Inspection on 19/02/08 for Thornton Leigh Care Home

This inspection was carried out on 19th February 2008.

CSCI found this care home to be providing an Adequate service.

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 Leigh Care Home 18/10/06

Thornton Leigh Care Home 16/02/06

Thornton Leigh Care Home 02/12/05

Thornton Leigh Care Home 21/03/05

Thornton Leigh Care Home 13/10/04

Thornton Leigh Care Home 25/03/04

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 Leigh Care Home 42 Huyton Lane Huyton Knowsley Merseyside L36 7XG Lead Inspector Mr Paul Kenyon and Mrs Lynn Paterson Unannounced Inspection 19th February and 3rd March 2008 09:30 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 Leigh Care Home DS0000021485.V358124.R02.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 Leigh Care Home DS0000021485.V358124.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Thornton Leigh Care Home Address 42 Huyton Lane Huyton Knowsley Merseyside L36 7XG 0151-489-1950 0151 480 9703 ronvaltd@yahoo.co.uk 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 Ronald William Baker Mrs Valerie Elizabeth Baker Mr Ronald William Baker Mrs Valerie Elizabeth Baker Care Home 15 Category(ies) of Old age, not falling within any other category registration, with number (15), Physical disability over 65 years of age of places (15) Thornton Leigh Care Home DS0000021485.V358124.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 15 OP and up to 15 PD(E) Date of last inspection Brief Description of the Service: Thornton Leigh is owned and managed by Mr and Mrs Baker. Both are retired nurse tutors who also hold a recognised nursing qualification. The home is an older property, which has been well maintained and has many original features. This helps to promote a comfortable and homely atmosphere. Thornton Leigh benefits from an established garden, which is readily accessible to residents. The home is situated on a main road within walking distance of the shopping facilities of Huyton Village. The home is managed around the Christian Ethos. Prayer meetings are held twice weekly and daily readings from the bible are read at lunchtime for those residents who follow a Christian faith and wish to be involved. Residents who are non-Christians are also welcome at the home. Fees are currently charged at £327 per week with charges for hairdressing and chiropody. Thornton Leigh Care Home DS0000021485.V358124.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This was the main key inspection to be undertaken at Thornton Leigh this inspection year (April 2007 to March 2008). The inspection was unannounced and was undertaken by two inspectors on separate days. The inspection included an examination of records relating to the care of service users, interviews with service users and staff as well as a tour of the building. National Minimum Standards for Older people were used to measure the quality of care provided by the service. Reference was also made to the Annual Quality Assurance document (AQAA) submitted by the service prior to the inspection. What the service does well: What has improved since the last inspection? No requirements made at the last inspection have been met. Thornton Leigh Care Home DS0000021485.V358124.R02.S.doc Version 5.2 Page 6 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 Leigh Care Home DS0000021485.V358124.R02.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 Leigh Care Home DS0000021485.V358124.R02.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): 3.Standard 6 is not applicable to Thornton Leigh at present. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Those who use the service do not benefit from having their needs fully identified before they come to live at Thornton Leigh and as a result their needs cannot be fully met. EVIDENCE: Two individuals have come to live at the home since the last inspection. A Local Authority funds one individual and the other is privately funded. In both cases the service had assessed the needs of the individual yet no Local Authority assessment had been obtained prior to one individual coming to live at Thornton Leigh. This is raised as a requirement in this report. Thornton Leigh Care Home DS0000021485.V358124.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans are not detailed or reviewed regularly and as a result the needs of residents are not fully identified. Residents or their families do not have the opportunity to influence the care they are given. Residents benefit from the safe management of medication. Not all residents consider that they have their wishes taken into account. EVIDENCE: Care plans maintained by the home appeared to be mainly a daily record of events. Some details of care needs are in place but these are not explicit and did not show how care would be carried out or when and by whom the care would be provided. Thornton Leigh Care Home DS0000021485.V358124.R02.S.doc Version 5.2 Page 10 Care plans did not hold signatures of residents or their representatives and when asked, people living in the home said they did not know what a care plan was. Evidence is in place outlining that residents are registered with local doctors and have their health needs monitored through care plans as well as through healthcare appointments. Examples of health care appointments included: blood tests. optician visits, appointments with the continence advisor, General Practitioner appointments and visits by the chiropodist. All resdeints have had their susceptibility or otherwise to developing pressure areas assessed and recorded on a regular basis. Weight is monitored. Observations of medication being provided to residents showed that staff, adhere to home policy and procedures. Medication is managed well. In respect of privacy and dignity, a sample of those who use the service were interviewed and comments included: ‘Staff call one resident by a name she does not like (shortened version of her name) Staff sometimes tell her what to do and not ask her what she wants to do. Staff sometimes tell her what to do and not ask her what she wants to do’ ‘Another resident feels that they sometimes do what they think is best and not ask what the individual wishes them to do.’ On the second day of the inspection, the Inspector was invited to view new en suite facilities. A resident was asked if the Inspector could enter her room to look at new en suite. They agreed and this was done in consultation with the resident involved. Thornton Leigh Care Home DS0000021485.V358124.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. While an activities programme is in place, residents do not consistently consider that this is appropriate to their wishes. Residents benefit from being as financially independent as possible given their needs. EVIDENCE: List of activities are prominently displayed and include both activities within the home as well as those further afield. In house activities include: light exercise, aromatherapy, music entertainers, videos, games and Christian meetings in line with the ethos of the home. Thornton Leigh Care Home DS0000021485.V358124.R02.S.doc Version 5.2 Page 12 Those who use the service were interviewed and comments included: ‘One said that the home, were restricted with activities due to the poor mental capacity of most of the people living therein but she managed.’ Another said that activities were limited again because of the varying abilities of the people living in the home. ‘Another stated that the staff do their best to arrange activities’ In respect of daily routines, one resident revealed that they and another resident were provided with breakfast in their rooms. On the initial visit a visitors book could not be found in order to gain information in respect of visitors. The second visit noted that this had now been addressed but did not appear to be used. In respect of independence, no advocacy service is in place. Discussions with the Manager suggested that it is considered that the majority of families act as advocates for residents. In most cases, residents have their financial matters dealt with by their families or in the case of one through power of attorney. The Manager provides a service to store monies and provide this to residents when required. All monies are satisfactorily administered and accounted for. The service is involved in collecting monies for two residents but this is just a practical matter as opposed to the Manager being appointee for their finds. The management of monies is further outlined in Standard 35 of this report. There was evidence that bedrooms had been personalised with items of personal furniture being accommodated. People have a choice were they wish to have breakfast served, either in their bedroom or in the dining room. The main cooked meal of the day is served at lunch time and the evening meal is from a choice of dishes, e.g. sandwiches, salads and soup for people to choose from. Thornton Leigh Care Home DS0000021485.V358124.R02.S.doc Version 5.2 Page 13 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): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents and their families do not benefit from a robust complaints procedure. Residents are not fully protected form abuse. EVIDENCE: A complaints procedure is available in all bedrooms detailing the action needed if a resident or their family wished to make a complaint. No complaints records are maintained. No allegations of abuse have been made since the last inspection. The home has a Local Authority procedure on the reporting of allegations of abuse and this is available to staff. A training programme for staff in respect of abuse awareness has accompanied this. A policy is in place in respect of physical or verbal aggression displayed by residents although this is not an issue at present. Thornton Leigh Care Home DS0000021485.V358124.R02.S.doc Version 5.2 Page 14 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): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from living in a well-maintained and clean environment. EVIDENCE: The service has a rolling maintenance programme. New en suites facilities have been provided in three bedrooms since the last inspection. A tour of the premises noted that the building appeared clean, tidy and free from unpleasant smells. A Maintenance member of staff was on site attending to bathrooms. Staff appeared happy in the home and said they believed the home provided a nice homely environment. Thornton Leigh Care Home DS0000021485.V358124.R02.S.doc Version 5.2 Page 15 One resident stated that they were delighted with their room and it has been very homely. The new en suite had just been put in and they very pleased. Another stated that the ‘Home (was) clean’ The second day of the inspection included an examination of the laundry area. This is well organised and equipped with industiral appliances. A sluice is available in this area, floors are non porous and hadwashing facilities are available close by. Protective clothing is available to staff. Thornton Leigh Care Home DS0000021485.V358124.