Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 21/02/07 for Thorpe House Nursing & Residential Home

Also see our care home review for Thorpe House Nursing & Residential Home for more information

This inspection was carried out on 21st February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

What has improved since the last inspection?

There were no issues from the last inspection, and the home continues to provide a good quality of care.

CARE HOMES FOR OLDER PEOPLE Thorpe House Nursing & Residential Home Knightthorpe Road Loughborough Leicestershire LE11 4JS Lead Inspector Mick Walklin Key Unannounced Inspection 21st February 2007 11:00 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 Thorpe House Nursing & Residential Home DS0000001928.V324280.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. 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 & Residential Home DS0000001928.V324280.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Thorpe House Nursing & Residential Home Address Knightthorpe Road Loughborough Leicestershire LE11 4JS 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) 01509 219877 01509 262710 Rushcliffe Care Limited Mrs Diana Mary Squire Care Home 50 Category(ies) of Dementia - over 65 years of age (9), Old age, registration, with number not falling within any other category (50), of places Physical disability (50), Physical disability over 65 years of age (50) Thorpe House Nursing & Residential Home DS0000001928.V324280.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. No person in categories OP, PD, PD(E), & DE(E) may be admitted into Thorpe House Nursing & Residential Home where there are 50 persons in total of these categories/combined categories already accommodated in the home. No one falling within category DE(E) may be admitted into the home where there are nine persons of category DE(E) already accommodated in the home. No one falling in the Category PD, under 55 years of age, may be accommodated within the home.. 9th December 2005 2. 3. Date of last inspection Brief Description of the Service: Thorpe House Nursing and Residential Care home is a purpose built home situated in the Thorpe Acre area of Loughborough, and is owned by Rushcliffe Care Limited. It is located close to the centre of the town, and is served by a bus route. The home is on a main road in a residential area. Facilities close by include a local church, a variety of shops and a number of social amenities, including several pubs and a social club. Accommodation is situated on two floors that can be accessed by a lift. The large garden is laid to lawn and is surrounded by flowerbeds and mature trees. The range of fees charged is between £319 - £640 per week. Thorpe House Nursing & Residential Home DS0000001928.V324280.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was undertaken using a review of all the information available to the inspector regarding the service history of Thorpe House Nursing and Residential Home, and through undertaking a visit to the home. The fieldwork visit took place over 7 hours. The registered manager was not available, but a senior manager was present throughout the inspection. The main method of inspection used was called case tracking which involved selecting three residents and tracking the support they receive through the checking of their records, discussion with the care staff and observation of care practices. A tour of the building was undertaken, and documents connected with the running of the care home were also inspected. A pre-inspection questionnaire had been completed in June 2006. What the service does well: Residents receive good support from well-trained staff. They are consulted about their lifestyles, and staff treat them with dignity and respect. There is a good range of information about residents support needs. They have good contact with their families, and the quality of food is of a good standard. There are a range of activities for residents to join in. Residents feel safe living at the home, and trust staff to take any complaints or concerns seriously. The accommodation is comfortable, and clean. The home is well managed and organised, and regular checks are made to make sure that the home is safe for residents. Comments from residents included: • • • “They spoil us rotten”. “Staff provide very good care”. “The staff are very competent”. Comments from relatives included: • • • • “Very nice – we have no complaints”. “The home is very clean”. “My wife has settled here pretty well”. “Thank you for the loving care, dignity and dedication you have given – we will always remember your friendship and kindness”. (From a recent ‘Thank You’ card). Thorpe House Nursing & Residential Home DS0000001928.V324280.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. Thorpe House Nursing & Residential Home DS0000001928.V324280.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Thorpe House Nursing & Residential Home DS0000001928.V324280.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 & 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has thorough admission procedures, which ensure that residents needs are fully assessed. EVIDENCE: The senior manager explained the process for dealing with new referrals to the home. Following an enquiry from the persons family or social worker, an enquiry form is completed, which gives basic information about the person. The manager will usually do an assessment within 48 hours, and the family, social worker, and the prospective resident are able to visit at any time during the procedure. The pre-admission assessment covers a wide range of information. All admissions are for a four-week trial period. The home prefers not to accept emergency admissions, and would expect all the necessary information to be faxed to them, if this was unavoidable. Thorpe House Nursing & Residential Home DS0000001928.V324280.R01.S.doc Version 5.2 Page 9 The home does not provide intermediate care. Thorpe House Nursing & Residential Home DS0000001928.V324280.