Inspection on 23/08/07 for Thornfield Care Home [Ferndown]

This inspection was carried out on 23rd August 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 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] 12/03/07

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 Key Unannounced Inspection 23rd August 2007 10:00 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 Thornfield Care Home DS0000068039.V348452.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.V348452.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.V348452.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th March 2007 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, although 2 rooms on the first floor are accessible by staircase only. 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 August 2007, the weekly fees were £490 - £530 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.V348452.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place between 10:00 and 15:00 on 23rd August 2007. Before the visit, the owners had returned an Annual Quality Assurance Assessment (AQAA) giving general management information about the home. Residents and visitors were invited to give their views through comment cards and six were returned in advance of the visit. During the inspection, further evidence was obtained through a review of records, a tour of the premises, discussion with residents, staff and the owners. This was the second inspection of the home which opened in September 2007. What the service does well: The home has continued to establish itself and they have made improvements for the benefit of those living at the home. The admission process ensures that the home has sufficient staff with appropriate skills to meet the needs of the individuals. Care planning and reviews help to inform staff how tasks are to be completed. During the visit the residents appeared calm and relaxed some were engaged in activities others were enjoying the garden. When one person did show signs of being upset the staff responded appropriately giving reassurance and support. There was clear evidence that the home involved healthcare professionals for the health needs of the individuals. This included referral to GP, paramedics, chiropodists, community nurses and opticians etc. There was an audit trail of medication coming into the home. The administration of medication was generally managed safely and the items securely held. In one file, there was evidence that information on the administration record had not been updated following a GP visit. The home had games and books for the residents and some people had enjoyed the rear garden over the summer months. Mr and Mrs Poordil took 2 or 3 residents out for excursions in their car and the staff escorted people to the local shops. There was an entertainment programme in the lounge and it showed that entertainers did visit the home. Comment cards showed high levels of satisfaction with the meals provided and the residents said that they found the meals were very good and alternatives were available if individuals did not want the offered items. During the visit Thornfield Care Home DS0000068039.V348452.R01.S.doc Version 5.2 Page 6 one person was clearly not enjoying her lunch and the staff were seeing what else she would prefer. The comment cards showed that the residents and visitors were able to voice concerns to Mr & Mrs Poordil and staff. One complaint had been recorded and appropriate action taken. The premises provide a comfortable environment the rear garden had improved access and security allowing residents unrestricted access. Work was continuing to improve the front garden. Other improvement work being considered was a walk –in shower and a chair lift. The rooms seen were comfortable and had been personalised by the occupant. Each had accessible call points allowing the occupant to call for assistance as needed. Equipment was provided and used to aid infection control. Since the last inspection staffing levels had increased in response to higher occupancy levels. The home was using a distance learning package to ensure that the staff were adequately trained in the key topics. The National Training Organisations Common Induction Standards had been obtained to use for new member of staff. Mr Poordil had recently completed his NVQ level 4 Registered Managers Award and was awaiting his certificate. The home was using a variety of methods to seek the views of those using the service and visitors including surveys, coffee mornings and a suggestion box. The home did not manage finances for individual residents. Where people could not manage personal allowances themselves additional expenditure is invoiced to the person responsible for funding. What has improved since the last inspection? The home had improved its procedure for informing the commission of significant events affecting the residents. At the last inspection, it was found that some fire doors were wedged open none were seen during this visit. The pre-admission assessment identified who had been involved in the assessment All residents had a mobility assessment and where necessary appropriate techniques identified. Each resident had nutritional assessments to ensure that changes in weight are monitored and when necessary referred for specialist support. Thornfield Care Home DS0000068039.V348452.R01.S.doc Version 5.2 Page 7 Recruitment practice had been reviewed and no gaps in employment history for the record of a recently appointed member of staff. Care records had been made using permanent ink, pencil was not be used, there was no recent evidence of errors being obliterated using correction fluid. The home’s roadside sign had been altered to accurately describe the category of resident accommodated. 