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Please note that the information on this website is now out of date.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 20/01/06 for Thurleston Residential Home

Also see our care home review for Thurleston Residential Home for more information

This inspection was carried out on 20th January 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

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

The home provides relevant information to prospective service users and their families. The statement of purpose and service users guides is readily available and they are published separately. The pre assessment documentation is good and is used when the manager or their deputy visit a prospective service user. The information that is requested is relevant to making an informed judgement about whether or not service users needs can be met by the home.

What has improved since the last inspection?

There have been four bedrooms upgraded with new furniture and furnishings. Carpets, curtains and lamps have been purchased and the rooms look well presented.

What the care home could do better:

There are a number of requirements and recommendations that have been made on this inspection. Areas for development include the continuation to improving the meals to incorporate more home cooking and a wider selection of meals. The home is required to provide a range of activities for the service users. There should be opportunities for activities both inside and outside the home, giving service users a chance of activities they wish as individuals to be involved in. The care plans for all service users should ensure that all the needs and wishes are included. This will ensure that the staff are made aware of the needs and will be able to deliver the appropriate care and support.

CARE HOMES FOR OLDER PEOPLE Thurleston Residential Home Limited Whitton Park Thurleston Lane Ipswich Suffolk IP1 6TJ Lead Inspector Iain Smith Unannounced Inspection 20th January 2006 08:00 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 DS0000060474.V279499.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. DS0000060474.V279499.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Thurleston Residential Home Limited Address Whitton Park Thurleston Lane Ipswich Suffolk IP1 6TJ 01473 240325 01473 240325 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) Guyton Care Homes Ltd Ms Anita J Dobien-Burton Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places DS0000060474.V279499.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd April 2005 Brief Description of the Service: Thurleston Residential Home is registered as a care home for older people. The home can accommodate up to a maximum of 24 service users. Guyton Care Home Ltd, with Mr Balaratnan as the Responsible Individual, owns the home. The home is located to the north east of Ipswich about three miles from the town centre. The easiest approach is from the Norwich Road and Whitton Church Lane areas. The home was first registered in July 1996. It is a single storey building located in parkland, some of which is lawned and includes shrubs and ornamental trees. Some of the rooms look over adjacent fields, others over the grounds. The whole setting is tranquil and pleasant. There is parking at the front of the home. The original bungalow has been developed with the addition of ten bedrooms. The building is of wooden design built on stilts and incorporating beamed walls and ceilings. The main lounge and dining areas are located within the original bungalow and another lounge is situated in the new part of the home. DS0000060474.V279499.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report is based on an unannounced inspection of the home, the second inspection for the year 2005/2006. The visit was arranged to incorporate an anonymous complaint that was made and received in the Suffolk Commission for Social Care Inspection (CSCI) offices a week prior to the visit. Mr Andrew Croft, Social Care Manager, Ipswich accompanied the lead inspector Iain Smith for the first part of the inspection. The visit took four hours and the registered manager Anita Dobien Burton was present throughout the inspection and contributed fully to the inspection process. What the service does well: What has improved since the last inspection? What they could do better: There are a number of requirements and recommendations that have been made on this inspection. Areas for development include the continuation to improving the meals to incorporate more home cooking and a wider selection of meals. The home is required to provide a range of activities for the service users. There should be opportunities for activities both inside and outside the home, giving service users a chance of activities they wish as individuals to be involved in. The care plans for all service users should ensure that all the needs and wishes are included. This will ensure that the staff are made aware of the needs and will be able to deliver the appropriate care and support. DS0000060474.V279499.R01.S.doc Version 5.1 Page 6 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. DS0000060474.V279499.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000060474.V279499.