CARE HOMES FOR OLDER PEOPLE
Thornlea Rest Home 308 St Annes Road Blackpool Lancashire FY4 2QP Lead Inspector
Ruth Edgington Announced 23 June 2005 9.30
rd The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Thornlea Rest Home F57 F09 S9737 Thornlea Rest Home V218378 230605 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Thornlea Rest Home Address 308 St Annes Road Blackpool Lancashire FY4 2QP 01253 345574 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Timothy Davies Wood CRH 15 Category(ies) of OP 15 registration, with number of places Thornlea Rest Home F57 F09 S9737 Thornlea Rest Home V218378 230605 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 6/10/05 Brief Description of the Service: Thornlea is a large bungalow which has been adapted to accommodate a maximum of 15 persons aged 65 years and over. The home has 13 single bedrooms and one double bedroom, none of which have en-suite facilites. There are two lounges and a dining room. The bathing and toilet facilties are sufficient to meet the number of resident that can be accommodated. The home is situated in a residential area of South Blackpool on a main road which is an advantage in respect of public transport and local amenities. Thornlea Rest Home F57 F09 S9737 Thornlea Rest Home V218378 230605 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was announced and commenced at 9.30 am and took place over 4 ½ hours. The Inspector spoke to four residents, two relatives, four staff and the homeowner. Prior to the inspection the Inspector received comment cards from six residents and six relatives. During the inspection a number of records were examined, including a random selection of staff and residents files. The Inspector looked around the home and spent time observing the daily activities in the home. What the service does well:
This is a care home where residents are well looked after. The staff team work well together and show a good understanding of the needs of the residents in the home. Residents spoken to said that they liked living at the home and felt that they were well cared for by the staff. The assessment and ongoing review of care is thorough, which ensures that residents’ care needs are met. The Inspector was able to observe the action taken when the staff became concerned over the condition of one of the residents. A request was made for the resident’s doctor to visit. Meals are varied and residents were pleased with the choices and variety available. One visitor commented that their relative was eating well and enjoyed the food and said, “I could stay for lunch myself, it smells so good”. Visiting arrangements at the home are informal and family and friends of the residents are encouraged to maintain contact. The Inspector was able to witness the positive and friendly relationship between residents, staff and relatives. Thornlea Rest Home F57 F09 S9737 Thornlea Rest Home V218378 230605 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? What they could do better:
The Inspector discussed with the staff improvements that could be made to the information recorded about each resident, to include more information about their life history. This would help the staff to have a greater understanding of their needs and individuality. Staff said that they thought that this would be helpful and would start to gather any information that the resident wished or were able to share with them. The work already commenced to improve the garden area should continue so that residents have a safe and secure environment in which to sit out if they wish. The homeowner should continue working towards obtaining a management qualification, so that any knowledge gained can be passed on to the staff team and further support them to continue to give the individual care that the residents need. Thornlea Rest Home F57 F09 S9737 Thornlea Rest Home V218378 230605 Stage 4.doc Version 1.40 Page 7 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. Thornlea Rest Home F57 F09 S9737 Thornlea Rest Home V218378 230605 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Thornlea Rest Home F57 F09 S9737 Thornlea Rest Home V218378 230605 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 The admission and assessment procedures were clear to ensure that the care needs of the residents are met. EVIDENCE: The records of two residents were looked at in detail and were found to contain a full assessment of needs that had been completed before they were admitted to the home, therefore ensuring the home could meet the needs of these people. The Inspector also noted that in each case the homeowner had written to the resident or relative to confirm that the home could meet these assessed needs. Staff spoken to during the inspection were able to describe in detail the care needs of the residents and from discussions with the residents and observations made, the Inspector found that the information recorded on the pre admission assessments was correct. Thornlea Rest Home F57 F09 S9737 Thornlea Rest Home V218378 230605 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9 &10 Promotion of health is taken seriously. Resident’s welfare is closely monitored and health needs were met. EVIDENCE: Individual records are kept for each resident with a care plan setting out in detail the action that needed to be taken by the care staff to ensure that all aspects of health, personal and social care needs of the residents were met. Significant events had been recorded and entries made of the care given. The Inspector was able to see that the residents had been involved in agreeing the care provided and that reviews had taken place. Discussions with staff demonstrated that they were knowledgeable of the individual needs of the residents. The Inspector suggested that staff develop a system for recording the life history of the individual residents, as far as they were able to, which would assist them in a greater understanding of the residents needs. Residents spoken to were happy with the care that they received and felt that they were involved in any decisions that affect them.
Thornlea Rest Home F57 F09 S9737 Thornlea Rest Home V218378 230605 Stage 4.doc Version 1.40 Page 11 The relatives of one service user who was presently on respite care said that they hoped that the resident would stay permanently as they had improved so much and this was down to the good care provided. During the inspection the Inspector observed the caring approach of all the staff towards the residents and was able to confirm that the practices in the home ensured that residents were treated with respect and their right to privacy was upheld. Medication practices observed were safe and good records had been maintained. Thornlea Rest Home F57 F09 S9737 Thornlea Rest Home V218378 230605 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13 & 15 Social activities and meals are well managed to suit both the individual and group. Contact between residents and their families is encouraged to help them maintain relationships. EVIDENCE: The individual care plans include information about the activities that the resident enjoys. The written information showed very clearly that staff encouraged residents to take part in activities in the home within their capabilities. An activities board is located in the entrance hall of the home to inform visitors of what activities are being done in any particular week. On the day of the inspection a film was to be shown in the afternoon, however the residents wanted to watch the tennis and therefore arrangements were made for them to have strawberries and cream whilst those who wanted to watched the television. The care plans seen showed very clearly that staff encouraged residents to take part in activities in the home and mix with others whilst keeping their independence. One resident spoken to said that they preferred to stay in their bedroom because they were able to watch passers by and also see what was going on in the home.
