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Inspection on 09/12/05 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 9th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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

Thorpe House Nursing and Residential Home provides a comfortable and homely environment for its residents. The home is clean, well maintained and decorated to a satisfactory standard. Residents` rooms are individual and personalised, reflecting the occupant`s personality. The communal areas are comfortable and well maintained and there are large, well tended gardens which the residents can enjoy through the changing seasons. Care plans were comprehensive, well maintained, accurate and regularly reviewed. Care plans addressed all assessed needs and included appropriate risk assessments. Falls risk assessments demonstrated a proactive response to identify areas of concerns, with interventions and evaluated outcomes resulting in a reduction in falls for identified residents.

What has improved since the last inspection?

Requirements and recommendations made following the previous inspection in October 2005 had been met.

What the care home could do better:

No requirements or recommendations were made.

CARE HOMES FOR OLDER PEOPLE Thorpe House Nursing & Residential Home Knightthorpe Road Loughborough Leicestershire LE11 4JS Lead Inspector Mrs C A Burgess Unannounced Inspection 10:00 9 December 2005 th 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.V261544.R01.S.doc Version 5.0 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.V261544.R01.S.doc Version 5.0 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 219878 01509 262710 Rushcliffe Care Limited Mrs Diana Mary Squire Care Home 50 Category(ies) of Old age, not falling within any other category registration, with number (50), Physical disability (50), Physical disability of places over 65 years of age (50), Terminally ill over 65 years of age (2) Thorpe House Nursing & Residential Home DS0000001928.V261544.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. No one under the age of 55 years may be admitted into the Home in Category PD. No one falling within category TI(E) may be admitted into the home where there are two persons of category TI(E) already accommodated in the home. 3rd October 2005 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, Leicestershire and is owned by Rushcliffe Care Limited. It is located close to the centre of the town within a ten-minute car journey and is situated on a bus route. The Loughborough community hospital is sited approximately half a mile from the home. The home is on a main road within a residential area. Facilities close by include a local church, a variety of shops and a number of social amenities which include several pubs and a social club. Accommodation is situated on two floors that can be accessed by a passenger lift. The large garden is laid to lawn and is surrounded by flowerbeds and mature trees. Thorpe House Nursing & Residential Home DS0000001928.V261544.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over five hours. An opportunity was taken to look around the home, view records, policies and care plans and to talk to staff, clients, their relatives and visitors. The primary method of inspection used was ‘case tracking’ which involved selecting three residents and tracking the care they receive through a review of their records, discussion with the residents (where possible), relatives and care staff, and the observation of care practices. Many of the residents were seen during the inspection. Four of the residents and three relatives gave the Inspector their impressions of the home. What the service does well: What has improved since the last inspection? Requirements and recommendations made following the previous inspection in October 2005 had been met. Thorpe House Nursing & Residential Home DS0000001928.V261544.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Thorpe House Nursing & Residential Home DS0000001928.V261544.R01.S.doc Version 5.0 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.V261544.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 & 6. The admission process is well managed. Residents and their relatives/representatives are given clear and detailed information regarding the service; thereby ensuring that the residents’ health and welfare needs will be met. EVIDENCE: There is a comprehensive Statement of Purpose & Service Users’ Guide. The Statement of Purpose & Service Users’ Guide reflects the care provided. The pre-assessment process is robust and reflective of the health and welfare needs of the residents. Intermediate care is not provided. Thorpe House Nursing & Residential Home DS0000001928.V261544.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 & 10. Residents are well looked after in respect of their health and personal care but care should be taken to ensure that residents feel that they are treated with respect and dignity at all times. EVIDENCE: Care plans were detailed and had risk assessments and interventions to address residents’ specific, health and welfare needs. Contact with other healthcare professionals was well documented and detailed. A resident stated in a Service Users’ Comment Card that some staff ‘talk over her in their own language’, which she found very rude. This was discussed with the Registered Manager who said that she would address this individually with staff during supervision, and as a staff group during the staff meeting. Other residents spoken with said that they were treated with respect by the staff. Standard 9 was inspected in October 2005 and found to be met Thorpe House Nursing & Residential Home DS0000001928.V261544.R01.S.doc Version 5.0 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. The staff ensure that residents experience a safe, homely life style. EVIDENCE: The home is currently trying to recruit a part-time activities officer. A carer is identified on the staff rota to be responsible for arranging activities on a daily basis. Special occasions