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1. People who use the service receive clear information to enable them to make the choice about whether they might wish to live in the home. EVIDENCE: The statement of purpose and residents guide were made available. Both the documents are presented separately for prospective and current service users and their families to read and refer to. The statement of purpose includes relevant information for example, the homes aims and objectives, philosophy of care, meal services and facilities. The staffing arrangements are stated and there is an appointed manager registered with the Commission for Social Care Inspection (CSCI). The service user guide is produced by the home and entitled the residents guide. This document includes a summary of the statement of purpose, policies and procedures, and the complaints procedure. The terms and conditions of the service users stay at the home are included, this ensures that people are clear about what the home can and cannot offer. DS0000060474.V279499.R01.S.doc Version 5.1 Page 9 The manager has a responsibility to assess each prospective service user before they move into the home. The assessment identifies each individuals needs and a decision is made if the service users needs can be met. The home has a document that the manager or another appropriately trained members of staff use when visiting a prospective service user. This is entitled prospective resident assessment portfolio. The document requests information relating to health, communication, eating, drinking and family support. One care plan was examined and found to include a pre admission assessment. The service users needs were assessed and included in the daily plan. DS0000060474.V279499.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,9,10 and 11. There was evidence that service users needs were assessed. The medication system was assessed as partially completed to ensure safe working practices. EVIDENCE: One service users care plan was examined. The pre admission assessment was included in the information for the individual service user and the information was included in the care plan. An example was to maintain independence. The objective on the plan was to encourage the person to help themselves with the support of the staff. The specific needs and wishes for example social interests and hobbies were not included in the plan that was assessed. Privacy and dignity of the service users was respected. Staff were seen to knock on the bedroom doors of the service users before entering and addressing people by their preferred name. Service users were seen to be wearing their own clothes and one service user stated that she choose the clothes that she was wearing. The administration of medication was partially observed in the morning. The senior carer was seen to check the Medication Administration Record (MAR) DS0000060474.V279499.R01.S.doc Version 5.1 Page 11 before administering the medicine. The carer took the medicine to the individual after signing the MAR chart. The practice of signing following the administration of medicine must be introduced. The Controlled Drugs (CD) cabinet was checked and found to include the appropriate medicines for example Temazepam. Three service users were receiving CD medication and there was evidence that each person had a separate CD recording book. It is recommended that only one Controlled Drugs (CD) hard back book is used and each service users drug and administration is recorded. Care and comfort of each service user at the time of death must be assured. The home has a procedure that states what to do in the event of death and dying. There are no guidelines for staff to follow when considering the service users spiritual needs, rights and respecting dignity. DS0000060474.V279499.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15. The home does not offer activities for the service users to encourage them to fulfil their social, cultural and recreational interests. The planning of meals is limited and there is a lack of choice for the service users. EVIDENCE: Part of the complaint was relating to the lack of activities for the service users in the home. Five service users were asked what activities they were involved in and each of them stated that there was none organised. There was no evidence of an activities programme and each of the service users sitting in the lounge, next to the dining area, had no magazines or books to read. The television was on but it was observed that none of the nine service users sitting in the lounge at the time, was looking at the screen or interested in the programme. One service user stated that ‘we don’t do anything else apart from sit here.’ The manager stated that the owner was looking into the possibility of employing an activities person and purchasing a mini bus to take the service users out on organised trips. The one care plan that was examined did not include the interests of the service user. This element of the complaint is therefore upheld. DS0000060474.V279499.R01.S.doc Version 5.1 Page 13 Visitors were welcomed into the home and one relative was seen during the inspection and two service users who were interviewed stated that their family came to the home. The lack of choice of when the service users were able to get up in the morning was an element of the complaint. On arrival at the home at 08.00 there were five ladies sitting in easy chairs in the lounge area. They were dressed and ready for breakfast. They each had had a cup of tea, the catering person on duty stated that she had prepared the drink. Two of the service users were able to state that they asked to get up and the night staff had assisted them before 08.00.The other three service users were unable to state when they got up. There was no evidence that any of the remaining 16 service users were in either of the lounge areas or dining room. One service user was seen when they exited their room and walking to the dining room for breakfast. They stated ‘I can get up when I want.’ The catering person was seen to take three trays with breakfast in to service users bedrooms; the remainder of the people came into the lounge and dining room for something to eat. On the evidence from the day of inspection this element of the complaint is therefore not upheld. The breakfast consisted of cereals, porridge and fruit juice. The catering person was seen to wheel a trolley out of the kitchen into the lounge and serve, initially five service users with their breakfast. There was no cooked breakfast evident but the catering person stated that if any service user requested some then they would cook. There was no menu evident on the day of inspection. The catering person stated that from next week there was a menu stating the lunchtime meals available. This was seen and an example of the meals included chicken pie for lunch, sandwiches and something on toast. The carers would visit each of the service users the day prior to the meal and request what they may wish to eat. Another element of the complaint was that meat that was being prepared for a meal was out of date. There was evidence that the two freezers had supplies of food, Tesco delivered this. There was a freezer with bread and rolls and another freezer containing meat, vegetables and pies. There was no evidence that meat was defrosting and out of date. On the day of the inspection there were fish and chips on the menu. The manager stated that the service users liked the fish and chips to be delivered from a local shop therefore this were arranged. The catering person therefore did not prepare any hot food for that day. This element of the complaint is therefore not upheld. The dry stores was examined and found to store tins of food, cereals, flour and mixes, for example soups. The catering person stated that they had commenced cooking classes with the service users. This took place on a Tuesday and would continue each week. On DS0000060474.V279499.R01.S.doc Version 5.1 Page 14 the first occasion the service users made Rice Crispie Cakes. The catering person stated that they had received new equipment for the kitchen including tablecloths, crockery and cutlery. The member of staff stated that they ‘feel better and I like things to look nice.’ DS0000060474.V279499.R01.S.doc Version 5.1 Page 15 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 and 18. The complaints procedure and the Protection of Vulnerable Adults (POVA) policies ensure that service users and staff have the required guidelines to follow if they have to report a concern. EVIDENCE: The complaints procedure is included in the statement of purpose, service users guide and is also displayed in the foyer of the home. The procedure states clearly the process when a complaint is made and the name; address and telephone number of the Commission for Social Care Inspection (CSCI) is included for information if a person wishes to make a complaint directly to them. There have been three complaints received by the Commission for Social Care Inspection during this inspection year. One of the complaint investigations is included in this report and the provider has investigated a previous one. One element of the complaint was that a member of staff had expressed their concerns to the manager but no action had been taken. There is no evidence that any complaint has been received and investigated in the home. This element of the complaint is therefore upheld. The Protection of Vulnerable Adults policy (POVA) was made available in the home. This is the multiagency policy and this is kept in the manager’s office. One senior carer stated that they were not aware of the policy or has received any training relating to this subject. DS0000060474.V279499.R01.S.doc Version 5.1 Page 16 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 The home was clean, tidy and warm. The decoration of the home varies in quality. The two lounges and dining room provides flexibility for the service users to choose where they sit. EVIDENCE: Four bedrooms have been decorated, rooms1, 19, 22 and 23. There were new fittings and fixtures with carpeting and curtains to match. The main lounge area was in need of decoration. One part of the wall was mouldy and bare of wallpaper therefore requires attention. The home was warm and comfortable with adequate numbers of chairs in both lounge areas. The dining room was set out with two main tables covered with cloths and seating to accommodate the service users. DS0000060474.V279499.