Inspection on 16/02/06 for Thornton Lodge

This inspection was carried out on 16th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 Lodge 12/06/07

Thornton Lodge 06/09/05

Thornton Lodge 08/03/05

Thornton Lodge 03/06/04

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

CARE HOMES FOR OLDER PEOPLE Thornton Lodge 43/45 Thornton Road Morecambe Lancashire LA4 5PD Lead Inspector Mr Patrick Rooney Unannounced Inspection 16th February 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 Lodge DS0000009658.V275081.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 Lodge DS0000009658.V275081.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Thornton Lodge Address 43/45 Thornton Road Morecambe Lancashire LA4 5PD 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) 01524 410430 01524 415438 rod@thorntonlodge.co.uk Mr Rodney Harold Taylor Mrs Karen Mary Taylor Care Home 28 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (28), Old age, not falling within any of places other category (10) Thornton Lodge DS0000009658.V275081.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 28 service users to include; up to 10 service users in the category of OP (Old Age not falling within any other category) up to 27 service users in the category of MD (Mental Disorder excluding learning disability or dementia) aged 60 years and above 1 named service user in the category of MD (Mental Disorder excluding learning disability or dementia) under the age of 60 6th September 2005 Date of last inspection Brief Description of the Service: Thornton Lodge is registered to accommodate 28 Service users, providing personal care for persons of either sex. The home is located near the sea front in Morecambe, and a short distance from the town centre. There is a patio and garden area with flowerbeds at the rear, with seating and tables accessible for service users. There are four floors, with a passenger lift providing access to all floors, and a chair lift serving part of the first floor. The home has twenty single rooms and four double rooms, which are furnished in a homely style. One of the single rooms is ensuite. There are accessible toilets and bathrooms located on all floors near to bedrooms and living rooms. Service users have access to three lounges, which are situated on the ground floor; one of these is a smoker’s lounge. There is a large dining area on the ground floor. Thornton Lodge DS0000009658.V275081.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 and covered the key Standards not covered in the last inspection. It was carried out over a five-hour period from 10 am. The inspector consulted care records and spoke to most of the residents living at the home. He discussed their care with them and visiting relatives. Their comments are, “ Its ever so good here”. “It’s the best thing I ever did coming here”. “The homes staff help me in every way, I am very happy with what they do for me”. Staff were also spoken to regarding their role within the home and confirmed they receive a full induction in caring for the elderly and the opportunity for on going training. The inspector toured the building, spoke to individual staff, had discussion with management and consulted records and policies and procedures. Questionnaires were issued to residents and relatives. What the service does well: Thornton Lodge continues to provide a high standard of individualised care for its residents. There is a good stable staff team who are well trained and able to provide a good continuity of care. All residents are individually supported in following their interests through the staff key worker system. There is a good programme of activities and outings available for all residents. The medication system is excellent and enables staff to access immediately a full history of all residents’ medication from the homes computer. This has proved to be invaluable when doctors are reviewing medication. Residents are provided with a very good standard and variety of food, resident’s comments on food are, “You get everything you want here”. “I am a fussy eater and they will make things especially for me. “ They got me fish in parsley sauce when I asked”. Thornton Lodge DS0000009658.V275081.R01.S.doc Version 5.1 Page 6 In a survey carried out by the home relatives said, “ staff are very skilled in client care” “all the family are very pleased with care that mum receives.” “we are very pleased with all aspects of the home”. 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 Lodge DS0000009658.V275081.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 Lodge DS0000009658.V275081.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): All key Standards in this section were met at t he last inspection. EVIDENCE: Thornton Lodge DS0000009658.V275081.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): 9 and 10 There are excellent policies and procedures in place for the safe handling and administration of drugs. Residents are treated with dignity and respect and privacy in the care they receive. EVIDENCE: All policies and procedures for receipt and dispensing of drugs are contained on the home computer. A record of all resident drugs is contained on a computer database this record also includes a full history of all drugs prescribed for each individual resident. This enables a full print out to be provided at any time for all drugs for each resident. This system has proved to be very effective and valuable to general practitioners and psychiatrists when assessing residents drug needs. When a resident is admitted to hospital the home is able to send a full print out of medication with them. Senior staff, who are trained, input into the system. Only trained staff are allowed to dispense medication. Records of medication seen at the time of the inspection were in order and well maintained. A colour Thornton Lodge DS0000009658.V275081.R01.S.doc Version 5.1 Page 10 coding system for morning, lunchtime and night medications also ensures correct medication is administered at the times required. Staff induction and training is excellent and gives them a good insight into the needs of residents living in the home. Discussion with staff confirmed this to be the case and it is noted that there is a good team approach to care. Residents said that the care they receive is very individual and that it is delivered in a caring manner. They feel that they are treated as individuals. A good interaction between residents and staff was observed. All personal care is carried out respecting the privacy of the individual. Thornton Lodge DS0000009658.V275081.