Inspection on 23/01/08 for Thorpe House Nursing Home

This inspection was carried out on 23rd January 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Thorpe House Nursing Home 15/05/07

Thorpe House Nursing Home 16/01/06

Thorpe House Nursing Home 13/09/05

Similar services:

Whiteley House

Tyndale Avenue

2-10 Norfolk Road

Bennfield House Nursing Home

Eastfield Residential Home

Sign Health

Springwood

Fairburn Mews

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

CARE HOME MIXED CATEGORY MAJORITY ADULTS 18-65 Thorpe House Nursing Home 22 Finthorpe Lane Almondbury Huddersfield West Yorkshire HD5 8TU Lead Inspector Karen Summers Key Unannounced Inspection 23rd & 28 January 2008 08:45 Thorpe House Nursing Home DS0000065036.V358389.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 Thorpe House Nursing Home DS0000065036.V358389.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 Older People and 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. Thorpe House Nursing Home DS0000065036.V358389.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Thorpe House Nursing Home Address 22 Finthorpe Lane Almondbury Huddersfield West Yorkshire HD5 8TU 01484 300385 01484 300368 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) Thorpe House Nursing Home Limited Mr James A Lockwood Care Home 21 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (21), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (21) Thorpe House Nursing Home DS0000065036.V358389.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Can provide accommodation and care for three named service users under the category of DE (dementia). 15th May 2007 Date of last inspection Brief Description of the Service: Thorpe House is a privately owned and managed care home registered to provide accommodation and nursing care for up to 21 adults with severe and enduring mental health needs. The establishment, a stone built period residence, is situated on the outskirts of the village of Almondbury. The property is set in extensive and well-maintained gardens and grounds. Private accommodation consists of five double and eleven single bedrooms. Communal areas are spacious, comfortable and furnished and fitted to a good standard. Fees at the home range from £502.17 - £1748.56 per week. Items not included in the fee include, hairdressing, chiropody, newspapers or magazines. Information about the home in the form of a Statement of Purpose, Service User’s Guide and the latest CSCI inspection report are available from the home. Thorpe House Nursing Home DS0000065036.V358389.R01.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 2 star. This means the people who use this service experience good quality outcomes. This report refers to an inspection, part of which included unannounced visits to the home on the 23rd and 28th January 2008. On the first day of the visit two inspectors visited the home, and on the second day one inspector. We spent a total of 12 hours visiting the home. There were 21 people living at Thorpe House at the time. As part of the inspection in order to provide information to help us form judgments about how the service is run, the manager was asked to complete an annual quality assessment document. This he did, and the document provided the Commission for Social Care Inspection (CSCI) with a lot of information about the way the home is run, and what they hope to achieve in the future. During the visit we spoke with members of staff and people who receive care to obtain their views. We also looked at a sample of care records, staff recruitment, and training records, quality assurance audits and looked around the home. To enable people who use the service to comment on the care it provides, we sent ten surveys to people living at the home, and eight of these were returned. Ten were sent to their next of kin and five of these were returned. Surveys were also sent to people’s doctors and health care workers (social workers, community nurses). None of these were returned at the time of writing the report. The feedback from those who returned surveys to the Commission was generally positive. We would like to thank all the people who gave feedback about this home, and would like to thank the manager and staff for their co-operation throughout the inspection process. What the service does well: People receive information about Thorpe House and as much as possible is done to make sure that individual needs can be met before someone goes to live there. The environment is clean and hygienic. People living at the home receive good standards of personal care. Staff are properly recruited, trained and supervised. Thorpe House Nursing Home DS0000065036.V358389.R01.S.doc Version 5.2 Page 6 Health and safety is promoted and maintained at the home. Thorpe House received a five star “Scores on the Doors” award in association with Kirklees Council’s food safety inspection of the catering facilities. Relatives’ surveys asked, “What do you feel the care home does well?” Responses include: • • Keeps the people motivated and their minds stimulated as well. “Gives care for physical as well as mental state. Includes family in all aspects of life as well as another relative would. We are more than pleased with staff at Thorpe House.” “Helping them with any activities that the home provides, and not making them join in if they don’t want to.” • Comments received from people who live at the home include: • • “I like being at Thorpe House.” “The staff have always helped me to cope with my problems and illness. There have been many times when I have been so glad I am a resident here.” What has improved since the last inspection? What they could do better: To ensure that the lifestyle