an individual bank sheet which details each withdrawal. Two signatures are required to record all transactions. This makes sure that people’s money is kept safe and accounted for. There is a commitment to health and safety and safe working practices in the home. All staff receive mandatory health and safety training with regular updates. Fire drills are carried out on a regular basis and all staff receive fire safety training. Detailed risk assessments are in place which are reviewed and updated on a regular basis. Certificates were seen which showed compliance with gas and electrical regulations, to make sure everybody is kept safe. A formal quality monitoring system is in place and people using the service, relatives and health and social care professionals are consulted as to their views on the service provided. The results of the survey have been published and the results were very positive. All of the people living at the home said they were very satisfied with the service provided, as did the relatives and the social care professionals. One relative said in this survey “I am delighted with everything”. Detailed policies and procedures are available to make sure that the systems are run in the best interests of the people living at the home. Thornfield DS0000068182.V327995.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 x 2 3 3 3 4 3 5 3 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 3 28 3 29 x 30 3 STAFFING Standard No Score 31 3 32 2 33 3 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 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 3 3 3 x 3 x Thornfield DS0000068182.V327995.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? N/A 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 YA32 Regulation 18 Requirement There must be a minimum of 50 of the care staff qualified to NVQ II to make sure that people using the service receive appropriate care. Timescale for action 31/12/07 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 Thornfield DS0000068182.V327995.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 Thornfield DS0000068182.V327995.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. 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