Care Home: Thingwall Hall Nursing Home

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What the care home does well Easy to understand information is given to the people living at Thingwall Hall about their home. This includes the use of pictures and photos and helps people to understand as much as possible about their daily lives and their rights. If anyone is considering moving into Thingwall Hall, then a full assessment of their needs and choices in undertaken. This along with the opportunity for people to visit and stay overnight helps people to have as much information as possible before they make a decision.The people living at Thingwall Hall and their relatives are as involved as possible in putting together their care plan. Plans are detailed and up to date and help to make sure, that staff have a good understanding of the person and their choices as well as their support needs. Good support is provided to people to meet their personal care and health care needs. People also receive support to get out and about in their local community or to take part in activities that they enjoy. Clear polices are in place for dealing with concerns or complaints and the people living at Thingwall Hall are confident their concerns are listened to and acted upon. There are good systems in place for the organisation to check the quality of the service they offer. These include obtaining the views of the people who live there and their representatives and provide a way for people to influence the support and services they receive. What has improved since the last inspection? Since the last big inspection of Thingwall Hall the way in which peoples money is managed has begun to change. People now receive their mobility money directly and pay towards the cost of the transport they use instead of paying a set price. This helps to ensure their money is safely and fairly looked after. Everyone living there now has a clear plan in place that advises and instructs staff how to manage medication the person is prescribed for occasional use. This helps to lessen the chance of mistakes occurring and also helps to ensure people get their medication when needed. What the care home could do better: Some peoples care plans could be expanded to ensure that they take account of their social needs and choices as well as their health and personal care needs. This will help to ensure people are supported to live as varied a lifestyle, as they would like to. The plans for more redecoration and refurbishment of some bathrooms will enhance the environment for the people living there. CARE HOME ADULTS 18-65 Thingwall Hall Nursing Home Thingwall Hall Drive Broadgreen Liverpool Merseyside L14 7NY Lead Inspector Ms Lorraine Farrar Key Unannounced Inspection 26th February 2008 10:50 Thingwall Hall Nursing Home DS0000005473.V357378.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Thingwall Hall Nursing Home DS0000005473.V357378.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Thingwall Hall Nursing Home DS0000005473.V357378.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Thingwall Hall Nursing Home Address Thingwall Hall Drive Broadgreen Liverpool Merseyside L14 7NY 0151 228 4439 0151 254 1951 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Brothers of Charity Mr Steven Wright Care Home 40 Category(ies) of Learning disability (40) registration, with number of places Thingwall Hall Nursing Home DS0000005473.V357378.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users to include up to 40 LD Maximum no registered 40, of which up to a maximum of 26 PC (Personal Care) and up to a maximum of 14 N (Nursing) 15th June 2006 Date of last inspection Brief Description of the Service: Thingwall Hall is owned and operated by a voluntary organisation called The Brothers of Charity. It provides accommodation and support for up to forty people who have a learning disability. Living accommodation for the registered care homes consists of six separate bungalows. In addition the site has some supported living accommodation, an activities centre, main hall and garden centre. There are large grounds and in addition each bungalow has a separate garden people can access and sit in. Staff are available twenty-four hours a day to support people when needed. Two of the Bungalows also provide nursing care support. Each Bungalow is self-contained and provides single bedrooms, a living area, domestic style kitchen and bathrooms. Aids and adaptations are available for people who need support with their mobility or personal care. All living and recreation areas are single story buildings, which enables people to get about more easily. There is access to the home via public transport and a number of car parking spaces are available on site. The manager advises that there are no set fees for living at Thingwall Hall. Fees are based on an assessment of the persons support needs. Thingwall Hall Nursing Home DS0000005473.V357378.