Inspection on 12/03/07 for Thornfield Care Home [Ferndown]

This inspection was carried out on 12th March 2007.

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

Thornfield Care Home [Ferndown] 23/08/07

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Stallcombe House

Belma

Hunters Care Centre

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

CARE HOMES FOR OLDER PEOPLE Thornfield Care Home 434 Ringwood Road Ferndown Dorset BH22 9AY Lead Inspector Trevor Julian Unannounced Inspection 12th March 2007 10:30 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 Thornfield Care Home DS0000068039.V332646.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 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. Thornfield Care Home DS0000068039.V332646.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Thornfield Care Home Address 434 Ringwood Road Ferndown Dorset BH22 9AY 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) 01202 861845 01202 871443 poordil@yahoo.com Mrs Sindamanee Poordil Mr Mohammad Ayoob Poordil Mr Mohammad Ayoob Poordil Care Home 17 Category(ies) of Dementia - over 65 years of age (17), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (17), Old age, not falling within any other category (17) Thornfield Care Home DS0000068039.V332646.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Thornfield is registered to provide residential care for up to 17 older people with Dementia. The service can also be offered to people with mental health problems. Mr and Mrs Poordil privately own the home. Mr Poordil is the registered manager, although the day to day running of the home is shared between them. The building is a large family home that has been extended to provide bedrooms on 2 floors. There are 17 single rooms; all have en suite or their own bathrooms. Communal space comprises a large lounge and separate dining room. There is a passenger lift to enable residents’ access to both floors. The home has car parking space at the front of the property and a large enclosed garden and patio area to the rear. Thornfield is situated on a busy main road, close to local shops, amenities and the public transport network. In March 2007, the weekly fees were £475 - £515 dependent on the level of care needs. Additional charges were made for hairdressing, chiropody, etc. See the following website for further guidance on fees and contracts: http:/www.csci.org.uk/about_csci/press_releases/better_advice_for_people_ choos.aspx Thornfield Care Home DS0000068039.V332646.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first inspection of the service since the home opened in September 2006. Mr and Mrs Poordil have gradually increased the number of places offered to allow staff to settle and gain experience. At the time of the visit, there were 11 residents in the home. The inspection started on the 12th March and was concluded on the 19th March 2007. Information for the report was obtained through discussion and observation with the residents, staff and the owners. Further evidence was gathered through a tour of the premises and examination of records and procedures. What the service does well: As a new home the owners had worked hard to establish good systems of care for the residents. They had gradually increased occupancy as the staff became more competent. New residents were assessed before being offered a placement to ensure the home could meet the assessed needs. All residents had care plans based on the pre – admission assessment, the care plan identified tasks that the resident was able to complete as well as those where assistance was needed. This approach encourages residents to maintain as much independence as their circumstances allow and promotes person centred care. Medication was well managed within the home. The medication records were up to date and there were no discrepancies seen. There were medication reference books available to the staff. There was a friendly and relaxed atmosphere in the home and the staff were calm and supportive in their interaction with the residents. Social care needs were considered in the care plan. One person, accompanied by a carer, collected his newspapers from a local newsagent. Another resident who had been active in a local church was collected by friends to attend Sunday services and other church based events. Several people commented that their families and friends were able to visit at any time. The meals served during the inspection were very well received by the residents and they were full of praise for the variety and choice of meals offered. Thornfield Care Home DS0000068039.V332646.R01.S.doc Version 5.2 Page 6 The home had a complaints procedure which was on public display on a notice board in the lounge allowing residents and visitors to raise concerns. The staff had been trained in how to respond to signs or allegations of abuse. 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 Care Home DS0000068039.V332646.R01.S.doc Version 5.2 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 Thornfield Care Home DS0000068039.V332646.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All residents had contracts giving details of services provided and funding arrangements. The manager completes a pre admission assessment to ensure the home is suitable and equipped to meet the needs of the individual. EVIDENCE: Mr and Mrs Poordil visit prospective residents at their current address. The three files seen, showed evidence that the assessment covered the recommended topics. Two of the assessments seen did not identify when or who had completed the document. There were copies of contracts and terms and conditions of residence. The information gave clear information about who was responsible for each Thornfield Care Home DS0000068039.V332646.R01.S.doc Version 5.2 Page 9 element of funding. The contracts seen had been signed by the relevant parties. None of the residents seen were able to discuss the admission process. Thornfield Care Home DS0000068039.V332646.