experienced in the home matches the expectations and preferences of people, and satisfies their recreational interests and needs, staff should ensure that this information is recorded in their care plans. People must receive personal support in the way they prefer and that respects their privacy and dignity. Facilities must be provided for people to prepare their own snacks and drinks. People should be able to choose what they would like for a meal near to the time when the meal is to be served; currently this is a week in advance. This will enable people to have more of a chance to remember what they chose and what they would prefer on the day. People should be free to take food and drink in the privacy of their own room. Thorpe House Nursing Home DS0000065036.V358389.R01.S.doc Version 5.2 Page 7 Attention must be given to changing the routines of the home in a way that fully supports people’s privacy, dignity, choice and respect. This is in order to run the home fully in the interests of the people who live there. 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. Thorpe House Nursing Home DS0000065036.V358389.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Individual Needs and Choices Lifestyle Personal and Healthcare Support Concerns, Complaints and Protection Environment Staffing Conduct of Management of the Home Scoring of Outcomes Statutory Requirements Identified During the Inspection Adults 18 – 65 (Standards 1–5) (Standards 6-10) (Standards 11–17) (Standards 18-21) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37-43) Older People (Standards 1–5) (Standards 7, 14, 33 & 37) (Standards 10, 12, 13 & 15) (Standards 8-11) (Standards 16-18 & 35) (Standards 19-26) (Standards 27-30 & 36) (Standards 31-34, 37 & 38) Thorpe House Nursing Home DS0000065036.V358389.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 (Adults 18 – 65) and Standards 1 – 5 (Older People) are: 1. 2. 3. Prospective service users have the information they need to make an informed choice about where to live. (OP NMS 1) Prospective users’ individual aspirations and needs are assessed. No service user moves into the home without having been assured that these will be met. (OP NMS 3) Prospective service users’ know that the home that they choose will meet their needs and aspirations. Service Users and their representatives know that the home they enter will meet their needs. (OP NMS 4) Prospective service users’ have an opportunity to visit and “test drive” the home. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. (OP NMS 5) Each service user has an individual written contract or statement of terms and conditions with the home. Each service user has a written contract/statement of terms and conditions with the home. (OP NMS 2) 4. 5. The Commission considers Standard 2 (Adults 18-65) and Standards 3 and 6 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People are properly assessed prior to moving into the home to ensure that their needs can be met. EVIDENCE: Information provided by the manager prior to this visit taking place, states that people are visited in their present environment to chat with them and carry out a pre-admission assessments of their needs. The purpose of the assessment is to make sure that the home will be able to meet the person’s needs prior to them moving into Thorpe House. In order to help the home reach their decision they also obtain information by way of a Community Care Assessment, which is completed by the social worker and funding authority. The information provided by the manager also explained how new people are invited to visit the home prior to moving in. They are also given a Service User Thorpe House Nursing Home DS0000065036.V358389.R01.S.doc Version 5.2 Page 10 guide telling them about the services offered at the home, and a leaflet explaining about advocacy in case they should need this service. With the exception of one person, people living at the home who completed the CSCI’s surveys confirmed that they received enough information about the home to help them decide if Thorpe House was right for them. One person said, ‘Yes they had received enough information before deciding to move in, and that they were kept up to date with any changes at the home’. Another person said that they would have preferred being able to live in a home closer to their friends and family, but understood that there was not a home that could provide for their needs in their area of choice. Thorpe House Nursing Home DS0000065036.V358389.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6-10 (Adults 18-65) and Standards 7, 14, 33 & 37 (Older People) are: 6. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. The Service Users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users make decisions about their lives with assistance as needed. Service Users are helped to exercise choice and control over their lives. (OP NMS 14) Service users are consulted on, and participate in, all aspects of life at the home. The home is run in the best interests of service users. (OP NMS 33) Service users are supported to take risks as part of an independent lifestyle. The service users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users know that the information about them is handled appropriately and that their confidences are kept. Service Users rights and best interests are safeguarded by the home’s record keeping, policies and procedures. (OP NMS 37) 7. 8. 9. 