Care Home: Don Thomson House

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What the care home does well Support plans for people who live at the home are becoming more person centred, ensuring there is detailed and comprehensive information recorded about their specific care needs, identified areas of risk and provide guidelines for staff as to how their support needs are to be met. The manager and the staff team understand the principles of providing person centred care. The healthcare needs of people are generally well documented. The practice at the home ensures that where appropriate people are supported by staff to attend appointments but also to encourage maximum independence for those people able to manage some aspects of their own healthcare needs. Medication practices and procedures in the home are good so as to ensure people`s health and welfare. People are able to make choices and decisions about how they spend their day and are supported by staff to develop their life skills. People who use the service are able to express their concerns and are overall protected from abuse. Training of staff in safeguarding is regularly arranged by the home. People living at Don Thomson House are happy with the care they receive, and the choices of food, and activities. One person stated "I like living here" and another said "I am happy here, they care for me very well". People confirmed they are enabled and supported to maintain close relationships with family members and to see friends and to receive visitors. Again this is echoed in the AQAA when the manager stated that "We provide a caring, warm and safe environment for residents to live in. The home`s strengths are the real community links that enable the residents to feel that they are still part of the wider community. Maintaining identity and person-hood whilst providing a person centred approach to care." They indicate they have a commitment to listening to both staff and service users and regularly making changes to their practice when offered best practice recommendations to promote improvement. There is an annual quality assurance system in place. The purpose of the reviews the home do validate service improvements and assess the service progress. What the care home could do better: Attention should be paid to ensuring care plan evaluations are not repetitive and that signatures and dates are clear on all documentation. Daily evaluations should be specific and not repetitive, detailing fully the care given so care staff can be sure they are meeting the service users care needs. Random inspection report Care homes for older people Name: Address: Don Thomson House Low Road Dovercourt Harwich Essex CO12 3TS two star good service The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Helen Laker Date: 1 9 0 5 2 0 1 0 Information about the care home Name of care home: Address: Don Thomson House Low Road Dovercourt Harwich Essex CO12 3TS 01255240978 01255506493 louisa.smith@sanctuary-housing.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Sanctuary Care Ltd Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 28 Number of places (if applicable): Under 65 Over 65 28 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users who can be accommodated is 28 The registered person may provide the following categories of service only: Care Home only - Code PC, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Date of last inspection Brief description of the care home Don Thomson House is a purpose built home situated in a residential area of Dovercourt near Harwich, Essex. The home provides residential care for 28 older people, over the age of 65 who may have varying dependency needs. Care Homes for Older People Page 2 of 10 Brief description of the care home Accommodation is provided through single room occupancy with all rooms except one having en-suite facilities. All areas of the home are accessible, including the gardens through the provision of ramps. There is a passenger lift to the first floor. To the front and side of the home there is ample parking. Current levels of fees charged by the home are between 578.00 and 676.00 pounds per week. Information about the service can be obtained from the home or from Sanctuary Care Head office. Care Homes for Older People Page 3 of 10 What we found: This was an unannounced random inspection. The visit took place over one day by one inspector and lasted a total of three hours. The purpose of the site visit was to monitor compliance to the Outcome Groups relating to Health and Personal Care, Concerns and Complaints and Management and Administration of the Home. As part of the process a number of records relating to people who live in the home, support staff and the general running of the home were examined. Prior to the site visit, surveys for people who live at the home and support staff were requested to be sent to the home for distribution. The response was positive and we received four completed surveys from people who live at the home, two from staff and four from relatives. We also looked at all the information that we have received, or asked for, since the last key inspection, including the Annual Service Review undertaken on 14th August 2008. Prior to this inspection, the manager submitted an Annual Quality Assurance Assessment (AQAA). This is a self assessment document, required by law, detailing what the home does well, what could be done better and what needs improving. Information given in this document has been incorporated into this report. At the time of the site visit there were twenty seven people living at Don Thomson House, whose predominant need was that of older people. A recent planning application is currently