Inspection on 14/11/06 for Thornton House

This inspection was carried out on 14th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Thornton House 28/11/08

Thornton House 24/02/06

Thornton House 17/10/05

Thornton House 01/02/05

Thornton House 08/11/04

Thornton House 09/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

Sunny Bank (P.R.S.) Ltd

Ruskin Lodge

Bushell House

Ashwood Court Unit 1

Langrigg House

Parkside

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

CARE HOMES FOR OLDER PEOPLE Thornton House Thornton House Teal Close Off Mayfield Avenue Thornton Cleveleys Blackpool FY5 2LS Lead Inspector Christopher Bond Unannounced Inspection 14th November 2006 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 Thornton House DS0000033224.V312769.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 House DS0000033224.V312769.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Thornton House Address Thornton House Teal Close Off Mayfield Avenue Thornton Cleveleys Blackpool FY5 2LS 01253 825845 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) Lancashire County Care Services Mrs Sheelagh Francis Chippendale Care Home 35 Category(ies) of Dementia (21), Mental disorder, excluding registration, with number learning disability or dementia (1), Old age, not of places falling within any other category (12), Physical disability (10) Thornton House DS0000033224.V312769.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Staffing to be provided to meet the assessed needs of the service users at all times and will comply with any guidelines which may be issued through the Commission for Social Care Inspection regarding staffing levels in care homes. The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. The home is to be registered for a maximum of 44 service users to include: Up to 1 named person in the category of Mental Disorder (female) (MD) (1) Up to 21 service users in the category of Dementia (DE) (21). Up to 10 service users in the category of Physical Disabilities (PD) (10). Up to 12 service users in the category of Older People (OP) (12). 24th February 2006 2. 3. Date of last inspection Brief Description of the Service: Thornton House is a large care home situated in Thornton-Cleveleys near Blackpool, Lancashire. The home is registered for up to 44 service users. This includes a number of service users with Dementia. After an extensive refurbishment in the summer of 2004 the home now has 44 single rooms and several of these are en-suite. A Day-Care centre had also been added and the rehabilitation unit had also been upgraded. The home is situated in a residential area fairly close to transport routes and shops. Thornton village is a short walk away where several shops and resources are situated. Garden areas within the home have also been refurbished and there are areas where service users can sit outside when the weather is good. The home has a lift, which accesses the first floor. At the time of this visit, (14/11/06) the information given to the Commission showed that the fees for care at the home are from 298.50 to £337.50 per week, with added expenses for hairdressing and chiropody. Thornton House DS0000033224.V312769.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place over a total of 5 hours. A tour of the home included bedrooms, lounge and dining areas, and bathrooms. All areas were clean, hygienic and pleasantly furnished. The residents’ personal files and care plans were examined. Care staff records were also looked at. Safety certificates for the home were also examined. Residents and care staff were also spoken to during this inspection. What the service does well: What has improved since the last inspection? Thornton House DS0000033224.V312769.R01.S.doc Version 5.2 Page 6 There have been a number of training events for the staff at the home. Good training means that staff are better prepared to deal with the assessed needs of the residents. 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. Thornton House DS0000033224.V312769.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 House DS0000033224.V312769.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): Standards 1 and 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Written information provided to prospective residents is good enabling an informed decision about admission to the home to be made. Thorough admittance procedures and careful assessment ensures that the home can meet people’s needs. EVIDENCE: Everyone who chose to live at the Thornton House received plenty of information about the home before moving in. Written information about the home was given to prospective residents in the form of a Service User Guide. The home also had a Statement of Purpose, which held more detailed information about the care provided and the facilities that were on offer. All of this information helped the residents and their families to make an informed choice about whether the home was right for them. Two of the residents were able to confirm that they had been given this information. Thornton House DS0000033224.V312769.R01.S.doc Version 5.2 Page 9 Most of the residents had been assessed before coming to live at the home so that a decision could be made as to whether the staff could care for them properly and address their specific needs. Others were assessed during a trial period. There was a copy of this assessment on each of the residents’ personal information files. The assessments included information on communication, physical and mental health, physical ability, mobility, social wellbeing and domestic tasks. Thornton House also has a Rehabilitation Unit that helped people to maintain their personal living skills. It was the purpose of this unit to assist people to return to their own homes in the community after a period of rehabilitation. Service users were generally admitted to this unit after a medical problem or a fall at home. It was clear that the service users were being regularly assessed in this unit before a decision could be made as to whether a return home would be in their best interests. Thornton House DS0000033224.V312769.