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Each person has a care plan to inform the staff how needs are to be met. Health needs are met with support from the community healthcare teams. Systems and training help to ensure that medication is safely administered. Residents were treated with dignity and respect to meet their basic rights. EVIDENCE: All files had photographs of the resident to aid identification and the administration of medication. The files contained care plans and there was evidence of reviews taking place. There were risk assessments including the risk of falls. There was one person in the home using bed rails. Guidance was given to ensure the latest information provided by the Medical Device Agency Thornfield Care Home DS0000068039.V332646.R01.S.doc Version 5.2 Page 11 was considered. The care plans identified what the individual could do and so helped to promote independence. The level of recording was appropriate to the level of care provided, however it was noted that some entries were made in pencil and correction fluid had been used to amend some records. The home works with local community healthcare teams to meet the health needs of the residents. The home arranges for foot care in the home for those who do not access NHS chiropody treatment. The home carried out weight checks on admission and nutritional assessments were discussed and advice given to ensure that significant changes were identified and then appropriate action taken. During the visit two staff members were assisting a resident from the chair; the technique used could have resulted in injuries to the resident and staff. Manual handling was discussed and all staff had been trained in safe moving techniques. Mr Poordil subsequently arranged for occupational therapist assessment for the residents with poor mobility; he had also reviewed techniques used in the home and was considering changing the lounge furniture to improve independence. Medication in the home was well managed and they used a monitored dosage system. Only staff who were trained and assessed as competent were able to administer the medication. It was found that time sensitive medication was not dated on opening and this could result in out of date medication being administered. The matter was discussed and Mrs Poordil agreed to date the items to reduce the risk. The staff had access to the medication policy and reference books; a copy of the Royal Pharmaceutical Society guidance was also available. During the visit, the staff were seen interacting well with the residents and treating them respectfully. One resident was in his room and the staff knocked on the door before entering. He said he was comfortable in his room and enjoyed the peace and quiet; he added that he went downstairs for his meals. Thornfield Care Home DS0000068039.V332646.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was developing activities and events based on the needs of the individual. People were welcome to visit the home at reasonable times. The meals served promote a good and health diet and offer choice and variety. EVIDENCE: The care plans seen had information on the social needs of the residents. The residents had access to the rear garden where there were seating areas. One resident said they went out with a carer to collect a daily newspaper and other people had newspapers delivered. Another resident said she was a regular churchgoer and often visited a friend locally. Within the home they organise art work and other activities and residents enjoy trips out with the owners. Communion is arranged in the home for those who wish to participate. Thornfield Care Home DS0000068039.V332646.R01.S.doc Version 5.2 Page 13 Some residents were able to confirm that the home welcomed visitors although no one visited during the inspection. The care plans did indicate the tasks that the individuals can complete for themselves; this allowed the staff to be alert to any deterioration and it encouraged independence. Residents said the standard of food provided at the home was good. The home had a series of menu cards and these offered a choice of main courses. The serving temperature of the meat dishes was recorded. There were records of the meals provided but not for alternatives taken. Thornfield Care Home DS0000068039.V332646.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s complaints procedure allowed individuals to raise concerns without recrimination. The staff were aware of their responsibilities to protect the residents from any form of abuse. EVIDENCE: The service users guide contained information on how residents and visitors could raise concerns, there was also a copy on display on a notice board in the main lounge. The home had a log and procedure for managing complaints; none had been recorded. None of the residents were able to recall raising any concerns. The home had a copy of local “No Secrets” guidance giving staff contact and procedural information for reporting adult protection concerns. Staff said the topic was also covered in the induction programme and there was a reasonable understanding of their responsibilities. Since opening there had been one incident recorded under adult protection and the matter had been resolved. Thornfield Care Home DS0000068039.V332646.