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. Information for this inspection was gathered in a number of different ways. Two Inspectors carried out an unannounced site visit on 26th February 2008 where time was spent reading records and looking at the buildings. ‘Case tracking’ was used as part of the visit. This involves looking at the support a person gets from the service including their care plans, medication, money and bedroom. Time was spent meeting and talking with some of the people living there and with staff about how they meet the person’s needs. Case tracking was used to look at life in the home for four of the people living there. We also met with some of the other people living there, the manager, deputy manager and area director. Any information we have received since the last big inspection of the home is also taken into account. This includes the results of comment cards sent out to some of the people living there, their relatives and staff. In total four of the people living there, three of their relatives and two members of staff returned comment cards. Their views have been taken into account in writing this report. The manager also had the opportunity to contribute information about the service by completing a self-assessment form. This information was used to plan our inspection and has been taken into account as part of the inspection findings. What the service does well: Easy to understand information is given to the people living at Thingwall Hall about their home. This includes the use of pictures and photos and helps people to understand as much as possible about their daily lives and their rights. If anyone is considering moving into Thingwall Hall, then a full assessment of their needs and choices in undertaken. This along with the opportunity for people to visit and stay overnight helps people to have as much information as possible before they make a decision. Thingwall Hall Nursing Home DS0000005473.V357378.R01.S.doc Version 5.2 Page 6 The people living at Thingwall Hall and their relatives are as involved as possible in putting together their care plan. Plans are detailed and up to date and help to make sure, that staff have a good understanding of the person and their choices as well as their support needs. Good support is provided to people to meet their personal care and health care needs. People also receive support to get out and about in their local community or to take part in activities that they enjoy. Clear polices are in place for dealing with concerns or complaints and the people living at Thingwall Hall are confident their concerns are listened to and acted upon. There are good systems in place for the organisation to check the quality of the service they offer. These include obtaining the views of the people who live there and their representatives and provide a way for people to influence the support and services they receive. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Thingwall Hall Nursing Home DS0000005473.V357378.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Thingwall Hall Nursing Home DS0000005473.V357378.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Before anyone moves into Thingwall Hall a lot of information is given to them and is obtained about their needs and choices. This helps everyone to decide if the home is the right place for the person to live. EVIDENCE: The people living at Thingwall Hall told us in their comment cards that before they moved in they were asked if they wanted to live there and given enough information about the service to help them decide if it was a suitable place for them to live. The manager explained on his self-assessment form that before anyone moves into the home a full assessment of their needs and choices is carried out. This is done with the person and anyone else involved in their care. He also explained that wherever possible people are invited to visit the service and stay overnight before they make a decision. Records and discussions with a member of staff showed that this process is followed. Assessment records for someone who has recently moved in showed that a detailed assessment had been carried out. This helps everyone to decide if Thingwall Hall is the right place for the person to live and whether their needs and choices can be met there. Thingwall Hall Nursing Home DS0000005473.V357378.R01.S.doc Version 5.2 Page 9 Information is given to people thinking of moving in and their family about the services they can expect and about local amenities. This information is provided in an easy to understand format with pictures to help people understand the contents. This is good practice as it helps to ensure people can understand as much as possible about the service they are using. Thingwall Hall Nursing Home DS0000005473.V357378.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s individual needs and choices are recognised and met within the service. EVIDENCE: Everyone living at Thingwall Hall has an individual care plan in place and we looked at four of these belonging to people who had a variety of support needs. Plans give clear information about they communicate. For example verbally communicate but how to and body language. This level of the person can do so effectively. the person, their health care needs and how one plan explained that the person did not understand and response to his expressions details helps to ensure that staff supporting Records showed that regular care reviews are held for people and they, their family and support staff are all involved in putting together their plan of care. Thingwall Hall Nursing Home DS0000005473.V357378.R01.S.doc Version 5.2 Page 11 This means that a rounded picture of the person and their likes and dislikes as well as their support needs can be obtained and plans made to support them. Care plans had been regularly updated with handwritten changes where needed to identify any changes to the person needs based on their health or social care needs. Individual risk assessments are in place in people’s care files. These cover areas of the person’s life that may present a risk, such as moving and handling or going out and about. Risk assessments give clear information about how to minimise this risk and keep the person safe. Those looked at during the inspection had been regularly updated to ensure they were accurate. One of the Bungalows provides care with nursing and care plans there were not as developed as others. For example