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents benefit from having sufficient staff on duty to meet their needs. The recruitment process does not protect residents. Qualified staff support residents. Residents are not supported by well-trained staff or indeed staff who have received an induction to support residents. EVIDENCE: A staff rota is available. This suggested that there are more staff in the morning (at most five, at least four) with three consistently on in the afternoon and at night. The staff team includes a number of ancillary staff such as domestic staff and domestic staff. The Manager is included in the rota for the most part of the week with senior members of staff (senior care assistants) included in the rota at other times. Records made available during the inspection and prior to the inspection (through the Annual Quality assurance audit-AQAA) suggested that 13 out of 16 care staff had attained Level 2 NVQ and in two cases, had progressed to NVQ Level 3. This is calculated at having above 50 of staff as indicated by the national minimum standard. Thornton Leigh Care Home DS0000021485.V358124.R02.S.doc Version 5.2 Page 17 One personnel file was requested in relation to one member of staff. This was found to be poorly managed and included no evidence of any documents. Information in the Annual Quality Assurance Audit provided prior to the inspection suggested that there is no induction programme for staff. This is raised as a requirement. Discussions with the Manager noted that some training had been done but there was a need to update this. Discussion with staff indicated that mandatory training was out of date but this was being “sorted”. Training files could not be located. Thornton Leigh Care Home DS0000021485.V358124.R02.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33, 35 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents benefit from having an experienced individual managing the service. Residents do not have their views taken into account. Residents have their financial interests safeguarded. The health and safety of residents is not fully promoted. EVIDENCE: Mrs Valerie Baker manages the home. She has been the Manager for a number of years and was formally a nurse tutor and holds a nursing qualification. Thornton Leigh Care Home DS0000021485.V358124.R02.S.doc Version 5.2 Page 19 A quality assurance system is in place and takes the form of questionnaires that have been issued to relatives. Some have been returned with the deadline set for early March 2008. Four were viewed. The assurance document covers issues such as: presentation of residents, environment, health, activities in the home, staff approach to visitors, comfort of residents, attitude of staff, numbers of staff, respect shown towards residents, availability of senior staff, complaints and privacy given to residents when receiving visitors. There is no evidence that residents have been consulted in respect of these and no questionnaires have been issued to them. In addition to this, there is no evidence of resident’s meetings. This links in with comments made by residents in respect of food, preferred names, assessment and care planning. The service is not responsible for directly administering any residents’ monies. It does have dealing for one person and this involves liaising with the power of attorney for this person. Families deal with any other monies yet the service has a role in storing monies and recording transactions. All monies are securely stored and are stored individually and records indicating any transactions as well as receipts accompany them. Health and safety systems were examined. Some statutory training needs to be updated and this is a requirement in this report. A clinical waste system is in place as well as arrangements for infection control. A notice on the main door asks visitors to take infection control issues into account before they enter the premises. There was evidence that gas systems had been serviced in September 2007 as well as electricity checks in 2005. Water temperatures are checked regularly and thermostatic valves are in situ with a legionella check proposed to undertaken. All radiators are covered and have low surface temperatures. The home is secure. Fire tests are carried out regularly and portable appliances have been tested. Thornton Leigh Care Home DS0000021485.V358124.R02.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 Thornton Leigh Care Home DS0000021485.V358124.R02.S.doc Version 5.2 Page 21 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 OP3 Regulation 14 Timescale for action An assessment identifying the 30/04/08 needs of those prospective residents who are funded by Local Authorities must be obtained before the person uses the service. Care plans must be reviewed on 30/04/08 at least a monthly basis. Residents and their 30/04/08 representatives must be provided with the opportunity to be consulted on the contents of their care plan A record of complaints must be 30/04/08 maintained Personnel files must be 30/04/08 maintained in line with associated standards and regulations Mandatory training for staff must 31/05/08 be kept up to date A structured induction process 31/05/08 for staff must be introduced. Requirement 2. 3. OP7 OP7 15 15 4. 5. OP16 OP29 22 17 19 6. 7. OP30 OP38 OP30 18 18 Thornton Leigh Care Home DS0000021485.V358124.R02.S.doc Version 5.2 Page 22 8. OP33 26 The quality assurance process 30/06/08 must involve the views of residents in respect of care planning, activities, preferred names and meals 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. Refer to Standard OP14 Good Practice Recommendations An external advocacy agency should be introduced into the service to gain the views of residents independently Thornton Leigh Care Home DS0000021485.V358124.R02.S.doc Version 5.2 Page 23 Commission for Social Care Inspection North West Regional Contact Team Unit 1, 3rd Floor 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 Leigh Care Home DS0000021485.V358124.R02.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. 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