Care Home: Thistledown

Similar services:

• Hillview Farm
• Dalewood Respite Care
• Orchard,The
• REACH Upton Court Road
• Fairways
• Treloar College
• Kestrel House, St Anne`s Opportunity Centre,
• Pinta

What the care home does well Thistledown is run as a large family home with the staff and four of the five people living and working together for over twenty years. The fifth person has lived in the home for over eight years. People know each other very well and the home is run very much like a family home, which comes alive when everyone returns home. It is clear the interests of the people who live in the home are at the fore front of all decisions. All people go to work on week days. They attend college courses and enjoy a range of social activities in the community. The home is well maintained and provides a clean, comfortable and safe environment for people. The home has a good relationship with peoples families and they can visit when ever they want. What has improved since the last inspection? The home continues to provide a homely environment for people who are encouraged to be independent. What the care home could do better: The home needs to ensure the Annual Quality Assurance Assessment has sufficient detail in it to reflect what the home has achieved and what it`s plans are for the future. One requirement was made at the last inspection which relates to the downstairs shower room. When discussing this with people in the home it was clear this is not an issue for them. However a policy still needs to be drawn up relating to maintaining peoples right to privacy and dignity at this time. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Thistledown 33 Beach Road Hayling Island Portsmouth Hampshire PO11 0JB     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: Michelle Presdee     Date: 1 5 0 1 2 0 0 9 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 Adults (18-65 years) 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 Adults (18-65 years) Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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 Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Thistledown 33 Beach Road Hayling Island Portsmouth Hampshire PO11 0JB 02392461282 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr R Bagoban Type of registration: Number of places registered: Mr R Bagoban,Mrs I Bagoban care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 6. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD) Date of last inspection Brief description of the care home The home provides care for up to six people (aged 18-65). Four of the five residents currently at the home have lived there since 1984, whilst the fifth took up residence in 2000. Residents have single bedrooms on the ground and first floors. The home has a lounge with a dining area, a large lounge at the rear of the property, a kitchen, shower room and bathroom. It is within easy reach of local amenities. Residents have the benefit of transport to day centres and other locations in the owners minibus. The current scale of fees being charged at the home is £53.85 per night. Care Homes for Adults (18-65 years) Page 4 of 26 Over 65 0 6 Care Homes for Adults (18-65 years) Page 5 of 26 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 Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The evidence used to write this report has been gained from various sources. This included the Annunal Quality Assurance Assessment, which was received on time from the provider. This did not include much detailed information but has been discussed with the provider. The home has sent us information including incident reports as necessary. Information from previous reports has also been considered. During the visit we (The Commission) spoke with all the people who live in the home and observed their interactions with staff. They all showed us their own bedroom and we looked around all the communal areas of the home. Documents relating to the running of the home were inspected during the visit. Care Homes for Adults (18-65 years) Page 6 of 26 Care Homes for Adults (18-65 years) Page 7 of 26 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 set out on page 4. 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 Adults (18-65 years) Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 26 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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. People have had their needs assessed reassuring them the home can meet their needs. The home has a process for assessing potential new people and has adequate information for them on the home. Evidence: There are currently five people living in the home, four people have lived there for over twenty years and one person moved in eight years ago. The assessments for these people have been inspected on previous visits and so were not looked at in detail during this visit. The manager reported at this time there are no plans to move anyone else into the home as everyone at the present time gets on very well with each other. Mr Bagoban discussed the assessment process he would use. We were showed copies of up to date Statement of Purpose and Service User Guide. Care Homes for Adults (18-65 years) Page 10 of 26 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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 have care plans and risk assessment, which supports them to make decisions about their lives. People are included in decision making and have opportunities to exercise choice and have a fulfilling life style. Evidence: The records of two people were looked at in detail, and the records held for each person follow the same format. Care plans, set out how peoples assessed needs should be met. The care plans details how people should be supported to make decisions. People spoken with said they were able to make decisions about their lives and felt well supported by staff. Care plans had been reviewed on a regular basis, but these had not always been signed or dated. Reviews had taken place with care managers, which the person attended. It was noted no areas for concern had been identified. Care plans include details of risk assessments. Risk assessments were dated and Care Homes for Adults (18-65 years) Page 11 of 26 Evidence: included information on how the risk could be minimised. One staff member explained how the risk assessment had been used in enabling a person to use public transport on their own. The person concerned was very proud of being able to use public transport on their own and felt it had enhanced their life. Care Homes for Adults (18-65 years) Page 12 of 26 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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 provides good support for people to take part in a range of activities, to maintain contact with family and friends and to maintain a healthy diet. Evidence: People work at a horticultural centre five days a week. Mr Bagoban takes and collects them everyday. In the evening when they returned they spoke of their enjoyment of working, one person stating he likes to be busy. We were advised people are supported to take part in a wide range of activities in the evening and at week end. Some are more planned and recorded others are on a more informal basis. It was agreed a more detailed record would be maintained of the informal activities. Some people enjoy training for the Special Olympics and were wanting to show all the medals they had previously won for their sporting activities. Other organised activities include attending a weekly cookery course, but we were advised people did not like Care Homes for Adults (18-65 years) Page 13 of 26 Evidence: cooking in the home. People also attend an art course at college in the evening. We were advised none of the people had any strong religious beliefs or attended church. People are supported to maintain contact with their friends and family, with staff providing support for service users to visit family where necessary. People spoken with said their friends and relatives were made to feel welcome by staff. We were advised most people go home for at least one weekend every month and the majority had spent time with their families over Christmas. Surveys for this inspection were not sent to relatives but were for the last two inspections. On these occasions they have reported they have good relationships with the home and they can visit when ever they want. People