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are of a good standard, and provide staff with good information about residents needs. There are good arrangements with local health providers to ensure that residents heath needs are met. Medication procedures ensure that administration is safe. Staff treat residents with respect. EVIDENCE: On admission, a care plan is prepared for the first 72 hours of care. This is a quick reference guide for staff, outlining basic needs. A more detailed care plan is then prepared, which covers all areas of assessed needs. Care plans are reviewed on a monthly basis, and signed by those residents able to do so. There are good daily records. There are an excellent range of assessments, including risk assessments. Care Plans contain a ‘Getting to know you’ assessment, which provides information about residents significant life events, Thorpe House Nursing & Residential Home DS0000001928.V324280.R01.S.doc Version 5.2 Page 11 formative years, occupation and hobbies and interests. The manager audits plans every six months. All residents are registered with one of a number of local GP practices. Most residents are from Loughborough, so are already registered with a local GP. A resident said, “Staff are good at calling the doctor if we are poorly”. The home has a contract for the home provision of dental, optical and chiropody services. Registered nurses are responsible for administering medication, and complete a half-day drug management course. They also have to complete an annual drug assessment. Medication storage and stocktaking is satisfactory. Medication administration records are fully completed. Staff were observed to knock on bedroom doors before entering, and ensured privacy when carrying out personal care tasks. A resident said, “The staff are very sweet – they provide very good care, and are very efficient. They are respectful to me, and respect my personal space”. Another resident said, “Things are pretty good here – I never think to myself, I wish they (staff) wouldn’t do that”. Thorpe House Nursing & Residential Home DS0000001928.V324280.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from an activity programme to stimulate them. Contact with family and friends is encouraged, and residents make decisions about their lives. Residents are able to exercise choice about menus. EVIDENCE: The home has employed an activity co-ordinator since the last inspection, who works 30 hours per week. She said that she prepares an activity programme every week, and tends to organise group activities for the morning, and 1-1 activities, such as reading or walks in the afternoon. Residents were joining in a painting and craft session on the morning of the inspection, and the activity co-ordinator was seen reading to residents in their bedrooms in the afternoon. External entertainers are booked periodically, and there are a number of planned themed activities for special occasions. The activity co-ordinator said, “I sometimes get a good response for the larger group activities, such as soft ball or skittles, but other times, residents need a lot of encouragement”. A resident said, “We usually have activities in the morning – I enjoy dominos and Thorpe House Nursing & Residential Home DS0000001928.V324280.R01.S.doc Version 5.2 Page 13 bingo. I go out to a support group meeting every Tuesday, and my husband takes me out every weekend”. A relative said, “My wife is in bed all the time, so she doesn’t join in the activities, but the activity person comes to read to her”. A member of staff commented, “Having an activity co-ordinator has improved activities for residents, and we now have a much better activity plan”. Residents confirmed that their visitors are received well in the home. One resident said, “My husband always gets a cup of char when he arrives”. A relative commented, “The staff are welcoming – very nice”. Another relative said, “I visit every weekday, and my daughter visits at weekends. The staff are very friendly and helpful”. The homes statement of purpose says, ‘Our policy is that visitors are always welcome at the home. As such, we keep an open house, and encourage relatives, friends and voluntary persons to call at any reasonable hour’. The ‘Getting to know you’ assessments in residents care plans contain good information about residents likes, dislikes and preferred routines. A resident said, “I get up, and go to bed when I like. I was sharing a bedroom, but I wasn’t very happy with that, so I have been moved to a single room”. Another resident said, “Staff have a good knowledge about our what we like, and what we don’t like”. Staff gave good examples of how they ensure that residents who have poor communication are able to exercise choice. There was good communication between a member of staff and a resident who is deaf, by them writing notes to each other. Two kitchen staff work each day until 2:30, and another works until 6:30. Menus are compiled on a four-week rolling rota, and there is a choice of two main meals and puddings. There are a range of choices for tea, with a hot option being available. Residents are encouraged to drink plenty of fluids, with jugs of drinks being available throughout the home. A resident said, “The food is nice – they will give you something else if you don’t want what’s on the menu The portions are a decent size – sometimes too much”. A relative said, “My father seems happy with the standard of food”. Thorpe House Nursing & Residential Home DS0000001928.V324280.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected by the adult protection procedures, and know that their complaints will be taken seriously by staff and management. EVIDENCE: The complaints procedure is displayed on the back of each bedroom door, and in communal areas of the home. Residents said that they had confidence in staff to act on complaints. One said, “Staff would listen if I had a complaint”. There has been one complaint since the last inspection, about a missing photograph. This was investigated fully by the management of the home. Staff demonstrated a good knowledge of the adult protection procedures, and their reporting responsibilities. Staff receive training as part of their induction, and National Vocational Qualification (NVQ) training. The Leicestershire Adult Protection Procedures are available for reference by staff. Thorpe House Nursing & Residential Home DS0000001928.V324280.