Inspection on 09/12/08 for Thurn Court

This inspection was carried out on 9th December 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Thurn Court 21/12/06

Thurn Court 03/11/05

Thurn Court 06/04/05

Thurn Court 10/01/05

Thurn Court 27/07/04

Similar services:

Applegarth

Trevayler Residential Care Home

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Thurn Court Thurncourt Road Thurnby Lodge Leicester LE5 2NG     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Linda Clarke     Date: 0 9 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 33 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 33 Information about the care home Name of care home: Address: Thurn Court Thurncourt Road Thurnby Lodge Leicester LE5 2NG 01162413126 01162418848 socis211@leicester.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Rajesh Parekh Type of registration: Number of places registered: Leicester City Council care home 38 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability sensory impairment Additional conditions: No person falling under 60 years of age who fall within categories/combined categories DE, MD and SI should be accommodated within Thurncoat No person falling within category OP should be admitted into Thurncoat where there are 38 persons of category OP already accommodated within the home No person falling within the categories/combined categories DE, DE/E, MD and MD(E) should be admitted into Thurncourt where there are 20 persons who fall within categories/combined categories DE, DE(E), MD and MD(E) already accommodated within the home. No person falling within the categories/combined categories SI and SI(E) should be Care Homes for Older People Page 4 of 33 20 20 0 5 10 Over 65 20 20 38 5 10 admitted into Thurncourt where there are 10 persons of categories/combined categories SI and SI(E) already accommodated within the home No person falling wthin the categories/combined categories PD and PD(E) should be admitted into Thurncourt where there are 5 persons of categories/combined categories PD and PD(E) already accommodated within the home The maximum number of persons to be accommodated at Thurncoat is 38. Date of last inspection Brief description of the care home Thurn Court is a residential care home run and owned by Adult and Housing Department of the Leicester City Council and is located in the residential area of Thurnby Lodge. The closest shopping area is on the Humberstone Road, where residents have access to shops, the post office and other amenities. Public transport is close to the home and car parking is available to the front. Thurn Court is registered to accommodate up to 38 residents under the categories of older people and elderly residents, with dementia, mental disorder, physical disability and sensory impairment. There are 38 single bedrooms without en-suite facilities. Thurn Court consists of two floors with level entry access, with the first floor accessible by use of the passenger lift or stairs. Residents have a choice of lounges and seating areas. All the bedrooms are close to toilets, bathing and washing facilities. The home has a garden to the front and rear of the building which is well maintained and which is accessible to all the people living at Thurn Court. Information regarding fees is available by contacting the Registered Manager of Thurncourt. There are additional individual expenditure such as hairdresser, chiropodist, newspapers, magazines and personal toiletries and the fee will depend on the services received. Information about the Thurn Court is located at the main entrance detailing the range of services offered, which includes the Statement of Purpose. A copy of the latest Commission for Social Care Inspection reports (CSCI), inspection report is located in the foyer with the displayed registration certificate. The residents are informed of the findings of the CSCI inspection at the `Residents Meetings? or individually. Care Homes for Older People Page 5 of 33 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We as it appears throughout the Inspection Report refers to The Commission for Social Care Inspection. The inspection process consisted of pre-planning the inspection, which included reviewing the Annual Quality Assurance Assessment (AQAA), which is a selfassessment tool completed by a representative of the service, reviewing previous Inspection Reports, and any information we have received. The unannounced site visit commenced on 9th December 2008, and took place between 09:30 and 17:30. The focus of the inspection is based upon the outcomes for people who use the service. The method of inspection was case tracking. This involved identifying people with Care Homes for Older People Page 6 of 33 varying levels of care needs and looking at how these are being met by the staff at Thurncourt. Four people accessing services were chosen and discussions were held with two of them, along with four other people living at the home, and visiting relatives. Staff members were spoken with along with the Registered Manager. We also sent surveys to some people living at the home, and their relatives. Surveys were also sent to health and social care professionals, and a selection of staff who work at the home. What the care home does well: What has improved since the last inspection? Environmental improvements to Thurncourt have included the provision of two flat screen televisions for the two large lounges, and the decoration of some communal areas within the home. External improvements have included the purchasing of an awning and new patio furniture. Care Homes for Older People Page 8 of 33 The self assessment tool, asks the person completing the form to identify what improvements have taken place of the previous year. The document said that staff at the home have worked with health colleagues to reduce the number of people falling within the home. Improvements with regards to staff means that all newly recruited staff receive training as to their roles and responsibilities in reporting concerns to protect the safety and welfare of people living at the home, and by increased levels of supervision. