Inspection on 15/08/06 for Thornton Hill

This inspection was carried out on 15th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Thornton Hill 31/07/07

Thornton Hill 15/09/05

Thornton Hill 26/05/05

Thornton Hill 09/02/05

Thornton Hill 17/09/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Thornton Hill Church Road Thornton In Craven Skipton North Yorkshire BD23 3TR Lead Inspector Mrs Irene Ward Key Unannounced Inspection 15th August 2006 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Thornton Hill DS0000060215.V307746.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. Thornton Hill DS0000060215.V307746.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Thornton Hill Address Church Road Thornton In Craven Skipton North Yorkshire BD23 3TR 01282 842023 01282 843959 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) sharon.blackwell@anchor.org Anchor Trust *** Post Vacant *** Care Home 64 Category(ies) of Old age, not falling within any other category registration, with number (64) of places Thornton Hill DS0000060215.V307746.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th September 2005 Brief Description of the Service: Thornton Hill provides personal care and accommodation for up to 64 older people who do not have any specialist requirements. It is owned and operated by Anchor Trust. The home is a large converted manor house with a purpose built extension known as the Manor Wing. The residents are located on the ground and first floors only and there is a vertical lift to provide level access to the first floor. The home is set in its own grounds overlooking a valley. Thornton Hill is situated in the village of Thornton-in-Craven approximately 8 miles from Skipton. The weekly fees on 15th August 2006 range from £425 to £600. This information was supplied to the Commission For Social Care Inspection via the pre-inspection questionnaire received on the 14th August 2006. Service users/relatives and other interested parties are able to have access to inspection reports as they are displayed in the reception area of the home. Thornton Hill DS0000060215.V307746.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report follows an unannounced site visit carried out on the 15th August 2006. This visit was carried out by one Regulation Inspector and started at 09.00 hrs and finished at 15.30 hrs with 3 hours preparation time. The inspection process included information provided by the home prior to inspection. Surveys were also sent to relatives and friends and health and social care professionals. One comment has been received from a relative/visitor, which was positive. The site visit comprised of a full inspection of the premises, which included some service users private accommodation. The care records of four service users were looked, which included service users assessments, care plans and medication records. Staff rotas and health and safety documentation were inspected. Time was spent observing activity in the home and interaction between service users and staff, talking and listening to service users, friends and relatives visiting the home. Time was also spent talking to members of staff. There was also opportunity to speak with a visiting District Nurse. The focus of the inspection was a number of key standards, inspecting the case records of service users in detail to establish if they corresponded with service users experiences in the home. The acting manager Andrea Smith was available throughout the day. There were no requirements outstanding from previous inspections. There were no requirements or recommendations made at this inspection. The last unannounced inspection was carried out on the 27th June 2006. What the service does well: The staff provide a clean, warm and comfortable home for service user to live in. The home provides good care for service users and supports them to maintain their independence. Members of staff were observed to provide appropriate care when supporting service users in maintaining their independence in daily tasks. One service user said, “ The best thing about the home is that the girls are excellent”. Comments from relatives/visitors and a visiting health care professional were all positive. Relatives made comments such as “the home is far better than it Thornton Hill DS0000060215.V307746.R01.S.doc Version 5.2 Page 6 used to be” “the environment is so much better it is clean and well furnished” “there is a consistent staff group”. A visiting health care professional said “ the home is very good, the home is kept very clean and there are never any odours, and the staff are very helpful and do not call you out unnecessarily”. Service users confirmed that they could see visitors at anytime enabling them to maintain relationships with their family and friends. 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. Thornton Hill DS0000060215.V307746.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 Thornton Hill DS0000060215.V307746.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3 and 6 Quality in this outcome area was good. This judgement has been made using available evidence including a visit to this service. Service users are given information and are assessed so that they able to make an informed choice about moving into the home. EVIDENCE: The manager confirmed that a service user guide is sent to all service users/relatives when making an enquiry about the home. Pre-admission assessments are in place and held on service users individual files and a care need assessment from local authorities were also in place where necessary. Assessments were carried out initially for all service users living at the home when the organisation first took over the home, to ensure that the home could continue meeting peoples needs. Thornton Hill DS0000060215.V307746.R01.S.doc Version 5.2 Page 9 Four service users files were looked at. All files held contracts /terms and conditions of residency, which had been signed and agreed with service users or their representatives. There have been no amendments made to the Statement of Purpose since the last inspection although the organisation intends to update them all. The home does not provide intermediate care. Thornton Hill DS0000060215.V307746.