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable and clean environment for residents to enjoy. EVIDENCE: There are a range of comfortable communal spaces for residents to enjoy. Residents said that they are happy with the standard of accommodation. Bedrooms are personalised to taste, with many pictures and mementos. One resident said, “I have been able to bring my own bits and pieces in to make it more homely”. A relative said, “The room is very clean – my father brought some of his possessions with him”. Thorpe House Nursing & Residential Home DS0000001928.V324280.R01.S.doc Version 5.2 Page 16 A relative raised an issue about shower facilities in the home. Although there are a range of special baths and hoists, there is only one shower. He said that his father does not like being hoisted into a bath, and a shower ‘wet room’ would be more suitable. The senior manager said that this is being considered as part of a refurbishment programme. Thorpe House Nursing & Residential Home DS0000001928.V324280.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are well supported by a well-trained staff group. It was not possible to fully assess whether recruitment and selection procedures protect residents. EVIDENCE: The home usually operates on 7 staff in the morning, 6 staff in the afternoon, and 4 staff covering nights. There is a registered nurse on duty at all times. In addition there are teams of domestics, cooks, and maintenance/gardening staff. The home is fully staffed at present, and the senior manager closely monitors any excess hours worked. Staff said that there are enough staff to meet residents needs, and the situation has improved following an increase of staffing in the dementia unit last year. However, a relative commented, “They are certainly not overstaffed”, and residents said that the staff are very busy. The company has a central training school in Loughborough, which is a training centre for National Vocational Qualifications (NVQ), and 80 of care staff have completed an NVQ. There is a training manager, and an NVQ co-ordinator, and three of the senior managers have an adult teaching qualification. New staff complete a three-day induction programme, and have to work through a comprehensive induction workbook during their first three months. A member Thorpe House Nursing & Residential Home DS0000001928.V324280.R01.S.doc Version 5.2 Page 18 of staff said, “I found the induction quite hard, but it was useful”. Staff said that training in the company is good, and the company holds the Investor in People Award. One member of staff said, “The training is very open – we are notified of a lot of courses. Another said, “The company provides a lot of training – it has given me confidence to do the job. Training records showed that staff had attended mandatory training course, and specialist courses. A resident said, “The staff are very competent”. The company routinely destroys Criminal Records Bureau (CRB) checks and Protection of Vulnerable Adult (POVA) checks on staff, when they are received. A record is kept of the disclosure number and date of the CRB check, but there is no record of when the POVA check was received. It was therefore not possible to check that staff had received satisfactory POVA checks before they had been employed at the home, as required by law. In some cases, there was a delay of several months between the person starting work, and the CRB check being received. The senior manager said that all staff have a POVA check before starting, and that they had been advised by the Criminal Records Bureau that they must destroy all disclosures because of the Data Protection Act. It is recommended that the home follow CSCI guidance on this matter. Thorpe House Nursing & Residential Home DS0000001928.V324280.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a well managed home. There are good systems in place to consult them about standards of care, and their health, safety and welfare is promoted. EVIDENCE: The manager is new in post, and has recently been registered by the commission. Staff and residents said that the home is well managed, and staff said that they receive good support from senior staff. One member of staff said, “We work well as a team, and any problems are sorted out by the care manager, or at a staff meeting”. A resident said that the manager is very Thorpe House Nursing & Residential Home DS0000001928.V324280.R01.S.doc Version 5.2 Page 20 approachable, and said, “If I want to speak to her, I can”. Two relatives praised the support that they had received, when their relatives were moved to Thorpe House after another care home had closed. One said, “The manager was very, very helpful. She was a tower of strength during a difficult time for us”. The senior manager said that the home does not deal with residents finances, and will refer to social services if there are no relatives to take on this responsibility. Two residents manage their own finances, and they have lockable storage facilities. Some money is held for incidental expenses, and the balances of three were checked, and all were correct. Residents and relatives are contacted every year, as part of a satisfaction survey. These were sent out last September, and the results are included in the service user guide. Of the 40 surveys sent out, 15 were returned. Seventyone percent of replies described the service as good or excellent. The senior manager confirmed that there is an action plan to address any issues identified. Residents and relatives meetings are held every three months, and the action plan from the satisfaction survey was discussed at the last meeting. Residents are invited to raise any issues about management or staffing arrangements. Health and Safety and maintenance documents are well organised, and regular checks and servicing are carried out. There are a comprehensive range of audits, which are carried out by the manager or senior manager, to ensure that equipment and working practices are safe. Thorpe House Nursing & Residential Home DS0000001928.V324280.R01.S.doc Version 5.2 Page 21 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Thorpe House Nursing & Residential Home DS0000001928.V324280.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? N/A 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. 1. Refer to Standard OP29 Good Practice Recommendations The registered person should follow CSCI guidance about making Criminal Records Bureau disclosures available for inspection. Thorpe House Nursing & Residential Home DS0000001928.V324280.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 & Residential Home DS0000001928.V324280.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!