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Older People Page 9 of 33 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 10 of 33 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 11 of 33 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Thurncourt enables people who require residential care to make an informed decision as to whether the home is appropriate to their needs by providing information about the services it provides and through its assessment process. Evidence: We wanted to look at the information provided to people who use the service to find out whether it was detailed and answered all their questions, and to find out how the service passed on the information. We spoke with people who live a Thurncourt and individuals who were visiting relatives on the day of our visit, all said they had been given information about the home, in some instances before they moved in, whilst others received information when they arrived at the home. Information available includes a colour brochure which includes photographs of the home, providing people with information about what they can expect. Care Homes for Older People Page 12 of 33 Evidence: We spoke with two people who had lived at the home for a while, one person told us that they had made an informed choice to move into residential care, and that their daughter had help them choose a home. The person told us they were very satisfied with their decision as Thurncourt was a lovely home. The second person told us that moving into residential care wasnt what they initially wanted, and that it took a while to adjust, but they now think of Thurncourt as their home, and that they are very happy. We sent surveys to some of the people living at the home and their relatives, surveys told us that everyone had receive a contract about their care and that they had received enough information about the home before they moved in, or that their relatives had visited the home on their behalf. We looked at the records of four people living at Thurncourt, and found that individuals had had their needs assessed by a Social Worker, before moving into the home, this enables the Registered Manager to look at the information provided and decide whether their needs can be met by the staff and facilities at the home. We spoke with two visitors who were visiting their relatives, and both told us that the care their relative receives is reviewed, and that the meeting includes themselves, representatives of the home and a Social Worker, this ensures that the care provided is as the person needs and expects. Care Homes for Older People Page 13 of 33 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people receive is based on their individual needs, choices and expectations of care, and the principles of respect, dignity and privacy are put into practise. Evidence: We wanted to find out how the health and personal care needs of people living at the home were met. We spoke with people living at the home along with visiting relatives, and observed the care and support provided by staff, we also looked at the care plans and records of four people. When we asked people about the care they received they told us the staff here are marvellous, nothing is too much trouble. Whilst someone else said the care is good, Ive been here a while now and Ive settled in, this is my home. We spoke with someone who was visiting a relative who lived at the home and they told us they always keep me up to date, and I have no concerns about the care provided, when asked about the staff they said the staff are very good, and always helpful. Care Homes for Older People Page 14 of 33 Evidence: We sent surveys to people who live at the home and their relatives and asked them about the care they receive. Everyone expressed satisfaction, and some people included additional comments. I believe Thurcourt is as good as any other home of its type i.e. good down to earth, home from home accommodation for elderly people. Thurcourt staff are always polite and friendly. The home is always pleasant and I am happy with the care my mother receives. I have been here at Thurcourt for several years, and I dont have any regrets what so ever, at choosing to home here as a resident. Care is what I receive in the true sense of the word. The staff are caring and treat me with respect. Im happy at Thurncourt, everyone is very good to me. Care plans contain good information about the care and support individuals need, and the role of staff in providing the support. The information contained within care plans could be improved by including information about a person life before moving into the home, such as information about their work and family life, hobbies and interests, and significant events and dates, this information would enable staff to develop a care plan more tailored to suit individual lifestyles. Development of care plans could also be improved for those people who have Dementia, by providing detailed information about how the condition affects the person, and what measures staff can put into place to reduce