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 24th February 2006 11:00 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.V283624.R01.S.doc Version 5.1 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.V283624.R01.S.doc Version 5.1 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.V283624.R01.S.doc Version 5.1 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). 17th October 2005 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 were 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 through floor lift. Thornton House DS0000033224.V283624.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place over three and a half hours. The manager gave the inspector a tour of the home. Care staff and residents records were looked at. The inspector spoke to two of the residents. Safety records for the home were also inspected. What the service does well: What has improved since the last inspection?
There have been several training events that helped to add to the skills of the care staff. These include medication training, infection control, catheter care, continence awareness, moving and handling and National Vocational Qualification level 2 and 3 training. This means that care staff have the information to help them do their jobs better. Most of the care staff now hold a nationally recognised care qualification (National Vocational Qualification level 2 or 3). Awareness of abuse issues had improved. An easy-to-read guide had been produced, and the managers had gone through this with each of the staff at individual support meetings and induction. This was also covered in staff
Thornton House DS0000033224.V283624.R01.S.doc Version 5.1 Page 6 meetings (evidence of this was seen in the minutes of meetings). This helped to make the home a safer place to live in. 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 House DS0000033224.V283624.R01.S.doc Version 5.1 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.V283624.R01.S.doc Version 5.1 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): EVIDENCE: This section was not assessed during this inspection. Thornton House DS0000033224.V283624.R01.S.doc Version 5.1 Page 9 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 Health and care needs were addressed correctly through good care planning, ensuring that the residents were looked after properly. Residents were treated with respect and their dignity was well maintained by understanding care staff. EVIDENCE: All of the residents living at the home had a plan of care where important information was recorded, and where the health of the residents is monitored. Notes were kept of the outcome of any visits by the District Nurse or the Doctor, which showed that individual health care needs were met. There was lots of information about the general care needs of each resident. All of the plans were reviewed on a regular basis to make sure that the information was always current and that the care staff knew the latest condition of a resident. None of the residents within the home were able to handle their own medication. There were good procedures and policies for the staff to follow when they were administering prescriptions and the medication was stored safely and appropriately. This helped to ensure that residents were not put at any risk when medication was being given out.
Thornton House DS0000033224.V283624.R01.S.doc Version 5.1 Page 10 There were some good examples seen by the inspector of care staff being polite, courteous and caring when attending to residents’ needs. Thornton House DS0000033224.V283624.R01.S.doc Version 5.1 Page 11 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 and 14. Residents enjoy planned and stimulating activities. EVIDENCE: In the entrance hall to the home there was a table with lots of information about the activities and resources available in the local community. There were local newsletters from Thornton Parish and the village of Thornton. There was information on the advocacy service, who help to provide representatives for those who find it difficult to handle their own affairs. Their were special activities arranged for those residents who had dementia. Staff were well trained in caring for those with this condition. Those residents who were spoken to who did not have dementia said that there was always a lot to do and that activities were regularly organised. The home had recently had a belly dancer to entertain people. There were visitors calling at the home at the time of the inspection, this helped to show that personal relationships were being valued and maintained. Thornton House DS0000033224.V283624.R01.S.doc Version 5.1 Page 12 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): 18 Good abuse awareness helps to keep residents safe from harm. EVIDENCE: Although the employing organisation had not provided regular and structured training about keeping people safe and free from harm, the manager of the home had ensured that all of the staff within the home were aware of protection issues. An easy-to-read guide had been produced, and the managers had gone through this with each of the staff at individual support meetings and induction. This was also covered in staff meetings (evidence of this was seen in the minutes of meetings). There was a comprehensive policy document called ‘Safeguarding Adults’ available which helped managers and staff identify forms of abuse and what procedure should be followed if abuse is suspected. Thornton House DS0000033224.V283624.R01.S.doc Version 5.1 Page 13 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, 21, 22, 23, 24, 25 and 26 Residents live in a clean, well-maintained home. Residents’ bedrooms are attractive and homely. EVIDENCE: The home was set in its own grounds and there were areas where the residents could enjoy the gardens around the house. It was clear that the residents had the specialist equipment that they needed to make their stay within the home more comfortable. There were hoists available for people who found it difficult to get around. This meant that they could be helped by the care staff to get around safely. There was a lift to help people get to their rooms on the first floor. There were several bathrooms within the home. All of them were in easy reach of the rooms and communal areas. All of the rooms were quite large and there were lots of personal possessions around that made them more homely. All of the residents that were spoken to
Thornton House DS0000033224.V283624.R01.S.doc Version 5.1 Page 14 said that they liked their rooms. The home was very clean and there were no unpleasant smells. There were domestics working at the home during the inspection and equipment was demonstrated which helped to clean the carpets if there were unfortunate accidents. The manager confirmed that the home is cleaned on a daily basis and thorough practices are used in dealing with issues around incontinence. One of the residents said, “My room is very special to me and I’m very happy with it. I have my own key and the view is nice.” She also said, “The whole home is kept spotless, that’s why I like it here.” Thornton House DS0000033224.V283624.R01.S.doc Version 5.1 Page 15 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): EVIDENCE: This section was not assessed during this inspection. Thornton House DS0000033224.V283624.R01.S.doc Version 5.1 Page 16 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, 32, 34, 35, 36 and 38. Service users benefit from a well run home. EVIDENCE: The manager of the home had nationally recognised qualifications in managing a care home (National Vocational Qualification level 4 in management and care). She had over 17 years experience in management. She had recently enrolled on the Certificate in Dementia Studies course at Bradford University. The residents of the home were protected by rigorous financial guidelines. Care staff had been trained in ensuring the safety of residents. This included learning how to move people safely and ensuring that food was prepared and served hygienically. Good records were being kept of safety checks within the home. These showed that tradesmen 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.
Thornton House DS0000033224.V283624.R01.S.doc Version 5.1 Page 17 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 X X X X 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 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 X 3 3 3 X 3 Thornton House DS0000033224.V283624.R01.S.doc Version 5.1 Page 18 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 House DS0000033224.V283624.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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