being progressed to increase the homes capacity to accommodate a further 42 beds, 32 of which will be elderly dementia and nursing. An application to vary the homes registration to provide this care has not yet been submitted to the Care Quality Commission. The work to extend the building is anticipated to take about eighteen months. the home is to keep CQC well informed of developments and progress. Sufficient members of care staff were noted to be on shift and additionally the registered manager was on duty. On inspection of four care plans these showed that these are developed with the person using the service and/or their representative. Each care plan was seen to be person centred detailing their specific care needs and included peoples strengths, abilities, choices and areas where they require specific staff support. The care plans included risk assessments detailing the identified risk and actions to be taken to reduce the risk. Records showed that the care plans were reviewed regularly and amended where the persons care needs had changed so as to ensure information recorded was accurate. Evidence showed that the support plans and risk assessment profiles can be easily used as a good source of information by newly appointed staff and/or others who are not familiar with the individual person. This will enable them to deliver a personalised and consistent quality of care and support. Daily evaluations should be specific and not repetitive, detailing fully the care given so care staff can be sure they are meeting the service users care needs. Staff spoken with on the day of inspection all confirmed they are given up to date information about the needs of the people they support. One stated I think we all work very well as a team to support people in the best way we can for them. We are flexible in our approach to work and always give support at the times it is most needed and we are always trying to improve the support we give and find ways to promote peoples independence. There is evidence that consultation with the individual goes ahead and that their choices are included, additionally other professionals are used as a part of this process. All care plans are signed for by the resident or their representatives to show that care to be provided is agreed. Looking through care plans it evidenced that specialist services are catered for, that appropriate equipment is provided and in place for those individuals that need it. There is a good process for monitoring of falls; pressure sores and other health issues in place. All residents have access to a GP, district and community nurse, chiropody, Care Homes for Older People Page 4 of 10 optician, audiologist and dental practice. Paperwork evidenced staff liaise well with other professionals and have strong links and good partnerships with external teams. Medication is stored within lockable cabinets. Controlled drugs are maintained in accordance with agreed procedures. Record sheets had been correctly recorded and signed for. Staff spoken with around medication issues evidenced that they were experienced, professional and competent. Staff who administer and stock check medication are all fully trained to do so. Overall the homes system for checking, monitoring, ordering, disposal and booking in of and accounting for medication are all to a good standard. Information relating to how people can make a complaint or raise concerns was displayed on the notice board in Don Thomson House. In the AQAA it is recorded that the home has received six complaints with five being upheld, in the last twelve months and three safeguarding referrals have been made. The home has a robust complaints policy overall and the AQAA confirms that they ensure staffs knowledge is continually updated to keep abreast of changes in legislation and any impact that may have on the service. All staff understand their part in reporting and recognising abuse, all staff have booklets from the vulnerable adults protection team and have attended safeguarding adults training recently. Complaints are investigated and responded to within 28 days. People who live in the home know how to make a complaint and to whom they would make it e.g. key worker, manager or other member of care staff. We have not received any complaints directly about the service or concerns from placing authorities who the home state regularly review the care of people living at the home in the last twelve months. The manager stated on the day of inspection that With regard to complaints each service user, family and friends are informed about our complaints procedures whilst being admitted to Don Thomson. There is a compliments/complaints file located in main office and all complaints are recorded accordingly, investigated and answered within the allotted time scale. All new employees must have clearance from the Criminal Records Bureau before commencing the post. The registered manager ensures staff receive the appropriate training with regard to protection from abuse. Each staff member must attend SOVA (Safe Guarding Adults) training and receive an induction on the homes policies and procedures which is kept on their personal file once completed. They must also do Skills for Care induction which now includes a unit on SOVA; this is then signed off by manager or line manager and kept on their personal files. The last SOVA course attended was noted to be on 20th March 2010. Evidenced through documentation are good environmental risk assessments of all areas inside and outside of the building. The carries out health and safety weekly, monthly and annual checks within the inside and outside environment of the home. The homes AQAA highlights there have been