are celebrated and a Christmas party and Carol service are being arranged to celebrate the festive season. Religious support is available and priests from local churches visit occasionally. Specific religious and cultural needs are supported as required. Some residents played Bingo on the day of inspection and daily activities are recorded. Hairdressing and nail care are available. The Registered Manager said that Rushcliffe Care Ltd are planning to purchase a vehicle to enable residents to get out and about more. Residents said that they are able to have visitors at any time and a number of people came to visit relatives during the course of the inspection. Thorpe House Nursing & Residential Home DS0000001928.V261544.R01.S.doc Version 5.0 Page 11 Residents are supported by staff when making choices in their everyday life and are enabled to vote via postal ballot. Residents said that the food was ‘generally good’ and that there was always plenty of food with choices at all meal times. Meals are cooked ‘on site’. Special diets such as diabetic, soft or liquidised diets are catered. Thorpe House Nursing & Residential Home DS0000001928.V261544.R01.S.doc Version 5.0 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 & 18. Arrangements for receiving and responding to complaints are sound. EVIDENCE: The home’s complaints process reflects the government’s adult protection guidelines, set out in the No Secrets’ publication. Minor verbal concerns made to the home are dealt with appropriately to ensure that residents’ concerns are addressed promptly. The CSCI had received one complaint about the home which has been satisfactorily addressed. Residents and relatives said that they had no complaints about their care; that they felt able to discuss any minor concerns with staff and that these were usually dealt with promptly. Thorpe House Nursing & Residential Home DS0000001928.V261544.R01.S.doc Version 5.0 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26. A comfortable, clean and safe standard of accommodation is provided for the residents. EVIDENCE: The home is safe and well maintained with adaptations to suit residents’ care needs. It is decorated and furnished to a satisfactory standard that creates a comfortable and homely environment. Residents have access to attractive, safe gardens and all areas of the home and garden are fully accessible for wheelchair users. The home is clean and hygienic throughout and has domestic, kitchen and maintenance staff in addition to the nursing and care staff. Thorpe House Nursing & Residential Home DS0000001928.V261544.R01.S.doc Version 5.0 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 & 30. Staff at the home are trained and supported, and employed in sufficient numbers to meet the residents’ needs. EVIDENCE: At the time of this inspection there were thirty-six residents living in the home. The home was staffed with six staff in the morning, five in the afternoon and three at night. An additional night carer is to be employed. At least one qualified nurse was included within these numbers on each shift. The Registered Manager said that staffing levels would be increased if occupancy or dependency levels increased. Residents and their relatives said that they felt staff were capable and caring, and that there were adequate staff on duty to meet the needs of the residents. However, two relatives said that there appeared to be less staff at the weekends. The Registered Manager stated that four of the care staff hold National Vocational Qualification (NVQ) in Care, Level 2 and a number of others are undertaking NVQ’s. Thorpe House Nursing & Residential Home DS0000001928.V261544.R01.S.doc Version 5.0 Page 15 New staff undertake a comprehensive induction programme with ongoing ‘in house’ and mandatory training in key areas such as Moving & Handling, First Aid, Protection of Vulnerable Adults etc. Recruitment records are kept centrally at Epinal Way Care Centre. Recruitment policies and procedure are examined during the inspection of the homes in that area. Standard 28 was inspected in October 2005 and found to be met Thorpe House Nursing & Residential Home DS0000001928.V261544.R01.S.doc Version 5.0 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38 The Registered Manager manages the home effectively resulting in a good standard of care and the safeguard of residents’ rights. EVIDENCE: The home has a Registered Manager who is a Registered Nurse with many years of experience in nursing and care and updates her own knowledge to ensure that she is able to provide optimum care for the residents. Residents’ monies are not managed by the home. Small personal allowances are kept safely and satisfactory records are maintained. Thorpe House Nursing & Residential Home DS0000001928.V261544.R01.S.doc Version 5.0 Page 17 Staff have annually appraisals and are regularly supervised to ensure that they receive appropriate support to enable them to provide the required care for the residents. Health and Safety Policy and Procedures, such as regular recorded fire drills and fire alarm tests are completed, to ensure the health and safety of the residents and staff. The Registered Manager stated that the fire risk assessment for the building is to be reviewed and updated by a Senior Manager. Falls risk assessments had been reviewed, interventions identified and outcomes measured demonstrating a reduction in falls for the residents identified during the inspection. Thorpe House Nursing & Residential Home DS0000001928.V261544.R01.S.doc Version 5.0 Page 18 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 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 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 4 Thorpe House Nursing & Residential Home DS0000001928.V261544.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Thorpe House Nursing & Residential Home DS0000001928.V261544.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Thorpe House Nursing & Residential Home DS0000001928.V261544.R01.S.doc Version 5.0 Page 21 - 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!