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): Standards 7, 8, 9, and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents health and social care needs are met, and people are treated with dignity and respect at this home. Residents are supported and protected in their daily lives. EVIDENCE: All of the residents had an extensive plan of care that documented all of their daily needs and how the home would address these needs. The care staff added information to the plans on a daily basis and each plan was reviewed every month so that information could be updated and appropriate action taken. The monthly review included updating information on bathing, mobility, nutrition, continence, and moving and handling needs. The main care plans were being kept on the separate units within the home and a review was being completed during the inspection. A new type of care plan was to be introduced within the home. These plans are to be more ‘person centred’ and concentrate more on the specific individual Thornton House DS0000033224.V312769.R01.S.doc Version 5.2 Page 11 needs of the residents. This will be beneficial, particularly for those residents who have dementia. There was evidence in the personal files of the residents that showed that health needs were being properly attended to. Notes were kept of the outcome of any visits or healthcare professional input, providing evidence that individual health care needs were being met. Several of the residents were spoken to during the inspection and the general feeling was that the care offered by the home was good. Residents also spoke of how the care staff that worked in the home respected them, and how their dignity was ensured. One of the residents said, “I’m very happy. This was the best move I’ve ever made. The girls look after me and always treat me well.” Another resident described the care as “excellent”. Four people who lived at Thornton House filled out a Care Home Survey questionnaire that was provided by the Commission for Social Care Inspection. Two of the four people said that they usually received the care and support that they needed. The other two people said that they always received the care and support that they needed. There were systems in place that helped to ensure that everyone who was prescribed medication by their doctor was helped to do so safely and correctly. Storage of medication was secure. In the main part of the home the medication record sheets were filled out correctly. Most of the residents had their photograph attached to their records to assist identification and help prevent mistakes. The photographs were quite small, however, and were difficult to see. Some of the residents did not have their photograph attached. This meant that identification could be difficult and mistakes could occur. The care staff confirmed that there had been recent training in the safe handling of medication. Care staff were therefore better prepared to undertake this important task. In the rehabilitation unit there were some gaps in the recording of the administration of medication. The system was complex because most of the residents had medication supplied by their own pharmacist and there were differing systems in place. A referral has been made to the Commission for Social Care Inspection Pharmacist who will be offering guidance and advice. Thornton House DS0000033224.V312769.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): Standards 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. Activities within the home were infrequent, particularly for those who had dementia. Friends and family are made welcome within the home, which helps to maintain positive relationships. Mealtimes are planned and unhurried and residents’ preferences are respected. EVIDENCE: Of the four residents who filled out a Care Home Survey questionnaire that was provided by the Commission for Social Care Inspection, three people stated that there were planned activities only ‘sometimes’. The manager of the home was aware that care staff did not have enough time to take part in planned, stimulating activities. Most of their time was taken up with caring tasks and there was little time to sit and spend quality time with the residents. There were a number of residents in the home who had been diagnosed as having dementia. The organisation had invested time and money to ensure that the care staff were aware of the needs of people who have dementia. There had been training courses regarding this. There was little evidence to show that specialised activities were taking place to help residents who had this condition. Thornton House DS0000033224.V312769.R01.S.doc Version 5.2 Page 13 It was acknowledged by the manager that extra care staff employed at specific times would help to address this situation. Two residents were spoken to regarding activities within the home. One resident said that a trip had been arranged to go and see a show at a local theatre and that there had been a recent trip to Blackpool Illuminations. Another resident said that she was “quite happy” with the activities on offer. The residents who were spoken to confirmed that those who wished to worship were able to do so. There were regular visits to the home by representatives of the church. The manager was aware of what action to take to ensure that everyone was treated equally and diversity was respected. There were several visitors to the home during the inspection and it was observed that the care staff and management team were polite and helpful. The menu’s for the home were seen and it was clear that a balanced and wholesome was being offered. All of the residents who filled out a survey questionnaire commented that they always enjoyed the meals within the home. One person commented that there “could be a little more at tea time”. The residents who were spoken to during the inspection confirmed that they enjoyed the food and mealtimes. One resident said that the food was “excellent”. There had, however, been a problem with the toasters on the units setting off fire alarms within the home. This meant that the fire services were called out, so the toasters could not be used. The resident concerned commented, “This is a shame because I enjoy my toast.” Thornton House DS0000033224.V312769.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): Standards 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints are treated seriously to ensure that the residents’ rights are protected. Residents were safeguarded from harm by good staff awareness although training in safeguarding adults was not seen as a priority by the organisation. EVIDENCE: There were policy documents for the staff to read about how to ensure that all the residents within the home were safeguarded from harm. All of the staff that were spoken to said that they had a good awareness of this important issue and knew what to do if they were not happy about something they had seen. Most of the care staff had undergone National Vocational Qualification level 2 training and had received instruction regarding the safeguarding of vulnerable adults. The manager was aware of her responsibilities and knew whom to contact should abuse be suspected. The employing organisation had still not undertaken proper training to help ensure that all of the vulnerable adults within the home were properly safeguarded. The manager of the home said that some training had been organised for the near future. All of the staff that were spoken to said that they knew what to do if someone was unhappy about the service. The manager was aware of her role regarding the complaints procedure and how complaints can be used as a quality tool to Thornton House DS0000033224.V312769.R01.S.doc Version 5.2 Page 15 ensure that the home is run in the best interests of the residents. The complaints procedure was displayed in the home and was part of the Service User Guide. Thornton House DS0000033224.V312769.