Care Home: Thackeray House

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What the care home does well All new people receive a comprehensive needs assessment before admission. This is carried out by staff with skill and sensitivity. Residents are able to enjoy a full and stimulating lifestyle with a variety of options to choose from. Personal support is responsive to the varied and individual needs and preferences. The home consults people using the service about their satisfaction with the service they are receiving. People who use the service are able to express their concerns, and have access to an effective complaints procedure, and are protected from abuse, and have their rights protected. The management and administration of the home is based on openness and respect, and has an effective quality assurance system. What has improved since the last inspection? Care plans are now more comprehensive and are being reviewed regularly. Medication records are now fully completed, contain required entries, and are signed by appropriate staff. Gold Standards Framework for End of Life Care has become a team approach. Some of the menus have been changed to reflect suggestions made by people using the service. The communal areas and some bedrooms have been re-decorated. There is more appreciation for the team effort which makes this home run smoothly. Barchester Healthcare has a Manager of Registration who monitors compliance with National Minimum Standards and Care Home Regulations. What the care home could do better: There are no requirements or recommendations from this inspection, however the registered provider/manager must ensure that the home continues to provide a good standard of care. Key inspection report Care homes for older people Name: Address: Thackeray House Thackeray House 58 Addiscombe Road Croydon Surrey CR0 5PH     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Mohammad Peerbux     Date: 2 8 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. that people have said are important to them: They reflect the things 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. Care Homes for Older People Page 2 of 23 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 23 Information about the care home Name of care home: Address: Thackeray House Thackeray House 58 Addiscombe Road Croydon Surrey CR0 5PH 02086498800 02086881393 thackeray@barchester.com www.barchester.com Barchester Healthcare Homes Ltd Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Type of registration: Number of places registered: care home 39 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 39 The registered person may provide the following category of service only: Care home with nursing (CRH - N) 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 Thackeray House is a purpose-built nursing home providing care to a maximum of thirty-nine residents. The home provides care for elderly frail residents and also offers a specific palliative care service. Communal space includes a large dining area, a pleasant conservatory and a quiet lounge. The latter two areas overlook a wellmaintained rear garden. The home is ideally situated as it is close to public Care Homes for Older People Page 4 of 23 Over 65 39 0 1 2 1 1 2 0 0 9 Brief description of the care home transport,the tram passes the front door and it is a short walk from East Croydon railway station and the excellent transport links this affords. The centre of Croydon, with vast shopping and cultural opportunities is only a short distance away. Parking is available directly outside the house. Care Homes for Older People Page 5 of 23 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: This unannounced visit to the home was undertaken as a part of the inspection process for the year 2009/2010. In writing the report, consideration has also been given to information received throughout the year such as comments from people who use the service, reports of incidents and complaints. Some of the people were spoken to and they commented positively on the care they are receiving. They are all thanked for their time and all of those who provided feedback for their support in the inspection process. A tour of the building was also carried out. All registered adult services are now required to fill in an annual quality assurance assessment (AQAA).It is a self-assessment that the provider (owner) must complete every year. The completed assessment is used to show how well the service is delivering good outcomes for the people using it. Some information from the AQAA are included in the report. Care Homes for Older People Page 6 of 23 What the care home does well: What has improved since the last inspection? 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. Care Homes for Older People Page 7 of 23 You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 23 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 9 of 23 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. The home undertakes an assessment of the healthcare needs of individuals prior to their admission to ensure that their needs would be met. Evidence: Admissions are not made to the service until a full needs assessment has been undertaken. Individuals are supported and encouraged to be involved in the assessment process. Information is gathered from a range of sources including other relevant professionals. The pre-admission assessment is carried out by a senior member of staff. Care Homes for Older People Page 10 of 23 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. Generally, individuals care plans include detailed information about their needs and personal goals. This helps staff to know their needs and how to meet them. Evidence: Residents in the home looked well cared for, clean and happy. Those people being nursed in bed looked warm and comfortable. They all have an individual plan of care which identifies areas where they might need support in their daily lives and we looked at four of these. Barchester have a corporate format for care plans and we found them to be comprehensive and in good order. They include information regarding mobility and how staff should help people to move, and assessments of risk, nutritional needs and any factors which could lead to pressure sores developing. Photographic evidence is in place to monitor the treatment of wounds. Appropriate aids and equipment are in place for those who need it. We could see that the plans are reviewed regularly so that any changes are identified Care Homes for Older People Page 11 of 23 Evidence: and can be addressed. Relatives are encouraged to participate in the process so that they are aware of how the service is caring for people and provide information about their preferences. During the inspection we met a Clinical Development Nurse who is employed by the company and part of her remit is to help staff construct the care plans and also to audit them. We did suggest that some more work might be done with regard to residents past lives and achievements in order to help staff understand more about them and also about their wishes, should they become unwell or in the event of their death. Clinical issues are well documented but there is a lack of information about psychosocial needs. Personal care is delivered in residents own rooms and we saw that staff are kind and respectful towards the people that they are caring for. One resident told us they are all very nice, they treat us all nicely, and we get everything done for us. There is an efficient medication policy supported by procedures and practice guidance, which staff understand and follow. Medication records are fully completed, contain required entries, and are signed by appropriate staff. Regular management checks are recorded to monitor compliance. Care Homes for Older People Page 12 of 23 