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area was good. This judgement has been made using available evidence including a visit to this service. The care provided to service users was good, and all identified needs are translated into individual plans of care. EVIDENCE: The service users are well cared for and some made comments about the care they received. One service user said that they were “the care here is excellent” and another said, “The best thing about the home is that the girls are excellent ”. Another service user said, “We are all well looked after”. Evidence showed that all identified needs that were assessed are recognised by care planning. The case records of four service users were looked at. All four care records had detailed risk assessments including reducing risks of falls. Care plans were comprehensive in detail about service users needs and how they were to be met by care staff. Daily records were detailed and gave a clear picture how both day and night care staff, meet service users care needs. Thornton Hill DS0000060215.V307746.R01.S.doc Version 5.2 Page 11 Referrals and visits by GPs and other health and social care professionals were recorded. A visiting District Nurse to the home was spoken to and said, “ the home is very good, staff are helpful and competent and residents are well looked after, and we are not called out unnecessarily”. Service users records confirmed that appointments are made for the dentist and optician. The home had a call bell system and service users confirmed that call bell requests were attended to quickly. The home is in the process of refurbishing a room, which will be specifically designated for the storage of all medication for the home. The current arrangement for the storage of medication is in a room adjacent to the main dinning room. The door to this medical room is kept locked and the senior carer on duty has responsibility for the key. The medication system and facilities were inspected. The home operates a monitored dosage system. Proper procedures were in place for the administration and storage of medication and a random check of medication supplies tallied with records. The medication administration records were up to date. Service users commented that they treated with respect by the staff at all times. Thornton Hill DS0000060215.V307746.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Daily routines enable service users to have control over their lives. Activities in the home are good and meets the social needs of people living in the home. EVIDENCE: The home employs an activities organiser three days weekly. The home has an activities room where service users are able to participate in arts and crafts, painting furniture, finger painting, videos, various board games, skittles and so on. The hairdresser visits the home regularly. The home ensures that religious services are held for those service users who wish to attend. The home has a small chapel for visiting clergy although the service users prefer to use one of the lounges. The home has a small library for those service users who like to read. Service users also have daily newspapers delivered to the home. Thornton Hill DS0000060215.V307746.R01.S.doc Version 5.2 Page 13 Service users all confirmed that they are able to get up and go to bed as they wish and that visitors are able to visit them at anytime. All service users said that the food at the home was very good. There is a choice at each mealtime one service user said “ the food is good here”. Another service user said, “ There is plenty of choices at each mealtime”. Staff were observed in the dinning room at lunchtime assisting service users who needed it and being available throughout the lunchtime period. Staff had recently completed the Dinning with Dignity course, which looks at how a home can improve meals for service users. This also involves things like showing service users each mealtime the choice of food available so that service users can actually choose what they want to eat. The staff was also made aware of such thing as making a difference for people who are partially sighted by the provision of suitably coloured plates not white plates so people can see the outline of the food they are eating. All of the staff that was spoken to said that they enjoyed the course, and that it made them more aware of how difficult it maybe for some service users when eating their meals. In discussions held with the cook, seasonal changes are made to the menu. Service users are given two main choices each mealtime. In addition to the daily menu’s that were displayed on a board in the dinning room. Options also available on the menu board were salad, omelettes, sandwiches, ice cream, yogurts, the cook also said they do baked potatoes or anything the service users wanted. Special diets are catered for such as diabetics, gluten and fat free diets. Drinks are available throughout the day. Staff were taking a drinks trolley around the home in the morning. Service users said that they are offered plenty of drinks throughout the day. There was a water dispenser in one of the lounges. Relatives said that they were always offered a drink by staff, which made them feel welcome in the home. Thornton Hill DS0000060215.V307746.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are confident that their complaints and concerns will be dealt with and are safe living in the home. EVIDENCE: The home has a comprehensive complaints procedure in place which is made available to service users as it displayed on the reception area. The home records all complaints they receive. No complaints have been made either to the home or the Commission For Social Care Inspection. Service users said that they were aware of how to raise any concerns. They said they would approach care staff or the homes management team and they were confident that they would put things right. Comprehensive policies and procedures on the protection of vulnerable adults were seen including the local multi-agency agreement. Staff have recently undertaken training on recognising abuse. In discussion they all appeared confident in the action to be taken should abuse be suspected or alleged. Thornton Hill DS0000060215.V307746.