10. The Commission considers Standards 6, 7 and 9 (Adults 18-65) and Standards 7, 14 and 33 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People’s healthcare needs are met. However there is little evidence that people exercise choice and control over their lives. Routines in the home are often task based and do not provide enough opportunity for people to meet their full potential as individuals. EVIDENCE: Surveys sent to relatives asked if the care home gives the support or care to their relative that they expect. Two responded, ‘always’, two relatives responded, ‘usually’ and one relative wrote, that she was happy that her Thorpe House Nursing Home DS0000065036.V358389.R01.S.doc Version 5.2 Page 12 relative lives at Thorpe House. She said that her relative seems so much happier and did not have much of a life until she came to the home. She also said that staff are approachable, helpful, and they always make you feel welcome. People living at the home were asked as part of their survey if they receive the care and support they need, five people responded, ‘always’ and two people replied, ‘usually’ and one said, ‘sometimes’. During the visit care plans for three people who live at the home were seen. One of the care plans had been newly developed by the manager in the style of the model adopted by the home. This care plan was very lengthy and included sentences and words which would not be familiar to the person whose care plan it was. An example of this is that each area of need for which a care plan had been developed included a nursing diagnosis which began with “Risk of ineffective therapeutic regimen management related to symptoms of…..” followed by a description of the persons condition or illness. Use of such language could be confusing for the person concerned and could mean that they do not understand their own care plan. The care plan went on to describe how staff should encourage the person to do certain things such as completing personal diary, going for daily walk or tidying own bedroom. The care plan then went on to say that if the individual refused to do these things staff should encourage the person to “reflect on possible consequences”. Whilst it was explained to us that this was intended as a way in which staff encourage people to take some control over their own lives, there is a risk that this sentence could be perceived as almost a threat. This particular care plan was very lengthy, at least 20 pages, and whilst it was very detailed, the risk would be that such care plans become a paper exercise rather than the working document they are intended to be. Other care plans seen were not so lengthy and complicated and contained good detail of the persons needs and how staff should offer support to meet these needs. Again, however, there was a tendency to use medical terminology rather than plain English, an example of this being “ Experiences difficulty masticating” for someone who has problems chewing their food. Although people’s needs in relation to their health and wellbeing are clearly documented there is little information about people’s likes and preferences within their lives and what support people are given to make their own choices about how they spend their time. Care plans do not always promote people’s privacy and dignity needs. One of the plans seen, which was removed by the registered person on the day, advised staff to watch an individual whilst they were using the toilet. There was no reasonable explanation for this intrusive level of observation, which shows a lack of respect for the individual concerned. Thorpe House Nursing Home DS0000065036.V358389.R01.S.doc Version 5.2 Page 13 To promote people’s safety, care plans were in place for how staff should deal with identified risks to individuals such as leaving the home unattended. There was also evidence that meetings take place between people who live at the home and staff, the first or second Tuesday in each month. Minutes of the meetings were seen and the information discussed included, the times when drinks are served and suggestions by people, the activities programmes, and budgeting arrangements as not all people choose to be involved in this. The records were clearly written, and showed that people are informed and are also able to participate in some decisions about the daily routines within home. Thorpe House Nursing Home DS0000065036.V358389.R01.S.doc Version 5.2 Page 14 Lifestyle The intended outcomes for Standards 11 - 17 (Adults 18-65) and Standards 10, 12, 13 & 15 (Older People) are: 11. Service users have opportunities for personal development. 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. (OP NMS 12) Service users are able to take part in age, peer and culturally appropriate activities. 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. (OP NMS 12) Service users are part of the local community. Service users maintain contact with family/ friends/ representatives and the local community as they wish. (OP NMS 13) Service users engage in appropriate leisure activities. 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. (OP NMS 12) Service users have appropriate personal, family and sexual relationships and maintain contact with family/friends/representatives and the local community as they wish. (OP NMS 13) Service users’ rights are respected and responsibilities recognised in their daily lives. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users are offered a (wholesome appealing balanced) healthy diet and enjoy their meals and mealtimes. Service users receive a wholesome appeaing balanced diet in pleasing surroundings at times convenient to them. (OP NMS 15) 12. 13. 14. 15. 16. 