whilst clear information was recorded about the support the persons needs with their health and personal care, there was less information recorded about how their social needs are met. One plan stated that the person was to be supported to go to church, however reviews of the plan did not state whether this support had been provided. The people living at Thingwall Hall told us in their comment cards that they can decide the things they want to do at all times. During the site visit people were seen to make everyday decisions like how to spend their time, when to have a drink and where to sit and they were supported in this by staff. There are a number of ways in which the people living at Thingwall Hall are supported to be involved in wider decision making. This includes monthly meetings with the people living there where they can influence future planning and raise any concerns or queries they may have. Staff spoken with were able to explain how people make daily decisions and how they can non-verbally communicate this. A number of polices and procedures in the home have been provided in an easy to read format with pictures. In addition any letters or newsletters for the people living there are also provided in an easy to understand format. This is good practice as it helps to ensure people understand as much as possible about the daily running of their lives. Thingwall Hall Nursing Home DS0000005473.V357378.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people living at Thingwall Hall are supported to live a lifestyle of their choosing. EVIDENCE: The people living at Thingwall Hall and their relatives told us in their comment cards that staff support them to stay in touch with each other. This was confirmed during our site visit when records and discussions showed that people’s family and friends are able to visit at all reasonable times and that staff do support people to go and visit their relatives at home. In the grounds of Thingwall Hall there is a garden centre open to the public which some of the people living their work in. There is also an activity centre, which provides sensory rooms and activities such as arts and crafts. A large hall on site is also used for bigger activities such as parties or a recent Indian culture night. Thingwall Hall Nursing Home DS0000005473.V357378.R01.S.doc Version 5.2 Page 13 Information about the things that people like to do is clearly recorded in their care plan. During our site visit it was evident that this support is generally offered. For example one lady was spending time with staff having her hair done and doing artwork and said she was going out for a walk later, all these activities were identified in her plan as things she enjoys. Records for other people showed that they are supported to go on holiday, shopping and to a variety of community activities based on their individual choices. There is not as much input from activity staff into one of the Bungalows providing nursing care. Records there did show that staff had supported people with some in house activities. However staff advised that due to recent bad weather people had not been out very much and that this improves in warmer months. A senior member of the management team later advised that plans are being put into place for the people living in this Bungalow to receive more support with their hobbies and activities. This would enable them to live a more varied lifestyle. From observing daily life in the home during our site visit and reading records it was evident that routines are flexible based on people’s individual needs and choices. Menus and records showed that varied meals are offered and that people’s individual choices are taken into account. On one Bungalow providing nursing care different tea time meals were being prepared to cater for individual choices and health needs. The planned menus and diet offer people a choice of eating a healthy diet with plenty of fruit and vegetables available. During the lunchtime meal on one Bungalow there were a number of interruptions. Three different members of staff who worked on site but not directly in the Bungalow rang the bell and stood in the hallway talking loudly. This is disruptive for the people living there and could impact on their enjoyment of what should be a leisurely mealtime. Thingwall Hall Nursing Home DS0000005473.V357378.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people living at Thingwall Hall receive support to maintain their personal and health care needs in a way they prefer. EVIDENCE: Relatives of the people living at Thingwall Hall told us in their comment cards that the people living there get the care and support expected and agreed. One relative explained, “I am very satisfied with the care”. Individual health action plans are in place for the people living at Thingwall Hall. These help to ensure that the person’s health can be easily monitored and action quickly taken if any issues arise. Records showed that people are supported to see other healthcare professionals and staff record the outcome of these meetings to help ensure any advice given can be followed. Thingwall Hall Nursing Home DS0000005473.V357378.R01.S.doc Version 5.2 Page 15 Clear recordings in care plans help to ensure that people receive personal care in a way that they prefer. The information recorded in very detailed. For example one plan advises to ensure the persons is given a flannel to cover their face whilst having their hair washed. This level of detail helps to ensure that where people cannot verbally communicate their choices, unfamiliar staff can still support them well. On one Bungalow notes had been written for staff that they may need to enter the bathroom whilst someone