are supported to plan a weekly menu, with help from staff to provide a balanced diet. Mealtimes are flexible to fit round activities and snacks are available at any time. It was noted there was a range of food stored in the kitchen. People spoken with said they liked the food and could eat what they like. All attend a weekly cookery course at college one evening a week. Care Homes for Adults (18-65 years) Page 14 of 26 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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. Peoples personal care is well met and people attend the health services they need. Medication is well managed ensuring the safety of people. Evidence: Care plans contain details of the personal care support people need and how it should be provided. People spoken with said staff treat them well and provide the support they need. Most people need little assistance with personal care but need more encouragement and supervison. People are supported by Mr Bagoban to attend a range of health services, including GP, nurse, optician and dentist. Details of these visits were recorded in the care plans. The home assists three people with their medication on a regular basis. The other two people are not on any current medication. Mr Bagaoban explained the medication is dispensed by the chemist from a prescription like any family would in their own home. It is stored in a locked cupboard in a locked room. Each person has their own shelf and medication is dispensed by the carer at the appropriate times. Medication was checked Care Homes for Adults (18-65 years) Page 15 of 26 Evidence: with the records for one person and it was found these were accurate. We were advised no one is currently on any controlled medication. Mr Bagoban and another member of staff are currently attending a course at college on the handling of medication. Care Homes for Adults (18-65 years) Page 16 of 26 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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. There are systems for dealing with complaints and responding to allegations of abuse. This gives people confidence any complaints will be taken seriously and responded to. Evidence: The home stated in their AQAA they have a complaints procedure. People spoken to on the day stated they would know how to complain and would discuss with either Mr Bagoban or their family members. Mr Bagoban reported in the AQAA that the home has not received any complaints in the last year. We have not received any complaints about the home since the last inspection. Mrs Bagoban told us that there had been no adult protection issues come to their attention at the home. The weekend carer in the past has been on an Adult Protection course and they keep themselves up to date with adult protection matters via e-mails and communication from the Hampshire Care Homes Association. Mr Bagoban explained the process he would undertake if he suspected abuse, which was in line with the homes and Hampshires procedure. Care Homes for Adults (18-65 years) Page 17 of 26 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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 well maintained and provides a clean, comfortable and safe environment for people to live in. Shower facilities on the ground floor do not maximise privacy and dignity. Evidence: During this visit all areas of the home were seen. As a family home each person has access to all communal areas and their own bedroom. Mr and Mrs Bagoban live on the premises with the service users and share their facilities with them. The home has a separate dining room, which can comfortably seat all the people. A separate lounge is available with comfortable furnishings. Each person has their own bedroom, which has been personalised by them. Each person was spoken to in their bedroom and all were happy with their rooms. All areas of the home were clean, people when they came home folded their clothes and put them away. They reported they helped keeping the home clean and tidy. The home has a large back garden with suitable furniture for the people living in the home. None of the bedrooms have en suite toilets and showers. There is a shower room on the ground floor, which has two individual showers. There is a lock on the external door but the double units are not in keeping with maximising privacy and dignity. Care Homes for Adults (18-65 years) Page 18 of 26 Evidence: There is also an adjacent toilet. There is a bathroom with shower, bath and sink and a separate toilet on the first floor. A requirement was made at the last inspection relating to there being a clear policy to maximise the privacy and dignity of residents using the down stairs shower room. It was also noted on this visit the paint was peeling on top of these showers. When speaking to people they stated it did not bother them having two showers next to each other and it had always been this way. The requirement will not be repeated as people stated it did not concern them but a policy should be drawn up as good practice. Care Homes for Adults (18-65 years) Page 19 of 26 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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 are supported by a small staff group. They know staff will support them and have had appreciate checks to ensure their safety. Evidence: Mr and Mrs Bagoban and one member of staff work in the home. The home has had the same three staff since 1994. Mr and Mrs Bagoban are trained nurses in the area of learning disability and told the inspector that they keep themselves up to date via the internet and information provided by Hampshire Care Homes Association. Mr Bagoban showed us evidence of keeping his nursing registration up to date. All staff have undertaken training in manual handling and infection control and two members of staff are currently undertaking a handling of medication course. People living in the home spoke favourably of the staff and comments made illustrated the home works as one large family home. Mr Bagoban verbally told us the process he would use if he had to recruit new members of staff. He demonstrated he was aware of the checks and information he would need before someone could start working in the home. Mr Bagoban showed us copies of checks he had made with the Criminal Reference Bureau for all three Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: members of staff. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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 benefit from a well managed home that is run in the best interests of people living there. Evidence: Mr and Mrs Bagoban have been the owners of the home for many years and have both qualified as nurses in the field of learning disabilities. The home is run as a family home and it was clear from observations and conversations people benefit from this arrangement. On the evening of the inspection people came in from work had showers and were looking forward to their tea and were then going out again in the evening to a college course. Discussions were held with Mr Bagoban to ensure all paperwork is completed to a good standard. The AQAA which was received had very little information recorded on it. Mr Bagoban did agree he would put more detail in the next AQAA he received. Evidence was seen in one persons file they had completed a survey on how they find Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: the home and if they have any concerns. Mr Bagoban stated all people living in the home were encouraged to complete a survey each year. He also stated he sent surveys out to family members as a formal way of seeking their views. No issues were seen on the survey seen and Mr Bagoban stated no issues had been raised. The manager reported in the annual quality assurance assessment that the electrical system, portable electrical equipment, and gas system are regularly serviced and maintained. These records were sampled during the visit and confirmed the managers report. Care Homes for Adults (18-65 years) Page 23 of 26 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 Adults (18-65 years) Page 24 of 26 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 Adults (18-65 years) Page 25 of 26 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. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) 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. Care Homes for Adults (18-65 years) Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!