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, 14 and 15 The homes routines are flexible and take into consideration the needs and wishes of individual residents. Care is taken in the assessment process to ensure residents can exercise as much control over their lives as possible. Residents are provided with a good variety of food with choices always available. EVIDENCE: From examination of files, discussion with residents and staff it was clear that the homes routines are flexible and led by the wishes of residents. Staff actively enable residents to take part in both inside and outside activities. The skills of residents are used in helping other residents; one resident is very good at art and card making and helps other residents in doing this during regular craft sessions. Other activities recorded are, board games, indoor skittles, Tai Chi, remedial massage, sing along, and provision of library books. There are regular outings and decisions on where to go are discussed in residents meetings. There is a key worker system in operation in which staff support individual interests identified in the initial assessment. Residents said that they are supported in pursuing their interests and that there is always something to occupy their time. Thornton Lodge DS0000009658.V275081.R01.S.doc Version 5.1 Page 12 All residents receive a very detailed assessment, which identifies their strengths and weaknesses, risks are assessed and a plan of action agreed with each resident. All assessments are carried out with the resident and/or their representatives and agreements reached. Residents are able to sign their care plans. An independent advisor is available to advise residents on their care. There is a policy on advocacy, which tells residents of their rights. Residents spoken to spoke very highly of the help they receive and felt that the home supports them in what they want to do. Comments received from residents are: “ Its ever so good here”. “It’s the best thing I ever did coming here”. “The homes staff help me in every way, I am very happy with what they do for me” There is a six weekly menus system, each weeks menus are published in advance and contain items asked for by residents. Menus seen showed a good variety of food on offer with choices always available. If a resident does not like what is on the daily menu they are able to ask for something else. Residents said that they are happy with the standard and variety of food they receive. Resident’s comments are: “ You get everything you want here”. “I am a fussy eater and they will make things especially for me. “ They got me fish in parsley sauce when I asked”. Thornton Lodge DS0000009658.V275081.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): All key Standards in this section were met at t he last inspection. EVIDENCE: Thornton Lodge DS0000009658.V275081.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 26 There are good systems in place to ensure the home is kept clean and hygienic. EVIDENCE: All staff receive training in infection control and are required to follow the homes policies and procedures regarding this all policies have recently been updated and alcohol gel dispensers have been placed in strategic areas to ensure good hand hygiene by staff. The home was observed to be clean and fresh during the inspection. Thornton Lodge DS0000009658.V275081.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): 30 Very high importance is placed on ensuring at staff receive training to carry out their duties. EVIDENCE: There is a comprehensive induction process for all staff, which ensures they receive good basic training. 82 of care staff are qualified to NVQ level 2. The home employs a training officer who ensures training needs are assessed and provided. A training matrix has been produced which shows training staff have received. Training has also been provided in Challenging behaviour, principles of care, dementia awareness, abuse and risk assessment. Thornton Lodge DS0000009658.V275081.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): 33 and 38 There are good systems in place to ensure resident’s views are obtained and quality of care maintained. Health and safety of residents and staff is promoted. EVIDENCE: Thornton Lodge is accredited with ISO 9001 and Investors in people both of which require and annual assessment. A survey of residents and relatives is carried out and examples of this were seen during the inspection. Relative’s comments in the survey are “ staff are very skilled in client care” “all the family are very pleased with care that mum receives.” “we are very pleased with all aspects of the home”. All staff receive training in health and safety, including moving and handling, infection control, first aid and cosh. All safety checks are carried out on lifts and electrical systems and items. Thornton Lodge DS0000009658.V275081.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 X 8 X 9 4 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 X 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X 3 STAFFING Standard No Score 27 X 28 X 29 X 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X X X X 3 Thornton Lodge DS0000009658.V275081.R01.S.doc Version 5.1 Page 18 Are there any outstanding requirements from the last inspection? 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 Lodge DS0000009658.V275081.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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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