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,29 and 30. The procedures for the recruitment and selection of staff are robust but there is a lack of the required information in files. The staffing was sufficient in numbers and skill mix and was reflected on the staff rota. EVIDENCE: The registered manager is supernumerary to the main staffing in the home. On the day of inspection there were two senior carers and another carer to care for 21 service users on the morning shift. In the afternoon there was one senior carer and two carers. At night two carers would be on duty and this was evidenced on the staff rota. The manager stated that for the morning and afternoon shifts a senior carer would be allocated to take charge of the home and one person would be nominated to take charge at night, from the two carers working together. The manager stated that recently, due to the reduction of service users from 24 to 21 there had been a reduction in the staffing numbers. The catering staff consisted of one cook and an assistant working full time from 08.00 to 13.00 five days a week. One cook and an assistant work alternate week ends with dedicated care staff covering the shortages. One element of the complaint was that there was no weekend catering staff therefore this part of the complaint was partly upheld. The home is required to operate a thorough recruitment procedure based on equal opportunities. One staff file was examined and found to have DS0000060474.V279499.R01.S.doc Version 5.1 Page 18 documentation missing. There were two references and a criminal records bureau (CRB) enhanced check included. There was no proof of the persons identity including a recent photograph or copy of the persons birth certificate. Staffs training records were not examined. The manager and one senior carer stated that the Prevention of Vulnerable Adults (POVA) training was required. This would ensure that staff was given the knowledge and understanding to help protect the service users from abuse. DS0000060474.V279499.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33,36 and 38 Staff are appropriately supervised and the health and welfare of the service users is promoted. EVIDENCE: The owner has recently completed service user questionnaires. This covered a number of areas, for example food and activities. The survey relating to food stated that service users would like the home to provide, for example a roast dinner, home cooked food, apple pie, Sunday lunch and old fashioned cheese and potato pie. For breakfast two service users requested scrambled egg and smoked haddock. This survey evidences that the service users requested additional choices of meals and more selection of home cooking. Staff supervision records evidenced that the manager undertakes this on a regular basis. Each member of the care staff is supervised at least six times a DS0000060474.V279499.R01.S.doc Version 5.1 Page 20 year and the supervision includes aspects of practice and training and development. The owner has invested in new equipment for the kitchen. Examples are a new oven, microwave and fridge. DS0000060474.V279499.R01.S.doc Version 5.1 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 3 X 3 X X x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 2 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 2 X X X X X X x STAFFING Standard No Score 27 2 28 X 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X X 3 X 3 DS0000060474.V279499.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 OP9 Regulation 13.2 Timescale for action The registered person must 10/02/06 ensure that the Medication Administration Records (MAR) are appropriately signed. The registered person must 31/03/06 ensure the home has a death and dying policy that includes the care and comfort service users will be given who are dying and at the time of their death. The registered person must 31/03/06 ensure that all residents are consulted about the programme of activities arranged for each individual. (This is a requirement from a previous inspection report 22.04.06) The registered person must 24/02/06 ensure that all service users are given a choice of a varied, appealing, wholesome and nutritious diet. (This is a requirement from a previous inspection 22.04.06) The registered person shall 10/02/06 ensure that any complaint made under the complaints procedure is fully investigated. The registered person must 24/02/06 DS0000060474.V279499.R01.S.doc Version 5.1 Page 23 Requirement 2. OP11 12.1. (b) 3. OP12 16 4. OP15 16.2 (i) 5. OP16 22.3 6. OP18 13.6 7. OP19 23.2 (b) 8. OP27 18.1 9. OP29 19.4 (b) ensure that staff are trained to understand and deal appropriately with the suspicion of abuse. The registered person must 24/02/06 ensure that the lounge area is decorated and kept in a good state of repair. Appropriate numbers of catering 24/02/06 staff must be employed to ensure the residents have their meals prepared and served by appropriately trained staff The registered person must 24/02/06 ensure that all staff provides the appropriate recruitment information and documents as specified in Schedule 2 of the Care Homes for Older People Regulations. 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 7. Good Practice Recommendations All care plans should be set out to include in detail the action which needs to be taken by care staff to ensure that all aspects of the health, personal and social care needs of the service user are met. The registered person should provide a one bound book or register with numbered pages to record Controlled Drugs. (Reference Royal Pharmaceutical Society for Great Britain publication June 2003) 2. 9. DS0000060474.V279499.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 DS0000060474.V279499.R01.S.doc Version 5.1 Page 25 - 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!