17. The Commission considers Standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 10, 12, 13 and 15 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15 - 17 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Thorpe House Nursing Home DS0000065036.V358389.R01.S.doc Version 5.2 Page 15 Whilst people living in the home are able to maintain contact with their family and friends they are able to have limited choice over their lives. Some social activities are provided. Food preferences of people have been taken into consideration when planning the main meals and they enjoy a varied and healthy diet. However choice is limited by the home’s routines. EVIDENCE: The home provides for a lifestyle that does not always meet individual needs in terms of personal development or age appropriateness. A relative commented that staff help people, and encourage them to participate in activities but do not make them join in if they don’t want to. Seven people living at Thorpe House said that there were always activities that they could take part in one said usually and that they were not made to take part if they did not want to. One person said that they have taken part in going to the Technical College, horse riding, and each year a holiday abroad or a cruise. One person said that they go walking every day, but that they like to go out walking. Another person said that they go out shopping or to a cafe if there are sufficient staff on duty, and that they like to join in with the activity of ‘movement to music’. The same person said that they go out to church each week and that staff arrange for a taxi to take them there. One person returned from going out for lunch, and spoke of their next trip out and where they would be catching local transport. Discussion took place with the manager and the registered person about the daily walk that the majority of people who live at the home undertake. Two of the people spoken with said that they didn’t really enjoy the walk but one person said they didn’t know what would happen if they said they didn’t want to go. One person said that they go whatever the weather but take flasks of warm drinks with them. The people going on the walk were of varying age and physical abilities but all undertook the same route. When asked about choices that people are given in relation to physical exercise for example gym membership, keep fit or swimming clubs the manager said that one person had had a gym membership in the past. The manager should consider the fact that so many people going out in such a large group on a daily basis has become a regular sight for people in the local area and identifies people as living in a care home. When visitors come to the home people have a choice if they would like to see their visitors in private, and this was confirmed by one of the people who live Thorpe House Nursing Home DS0000065036.V358389.R01.S.doc Version 5.2 Page 16 there, who said that they take their visitors to their room. Another person said that they sometimes feel tired in the afternoon, and when asked if they would be allowed to go and have a lie down, at first said “No” but then said that they were not sure. Relatives were asked, “Does the care home help your friend or relative to keep in touch with you?” Three people said always, and one person said, “Usually” “As far as I am aware she can phone her family at anytime and vice versa.” Another relative said, “The staff are all approachable and helpful, and they always make you feel welcome.” Individuals have very little choice of what they eat, are not involved in shopping for food, the preparation or serving. Residents are not given the choice of where they eat. The menu was displayed for people to see, and the manager confirmed that the food preferences and specialised diets people have had been taken into consideration when planning the week’s meals. He also said that cultural needs would be accommodated but there was no one with those needs at the moment. Three people said in the surveys that they always liked the meals at the home; three said usually, one person said sometimes and one person said never. The person who said never, also said that they felt that they had to eat the food put in front of them and that they did not get much choice. They said that there were too many vegetables and not enough meat. The same person when spoken with said that they preferred fatty food, but that they had been trying to cut this type of food out and have it grilled as they felt that she needed to lose weight. One person also said that they did not feel that they could have breakfast in bed unless they were ill. A relative commented that they had noticed that people always eat and drink at the dining room table, and no food or drink is allowed in the bedrooms. They said that they thought people are encouraged not to eat between meals, and they also thought that this was not a bad thing, but very strict. When asked what would happen if anybody wanted to take a drink to bed with them, the registered person said that this would not be allowed as the people may spill the drink or scald themselves. This again takes away the element of personal choice and home comfort, people’s bedrooms being their own personal space. Other people who were spoken with said that the food was nice. One person said, “On the whole the meals are very good.” People said that they choose on a weekly basis the meals that they would like to have the following week and the manager confirmed this. Due to the fact that people may not remember the food that they chose a week earlier and that their choice may have changed, a recommendation is made that people should not have to choose what they would like for a meals so far in advance. Thorpe House Nursing Home DS0000065036.V358389.R01.S.doc Version 5.2 Page 17 The minutes of the ‘residents’ meeting were seen and reference was made to the evening beverages. On the request of people living at the home an extra drink had been introduced late evening. One person