Inspection on 16/02/06 for Thurlestone Court

This inspection was carried out on 16th February 2006.

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

Other inspections for this house

Thurlestone Court 14/03/07

Thurlestone Court 14/12/04

Thurlestone Court 20/07/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Thurlestone Court Thurlestone Kingsbridge Devon TQ7 3NZ Lead Inspector Annie Foot Unannounced Inspection 16th February 2006 9:00 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 Thurlestone Court DS0000003843.V282739.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. Thurlestone Court DS0000003843.V282739.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Thurlestone Court Address Thurlestone Kingsbridge Devon TQ7 3NZ 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) 01548 560737 01548 560737 Thurlestone Court Limited Mrs Yvonne Hooper Care Home 25 Category(ies) of Dementia - over 65 years of age (25), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (25), Old age, not falling within any other category (25), Physical disability over 65 years of age (25) Thurlestone Court DS0000003843.V282739.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Age 50 Date of last inspection 25th May 2005 Brief Description of the Service: Thurlestone Court is a detached two-storey property standing in its own grounds in the coastal village of Thurlestone in the South Hams area of South Devon. It is part of the Court Group of care homes, and is registered to provide care for 25 older persons who may also have a physical disability and/or dementia. Accommodation is provided in single en suite rooms on two floors with a passenger lift providing access to the upper floor. Communal rooms are spacious and are situated on the ground floor. A large conservatory adjoins the lounge. Outside there is a level garden area. Aids and adaptations are provided to meet residents needs. Thurlestone Court has regular access to the Court Group minibus for outings. Thurlestone Court DS0000003843.V282739.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection was the second inspection of the year. It was conducted over the morning of 16 February 2006. The purpose of the inspection was to follow up on requirements and recommendations made at the last inspection and review progress made in other areas. The registered manager Yvonne Hooper was on duty and present throughout the inspection. 22 residents are currently living at the home. There is a mix of residents who are frail and those who have a form of dementia. Over half of the inspection was spent in talking with residents. 10 residents were spoken with and several others were met. In addition to the manager, 3 care staff were on duty, a cook and the housekeeper. Staff were observed in their duties and all were spoken with. A visitor to the home was also met. A tour of the premises took place. Care, medication records and risk assessments were inspected. Recommendations made at this inspection are made to improve already good working practice. What the service does well: The home provides a welcoming and homely environment. The standard of accommodation and quality of care is high. The manager knows the residents well and has a warm rapport and relationship with them. There is an open and inclusive atmosphere throughout the home, created by the manager who provides a clear sense of leadership and direction. Time made available by the manager to spend with residents on a one to one basis is greatly valued. All the residents said how happy they were living at the home and spoke of the kindness and help provided by staff. One resident said that they “never feel deserted, there’s always someone there even at 4.00 a.m.” Food is freshly prepared and residents said meals were presented attractively and were enjoyable. Homemade cakes are offered at afternoon tea. The daily menu is displayed on dining rooms tables and as one resident said “it is just like a restaurant”. Visitors are made welcome and the one visitor met said the home had lots more contact with the village, since the manager’s appointment. The home is well organised with efficient systems in place to ensure a high standard of care are provided. Thurlestone Court DS0000003843.V282739.R01.S.doc Version 5.1 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. Thurlestone Court DS0000003843.V282739.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 Thurlestone Court DS0000003843.V282739.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): Standards in this section were all inspected and fully met at the last inspection. They were not reassessed on this occasion. EVIDENCE: The statement of purpose is on display and available in the reception area. Thurlestone Court DS0000003843.V282739.R01.S.doc Version 5.1 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): 7,9,10 Informed care plans and risk assessments ensure that resident’s needs are regularly reviewed and met. Systems for the administration of medication are clear, with arrangements in place to ensure service users medication needs are met. Procedures and working practices ensure residents right to privacy and, respect and dignity. EVIDENCE: Four service user files were examined. These were well organised and up to date, containing relevant information regarding resident’s needs. Care plans and risk assessments are reviewed each month with the involvement of individuals. Medications records were inspected and found to be complete. There is a Controlled Drugs register in use and this too was