Inspection on 21/11/07 for Thorntree Way

This inspection was carried out on 21st November 2007.

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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Thorntree Way 08/01/07

Thorntree Way 13/12/05

Thorntree Way 27/09/05

Thorntree Way 14/01/05

Thorntree Way 17/06/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 Thorntree Way 15 Thorntree Way Chase Farm Blyth Northumberland NE24 4LS Lead Inspector Allan Helmrich Unannounced Inspection 21st November 2007 11:00 Thorntree Way DS0000000608.V352457.R01.S.doc Version 5.2 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 Thorntree Way DS0000000608.V352457.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 Adults 18-65. 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. Thorntree Way DS0000000608.V352457.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Thorntree Way Address 15 Thorntree Way Chase Farm Blyth Northumberland NE24 4LS 01670 545568 01670 545569 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) www.flexiblesupportoptions.co.uk Flexible Support Options (UK North East) Limited Michelle Ann Taylor Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Thorntree Way DS0000000608.V352457.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category 2. Learning Disability - Code LD, maximum number of places 9 The maximum number of service users who can be accommodated is 9 Date of last inspection 8th January 2007 Brief Description of the Service: 13 and 15 Thorntree Way is registered to provide personal care and support to nine adults with learning disabilities, some residents also have a physical disability. Of the current residents, seven are under the age of sixty- five years and two are over 65 years. Nursing care is not provided. The properties are two purpose-built bungalows. They are situated on a modern residential housing estate on the outskirts of Blyth. They are close to many amenities such as shops, pubs and restaurants. The bungalows are spacious. Each person has their own bedroom and there are sufficient bathing and lavatory facilities for the use of residents. Residents also have access to two large gardens. Fees payable for living at the home are £856 to £1112. Residents who are interested in coming to live at the home are provided with a Statement of Purpose and service user guide which describes the services and facilities provided by the home and how staff are trained to meet residents care and support needs. CSCI inspection reports are also available at the home detailing the quality of care provided by the home. Thorntree Way DS0000000608.V352457.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. How the inspection was carried out Before the visit: We looked at: • Information we have received since the last visit on 8th January 2007. • How the service dealt with any complaints & concerns since the last visit. • Any changes to how the home is run. • The provider’s view of how well they care for people. • The views of people who use the service & their relatives, staff & other professionals, where this information was available. The Visit: An unannounced visit was made on 21st November 2007 and this lasted 5½ hours. During the visit we: Talked with people who use the service, staff and management. No visitors were seen. • Looked at information about the people who use the service & how well their needs are met, • Looked at other records which must be kept, including medication, • Checked that staff had the knowledge, skills & training to meet the needs of the people they care for, • Looked around the building to make sure it was clean, safe & comfortable, Checked what improvements had been made since the last visit. • What the service does well: Staff provide a good level of support to residents and included them in general conversation throughout the day. Residents have the opportunity to lead very busy lives and be part of the local community. They also enjoy a wide range of social and leisure activities. Residents are supported to holiday both in this country and abroad. There is a commitment to training so staff can provide the necessary levels of support to residents’ as individually as possible. Access to healthcare services is well promoted to ensure the well being of residents. The premises are very well maintained and comfortable. Thorntree Way DS0000000608.V352457.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Thorntree Way DS0000000608.V352457.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Thorntree Way DS0000000608.V352457.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2. People who use the service experience excellent quality outcomes in this area. The home has up to date information to provide to prospective residents about the home and its facilities to help them to make a choice about where to live. The home collects enough information about the needs of residents before they move in to help ensure staff are aware of the amount of care and support needs of the resident as they settle in. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The Home’s Statement of Purpose and service user guide contain the necessary information as required by the Care Homes Regulations 2001. They provide information detailing what it would be like for a resident to live in the home. Since the last inspection information for prospective residents has been improved and is now available in audio and picture formats. The home has been full since May 2005 therefore no new assessments were reviewed. Records for two of the residents showed that when they were admitted to the home an assessment of their care needs had been carried out Thorntree Way DS0000000608.V352457.R01.S.doc Version 5.2 Page 9 before their admission. The resident and relevant people who knew the person were involved in the initial assessment. This information and the care manager’s assessment of the resident’s care needs were used to ensure all the needs of the resident could be met by staff. The records contained a range of good information. Written contracts were available on residents files and these have been recently upgraded to a picture format for the benefit of residents who cannot appreciate the written word. Thorntree Way DS0000000608.V352457.