their anxiety. We sat with the care plan of one person whilst speaking with them, they were fully aware of the contents of their care plan, and were happy about what was written about them. They spoke of the health care support they receive from a District Nurse, who visits regularly. We sat with one person at lunchtime, they told us that they had been asked to write their own care plan, this is good practise and should be encouraged for everyone, with involvement from relatives. Records we looked at showed us that people living at the home have access to a range of health care professionals, and that additional areas of care are assessed to ensure that people receive the care and support they need. Thurncourt supports people in conjunction with health care professionals to remain at home if they so wish in the final stages of their life, enabling them to die with dignity in the home, and not go into Care Homes for Older People Page 15 of 33 Evidence: hospital if they so choose. We sent surveys to health and social care professionals and asked them for their views about the care people receive at the home, positive responses were received to questions, along with additional comments. One Social Worker wrote I have always found the staff and carers at Thurncourt very supportive and accommodating. Whilst a General Practitioner wrote a good health care service looking after individuals needs very well. We looked at the medication and medication records for some people, and found them to be in good order, recent changes to legislation mean that the Registered Manager needs to ensure that the way in which Controlled Drugs are stored and managed is satisfactory. The Registered Manager told us that they had discussed this with a Pharmacist who said that arrangements at the home were satisfactory, there was no written evidence to confirm this. One person we spoke with said that the home helps them to maintain their independence by enabling them, with supervision, to manage their medication for Diabetes. Care Homes for Older People Page 16 of 33 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Opportunities are available for people to engage in activities, but these are not far ranging and are dependent upon the availability of staff to provide them, and the ability of people to participate. Thurncourt provides a wholesome and varied diet. Evidence: We wanted to find out about how people spend their day, and how the staff working at the home support people to make decisions and stay in contact with relatives and friends, we did this by observing people throughout the day, talking with people living at the home and by looking at the care plans and records of four people. Thurncourt has a relaxed atmosphere, with people getting up and spending time where they choose too, for some this meant staying in their bedroom, whilst others sat in one of the five lounges in the home. We sat with two people in a small lounge on the first floor in the morning, both said that they prefer the quiet of the smaller lounge, as this enables them to talk to each other and to read. One person told us that the visiting library was very good, and that they were able to order books of their choosing. In the afternoon the two people in the small lounge were visited by a Church Minister and family members who took part in Prayer. One of them told us that the local Church Care Homes for Older People Page 17 of 33 Evidence: also visits regularly and holds Church Services within the home, and that occasionally outside entertainers visit and facilitate a sing a long, or staff organise bingo. One lady told us that at Christmas they are visited by The Thurncourt Santa, who gives them a Christmas present, in addition everyone receives a present from the local Church when they visit. On the ground floor their are two large lounges, and two small lounges of which one is for people living at the home who wish to smoke. The two larger lounges have a flat screen television mounted onto the wall, whilst the smaller lounges have a smaller television on a stand. A majority of people choose to sit in one of the larger lounges, the television was on throughout the day, but few people appeared to be interested in the programme, in addition the volume was low, so only those sitting near to the screen would have been able to hear. We saw a member of staff facilitate a quiz in one of the larger lounges, only a few people responded to the quiz questions, it may have been that some people could not hear the questions, or were not interested in the quiz, or found the questions difficult to comprehend and understand. There were also disruptions to the quiz session, with other members of staff coming in and out of the lounge providing personal care and attention where required. The Registered Manager told us that they have recently interviewed someone who will be responsible for the organising of activities and recreational events, and that he hoped they would be commencing their role once the appropriate pre-employment checks had been completed. We sent surveys to people who live at the home and their relatives. The surveys indicated that some people are happy with the activities offered, particularly those who are independent and able to make positive choices, surveys also indicated that for those who are dependent upon staff for recreation and stimulation their is a shortfall in their expectations. People living at the home and their relatives made the following comments:I am self sufficient and have lots to do in my own room, library books supplied, a television, a lovely view from my window