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): Standards 19, 20, 21, 23, 24, 25 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are provided with a comfortable, clean and hygienic environment and bedrooms were personalised. This means that residents will feel at home with their belongings around them. EVIDENCE: The home had undergone a major refurbishment two years ago. Facilities for the resident were still good and the home was well maintained. Some of the residents had en-suite facilities in their bedrooms. Bedrooms were personalised and comfortable and several residents were able to say that they were happy with their rooms. All of the rooms had photographs, books, ornaments and other personal items within them. This helped to make the bedrooms more homely and personal. One resident commented, “My room is absolutely super.” Thornton House DS0000033224.V312769.R01.S.doc Version 5.2 Page 17 The home was also clean and hygienic. There were no unpleasant smells. There were issues of continence within the home and there were strict cleaning regimes to ensure that the comfort and safety of the residents were maintained. A member of the domestic team was spoken to during the inspection. She had completed a nationally recognised qualification (National Vocational Qualification level 1 and 2). She was fully aware of safety aspects within the home and had completed training in Infection Control. The home had separate units where people of similar needs and abilities lived. Each unit had a separate lounge and dining area. There were small kitchen areas attached to the dining facilities. The kitchen facilities could be closed up for safety reasons but were not lockable. The manager pointed out that the kitchen units had been badly designed and had become damaged quite quickly. The floors were becoming rotten with water damage. Thornton House DS0000033224.V312769.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 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good recruitment practices meant that residents were protected from unsuitable staff working in the home. Staff were caring and competent in their roles. Regular training meant that staff were better prepared to do their jobs effectively. EVIDENCE: There were enough care staff on duty during the inspection to ensure that the assessed needs of the residents were adequately dealt with. The staff rotas showed that staffing was good and that there were plenty of staff on each shift to ensure that people were being properly looked after. All of the questionnaires received said that there was always or usually staff available when they were needed. The manager expressed a concern that there were not enough staff to ensure that activities within the home were available when most needed. This was particularly evident for those residents who had dementia. Two of the staff were spoken to at length. Both said that they had had training in important areas since the last inspection. These areas included mandatory training in fire safety, moving and handling, infection control, and food hygiene. There were shortly to be training courses in safeguarding vulnerable Thornton House DS0000033224.V312769.R01.S.doc Version 5.2 Page 19 adults. There was information on the personal files of the care staff about what training courses they had attended. Most of the care staff had achieved a national qualification in care (National Vocational Qualification level 2 or 3). Evidence of this training was found on records within the home. Two of the care staff that were spoken to confirmed that they had achieved this qualification. Staff records showed that new carers had been properly checked before starting their jobs. This helped to make sure that the residents were safer. There was a good induction process to help ensure that new care staff were competent before commencing their role. Thornton House DS0000033224.V312769.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): Standards 31, 32, 33, 35, and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are protected and safeguarded by good management practice and a well maintained home. EVIDENCE: Good records were being kept of safety checks within the home. These showed that professionals were checking the lift, electric and gas equipment and the fire alarm system regularly. This helped to ensure that the residents lived in a safe home. Trained maintenance people were also checking the lifting equipment in the home on a regular basis. Staff were being instructed in safety aspects within the home. Some of the residents had small amounts of money held by the home. This was held very securely and was safeguarded by good recording and checking. Thornton House DS0000033224.V312769.R01.S.doc Version 5.2 Page 21 All of the residents and care staff that were spoken to during the inspection were complimentary about the style of management within the home. One resident said, “The manager is a very caring and professional person. She walks round the home every day and she’s always available for a chat.” The resident were asked for their views on a regular basis. Questionnaires had been handed out and the results had been collected and written up. This helped the manager to find out what the home was doing right and where improvements could be made. The inspector saw an example of this. Thornton House DS0000033224.V312769.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 3 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 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 3 3 X 3 X X 3 Thornton House DS0000033224.V312769.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 OP12 Regulation 14 (1) (a) Requirement Regular, appropriate activities must be provided for all of the residents within the home. Particular consideration must be given to people with dementia and other cognitive impairments. Timescale for action 31/12/06 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 2 Refer to Standard OP9 OP9 OP19 Good Practice Recommendations A photograph of the resident concerned should accompany all individual medication records. All medication records must be clear, accurate and up-todate. The kitchen units in each area should be kept in good condition or replaced with a more appropriate facility. Thornton House DS0000033224.V312769.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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 Thornton House DS0000033224.V312769.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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