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9. People who use the service experience good quality outcomes in this area. There are good arrangements in place to ensure that residents’ health and social care needs are met. Residents are encouraged to be involved in decision- making and to communicate and make their views known. Staff support residents to take risks as part of independent living. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a range of information to instruct staff in providing appropriate levels of care to each resident. There are detailed assessments including information provided by outside professionals. Personal support needs are documented and give instructions to staff on how to support people in tasks such as washing, bathing, dressing, communicating and carrying out any assessed tasks to help promote the independence of the resident. Much of the information is in picture format to involve residents as Thorntree Way DS0000000608.V352457.R01.S.doc Version 5.2 Page 11 much as possible in determining the level of support needed. A system is in place to review the changing care needs of residents on a three monthly basis and each resident also meets with their key worker at least monthly to ensure their health and wellbeing is maintained. Residents are given the opportunity each month to meet in a group with staff to ensure they are fully involved in the running of the home. The home promotes the independence of the resident and provides whatever levels of supports are required and to take risks in order to live a more fulfilled lifestyle. Up to date risk assessments were in place in residents care records. Although residents in the home have limited communication abilities, everyone seen appeared happy and content. Thorntree Way DS0000000608.V352457.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17. People who use the service experience good quality outcomes in this area. Residents are involved in a range of fulfilling activities. They are very much part of the local community and maintain regular contact with friends and family. Staff did not demonstrate that healthy eating is encouraged. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A range of options is available to each resident ensuring they have an active social life and fulfilling activities. The care plans showed that residents attend college, are involved in arts and crafts and generally use a range of community facilities. A womans’ group has been set up to support residents in having a say in how care is provided and staff are looking at other activities to develop. Leisure activities include visits to the theatre, cinema, local pubs and cafes’. Thorntree Way DS0000000608.V352457.R01.S.doc Version 5.2 Page 13 Each resident is involved in planning their annual holiday. This can be in England or abroad. Staff stated they help residents keep in touch with relatives and friends. Holiday postcards and greeting cards are sent to family and friends. Residents are asked individually each day what they wish to eat. As some residents are out during the week at college placements and day services the main meals are served at different times to suit those residents. Residents are involved in regular food shopping trips and during the inspection a range of fruit and vegetables were seen. The actual recording of meals eaten is not in sufficient details to demonstrate that each resident is provided with a healthy diet involving fruit and vegetables. Thorntree Way DS0000000608.V352457.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20. People who use the service experience good quality outcomes in this area. The personal and healthcare support residents obtain promotes their dignity and independence. The medication system in place meets the needs of the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The individual care plans reviewed demonstrated that each resident’s personal and healthcare needs are met. Each resident meets with their key worker on a monthly basis. The support provided by staff is reviewed and changed when appropriate to meet the individual needs of the resident. Each resident’s health is monitored and when necessary, appropriate professionals are involved to support the staff team. Residents care records showed that they have access to external health care services. GPs and Community Nurses were regularly consulted for advice and treatment. The Thorntree Way DS0000000608.V352457.R01.S.doc Version 5.2 Page 15 records show residents are assisted to access chiropody, dental and optical services as often as required. Each resident seen was dressed in clothes appropriate to their age and individual style. Everyone spoken to was content and in good health. The home is equipped with a range of equipment to support residents in maintaining their personal care. New hoists and a specialised bath have been installed since the last inspection. Staff are trained and a system is in place to ensure that medicines and stored, administered and recorded appropriately in the home. Further staff training in the handling of medicines is planned. Thorntree Way DS0000000608.V352457.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. People who use the service experience good quality outcomes in this area. Residents are supported by a good complaints process and are kept safe by a well trained staff team. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each resident has a copy of the home’s complaint process and every month a meeting takes place with a key worker when any issues of dissatisfaction are identified. Two complaints have been identified and addressed by management. Staff receive training related to the protection of vulnerable people and further refresher training is planned to ensure residents wellbeing is promoted. Staff also receive support from the local authority in how to deal with challenging behaviour. Staff were observed during the day dealing sensitively with any issues that arose. Staff spoken with were aware of their responsibilities relating to the protection of vulnerable people. Thorntree Way DS0000000608.V352457.