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.V348452.R01.S.doc Version 5.2 Page 8 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.V348452.R01.S.doc Version 5.2 Page 9 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. People are offered a placement only after an assessment of need has determined that the home has capacity to meet those needs. EVIDENCE: Three files were examined as part of case tracking. All showed evidence that assessments had been carried out prior to placement. Those funded residents had care plans from the funding authority. The recent admission had been signed and dated by the person carrying out the assessment. None of the comment cards showed any issues with the admission process. None of the residents seen during the visit were able to recall the detail of their admission. Thornfield Care Home DS0000068039.V348452.R01.S.doc Version 5.2 Page 10 The AQAA states that potential residents or their representatives are invited to view the home before deciding on the placement and given a contract with terms and conditions. Thornfield Care Home DS0000068039.V348452.R01.S.doc Version 5.2 Page 11 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 good. This judgement has been made using available evidence including a visit to this service. The home’s care planning and their relationship with local healthcare professionals helps to ensure the wellbeing of the residents. Training and procedures protect the residents from medication errors. EVIDENCE: In each of the files examined, there was a care plan and risk assessment detailing how the needs were to be addressed. One person was in the home for respite care and there were some gaps in the information provided due to the particular circumstances of the admission. There was evidence of mobility assessments being carried out. Another person had an assessment for the use of bedrails. The files seen contained information on nutritional assessment and there were referrals for assistance as needed. Thornfield Care Home DS0000068039.V348452.R01.S.doc Version 5.2 Page 12 One person was unwell, the home was in contact with their GP, and later an ambulance was called. The records showed good levels of communication with healthcare professionals. Medication was generally safely stored and controlled in the home. The records showed that there was an audit trail for items coming into the home. One file showed that a consultant had varied a dose on the previous record chart, however the amendment had not been transferred to the current chart and could have resulted in over medication. In discussion with those staff administering the medication, it was clear that the revised dosage had been given. Items of medication, which have a limited shelf life, were labelled with the date on which they were opened. During the visit, the staff were seen working with the residents in a supportive and caring manner. The comment cards confirmed that the staff “took time to talk to them”. “Staff always seem very caring and cheerful”. One relative described the staff as “watchful”. Thornfield Care Home DS0000068039.V348452.R01.S.doc Version 5.2 Page 13 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 promotes good levels of choice allowing residents to make decisions about their daily lives. EVIDENCE: Comment cards from relatives showed that the there were concerns that their was little stimulation provided in the home and the TV was left on all the time to provide a distraction. On arrival, most residents were in the lounge or enjoying the rear garden. Three people were playing connect 4 another working on a jigsaw puzzle. One carer was explaining something to two residents and two people were having a conversation. There was information on the notice board in the lounge about when entertainers were coming to the home. Relatives had been invited to a coffee morning one week after the inspection. Two people go to local churches and the home offers a monthly in house service for those who cannot attend. Some of the people visit local shops but are escorted by a member of staff. Mr & Mrs Poordil also take Thornfield Care Home DS0000068039.V348452.R01.S.doc Version 5.2 Page 14 people out to the shops or on excursions. There was a separate record of activities. Although no visitors were seen during the visit the comment cards received were positive about their access to the home and the support they receive one person confirmed that the home provided them with any changes in need for their relative. On the AQAA Mr & Mrs Poordil showed that they were looking to recruit a suitable activity co coordinator. The comment cards showed that the standard of food was good. There were records of food taken by individuals as well as the serving temperature. As a small home, they knew the likes and dislikes of the residents. Each morning the cook speaks to all the residents to find out their preference for the midday and teatime meal. The records showed that where the individual had declined the meals offered an alternative was given. During lunch, most people said they were enjoying their meal, one new resident was not eating and the staff were talking to her to decide on a suitable alternative. Food stocks were replenished from the local supermarket as needed. Thornfield Care Home DS0000068039.V348452.R01.S.doc Version 5.2 Page 15 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. Procedures in the home ensure