and I carry on a large correspondence with friends. There are not a lot of activities, I think there should be more to do. More activities for residents. Care Homes for Older People Page 18 of 33 Evidence: A survey returned by a Social Worker indicated that people would benefit from additional activities and stimulation, which can only be achieved by staff receiving training and by the employment of additional staff, they wrote the range of activities is poor, there are a large number of residents would would like trips out even just to the local shopping centre, but are told it is not possible due to staff time. The assessment process for people moving into the home needs to include information as to a persons, hobbies and interests and expectations of care, so that a care plan can be developed which supports a persons lifestyle choices. The way in which activities are organised needs to be reviewed, given that a majority of people living at the home cannot or find it difficult to take part in large group activities, this again would support and promote person centred care. We sat and joined in the lunchtime meal with a group of people in the dining room, and asked them what they thought about the food provided. One person said its very good, you can have as little or much as you like. We observed that vegetables were put into serving dishes on the individual dining tables, enabling people to serve themselves. People who required support from staff received it as detailed within their care plan. The dining experience was unhurried and relaxed, and people sat talking to each other and sharing jokes. The menu for meals for the day is displayed in the dining room, and people were asked what they wished to eat. We sent surveys to people who live a Thurncourt and asked them for their views about the meals. Our Cooks and assistants are excellent. We have varied menus and at resident meetings, Cook sits in and asks for any fresh ideas or any particular requests. The tea time choice is always a hot snack or assorted sandwiches. Birthdays are always celebrated and Cook makes a cake to share. Meals are prepared to a high standard and are varied. A good selection of food at all meal times. Meals can be obtained at other times if necessary. Care Homes for Older People Page 19 of 33 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Thurncourt are able to express their concerns, and have access to a complaints procedure, improvements need to take place to ensure that all staff are aware of their role and responsibilities in protecting people from abuse. Evidence: We wanted to find out how the staff of Thurncourt promote the safety and welfare of people who use the service, written information supplied by the Registered Manager before our visit told us about the policies and procedures staff have to follow, to safeguard vulnerable people. Newly appointed staff undertake a period of induction which takes places over three months, and includes training as to their roles and responsibilities in ensuring people in their care live a life free of abuse. Information supplied by the Registered Manager prior to our visit and discussions during our visit confirm that the home has not received any complaints or concerns in the last twelve months, and our records indicate that we have not received any complaints about the service. We spoke with people living at the home and asked them if they knew who to speak with if they were unhappy or wished to complain, some people said they would speak to the Manager, whilst others said they would speak to a relative or their Social Worker. Care Homes for Older People Page 20 of 33 Evidence: We sent surveys to people who use the service and their relatives, all indicated that they knew how to raise a concern, and felt that staff listened and acted upon what they say. We also sent surveys to staff, who told us that they were aware of the homes complaints procedure, and their role in reporting concerns to the Manager. We spoke with staff and looked at records to find out about the training care staff receive, whilst newly recruited staff have attended training which enables them to understand their roles and responsibilities in reporting concerns and protecting people from abuse, many staff have not received any training. We spoke with staff who said they would tackle poor practise, but would not always tell the Manager, which is not consistent with the policies and procedures of the home. Staff did say that they had been given a copy of the General Social Care Council (GSCC) Codes of Conduct and the homes Whistle Blowing Policy, which outlines good practise and the role and responsibilities of staff. Care Homes for Older People Page 21 of 33 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Thurncourt provides, a comfortable and homely environment, which is well maintained. Evidence: We had a tour of Thurncourt, all communal areas of the home were decorated to a good standard, and provided people with light and airy rooms in which to relax. There is an ongoing programme of maintenance and decoration for the home, and in the surveys we sent to people living at the home we asked them if the home was fresh and clean. All said that it was, whilst some congratulated the domestic team of staff, one person wrote the ladies in the domestic department work hard doing a job that not every would choose to do and are always cheerful. Whilst someone else wrote the cleanliness of the home is exceptional. Another person wrote every effort is made to maintain a clean, fresh environment, which is not always an easy task. Thurncourt has