complete. There is good storage of medicines. Residents said that staff treated them with respect and gave several examples. Staff were observed to be respectful in their interaction with residents. Staff described how they provided personal care that afforded both privacy and dignity. Thurlestone Court DS0000003843.V282739.R01.S.doc Version 5.1 Page 10 Thurlestone Court DS0000003843.V282739.R01.S.doc Version 5.1 Page 11 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): 13,14,15 Residents are supported in maintaining friendships and contact, outside the home. Support for daily living is well managed giving residents choice and control over their lives. Meals in the home are well balanced, offering a good choice and variety of foods, which cater for individual tastes, and special dietary needs. EVIDENCE: Links with the community are strong. A singing group from the church was expected on the day of the inspection, but unfortunately it was cancelled unexpectedly. A member of the church called in during the morning and rearranged a time for the following week. Residents said they enjoyed a recent slide show, and the various entertainments organised over Christmas. The manager is open to suggestion to improve the range of activities. The opportunity to identify a member of staff to coordinate activities was discussed. There is lots of contact between residents and their families and this is encouraged and supported by staff. The visitor met said it was very easy for local people to pop into the home. They are always welcomed. Some of the residents attend a local coffee morning in the village and others attend a lunch club. Thurlestone Court DS0000003843.V282739.R01.S.doc Version 5.1 Page 12 Staff have a good understanding of residents needs and interests. Several examples of enabling a resident’s choice were given e.g. personal care, choosing their clothes and meals. One resident likes to do her own washing of small items and this is supported. Lunch on the day of the inspection comprised: Beef in red wine sauce with potatoes and green beans, followed by Banoffee pie. The meal looked was well presented and looked very appetising. Residents said it was very good. There is one vegetarian resident; she said that the staff did “very well” in catering for her meals. Fresh fruit is freely available for residents. A bowl containing a selection of fruits was seen in the lounge. Meals are freshly prepared with plenty of fresh ingredients. The cook is very experienced and said she likes to make homemade cakes for afternoon tea every day. Meals are eaten in the homely dining areas. A glass of sherry is offered at lunch at the weekends. Meals can be flexible with the main meal usually provided at lunchtime. One resident prefers to eat their main meal in the evening and this is provided. Tea/supper is provided at 5.00 p.m. During the evening, drinks and snacks are always available. Thurlestone Court DS0000003843.V282739.R01.S.doc Version 5.1 Page 13 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): 16,18 There is a robust procedure in place with evidence that residents feel their concerns are listened to and acted upon. EVIDENCE: There has been one complaint since the last inspection. Records confirmed that this had been investigated and resolved in a timely manner. Records are clear but the outcome needs to stated more clearly. The resident in question said that the issue raised had been managed well. Staff receive in-house training in adult protection, but neither the manager of staff have received multi-agency external training in this area. This was recommended at the previous inspection and is repeated. There have been no allegations of abuse but staff are clear about procedures to follow should one occur. Thurlestone Court DS0000003843.V282739.R01.S.doc Version 5.1 Page 14 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): 19,25,26 Service users are provided with an attractive and well-maintained environment. The manager has a good understanding of areas of the home, which need to be improved. The heating and water supply to the home present potential risk to vulnerable residents EVIDENCE: The home is well maintained and furnished to a high standard. Domestic staff are employed and were observed in their duties, taking a pride in the cleanliness of the home, which was spotless. All the residents spoken to said they liked their rooms and said they were very comfortable in them. Many of the rooms have large windows and have pleasant outlooks. Radiators are now all fitted with guards. Unfortunately since radiator covers have been fitted the heat in resident’s rooms is restricted. The recent Thurlestone Court DS0000003843.V282739.R01.S.doc Version 5.1 Page 15 complaint concerned the temperature of a resident’s bedroom. Management has attempted to overcome the problem by providing, where requested, freestanding oil filled radiators. These were seen in some bedrooms. Temperatures in rooms varied widely, some were quite warm while others felt chilly. One resident had a convector fitted to the bedroom wall to overcome the problem. But, the health and safety officer deemed the heater unsafe and removed the plug. The manager confirmed that an oil filled radiator is on order for this resident. In the meantime the resident is content to sit in their room with a blanket covering them. This is not wholly satisfactory and must be addressed. The manager expressed concern about the drop in temperature where residents are sitting still. The heating is kept turned on