Inspection on 08/11/05 for Thornton House

This inspection was carried out on 8th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 House 30/10/06

Thornton House 13/07/05

Thornton House 17/01/05

Thornton House 04/08/04

Thornton House 20/01/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Thornton House 94 Chester Road Childer Thornton South Wirral Cheshire CH66 1QL Lead Inspector A Gillian Matthewson Unannounced Inspection 8th November 2005 10:30 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 DS0000006545.V263832.R01.S.doc Version 5.0 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 DS0000006545.V263832.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Thornton House Address 94 Chester Road Childer Thornton South Wirral Cheshire CH66 1QL 0151 339 0737 0151 339 0737 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) Mr Andrew Henry Blomfield Beryl Tidbury Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22) of places Thornton House DS0000006545.V263832.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th July 2005 Brief Description of the Service: Thornton House is registered as a care home to provide a service to older people who may need assistance with a range of personal care tasks. The home is run as a private enterprise with the registered provider having an active participation in the daily management of the home. The home is located on the outskirts of Ellesmere Port in a small community within reach of local services, community facilities and public transport. The facilities offered by the home include single bedroom accommodation, a separate dining room and three lounge areas, one of which is a conservatory extension to the building. There is a large and well-maintained garden to the rear of the property. The home is staffed 24 hours a day including two waking night staff. The staffing complement also includes kitchen and domestic staff. A stair lift is available to transfer residents between the ground and first floors. Thornton House DS0000006545.V263832.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out by one regulatory inspector. The inspector spent an hour planning the inspection by reviewing previous inspection reports, the service history over the last twelve months and comment cards. The inspection took place over four hours and included a tour of the building, inspection of records and discussion with three residents, the registered provider and registered manager, and three staff. Feedback was given to the registered manager immediately following the inspection. What the service does well: All prospective residents’ needs are assessed prior to admission and the manager discusses with them or their relatives how the home will be able to meet their needs. They are also provided with detailed written information about the home. This enables them to make an informed choice about whether to take up residence. The home provides a very high standard of care and residents are treated with respect. A resident commented that ‘the staff, without exception, are excellent’ and ‘I have never regretted moving here’. Another said ‘the staff are very friendly and have made me feel at home’. Residents are able to maintain autonomy and exercise personal choice in all aspects of their daily lives. Meals are appetising and nutritious. One resident commented that ‘the food is always good’. The home has good systems in place to reduce the risk to residents of harm or abuse. The home is clean, well furnished and nicely decorated. Staffing levels ensure that residents’ needs can be met. Thornton House DS0000006545.V263832.R01.S.doc Version 5.0 Page 6 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 House DS0000006545.V263832.R01.S.doc Version 5.0 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 DS0000006545.V263832.R01.S.doc Version 5.0 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, 3 & 5. The home provides prospective residents with the information they need to help them make a decision about whether they want to live there and assessments are carried out to ensure that the home has the resources to meet their needs. EVIDENCE: Thornton House DS0000006545.V263832.R01.S.doc Version 5.0 Page 9 The home had a statement of purpose containing all the information required by Schedule 1 of the Care Homes Regulations. It was last reviewed and updated in June 2005. The home also supplied each resident with a residents’ handbook for easy reference, which contained all the information they needed about the home. The care of three residents was reviewed as part of the case tracking exercise. The registered manager had carried out pre admission assessments on all three and where appropriate there were supporting assessments from health and social care professionals. She said it was normal practice for a representative from the home to visit the prospective resident in his or her own home or in their current health or social care setting prior to admission. Two residents confirmed that the manager had visited them and that they had been able to visit Thornton House prior to their admission. Thornton House DS0000006545.V263832.R01.S.doc Version 5.0 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 & 10. Residents’ needs are set out in an individual plan of care to ensure that all their personal and health care needs are met. Their privacy and dignity is maintained in accordance with their wishes. EVIDENCE: Case tracking was carried out for three residents. This included talking with the residents and staff and reviewing their care records. Care plans were drawn up to provide staff with details of what action they needed to take to ensure that the residents’ needs were met. These care plans were reviewed on a regular basis and updated as needs changed. They also contained signatures of residents and relatives, which indicated that they were consulted throughout the care planning process. Residents confirmed that staff assisted them to maintain their personal hygiene as necessary. Examination of care files evidenced that staff are clearly guided towards maintaining and promoting personal health as a significant aspect of the care offered. Residents were assessed as to their risk of developing pressure sores and appropriate pressure relieving equipment was Thornton House DS0000006545.V263832.R01.S.doc Version 5.0 Page 11 provided. Residents were referred to a continence adviser if necessary and appropriate aids were obtained. Adequate arrangements were in place for residents to obtain hearing and sight tests and access to health care professionals as required. Care files contained evidence of referrals to GPs, district nurses, dentist, optician and chiropodist. Residents confirmed that staff treated them with respect and maintained their dignity when attending to personal care needs. Residents had access to a telephone in a quiet area of the home and received their mail unopened. Residents