is using it to dispose of items in a clinical waste bin. Although they said that staff must carry out this task quickly and ensure the door is closed this practice could compromise peoples right to privacy and dignity. However in discussion with the senior management team at the end of our visit they gave assurances that this practice would cease. Clear records are kept of medication that is received into the home, given to people and disposed of. This provides a clear audit trail and helps to prevent errors occurring. Where a fridge is provided to store medication daily records of the fridge temperatures are not always being recorded. This needs to be carried out to make sure that the medication is correctly stored and is as effective as it should be. Some of the people living at Thingwall Hall are prescribed medication to take occasionally. Very clear written instructions of what to give and when to give it were available as well as what to do if the medication doesn’t work. This is good practice as it helps to ensure people get the medication they need. A record for one person stated that they were allergic to penicillin. However this information had not been repeated in future records. Staff explained that they thought that this information may not be true, as this persons G.P. had never confirmed it. The lack of proper recording and facts on this issue could compromise the person’s health. Thingwall Hall Nursing Home DS0000005473.V357378.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people living at Thingwall Hall can be confident any concerns they have will be listened to and dealt with appropriately. EVIDENCE: The people living at Thingwall Hall told us in their comment cards that they know who to talk to if they are unhappy with something and how to make a complaint. One person explained, “I tell the staff”. Their relatives also confirmed that they are aware of the homes complaints procedures and said that any concerns they had raised had been dealt with appropriately. The home has a clear complaints procedure in place and audits any complaints that they receive. This is good practice as it helps to identify any possible trends so that they could be dealt with quickly. The manager explained in his self assessment form that the people living at Thingwall Hall and their relatives have all been sent forms that explain to people how to raise any concerns and give them an opportunity to do so. Information about concerns and complaints is given to the people living there in easy read and picture format. This helps to ensure people understand as much as possible about the process. Regular meetings are held with the people living at Thingwall Hall. Records showed that time is spent at these meetings listening to and addressing any concerns people may have and responding to these. Thingwall Hall Nursing Home DS0000005473.V357378.R01.S.doc Version 5.2 Page 17 This not only supports people to raise their concerns but also helps to ensure they are as informed as possible about their home and how it operates. Information about how to recognise and deal with any adult protection issues that arise is readily available to staff and they receive training in this area. In the past year the management of the home have identified possible protection issues and referred them appropriately to be investigated. Since the last big inspection of the service in June 06 we carried out a smaller Inspection in March 2007. Staff had commenced work in ensuring people’s money is managed well and in their best interests. People now receive their mobility money into their own bank account and are charged for their use of vehicles rather than all paying a standard amount. This helps to ensure that their money is managed in their best interests. Thingwall Hall Nursing Home DS0000005473.V357378.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 27 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Thingwall Hall provides a safe place for people to live in, that can meet their support needs. The plans for further development of the premises will ensure all areas are of a good standard of décor. EVIDENCE: Each Bungalow operates as a domestic style home. People have their own bedrooms and share a lounge, kitchen, bathrooms and garden. The people living at Thingwall Hall told us in their comment cards that their home is always fresh and clean and this was observed during our site visit. Bedrooms are decorated to suit peoples individual needs and choices. For example one person who enjoys arts and crafts had a small table in her room for this purpose. Thingwall Hall Nursing Home DS0000005473.V357378.R01.S.doc Version 5.2 Page 19 Aids and adaptations are available throughout the home to support people with their mobility and personal care. This include providing accessible showers and bathing facilities, grab rails and ramps. In addition there are hoists for lifting people and electric beds provided to people who need them. Some areas of the home have been redecorated in the past year and look homely and welcoming. Other areas such as some bathrooms are looking shabby and would benefit from redecoration. The manager explain there are plans in place to replace some bathrooms with wet rooms as these would meet peoples needs better. He also explained in his self assessment form that the organisation are aware that some parts of the home would benefit from redevelopment and plans being made to address this. Systems are in place for preventing any outbreak of infection and staff were able to explain how these work in practice. For example cleaning rotas are followed and systems for dealing with laundry are clear. Thingwall Hall Nursing Home DS0000005473.V357378.