improvements to the environment Change of carpets and bedroom furniture to some bedrooms. Change of carpet to the reception area and ground floor areas. Redecoration of bedrooms and all corridors and reception areas. Redecoration of the building undertaken. Automatic closure fitted to bedroom doors. New fire door as per last inspection requirement which is now met. A new emergency lighting system fitted and new blinds fitted in the dinning areas. There are plans to update some of the tired furniture in rooms, including arm chairs and consider replacing the first floor carpets. The maintenance and up keep of the home was confirmed by one survey as A welcoming environment and always kept clean The home is odour free, clean, homely and meets the needs of the client group. Individual rooms are personalised and well maintained. The home does consult with the resident group about improvements to be made in communal areas and individuals are consulted with regarding re-decoration of their private rooms. Laundry facilities are well maintained and looked after, staff spoken with showed good knowledge and understanding around infection control. Documentation showed that staff have universal inflection control training and that all health and safety equipment, Care Homes for Older People Page 5 of 10 protective clothing is available for staff to enable them to protect both the health safety and welfare of themselves and of residents. The manager who has been in post since September 2009 has made an application for registration. This is currently being progressed by the CQC. She has twenty five years experience in care and a background in nursing. She is currently doing her LMC (Leadership and Management Award fo Care Services) They have made a positive impact on the running of the home. The manager evidenced through discussion, documentation looked at during the site visit and the AQAA sent back to CQC that she is knowledgeable, has good experience and is organised in her role. There is clear accountability of roles amongst the team and a strong management support system in place. The policy, procedures and support for both residents and staff maintain that their health, safety and welfare is protected. The manager leads by example and encourages the staff team to practice in terms of a residents rights and empowerment. The homes practice is continually changing and adapting according to individual and group need which in turn moulds the service provided. Residents are benefiting from a good management team and the level of service is continuing to improve. Residents finances are protected and good accountable systems are is place. The homes Quality Assurance, which is to a good standard and residents meetings partly mould the homes business plan. Overall the home provides a very person centred based service which promotes and encourages independence of the individual. What the care home does well: Support plans for people who live at the home are becoming more person centred, ensuring there is detailed and comprehensive information recorded about their specific care needs, identified areas of risk and provide guidelines for staff as to how their support needs are to be met. The manager and the staff team understand the principles of providing person centred care. The healthcare needs of people are generally well documented. The practice at the home ensures that where appropriate people are supported by staff to attend appointments but also to encourage maximum independence for those people able to manage some aspects of their own healthcare needs. Medication practices and procedures in the home are good so as to ensure peoples health and welfare. People are able to make choices and decisions about how they spend their day and are supported by staff to develop their life skills. People who use the service are able to express their concerns and are overall protected from abuse. Training of staff in safeguarding is regularly arranged by the home. People living at Don Thomson House are happy with the care they receive, and the choices of food, and activities. One person stated I like living here and another said I am happy here, they care for me very well. People confirmed they are enabled and supported to maintain close relationships with family members and to see friends and to receive visitors. Again this is echoed in the AQAA when the manager stated that We provide a caring, warm and safe environment for residents to live in. The homes strengths are the real community links that enable the residents to feel that they are still part of the wider community. Maintaining identity and person-hood whilst providing a person centred approach to care. They indicate they have a commitment to listening to both staff and service users and regularly making changes to their practice when offered best practice recommendations to promote improvement. There is an annual quality assurance system in place. The purpose of the reviews the home do validate service improvements and assess the service progress. Care Homes for Older People Page 6 of 10 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 2. Care Homes for Older People Page 7 of 10 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 8 of 10 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 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 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 6 Daily evaluations should be specific and not repetitive, detailing fully the care given so care staff can be sure they are meeting the service users care needs. Care Homes for Older People Page 9 of 10 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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