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,23,24,25 and 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People live in a safe, clean and comfortable environment that is suitable for their needs. EVIDENCE: The major refurbishment has now nearly been completed within all areas of the home. This includes the main reception area all of the communal areas such as lounges, dinning room, and service users rooms and all assisted bathrooms have all been refurbished to a high standard. The quality of furnishings in the home now is to a high standard. All service users, relatives and visitors said that how much better the environment was at Thornton Hill. Comments from relatives/visitors and a visiting health care professional were all positive. Relatives made comments such as “the home is far better than it used to be” “the environment is so much better it is clean and well furnished” Thornton Hill DS0000060215.V307746.R01.S.doc Version 5.2 Page 16 A visiting health care professional said, “ the home is very good, the home is kept very clean and there are never any odours, they must have really good cleaners”. The manager said that there were sixteen bedrooms that are occupied that are left the need to be refurbished. There has been attention to detail given in all parts of the home such as bowls of fruit and sweets made available to service users. Pot- pouri in bowls on sideboards. Dried flowers in vases were on display around the home. The unoccupied rooms were welcoming with new towels/facecloths folded neatly in the en-suites. The manager had bought two new extremely large clocks that had large numbers so that service users, who are visually impaired, could see what time of the day it was. These had been put on the walls of the main hallway and the dinning room. The home has had a new vertical lift installed, which is voice activated to let passengers know what floor they have arrived at. There has been a complete overhaul of the laundry in the basement. This area now has 4 industrial washing machines, all have sluice facilities, and two of the washers have large openings so that duvets and pillows can be washed. There are four driers. Complete new floor covering has been fitted. There are individual shelves for all service users clothing. The home is installing a washing machine and dryer in one area of the home for those service users who are able and want to do their own washing. The environment at Thornton Hill has changed considerably since the last two inspections and this is clearly to the benefit of the service users living in the home and the staffs working environment. Both the cook and the acting manager said that the kitchen is to be completely refurbished in the next financial year. Thornton Hill DS0000060215.V307746.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome is good. This judgement has been made using available evidence including a visit to this service. Staffing levels are sufficient in meeting the assessed needs of service users. Service users are protected by the home’s vigorous recruitment procedures. EVIDENCE: The staff records of three staff including a recently appointed member of staff were looked at. All records showed completed application forms, two written references, CRB (Criminal Record Bureau) checks had been obtained. A POVA first check had also been carried out. Fourteen staff have commenced NVQ Level 2 and four staff are completing NVQ Level 3. Three staff are completing the Assessors Award. Training such as First Aid, COSHH Health and Safety, moving and handling, food hygiene and Dinning with Dignity are some of the training that has been completed by staff. One relative said that when they had spoken with staff on the telephone about their relative “staff are very knowledgeable” The staff roster showed that there are at least five care assistants on duty each morning and five in an afternoon. There is three staff on duty each night, one senior carer and two night carers. Thornton Hill DS0000060215.V307746.R01.S.doc Version 5.2 Page 18 The home also employs a large number of ancillary staff. The home holds a training file for staff. This identifies what training staff have completed and what training is needed. Further training such as Protection of Vulnerable Adults, dementia care, palliative care is to be arranged for staff Thornton Hill DS0000060215.V307746.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The service users and staff benefit from the ethos and leadership of the management team who safeguard service users interests and ensure their safety. EVIDENCE: Information provided from the pre-inspection questionnaire and the examination of selected health and safety documents show that regular checks to hot water delivery, electricity and gas and fire safety equipment are regularly undertaken. Thornton Hill DS0000060215.V307746.R01.S.doc Version 5.2 Page 20 The home has a good and effective management team in place. The ethos of the home is open and positive. Service users, relatives/visitors and health and social care professionals all commented highly about the home. Service users finances were not checked at this site visit, however information supplied by the pre-inspection questionnaire and historical evidence from previous reports gives evidence that service users financial interests are safeguarded. Staff confirmed that staff supervision and annual appraisals is carried out. Records were held on the three staff files seen. Quality Assurance systems are in place and the home is audited regularly by the organisation. One of the organisations area managers carries out regular monthly visits to the home and a report is completed and a copy sent to the Commission for Social Care Inspection. Internal surveys have been carried out and distributed to all service users. The outcomes from the surveys are to be commented upon in a report to be compiled by the manager. Comments received from the survey from service users who had stayed at the home on a short stay basis said “Thornton Hill has justified our daughters choice and that we both feel ready to return home to carry on with our normal lives”. Thornton Hill DS0000060215.V307746.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 3 3 3 X X 3 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 3 X X 3 3 3 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 Thornton Hill DS0000060215.V307746.R01.S.doc Version 5.2 Page 22 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 Thornton Hill DS0000060215.V307746.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: 0845 015 0120 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 Thornton Hill DS0000060215.V307746.R01.S.doc Version 5.2 Page 24 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!