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home offers a comfortable clean and safe environment. EVIDENCE: All the rooms occupied at the time of the inspection had been refurbished and provided a comfortable and homely environment for the residents. The rooms seen had been personalised by the occupants with pictures and other mementoes. Each room had an ensuite bathroom or an adjacent bathroom for individual use. A call alarm system was in place and was accessible to the residents. There was a bathroom on the ground floor with a portable lifting seat available for residents to use. All the lifting and safety equipment in the home had been inspected before residents were admitted. Thornfield Care Home DS0000068039.V332646.R01.S.doc Version 5.2 Page 16 Outside there was an attractive and secure rear garden fitted with handrails to aid mobility. The radiators had been covered to reduce the risk of burns. The windows on the first floor had restricted openings. The home was warm, clean and comfortable. The laundry area was sited away from the food storage and preparation areas. Thornfield Care Home DS0000068039.V332646.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels were appropriate to the needs and numbers of residents. Omissions in the recruitment process did not fully protect the residents. The staff training programme was being developed to ensure the staff had the skills and competence to provide good standards of care. EVIDENCE: During both visits, the home was staffed by 3 carers who also undertook cooking duties. This ratio provided very good levels of staffing. Two staff files showed the home had ensured the required checks and clearances had been obtained before new staff were appointed. One file did not contain a full employment nor was there any record showing gaps in the employment history had been explored. The staff had all received training in Dementia Awareness and fire safety training from a specialist company. Mr Poordil was introducing Skills for Care induction training for all new staff during their first twelve weeks of employment to ensure they are aware of basic care skills and specific Thornfield Care Home DS0000068039.V332646.R01.S.doc Version 5.2 Page 18 information about the home. Staff were being encouraged to gain a National Vocational Qualification (NVQ) in care. Thornfield Care Home DS0000068039.V332646.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed for the benefit of the residents. The home did not get involved with the residents’ financial affairs. Record keeping practices need improvement to ensure that information is safely held. Health and safety systems are generally good however fire precautions must not be compromised. EVIDENCE: Thornfield Care Home DS0000068039.V332646.R01.S.doc Version 5.2 Page 20 Mr and Mrs Poordil have operated a care home in Hampshire for several years and have the skills and experience to run the home successfully. Residents were seen chatting to the owners and some confirmed that they were able to discuss any worries with them. The home had failed to notify the Commission of a significant event in the home, the regulation was discussed and clarified for future reporting. The owners had started to consider developing a quality assurance system for the home and will have it in place before the home’s first anniversary. The home did not look after finances for any of the residents, any additional expenditure was invoiced to the person responsible for managing the residents’ finances. The home had contracts with approved contractors for the disposal of clinical and household waste. A fire safety risk assessment had been completed and a routine set up for in house testing and training of fire prevention and detection. The fire safety system was serviced and maintained by approved engineers. During the first visit it was seen that some fire doors were wedged open, this seriously compromised the fire safety systems in the home and the matter was raised with Mr Poordil who removed the wedges immediately; there were no wedges in evidence on the second visit and Mr Poordil confirmed that doors would not be wedged in future. Control of substances hazardous to health (COSHH) assessments had been carried out and were available to the staff. Thornfield Care Home DS0000068039.V332646.R01.S.doc Version 5.2 Page 21 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 2 3 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 x X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X 3 X 2 2 Thornfield Care Home DS0000068039.V332646.R01.S.doc Version 5.2 Page 22 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 OP31 Regulation 37 Requirement The registered person must inform the commission of significant events affecting the residents. The registered person must ensure that fire precautions are not compromised. Fire doors must not be wedged open. Timescale for action 30/04/07 2 OP38 23(4) 30/04/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP3 OP8 Good Practice Recommendations The pre-admission assessment should be signed and dated by the person completing the assessment. Before installing bed rails a risk assessment considering latest guidance should be completed. All residents should have a manual handling assessment and where necessary appropriate techniques identified. The staff must be trained in those techniques. The home should ensure that nutritional assessments are completed to ensure that changes in weight are monitored DS0000068039.V332646.R01.S.doc Version 5.2 Page 23 3 OP8 Thornfield Care Home 4 5 6 OP29 OP37 OP1 and when necessary referred for specialist support. Gaps in employment history should be explained and recorded. Care records should be made using permanent ink, pencil should not be used, nor should errors be obliterated using correction fluid. The home’s roadside sign should accurately describe the category of resident accommodated. Thornfield Care Home DS0000068039.V332646.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 Care Home DS0000068039.V332646.R01.S.doc Version 5.2 Page 25 - 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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