said that they had requested a drink of tea at a different time to when drinks had been given out, and that they were allowed to have one. The manager said that people had been made aware that they could have a drink when they wished and that they should ask for one. Beverages were discussed with the manager about the need for people to be allowed to make a drink when they wished. Taking into account that there are some people who live at the home that free access to beverages could have an detrimental impact on their health, the manager said that when people would like a drink at times other than the scheduled ones, staff will provide flasks for people to help themselves, and provide supervision for those people whose risk assessments identify a risk. The supper menu indicated that one sort of sandwich would be served each evening with a different sandwich for each day. When asked about this the manager said that the choice of sandwich filling was on the advice of the dietician but if people didn’t like that sandwich they could ask for another sort. This does not give people a choice of whether to follow the nutritional advice or whether to have a supper to their personal taste. Thorpe House Nursing Home DS0000065036.V358389.R01.S.doc Version 5.2 Page 18 Personal and Healthcare Support The intended outcomes for Standards 18 – 21 (Adults 18-65) and Standards 8 – 11 (Older People) are: 18. 19. 20. Service users receive personal support in the way they prefer and require. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users’ physical and emotional health needs are met. Service users’ health care needs are fully met. (OP NMS 8) 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. Service users, where appropriate, are responsible for their own medication and are protected by the home’s policies and procedures for dealing with medicines. (OP NMS 9) The ageing, illness and death of a service user are handled with respect and as the individual would wish. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. (OP NMS 11) 21. The Commission considers Standards 18, 19 and 20 (Adults 18-65) and Standards 8, 9 and 10 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18 – 20 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People’s health care needs are met, but they do not always receive personal support in a way that promotes privacy and dignity. EVIDENCE: One of the people spoken with said that the staff helps them to meet their needs. They said that staff spend time chatting with them, and that they felt safe and happy with the care they receives. One person said that a number of things had recently changed; at one time no one was allowed a key to their room, but this had recently changed and the manager said he was looking into getting a key for everyone who wished to Thorpe House Nursing Home DS0000065036.V358389.R01.S.doc Version 5.2 Page 19 have one. They also said that when they had a bath the staff stayed with them, but this had also changed and people now have a bath on their own. Two people who live at the home said that staff watched them whilst they took a bath or shower. Both people said they did not like this. One person said that their bath day is on a Thursday but they could have a shower in between baths if they wished. Staff were seen to speak with people in a respectful manner and fondness was displayed between some people and the staff. One person who lives at the home said that they didn’t like it when staff shouted at them but did not wish to elaborate on this statement. There was evidence in people’s care records that they are able to access health care services, such as the dentist, chiropodist, optician and everyone living at the home is registered with a doctor. A relative commented that staff keep people motivated and their minds stimulated as well. All five people living at the home who completed the CSCI’s surveys replied that they ‘always’ receive the medical support they need. Two people replied, ‘sometimes’ and one person said that they did not need any medical support. One person said, “I have been rather poorly at times, and have always received the necessary care and medication to make me well.” A sample of three people’s medication was checked during the visit. This showed there to be good systems in place for the recording, storing, administration and disposal of medications, and there was evidence that the medication is audited for any errors on a regular basis. There was one discrepancy found when checking the medication and the manager tried to find out the reason why it had occurred. The manager plans to continue to monitor and audit the medication to try to prevent further errors occurring. Thorpe House Nursing Home DS0000065036.V358389.R01.S.doc Version 5.2 Page 20 Concerns, Complaints and Protection The intended outcomes for Standards 22-23 (Adults 18-65) and Standards 16-18 & 35 (Older People) are: 22. 23. Service users feel their views are listened to and acted on. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted on. (OP NMS 16) Service users’ are protected from abuse, neglect and self-harm. Service users legal rights are protected. (OP NMS 17) Also Service users are protected from abuse. (OP NMS 18) Also Service users financial interests are safeguarded. (OP NMS 35) The Commission considers Standards 22-23 (Adults 18-65) and Standards 16-18 and 35 (Older People) 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. This judgement has been made using available evidence including a visit to this service. People’s views are listened to. People using the service are protected from harm. EVIDENCE: There is a complaints procedure, which is clearly communicated to people using the service, their families and professionals. A person who uses the service has made a complaint, which is currently under investigation by the adult safeguarding team. People who use the service said that they knew how to make a complaint and knew who to speak with if they were not happy. One person said, “If any of us have a problem that requires attention a staff member will do his/ her best to help. Relatives commented that staff responded appropriately if concerns have been raised. Thorpe House Nursing Home DS0000065036.V358389.R01.S.doc Version 5.2 Page 21 There are systems in place to prevent abuse of people using the service. Staff have received safeguarding training (protection of vulnerable adults) and guidance in using the company’s whistle blowing procedures and there was evidence of this in the staff files and staff also confirmed this. Staff who spoke with the inspector were very clear about what they should do if they suspected any abuse. The home has a copy of the Kirklees multi-agency adult safeguarding policy to guide staff on whom to contact in the event of abuse taking place. Thorpe House Nursing Home DS0000065036.V358389.R01.S.doc Version 5.2 Page 22 Environment The intended outcomes for Standards 24 – 30 (Adults 18-65) and Standards 19-26 (Older People) are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users live in a safe, well-maintained environment (OP NMS 19) Also Service users live in safe, comfortable surroundings. (OP NMS 25) Service users’ bedrooms suit their needs and lifestyles. Service users own rooms suit their needs. (OP NMS 23) Service users’ bedrooms promote their independence. Service users live in safe, comfortable bedrooms with their own possessions around them. (OP NMS 24) Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Service users have sufficient and suitable lavatories and washing facilities. (OP NMS 21) Shared spaces complement and supplement service users’ individual rooms. Service users have access to safe and comfortable indoor and outdoor communal facilities. (OP NMS 20) Service users have the specialist equipment they require to maximise their independence. Service users have the specialist equipment they require to maximise their independence. (OP NMS 22) The home is clean and hygienic. The home is clean, pleasant and hygienic. (OP NMS 26) The Commission considers Standards 24 and 30 (Adults 18-65) and Standards 19 and 26 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People live in a homely, comfortable and clean environment. EVIDENCE: As part of the inspection a tour of the home was conducted which included the communal areas, a number of people’s bedrooms, and the laundry. The decorative condition of the home continues to be a good standard. The Thorpe House Nursing Home DS0000065036.V358389.R01.S.doc Version 5.2 Page 23 premises were clean and systems are in place to control the spread of infection. Without exception people commented that the home was always clean. One person when asked the question said, “The staff make sure the home is clean at all times.” One person living at the home said that people are encouraged to use the communal rooms however; on the second day of inspection people were seen to be spending time in their own rooms. Relatives responding to the surveys also said that the care service meets the different needs of people in relation to age, disability, gender, faith and sexual orientation. One person however, did say that facilities could be improved for people who have a disability, e.g. a rail should be in place to help people up the stairs, and rails at the entrance would help to maintain peoples independence. Thorpe House Nursing Home DS0000065036.V358389.R01.S.doc Version 5.2 Page 24 Staffing The intended outcomes for Standards 31 – 36 (Adults 18-65) and Standards 27 – 30 & 36 (Older People) are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users are supported by competent and qualified staff. Service users are in safe hands at all times. (OP NMS 28) Service users are supported by an effective staff team. Service users needs are met by the numbers and skill mix of staff. (OP NMS 27) Service users are supported and protected by the home’s recruitment policy and practices. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users’ individual and joint needs are met by appropriately trained staff. Staff are trained and competent to do their jobs. (OP NMS 30) Service users benefit from well supported and supervised staff. Staff are appropriately supervised. (OP NMS 36) The Commission considers Standards 32, 34 and 35 (Adults 18-65) and Standards 27, 28, 29 and 30 (Older People) 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 good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People are supported by qualified, competent and experienced staff in sufficient numbers and that has had all the necessary checks before working with people so that they are kept safe. EVIDENCE: There continues to be sufficient numbers and skill mix of staff on duty, day and night, to care for the number of people, and the manager’s hours are supernumerary two to three times a week. Thorpe House Nursing Home DS0000065036.V358389.R01.S.doc Version 5.2 Page 25 Relatives’ surveys state that staff have the right skills and experience to look after people properly. There is a qualified nurse on duty twenty-four hours a day and sixty five percent of care staff have a National Vocational Qualification (NVQ). Through speaking to staff and looking at their training files there was evidence that they had received Induction training, supervision a minimum of six times a year, and the training that is needed to look after people in their care. Three staff files were examined and found to contain all the necessary information showing that thorough recruitment procedures are followed in order to protect people from potentially unsuitable staff. Thorpe House Nursing Home DS0000065036.V358389.R01.S.doc Version 5.2 Page 26 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 (Adults 18-65) and Standards 31-34, 37 & 38 (Older People) are: 37. Service users benefit from a well run home. 