Thornlea Rest Home F57 F09 S9737 Thornlea Rest Home V218378 230605 Stage 4.doc Version 1.40 Page 13 Residents spoken to said that they keep in touch with their friends and relatives and that visitors were welcome at any time. The Inspector was able to observe the open and friendly manner of staff and the homeowner when speaking to relatives who were visiting at that time. A number of residents spoken to commented that the food was good. The Inspector was able to see the record of meals being provided, any individual likes and dislikes and any special diets required. At the time of the inspection the home was accommodating two residents who had diabetes, which was being controlled by diet. The cook was able to demonstrate to the Inspector their understanding of the needs of these residents. One visitor commented that their relative was eating well and enjoyed the food and said,” I could stay for lunch myself, it smells so good”. The Inspector noted that the dining room had been redecorated and refurbished. There was now one large table, which encouraged those resident who wished to eat in the dining room, to make meal times a social activity. Thornlea Rest Home F57 F09 S9737 Thornlea Rest Home V218378 230605 Stage 4.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not looked at during this inspection. EVIDENCE: Thornlea Rest Home F57 F09 S9737 Thornlea Rest Home V218378 230605 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,23,24 25& 26 Improvements have been made since the last inspection and a programme of upgrading and refurbishment is in place to ensure that the residents live in safe, comfortable surroundings. EVIDENCE: The Inspector toured the home and was very impressed by the improvements that had been made since the previous inspection. Bedrooms had been redecorated, some beds had been replaced and blinds had been fitted where required. The Inspector found that appropriate locks had been fitted to all bedroom doors. All radiators except for those in the bay of the front bedroom and lounge are fitted with appropriate guards. The two radiators in question would be difficult to guards due to their shape, however the homeowner has taken steps to ensure that they do not pose a risk to the service user and this situation is monitored.
Thornlea Rest Home F57 F09 S9737 Thornlea Rest Home V218378 230605 Stage 4.doc Version 1.40 Page 16 The communal rooms were comfortable and furniture was appropriate to meet the needs of the residents. The residents’ bedrooms were all individual, reflecting their preferences and contained personal possessions. The homeowner confirmed that the improvements in the home had been achieved through the staff commitment. The staff said that they wanted the home to “be the best” and were very proud of what they had achieved. The home was found to be warm, clean and free from any offensive odours. Thornlea Rest Home F57 F09 S9737 Thornlea Rest Home V218378 230605 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29&30 The policies and procedures for the recruitment of staff are robust and provide safeguards for the protection of residents. EVIDENCE: The Inspector examined two staff files and found that they contained all the information required, confirming that the recruitment procedures had been followed. The Inspector examined the rotas and found that the staffing levels were sufficient for the number of residents in the home and to meet their needs. The training records were seen which showed that all staff had undergone induction training and attended relevant training courses as their employment progressed. At the time of the inspection of the ten care staff employed, one care staff member had almost completed level National Vocational Qualification (NVQ) four staff had completed level 2 NVQ and were either in the process of obtaining level 3 or had already gained that qualification. Evidence was available to confirm that training in many areas was ongoing and the staff spoken to were very enthusiastic and proud of what they had achieved. A senior member of staff said that they wished to progress with their training and eventually take the Registered Managers Award (RMA), as they wished to eventually become a manager. Thornlea Rest Home F57 F09 S9737 Thornlea Rest Home V218378 230605 Stage 4.doc Version 1.40 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,33,36 & 38 The home is well managed and run in the best interests of the residents. EVIDENCE: The homeowner and senior staff work very closely together and the homeowner praised the staff for their commitment and hard work in the improvements that had been achieved since the previous inspection. The homeowner confirmed that they had achieved level 4 NVQ and had enrolled on the Registered Managers Award (RMA), which is due to commence in September 2005. Residents, relatives and staff spoke well of the homeowner and the care and support given. The Inspector was able to witness his approach to the residents and staff and confirm the comments made. Thornlea Rest Home F57 F09 S9737 Thornlea Rest Home V218378 230605 Stage 4.doc Version 1.40 Page 19 As part of the inspection residents and relatives were provided with questionnaires to complete if they wished. The comments received were very positive, although there were a few comments about the availability of suitable activities. The Inspector found that since the questionnaires were completed in April 2005 improvements had made in this area. Staff spoken to had a clear understanding of their role and what was expected of them. The Inspector saw documentation that confirmed that staff received regular supervision. Information provided in the pre-inspection questionnaire stated that all safety equipment was regularly serviced. The policies and procedures in the home ensured that the health, safety and welfare of the residents and staff were promoted and protected. During the inspection the Inspector was informed that senior members of staff had been on a Risk Assessment course and were in the process of undertaking risk assessments of the building. The Inspector was shown the documentation that they had begun to complete and was able to offer some advice and reassurance that they were doing these assessments satisfactorily. Thornlea Rest Home F57 F09 S9737 Thornlea Rest Home V218378 230605 Stage 4.doc Version 1.40 Page 20 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3
COMPLAINTS AND PROTECTION 3 x x x 3 x 3 3 STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 2 x 3 x x 3 x 3 Thornlea Rest Home F57 F09 S9737 Thornlea Rest Home V218378 230605 Stage 4.doc Version 1.40 Page 21 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 29 31 Good Practice Recommendations 50 of care staff should achieve level 2 NVQ The registered provider should achieve level 4 NVQ in management. Thornlea Rest Home F57 F09 S9737 Thornlea Rest Home V218378 230605 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection 2nd Floor Unit 1 Tustin Court Portway Preston PR2 2QY National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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