also had a telephone in their own room. Staff used a formal term of address, such as Mrs Smith or Mr Jones, unless the resident requested otherwise. Thornton House DS0000006545.V263832.R01.S.doc Version 5.0 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, 14 & 15. The range of activities available for residents has improved, allowing residents greater opportunity to fulfil their recreational needs. The home is conducted so as to maximise residents’ choice and control over their lives. Dietary needs of residents are well catered for with a balanced and varied selection of food available that meets residents’ tastes. EVIDENCE: Discussion with residents confirmed that the range of activities had improved since the last inspection. This included quizzes, bingo, word games, sing a longs, discussions, gentle exercises, visits from a mobile library, visiting singers every other month, a visiting hairdresser twice a week, trips out to the local garden centre and an occasional visit to the theatre. Staff were also willing to spend time with residents on an individual basis playing board games, doing manicures and assisting with crosswords or letter writing. The manager said that the home employed an activity coordinator but she had left earlier in the year. She said there was an intention to recruit another activity organiser after Christmas to further extend the range of activities available. Residents were able to bring personal possessions into the home with them, and most bedrooms were well personalised with small items of furniture, Thornton House DS0000006545.V263832.R01.S.doc Version 5.0 Page 13 pictures, photographs and ornaments. The notice board displayed details of an advocacy service provided by Age Concern, who would act in residents’ interests if required. The manager had recently referred a resident with no relatives to this service. Menus demonstrated that residents are offered one of two choices at every mealtime, apart from Sunday lunch, which is always a roast dinner. Residents said that the meals were excellent and two residents said that when they hadn’t been well they were able to ask for more or less anything they wanted and it was provided. Tables were set attractively for lunch with a centre piece of flowers and place names. Staff were observed serving and assisting residents, both in the dining room and in residents’ bedrooms. They paid attention to detail to ensure that the food looked appealing and was served in a way that enabled the resident to eat independently if possible, for example peeling and cutting fruit. The cook confirmed that she consulted with residents about the menus on a regular basis to determine those foods they enjoyed and those (if any) they didn’t enjoy. She also asked residents for suggestions for meals and said that the menus weren’t reviewed at set intervals, but tended to ‘continually evolve’. Thornton House DS0000006545.V263832.R01.S.doc Version 5.0 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): 18 Arrangements for protecting residents are satisfactory, thereby reducing the risk of harm or abuse. EVIDENCE: The home had satisfactory policies on the protection of individuals from abuse, whistle blowing and the management of aggression and restraint. A copy of Cheshire County Council’s adult protection protocol was available in the home and staff received training on how to recognise and respond to abuse and neglect during their induction. Discussion with the manager revealed that she was aware of the correct procedures to follow should she witness any abuse or if an allegation of abuse was made. Residents were also made aware of their right to live free from fear of abuse, and what to do if they were concerned, in the written information supplied to them. Thornton House DS0000006545.V263832.R01.S.doc Version 5.0 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, 22 & 26. The home provides a clean, well equipped and pleasant environment for residents to live in. EVIDENCE: The home was clean, well furnished and maintained in good decorative order. Two small requirements from the last inspection had been addressed and the dining room had recently been redecorated. Residents had access to all parts of communal and private space through the provision of ramps and a chair lift. Aids, hoists and assisted toilets and baths were installed. A call system was provided in every room. Case tracking revealed that residents were assessed as to their need for any equipment, such as mobility aids and/or pressure relieving equipment and these were provided. Thornton House DS0000006545.V263832.R01.S.doc Version 5.0 Page 16 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. Residents’ needs are met by sufficient numbers of staff. EVIDENCE: There were twenty one people resident at the time of the inspection. The home provided three care staff on duty from 8am to 6pm, and two from 6pm to 8am. These numbers were sufficient to meet residents’ needs. The manager was supernumerary. The home also employed domestic and catering staff. Thornton House DS0000006545.V263832.R01.S.doc Version 5.0 Page 17 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): 33 & 35. EVIDENCE: The home only retained small amounts of personal spending money for residents. This was kept in individual wallets in a safe place, together with a record of all receipts and withdrawals and a running balance for each resident. Two signatures were obtained for each transaction. A random sample were audited and found to be correct. The home had a set of user satisfaction questionnaires that could be distributed to residents, relatives and other key stakeholders to seek feedback, but these had not been distributed for well over a year. However, residents had been told about the previous inspection, which was announced, and requested to complete comment cards for CSCI. The manager said that she Thornton House DS0000006545.V263832.R01.S.doc Version 5.0 Page 18 had meetings with residents and relatives at least four times a year, but these no minutes were taken. See Requirement 1. Thornton House DS0000006545.V263832.R01.S.doc Version 5.0 Page 19 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 3 N/A 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 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 X X 3 X X X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 1 X 3 X X x Thornton House DS0000006545.V263832.R01.S.doc Version 5.0 Page 20 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. 1 Standard OP33 Regulation 24 Requirement The registered person must maintain a system for reviewing and improving the quality of care provided at the home. Timescale for action 31/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Thornton House DS0000006545.V263832.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 House DS0000006545.V263832.R01.S.doc Version 5.0 Page 22 - 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!