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. (OP NMS 31) Service users benefit from the ethos, leadership and management approach of the home. Service users benefit from the ethos, leadership and management approach of the home. (OP NMS 32) Service users are confident their views underpin all self-monitoring, review and development by the home. The home is run in the best interests of service users. (OP NMS 33) 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 homes record keeping, policies and procedures. (OP NMS 37) Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping policies and procedures. (OP NMS 37) The health, safety and welfare of service users are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (OP NMS 38) Service users benefit from competent and accountable management of the service. Service users are safeguarded by the accounting and financial procedures of the home. (OP NMS 34) 38. 39. 40. 41. 42. 43. The Commission considers Standards 37, 39 and 42 (Adults 18-65) and Standards 31, 33, 35 and 38 (Older People) 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 good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The health, safety and welfare of people living at the home are protected by the home’s policies and procedures. Thorpe House Nursing Home DS0000065036.V358389.R01.S.doc Version 5.2 Page 27 EVIDENCE: The registered manager is a qualified mental health nurse and also has an NVQ level 4 in management. Records show that he and his staff attend regular training, and updates of existing training. The manager demonstrates a clear sense of direction and acts as a positive role model for the team. Staff said the Manager is approachable and supportive. Satisfaction surveys are sent out by the home annually, and the last survey was sent out in December 2007. Once the surveys have been returned the manager said that he would circulate the results at the monthly meetings to people who live at the home and also make the results available to people who visit the home. A sample of the surveys was seen and the information covered; people’s access to care records, independence, choice, and dignity. One person had made a commented on the survey that they felt that their wishes were respected. The information provided to CSCI before this visit indicates that maintenance of equipment and health and safety checks have been carried out at the required intervals. Records also show that staff have received relevant training in this area. Records relating to health and safety were in good order and demonstrate that the necessary action is taken to keep people and staff safe. Thorpe House were given five stars after for the “Scores on the Doors” scheme operated by Kirklees food safety officers following their inspection of the catering facilities. Attention must be given to changing the routines of the home, as discussed earlier in this report, in a way that fully supports people’s privacy, dignity, choice and respect. This is in order to run the home fully in the interests of the people who live there. Thorpe House Nursing Home DS0000065036.V358389.R01.S.doc Version 5.2 Page 28 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. Where there is no score against a standard it has not been looked at during this inspection. 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 X 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 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT Standard No Score 37 3 38 X 39 3 40 X 41 X 42 3 43 X 2 1 X 2 X LIFESTYLES Standard No Score 11 X 12 2 13 3 14 X 15 3 16 1 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Thorpe House Nursing Home Score 1 3 3 X DS0000065036.V358389.R01.S.doc Version 5.2 Page 29 N/A 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 YA7 Regulation 15. – (1) Requirement Care plans must demonstrate how people have choice and control over their lives. There must be facilities for people to prepare their own snacks and drinks. People must receive personal support in the way they prefer and that respects their privacy and dignity. Timescale for action 16/03/08 2. YA17 16. (2)(h) 12. – (4)(a) 16/03/08 3. YA18 & YA16 16/03/08 Thorpe House Nursing Home DS0000065036.V358389.R01.S.doc Version 5.2 Page 30 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. Refer to Standard YA6 OP9 OP12 Good Practice Recommendations Care plans should be written in words that people can understand. To ensure that the lifestyle experienced in the home matches the expectations and preferences of people, and satisfies their recreational interests and needs, staff should ensure that this information is recorded in their care plans. People should be able to choose what they would like for a meal near to the time when the meal is to be served. This will enable people to have more of a chance to remember what they chose and what they would prefer on the day. 3. YA17 Thorpe House Nursing Home DS0000065036.V358389.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Brighouse Area Team First Floor St Pauls House 23 Park Square Leeds LS1 2ND 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. Thorpe House Nursing Home DS0000065036.V358389.R01.S.doc Version 5.2 Page 32 - 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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