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 27, 30. People who use the service experience good quality outcomes in this area. The home is well maintained, comfortable and homely. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is purpose built to provide bungalow style living for up to nine people. There is a good standard of maintenance and hygiene in place. Residents’ bedrooms are bright, comfortable and well furnished. They are well equipped with personal possessions of the resident. They contain musical equipment and televisions if residents are interested in them. They also contain sensory equipment to supply visual stimulation, depending upon the needs of the resident. Bedroom doors did not have a thumbturn locking system to promote the privacy of the resident. Thorntree Way DS0000000608.V352457.R01.S.doc Version 5.2 Page 18 The lounges are an adequate size for communal use, as is the kitchen that was a meeting place for both residents and staff in one bungalow. The bathrooms are fitted with appropriate bathing facilities to meet the needs of some residents with physical disabilities. The locking mechanism to one toilet door was stiff and should be made easier to use to promote privacy and dignity. The laundry contained suitable equipment to promote good hygiene standards. Thorntree Way DS0000000608.V352457.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35. People who use the service experience adequate quality outcomes in this area. A training plan is in place to ensure residents are supported by well qualified staff. Not all of the information to assess if recruitment is conducted appropriately is available to the inspector or home manager. This is required to ensure residents are safe. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staffing of the home meets the needs of the residents. Staff stated they are flexible with shifts to ensure that residents can attend evening and weekend functions. During the inspection the staff team was found to be caring and dealt with all issues appropriately. Staff members carry out cooking and cleaning with the help of residents where possible. Thorntree Way DS0000000608.V352457.R01.S.doc Version 5.2 Page 20 Of 23 care staff employed in the home, 13 have a NVQ in care that demonstrates their ability to provide appropriate care for the residents. All of the other care staff currently working in the home are working towards this qualification. Two staff files reviewed did not contain sufficient information to confirm appropriate recruitment checks are made to ensure residents are safe. The manager stated that only limited information is available in the home as master files are retained at head office. Staff receive LDAF Learning Disability Award Framework as part of their induction. Staff said and their records showed that they also receive advice and /or training in other areas. The manager maintains a training matrix to monitor training needed to support residents but this needed updating. Staff receive supervision every two months from the management team. Thorntree Way DS0000000608.V352457.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42. People who use the service experience excellent quality outcomes in this area. A manager who is aware of how to promote good care practices supports residents and staff. A quality monitoring system is in place to identify areas for improvement. Residents live in a safe environment. This judgement has been made using available evidence including a visit to this service. Thorntree Way DS0000000608.V352457.R01.S.doc Version 5.2 Page 22 EVIDENCE: The manager has achieved the Registered Managers Award. This demonstrates her ability to manage a home for vulnerable people. She has worked in the home since it opened 10 years ago and has been in a senior position for 6 years. In conversation with the manager she demonstrated an awareness of areas for improvement and was forward thinking. Staff spoken to confirmed she provides good direction to them. There are systems in place in the home to ensure it is maintained to a high standard and that staff follow a pattern of consistency in the care provided. Not all systems are supported by an audit tool. The home is safe. Maintenance records are in place and the systems that ensure residents are safe such as fire checks and staff training are maintained. Thorntree Way DS0000000608.V352457.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 4 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 3 ENVIRONMENT Standard No Score 24 4 25 X 26 3 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 4 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 X 4 X X 3 X Thorntree Way DS0000000608.V352457.R01.S.doc Version 5.2 Page 24 No 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. 1. Standard YA34 Regulation Requirement Timescale for action 31/01/08 19(1)(b)(i) The manager must ensure that records as specified in Schedule 2 of The Care Home Regulations are available in the home. Or agreement has been obtained to those records being held elsewhere. Thorntree Way DS0000000608.V352457.R01.S.doc Version 5.2 Page 25 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. 3. 4. Refer to Standard YA17 YA26 YA27 YA35 Good Practice Recommendations Instruct staff to record the meals eaten by residents to enable management to review if a healthy diet is being maintained. Consider providing thumb turn locks on bedroom doors to promote the privacy of residents when in their bedrooms. Instruct staff to test door locks for ease of use and report any problems that may affect residents privacy and dignity to maintenance staff. Update the matrix used to monitor staff training. Thorntree Way DS0000000608.V352457.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection 4th Floor St Nicholas Building St Nicholas Street Newcastle upon yne NE1 1NB 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. 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