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people living at Thingwall Hall are supported by a competent staff team who can recognise and meet their needs and choices. EVIDENCE: The people living at Thingwall Hall told us in their comment cards that staff treat them well and listen and act on what they say. During our site visit staff spoken with had a good understanding of peoples support needs and choices and were able to explain how they respond to these. Staff were seen to spend time with the people living there and to socialise with them as well as meet their basic care needs. Over half of the staff team hold a qualification in care (NVQ) this helps to ensure that they are aware of current good practice in supporting people effectively and well. A member of staff told us in their comment card that, “I have been with the BOC for 6 years and am still learning new things on a daily basis,” whilst another told us, “I think the training is second to none”. Thingwall Hall Nursing Home DS0000005473.V357378.R01.S.doc Version 5.2 Page 21 Records and discussions with staff showed that they undertake a variety of training to help them support people. The training staff undertake is varied and covers areas of health and safety, basic care practices and more specialist areas such as recognising and dealing with peoples different lifestyles and needs and supporting people to manage their behaviour. The amount and variety of training staff undertake helps to ensure that they are aware of the best ways to support the people living at Thingwall Hall safely and well. Records showed that before anyone starts work at Thingwall Hall a series of checks are carried out on them. This includes obtaining written references and a Criminal Records Bureau (CRB) check. These checks help to ensure that staff are suitable to work with people who may be vulnerable. A member of staff explained that when she began working for the organisation she had a good induction programme with “lots of” training. Another carer who had moved from one Bungalow to another explained that for her first week at the new Bungalow she shadowed another member of staff and was given time to read care files. This planned process for introducing new staff to the people living there helps to ensure the people living there are always supported by competent staff. Thingwall Hall Nursing Home DS0000005473.V357378.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Thingwall Hall is safely and well managed for the benefit of the people who live there. EVIDENCE: Mr Steven Wright is the registered manager of Thingwall Hall. Mr Wright is an experienced manager within services for adults with a learning disability and holds a care and management qualification. Records showed that he undertakes training to ensure that he is up to date within his role. There is a clear management structure within the home which both the people living there and staff were aware of. For example people told us in their comment cards that they would speak to a member of the management team if they had any concerns. Thingwall Hall Nursing Home DS0000005473.V357378.R01.S.doc Version 5.2 Page 23 There are a number of systems in place within the service for checking the quality of the support that they provide. This includes regular reviewing and updating of care records and monthly health and safety checks. Regular meetings with staff and the people living there offer an opportunity for any issues to be raised and resolved. A big quality assurance check of the service was carried out by staff in December 2007. This included obtaining the views of relatives and those living at Thingwall Hall. Following on from that an action plan has been put together. This states planned improvements, how they will affect people and how and when they will be achieved. The manager explained in the self-assessment questionnaire that this will be monitored regularly to ensure it is achieved. Records and certificates showed that regular checks and servicing are carried out on the safety of the building and equipment. Staff undertake training in a variety of areas of health and safety such as fire prevention and food hygiene. This helps to ensure that Thingwall Hall is a safe place for people to live and work in. Thingwall Hall Nursing Home DS0000005473.V357378.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 3 X Thingwall Hall Nursing Home DS0000005473.V357378.R01.S.doc Version 5.2 Page 25 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA6 Regulation 13(2) Requirement The temperature of medication fridges must be recorded daily to ensure that the fridges are working properly and that medication is being stored correctly. An investigation into whether or not the person discussed during the site visit is allergic to penicillin must be carried out and recorded. This will help to prevent errors occurring with people’s medication. Timescale for action 30/04/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA6 Good Practice Recommendations Care plans on units providing nursing care should be further developed. Thingwall Hall Nursing Home DS0000005473.V357378.R01.S.doc Version 5.2 Page 26 2. YA17 This will help to ensure peoples social needs as well as their health needs are identified and met. The amount of interruptions that can occur during mealtimes must be explored and action taken to minimise these. This will help to ensure people have a relaxing and pleasant mealtime experience. Thingwall Hall Nursing Home DS0000005473.V357378.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection North West Regional Contact Team Unit 1, 3rd Floor Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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