two large lounges, and one smaller lounge on the ground floor, which overlooks the front of the home and its gardens, whilst a further smaller lounge is used for people who wish to smoke. There is a garden to the rear of the property and information supplied by the Registered Manager prior to our visit told us that an awning has been installed to the front of the building, and that patio furniture has been purchased. The dining room, entrance foyer and lounge have been decorated within the last twelve months and key pads have been installed to the front door to Care Homes for Older People Page 22 of 33 Evidence: improve security arrangements. The first floor provides a small lounge and further lounge/dining space. Bathing, shower and toilet facilities are located on the ground and first floor as are the bedrooms. Access to the first floor is via a stairwell or passenger lift. We looked at some of the bathing facilities and bedrooms of people who live at the home, all were deocrated to a reasonable standard, and bedrooms had been personalised with the belongings of people living at the home. Care Homes for Older People Page 23 of 33 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Thurncourt are supported by staff who have undergone a robust recruitment process and are employed in sufficient numbers to meet their personal care needs, the care people receive would be improved by staff receiving additional training. Evidence: We spoke with staff who worked at the home and asked them about staffing levels, all staff including the Registered Manager said their are five staff on duty in the morning, and four in the afternoon and evening, staff felt that generally this was sufficient, but that they felt that when people are ill and needed additional support, that this can cause difficulties. We sent surveys to people who use the service and asked them about staffing levels and the ability of staff to provide the care they need, views were mixed with some people indicating that staff are always available, whilst some reflected usually or sometimes. Additional comments were made by some people living at the home. Thurncourt staff could benefit from a couple more colleagues, they work very hard, I am well satisfied with what they are able to do, a shortage of staff can sometimes mean a short wait for a non-emergency request, but it doesnt bother me. Care Homes for Older People Page 24 of 33 Evidence: The staff are always near to hand but most of the residents have mobility difficulties so wait for staff to be within sight to communicate with them or press the buzzer. If they are are not to busy with other people they are available. A survey completed by a social care professional wrote the most complained about issue is the response time taken when the service user calls for assistance, this issue needs addressing. We sent surveys to staff and asked them for their views as to whether there are enough staff to meet the indivdual needs of people living at the home, responses were mixed, with some making additional comments, which related to the delay in attending to people in the mornings, with people having to wait a short time. Whilst one person wrote it seems more and more residents need more help in what seems almost nursing care which takes longer and care staff often are very stretched. Our observations of the day were that responses times to call bells were reasonable, and that emergency calls were dealt with efficiently, we also noted that staff were very busy, which left little time to spend with people, offering reassurance or engaging in conversation. We wanted to find out how staff were recruited and whether the recruitment of staff promotes the health and well being of people who use the service. The recruitment of staff at Thurncourt is managed by the Human Resources Department of Leicester City Council, where records are kept, we therefore could not view these. Information supplied by the Registered Manager within the AQAA stated that staff are recruited following a robust procedure, which includes seeking two written references and the obtaining of a Criminal Record Bureau (CRB) disclosure. Information provided to us by the Registered Manager before our site visit states that 60 of staff have obtained a National Vocational Qualification (NVQ) in Care, with a further 6 working towards the Qualification. We looked at the training records of staff, and found that staff receive training related to their role in ensuring the health, safety and welfare of people living at the home, which includes food hygiene, moving and handling and infection control. The Registered Manager said that records within the home were not up to date, and did not reflect all of the training staff had undertaken during the current year. Thurncourt is registered to care for people with a range of needs including Dementia, Physical Disability and Sensory Impairments, however training records showed that Care Homes for Older People Page 25 of 33 Evidence: very few staff have received training within these specialist areas. If the service is to further develop to provide person centred care and to build on current care plans staff need to receive training which represents the needs and care people living in the home require. Care Homes for Older People Page 26 of 33 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management of Thurncourt encourages and includes people who live at the home, their relatives and its staff to share their views to ensure that the home is run in the best interests of people who receive a service. Evidence: The Registered Manager of