that the residents and visitors can express concerns without fear of recrimination. EVIDENCE: The complaints procedure is posted in each bedroom and on the notice board in the lounge. Comment cards showed that all respondents knew how to raise their concerns with the owners or senior staff. The complaint file contained one complaint which had been responded to within the stated timescale. There was a copy of the local “No Secrets” document giving details of how to respond to allegations or signs of abuse. The topic was included in the home’s training programme. In discussion with two of the staff, both were aware of their responsibilities. Thornfield Care Home DS0000068039.V348452.R01.S.doc Version 5.2 Page 16 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’s environment provides a safe and comfortable haven for those using the service. EVIDENCE: Since the last inspection improvements for accessibility have been made to the rear garden and work started on the front garden to cut back overgrown trees and shrubs. The rear garden was being enjoyed by several of the residents. It provides a secure area where people can walk without restriction. The owners were considering the provision of a walk in shower on the first floor to give residents greater choice. Two rooms on the first floor are Thornfield Care Home DS0000068039.V348452.R01.S.doc Version 5.2 Page 17 accessible by staircase only and the owners were considering providing a stair lift to improve access. The bedrooms seen had call points allowing the occupant to call for assistance. All the rooms were comfortable and well aired, each had been personalised for the occupant. Residents said their rooms were comfortable. All areas of the home were clean and odour free. Staff had access to protective gloves and aprons to help manage infection control. There was a current contract for the removal of clinical and commercial waste. The AQAA identified areas where the owners were looking to make improvements to the environment. None of the comment cards identified any concerns about the environment. Thornfield Care Home DS0000068039.V348452.R01.S.doc Version 5.2 Page 18 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. The home’s staffing arrangements and recruitment practice helps to ensure the staff have the required skills to meet the needs of the individuals living at the home. EVIDENCE: The home was staffed by three carers during the daytime reducing to two in the evening and overnight. A cook had been employed to prepare and cook the lunch. Staff said the shifts were manageable although they could be busy at night if residents were restless. Only one person had been employed since the last inspection. The files of three employees showed that people were only offered employment once Criminal Records Bureau and Protection of Vulnerable Adults lists had been checked. Where needed, there was evidence of work permits for overseas workers. The home had an induction programme ready for any new staff. There was a training programme with topic delivered by distance learning and accredited by a training organisation. Three of the staff have achieved NVQ level 2 in care Thornfield Care Home DS0000068039.V348452.R01.S.doc Version 5.2 Page 19 and Mr & Mrs Poordil were aiming to enrol another two staff onto the programme. Thornfield Care Home DS0000068039.V348452.R01.S.doc Version 5.2 Page 20 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’s management systems help support the safety and welfare of those living in the home. EVIDENCE: Mr Poordil had submitted his portfolio to the awarding body for the Registered Manager Award, NVQ 4 and was waiting confirmation that he had provided sufficient evidence to achieve the award. Mr and Mrs Poordil have gained experience of operating a specialist care home over several years. Since the last inspection, the home had been informing the Commission of significant events affecting the wellbeing of the residents. Thornfield Care Home DS0000068039.V348452.R01.S.doc Version 5.2 Page 21 Comment cards showed that the owners were approachable and supportive. The home sought the views of residents and relatives in order to identify how improvements to the service could be made. A coffee morning for relatives was due to be held the week following the inspection. There was also suggestion box in the hallway accessible to residents, staff and visitors. The home did not manage the finances for any of the residents, where there was additional expenditure e.g. hairdressing, chiropody etc. invoices were given to the person responsible for funding. Some people retained their own personal allowances to fund the extras. The home’s public liability insurance certificate was displayed in the hallway. A check of fire records showed items were tested and up to date. There was a chart showing when equipment was due for servicing or inspection. The accident reporting procedure was up to date and the reports kept in line with Data Protection guidance. Thornfield Care Home DS0000068039.V348452.R01.S.doc Version 5.2 Page 22 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 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 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Thornfield Care Home DS0000068039.V348452.R01.S.doc Version 5.2 Page 23 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. Refer to Standard Good Practice Recommendations Thornfield Care Home DS0000068039.V348452.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.V348452.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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