during cold spells. Hot water outlets have been individually risk assessed, but no work yet commenced to fit fail safe devices to taps in resident’s rooms. In some cases this is causing a potential risk of scalding. Water temperatures were checked in various rooms. Temperatures varied between 34oC to 50oC. In 2 residents rooms the water was extremely hot. This was discussed with the manager who explained that work is expected but as yet no date has been given for work to commence. Safety notices have been put up in residents rooms warning of unregulated water, but as some residents are confused, written notices are of limited use. Some of the residents spoken to said that the water often flowed in very hot flushes. The laundry has new washing machines installed. Redecoration of the walls in the laundry is still needed. Thurlestone Court DS0000003843.V282739.R01.S.doc Version 5.1 Page 16 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 Resident’s benefit from skilled and experienced staff. Staff are provided with a thorough training programme to meet residents needs. EVIDENCE: All of the staff on duty were spoken were and all participated in some way with the inspection. Staff were observed in the course of their duties, to treat residents sensitively and kindly. Staff have positive relationships with residents and this was confirmed. A new member of staff is currently undertaking an induction period. As she previously worked for another home in the Court group she was already familiar with many of the procedures despite only working her second day. Staff were able to clearly describe their role and responsibilities. They explained how they gave choice to residents and emphasised an importance on privacy and dignity. A foreign member of staff is employed at the home who lives on the premises. She has settled well into the home and previously had experience of working with older people. Staff said plenty of training was provided. 4 people have attended training in dementia. The annual training programme was seen. The majority of staff have achieved NVQ Level 2 or 3. New staff are encouraged to undertake NVQ training. Thurlestone Court DS0000003843.V282739.R01.S.doc Version 5.1 Page 17 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): 31,32,36,38 Resident’s benefit from a competent, enthusiastic and committed manager with a good understanding of meeting older peoples needs. Health and safety standards are maintained but there is a lack of protection from unregulated hot water temperatures, which is causing a potential risk to vulnerable residents. EVIDENCE: The manager has been in post for just over a year. She has achieved the Registered Managers Award and has just become an NVCQ Assessor. She has experience of working with older people and demonstrates a good understanding of residents needs. The manager provides a clear sense of direction and leadership to the home. She is very enthusiastic about her role and says she “loves her job”. She is open and accessible. Staff said they felt well supported by the manager. Regular supervision and appraisal is Thurlestone Court DS0000003843.V282739.R01.S.doc Version 5.1 Page 18 undertaken. The manager takes time each day to talk with each resident. From her interactions with residents it is evident that she knows residents well and that they have confidence in her management style. Hot water to wash basins is not regulated (see also Standard 25). Although all service users have been risk assessed there continues to be a potential risk of scalding until the work has been completed. The manager explained that all homes in the Court group are expected to have this work done, but as yet she had no date for work to commence. Written warning signs are not sufficient to protect residents who are mentally of physically frail from the risk of scalding. This area was required at the previous inspection and has not been addressed. It now must be done. Miscellaneous toiletries were seen in the bathroom. These should be removed to prevent risk of cross infection. Thurlestone Court DS0000003843.V282739.R01.S.doc Version 5.1 Page 19 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 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 4 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x 1 3 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 x x x 3 x 2 Thurlestone Court DS0000003843.V282739.R01.S.doc Version 5.1 Page 20 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 OP25 Regulation 23 (4) (p) Requirement The heating system in the home must be reviewed to ensure that the temperature is maintained at a comfortable level for residents. The registered provider must ensure that all hot water outlets, accessible to residents are fitted with fail safe devices, and hot water regulated to 43oC as required. ( Previous timescale of 25/11/05 not met) Timescale for action 31/03/06 2 OP38 13 31/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard OP16 OP18 OP26 OP38 Good Practice Recommendations To clarify the recording of the outcome of any complaint received for purposes of closure. The manager and senior staff to attend multi agency training on adult protection. Laundry wall should be redecorated. To remove miscellaneous toiletry items from bathrooms. DS0000003843.V282739.R01.S.doc Version 5.1 Page 21 Thurlestone Court Thurlestone Court DS0000003843.V282739.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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. 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