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home tries to be flexible and attempts to provide a service, which is as individual as possible. Dietary needs are well catered for and a well balanced diet is provided, to ensure health and enjoyment of food. Evidence: The people that we spoke with told us that they are able to choose how they spend their days. There is an activities programme arranged for them although, at the time we visited, the activities organiser was away. Two residents we spoke with, told us that another member of staff had been taking her place, she was very good and they were looking forward to playing bingo with her that afternoon. They also told us that the hairdresser comes in regularly, sometimes they get their feet done and a church representative comes every month to give communion. Musical entertainers visit the service and there are trips out in the homes minibus. We noticed that some residents had polling cards for the forthcoming elections and a nurse explained that they are encouraged to vote if they would like to. Visitors agreed that they were always made very welcome when they came. One person told us the home is always so clean, doesnt smell, and the staff are pleasant and friendly. Visitors are invited /welcome to lunch and relatives are included in Care Homes for Older People Page 13 of 23 Evidence: events organised by the home such as Summer fete, Coffee mornings which are held first Saturday of every month. This year the service is celebrating the Barchester Foundation 10th Anniversary to which relatives and the Care Quality Commission have been invited to. The lunch time meal was served while we were in the home. It was well presented and residents told us that it tasted nice. Many of them sit in the dining room and the tables were laid with cloths, flowers, salt and pepper and the days menu. Everyone had a drink and two residents we spoke with were enjoying a glass of sherry. They said that they chose their meal from a menu the day before although sometimes they didnt get what they had asked for. We are told that this issue is now being addressed. Care staff are sensitive to the needs of those residents who find it difficult to eat and offer assistance as appropriate. Residents can choose to dine in the dining room or have room service. Care Homes for Older People Page 14 of 23 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 who use the service are able to express their concerns, and have access to an effective complaints procedure, and are protected from abuse, and have their rights protected. Evidence: The home has an open culture that allows people to express their views and concerns in a safe and understanding environment. The service has a complaints procedure that is clearly written and easy to understand. Unless there are exceptional circumstances the service always responds within the agreed timescale. The service appreciates and recognises that complaints will always occur and rise to the challenge to deal with them quickly and as efficiently as they are able to. They want all residents to feel confident that they have the right to tell them when things are not correct without fear of retribution. The ethos of the home is that it welcomes complaints and suggestions about the service, uses these positively and learns from them. The home keeps a record of complaints and includes details of the investigation and any action taken. There are policies and procedures for safeguarding people who use the service. The manager stated that most of the staff working within the home are fully trained in Safeguarding Adults and know how to respond in the event of an alert. Staff working at the service know when incidents need external input and who to refer the incident to. In house training is updated annually. All staff are aware of the whistle blowing policy which is included in the Barchester Employee Handwork and this is given to Care Homes for Older People Page 15 of 23 Evidence: each new employee upon commencement of employment. Care Homes for Older People Page 16 of 23 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. The home is generally hygienic and clean, homely and comfortable; this environment therefore facilitates the individuals health and emotional well-being. Evidence: The home provides a physical environment that is appropriate to the specific needs of the people who live there. The well-maintained environment provides specialist aids and equipment to meet their needs. Residents are encouraged to personalise their bedrooms. The home is kept clean and hygienic and free from offensive odours throughout. Systems are in place to control infection in accordance with relevant legislation and published professional guidance. Care Homes for Older People Page 17 of 23 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can rely on the home providing adequate staff in sufficient numbers, and being duly competent and well trained, to provide a service that seeks to meet their individually identified needs effectively. Evidence: There are consistently enough staff available to meet the needs of the people using the service, with more staff being available at peak times of activity. 65 of Care Staff are trained to the equivalent of NVQ level 2 or above. Recruitment procedures seemed appropriate. Three staff files were examined at random and found to contain all the information required by the Care Homes Regulations 2001 including a completed job application, terms and conditions of employment, an enhanced CRB check and proof of their identity. The management of the service recognises the importance of training, and tries to deliver a programme that meets any statutory requirements and the National Minimum Standards. Care Homes for Older People Page 18 of 23 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 home management generally provides guidance and direction to staff to ensure people receive consistent quality care. There is a quality monitoring system and this ensures the home is run in a way that is in the best interests of the individuals. Evidence: The manager has the required qualifications and experience to run the home. She has a clear understanding of the key principles and focus of the service, based on organisational values and priorities. There is a strong ethos of being open and transparent in all areas of running of the home. Managerial support is part of the organisations culture. There is a support team as well as Operational Directors. Effective quality assurance and quality monitoring systems, based on seeking the views of residents, are in place to measure success in meeting the aims, objectives and statement of purpose of the home. The annual quality assurance assessment (AQAA) was received on time and contains clear and relevant information. The AQAA lets us know about changes the home has made and where they still need to make Care Homes for Older People Page 19 of 23 Evidence: improvements. It shows clearly how they are going to do this. The service puts a stong emphasis on getting it right for the people they provide a service to by listening to their requests and comments and acting accordingly. Certificates relating to health and safety were up to date servicing certificates. There are regular health and safety checks including POVA checks, so that the staff are confident that they are working in a safe environment. Care Homes for Older People Page 20 of 23 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 21 of 23 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, 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 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 Care Homes for Older People Page 22 of 23 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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. 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