Thurncourt, Mr Rajesh Parekh has worked at the home for many years, and has gained a National Vocational Qualification (NVQ) at level 4 and has attained the Registered Managers Award. Throughout the day we saw people who live at the home, staff, visitors and professional visitors approach the Registered Manager and members of the Management Team, who were able to deal with all queries effectively, conversations Mr Parekh had with us throughout the day demonstrated that the Registered Manager is knowledgeable about the needs of people living at the home, and that his management approach is positive and inclusive taking on boards the wishes and views Care Homes for Older People Page 27 of 33 Evidence: of everyone. Questionnaires are sent out to people who use the service, which are audited, and individual issues actioned by the home. We discussed with the Registered Manager how quality assurance processes could be improved, by analysing results and providing an action plan to address any issues raised, which is circulated to all service users, their relatives and other interested parties. We also discussed with the Registered Manager information supplied by him within the AQAA and how the information could be expanded upon to reflect how the way in which the service runs effects the people living at the home. Staff meetings take place, and staff we spoke with said that they do receive supervisions on a regular basis. Resident meetings also take place regularly throughout the year, and meetings of both staff and residents were included in the quality assurance review for the year. We spoke with staff who said that they receive regular supervisions and attend meetings throughout the year, all indicated that the management team were helpful. Surveys we received from members of staff told us that staff are confident in the support they receive from the management team. Care plans we looked at evidenced that people living at the home or their representative manages their money, the Registered Manager advised that the day prior to our site visit, they had had an unannounced visit by the financial auditing department of Leicester City Council, which was a routine visit. Information the Registered Manager supplied prior to the site visit details the regular maintenance of equipment and systems in the home, including heating and electrical systems along with fire fighting equipment and systems. Care Homes for Older People Page 28 of 33 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 29 of 33 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action 1 30 18 The Registered Manager to 11/03/2009 develop a training plan, which enables staff to receive training that reflects the categories of registration the service is registered and the needs of people living at the home. The care provided to people living at the home is delivered by competent and knowledgeable staff who can meet peoples individual needs. Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 13 The Registered Manager to 11/03/2009 establish and have written information to confirm that the cabinet which stores Controlled Drugs at Thurncourt complies with the Misuse of Drugs (Safe Custody) Regulation 1973. If it is found current storage facilities do not meet the regulations then a storage system, which does comply with the Misuse of Drugs (Safe Custody) Regulation Care Homes for Older People Page 30 of 33 1973 is to be purchased and installed. To ensure the safe storage of Controlled Drugs. 2 12 16 The Registered Manager to 11/03/2009 consult with people living at the home and their relatives about their individual wishes and expectations as to their recreational and leisure interests, and to develop a plan of care supporting this. To enable everyone living at Thurncourt to live a rewarding life in a manner of their choosing. 3 18 13 The Registered Manager to establish a programme of training which ensures that all staff receive training as to their role and responsibilities in protecting adults from abuse. To promote the health, safety and welfare of people living at the home. 4 18 13 The Registered Manager to ensure that all staff are aware of their specific roles and responsibilities in safeguarding adults from abuse. To promote the health, safety and welfare of people living at the home. 5 33 26 The Registered Provider to 12/01/2009 ensure that a representative of the company visits the home at least once a month, 11/01/2009 11/03/2009 Care Homes for Older People Page 31 of 33 and speaks with people living at the home, staff and visitors, undertakes an inspection of the premises and views records, and prepares a written report as to the conduct of the care home. To ensure that the home is being managed well. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 The care people who live at Thurncourt receive could improve through the development of person centre care, which would include the further development of care plans to include historical information about a persons lifestyle, and by comprehensively recording the support and care they need where people have Dementia, to reduce anxiety and disorientation. Quality assurance process includes service users, their relatives and visiting health and social care professionals, and that results from the process are collated and analysed, and an action plan produced. This is then circulated to all relevant parties. 2 33 Care Homes for Older People Page 32 of 33 Helpline: 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 We want people to be able to access this information. 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