Care Home: Thistleton Lodge Care Home

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What the care home does well The people living at the home and their representatives were positive in their views about the standard of care provided. They considered the staff to be approachable and enthusiastic. Their comments included: ` I am very satisfied. The staff are very good. The manager is great. Any complaints are sorted out straight away. My room is very comfortable and has a lovely view.` `I always like the meals at the home because we have an excellent choice.` `It is excellent. The laundry is very quick and perfect. The maintenance man is very prompt and pleasant when doing any jobs requested by me.` `I couldn`t have coped without the support of the staff during the difficult times; they always greet me with a friendly welcome. The care my mother receives is very good. The staff are very patient and understanding.` `The home provides a safe and friendly environment.` `The manager, deputy manager and seniors always keep us up to date with new service users and new information relating to service users who have been with us a while.` `I think most of the carers are very pleasant and would do anything if asked. We find the care home very pleasant and the staff always kind and caring.` Residents spoken with felt that staff worked hard and were confident that the staff understood their needs. There are times when the staff are very busy, however overall most residents and relatives felt that the care provided was of a good standard. The residents spoken with were confident that their health needs were being met. The staff showed a good understanding of the individual needs of the residents. The manager and senior staff provided good support through every day contact, team meetings and more formal ways, such as appraisals of staff performance. The staff spoken with felt that there was a good team spirit. What has improved since the last inspection? What the care home could do better: It is important that any risks identified when providing care for a resident are addressed and any steps taken should be noted in the care records. The reports provided by the representative of the company which owns Thistleton Lodge have been produced for most months since the last inspection. These reports are a legal requirement. It is important that the representative visits, to review the standards of care and accommodation and ensure that residents are satisfied with the service they receive. The visits and subsequent reports should be completed every month. The manager should continue with the good progress made toward achieving the recommended ratio of trained staff. CARE HOMES FOR OLDER PEOPLE Thistleton Lodge Care Home Fleetwood Road Thistleton Nr Kirkham Lancashire PR4 3YA Lead Inspector Mrs Felicity Lacey Unannounced Inspection 23rd April 2008 09:20 X10015.doc Version 1.40 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 Thistleton Lodge Care Home DS0000006089.V359576.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 Older People. 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. Thistleton Lodge Care Home DS0000006089.V359576.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Thistleton Lodge Care Home Address Fleetwood Road Thistleton Nr Kirkham Lancashire PR4 3YA 01995 671088 01995 671084 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) Thistleton Lodge Limited Sally Clarke Care Home 55 Category(ies) of Dementia (18), Old age, not falling within any registration, with number other category (37) of places Thistleton Lodge Care Home DS0000006089.V359576.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only. Care home only - code PC, to people 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, (maximum number of places: 37) Dementia - Code DE (maximum number of places: 18) The maximum number of people who can be accommodated is: 55 Date of last inspection 19th April 2007 Brief Description of the Service: Thistleton Lodge Care Home is a very large detached property in its own grounds situated on the main Fleetwood road near to Kirkham. It is easily accessible and there is ample car parking space for visitors. The home provides care for up to 55 service users incorporating residential, respite and dementia care on the ground and first floors. Accommodation is in single and double rooms; each bedroom complies with minimum space requirements. There are four lounge areas and a conservatory. The lounge areas incorporate dining space and there is a separate dining room on the ground floor. There is a passenger lift and access for wheelchairs throughout. Thistleton Lodge Care Home DS0000006089.V359576.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 stars. This means the people who use this service experience good quality outcomes. This inspection included an unannounced visit to Thistleton Lodge. Information about the service provided at the home has been collected since the last key inspection, which took place in October 2007. Information was provided by the manager of the home including the way in which the staff of the home meet the needs of the residents, the training and support staff receive and data about health and safety at the home. Eight residents, one relative and eight members of staff completed surveys. Residents, a visitor, the manager and staff members were spoken with during the visit. Care and administration records were looked at. The premises were toured. What the service does well: The people living at the home and their representatives were positive in their views about the standard of care provided. They considered the staff to be approachable and enthusiastic. Their comments included: ‘ I am very satisfied. The staff are very good. The manager is great. Any complaints are sorted out straight away. My room is very comfortable and has a lovely view.’ ‘I always like the meals at the home because we have an excellent choice.’ ‘It is excellent. The laundry is very quick and perfect. The maintenance man is very prompt and pleasant when doing any jobs requested by me.’ ‘I couldn’t have coped without the support of the staff during the difficult times; they always greet me with a friendly welcome. The care my mother receives is very good. The staff are very patient and understanding.’ ‘The home provides a safe and friendly environment.’ ‘The manager, deputy manager and seniors always keep us up to date with new service users and new information relating to service users who have been with us a while.’ ‘I think most of the carers are very pleasant and would do anything if asked. We find the care home very pleasant and the staff always kind and caring.’ Residents spoken with felt that staff worked hard and were confident that the staff understood their needs. There are times when the staff are very busy, Thistleton Lodge Care Home DS0000006089.V359576.R01.S.doc Version 5.2 Page 6 however overall most residents and relatives felt that the care provided was of a good standard. The residents spoken with were confident that their health needs were being met. The staff showed a good understanding of the individual needs of the residents. The manager and senior staff provided good support through every day contact, team meetings and more formal ways, such as appraisals of staff performance. The staff spoken with felt that there was a good team spirit. What has improved since the last inspection? There have been improvements to the way in which the care needs of people are documented and monitored, this system has been fully introduced in the part of the home which provides services for people with dementia, and is in the process of being implemented in the part of the home which supports older people. The new system ensures that all assessments and guidance are kept together and is easily available to the staff. The new system also includes records that may be needed to monitor the health and well-being of residents, for example weight records. The way in which staff support to residents is arranged at Thistleton Lodge has been improved. Staff now have a number of residents who they support during their shift, this system gives staff responsibility for making sure that the care needs of the residents are met during their shift, when staff change there is a handover meeting to pass on information. This system provides direction for staff and promotes a consistent approach. The staff team are stable and well established at the home. Residents spoken to said that they found the staff to be helpful and kind. There have been additional staff hours provided to increase the activities on offer at the home. The range of activities has been improved and also activities based on the hobbies and interests of residents have been identified. There are regular outings in the mini bus. A number of people continue to be quite isolated and choose not to take part in organised activities, preferring their own company. The development of a sensory/relaxation room, in the unit that provides support for people with dementia, has provided a new environment and range of activities. Medication administration and audit procedures at the home have been improved. The medications now received at the home are accurately recorded and checked. Promotion of resident’s choice of GP when coming to the home has improved. Although many residents are registered with the local health centre, some residents have retained the services of their own GP when possible. There have been some improvements to the furnishings and décor at the home. Efforts have been made to improve the appearance of the unit for Thistleton Lodge Care Home DS0000006089.V359576.R01.S.doc Version 5.2 Page 7 people with dementia. Flowers and pictures have been used to brighten up the unit. There has been some decoration of rooms and carpets replaced. Signs with pictures have been used to help residents recognise their bedrooms. Training opportunities for staff at Thistleton Lodge have improved. The number of staff with National Vocational Qualifications has increased, with some staff undertaking qualifications at a higher level. Staff supporting residents who have dementia have undertaken training, including activities and therapeutic approaches and are enthusiastic about putting this training into practice. There have been improvements in the recruitment process. All references and security checks are now obtained prior to staff beginning work at the home. 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. Thistleton Lodge Care Home DS0000006089.V359576.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Thistleton Lodge Care Home DS0000006089.V359576.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 4 Quality in this outcome area is good. The assessment of personal care needs, before a resident moves to the home, ensures that staff understand and can be confident that they can meet the identified needs of the resident. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Consideration of case files and discussion with people who live at the home demonstrated that an assessment of care needs was conducted prior to moving to the home. A senior member of staff visits prospective residents to ensure that the home is able to meet their care needs. In exceptional circumstances, for example when a person is moving from another area, there was evidence of liaison with health professionals and representatives to ascertain the level of support needed. The pre admission assessment forms the basis of the on going plan of care. The improvements made at the last inspection to the dementia unit have continued. The staff of the unit have undertaken further training and it is planned that five members of senior staff attend a specialist course that Thistleton Lodge Care Home DS0000006089.V359576.R01.S.doc Version 5.2 Page 10 promotes person centred ways of working. The manager of the unit is keen to introduce and promote a philosophy of care in the unit that respects the individual strengths and experience of each resident. The atmosphere and relationships observed during the visit to the home were positive and respectful. Thistleton Lodge Care Home DS0000006089.V359576.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is good. The care planning system used ensures that the personal care and health needs of residents are assessed and monitored, in this way the welfare of residents is promoted. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans seen during the visit to the home contained relevant information and identified the care needs of each resident. A new system is being introduced to ensure that all relevant records are maintained in one place and are easily accessible for care staff. The new system has been fully introduced in the dementia unit. This provides assessment, care planning, monitoring and on going information. The care plans seen were focused on the needs of the individual and also promoted independence and decision making by residents. Some plans had been signed by residents or their representatives. The manager is in the process of transferring all previous care plans and records to the new system. The identified care needs were addressed in the care plan for the resident. The plans had been reviewed. Specific instructions and guidance was noted on the Thistleton Lodge Care Home DS0000006089.V359576.R01.S.doc Version 5.2 Page 12 care needs assessment and examination of the monitoring records showed examples of instructions being followed, for example if monthly weighing was required this was being carried out. It is important that any new risks that are identified are addressed in the care plan, in one instance a resident had trapped her toe in the bedrails that were in use however there was no risk assessment in place regarding the use of the rails or the measures take to prevent any further accident. The residents spoken with felt that their health needs were met by the staff of the home and when specialist advise was needed this was arranged. Records of visits from the GP and district nurse are maintained. Residents are supported to attend hospital appointments, and when necessary arrangements are made with the residents family to accompany their relative to hospital. The NHS chiropodist visits the home, or the residents own arrangements are followed. The manager has ensured that residents choice of GP cover is now respected and it is no longer the practice of the home that all resident register with the local health centre. The medication records and storage arrangements at the home were satisfactory. The deputy manager now checks in all medication and ensures that the records are accurately completed. A system of faxing any changes to existing prescriptions or quantities required has been put in place. The medication administration sheets were completed accurately. The privacy and dignity of residents is respected at Thistleton Lodge. Residents spoken with thought that staff acted with respect. Visits by health professionals are conducted in private. Some residents have their own private phones. Letters are delivered unopened to residents. Staff are reminded in care plans of those residents with dementia of the need to respect the choices and preferences of the individual, and to encourage the resident to be as active as possible in making decisions. Thistleton Lodge Care Home DS0000006089.V359576.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good. The social and cultural interests and needs of residents are understood, in this way daily life and social activities can be arranged to meet the expectations of residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staff of the home have made efforts to gather information about hobbies and interests of residents, sometimes this information is gained from discussion with relatives and friends. The home has a dedicated activities organiser, who plans both group and individual activities. There is a planned programme of activities that is on display, this includes regular outings in the minibus, arts and crafts and entertainment at the home. The activities on offer in the dementia unit have been improved. Staff have attended training and have developed a range of activities that can be enjoyed, such as gardening, baking and reminiscence sessions. A sensory room has been developed with a range of sound and lighting equipment which can be used to create a range of stimulating and relaxing environments. During the visit several residents were enjoying a session in the room, one resident commented how unusual and fascinating the effects were. Thistleton Lodge Care Home DS0000006089.V359576.R01.S.doc Version 5.2 Page 14 The resident’s wishes regarding participating in activities are respected. Residents spoken with and surveys returned indicated that some people have difficulty in part taking in organised activities and spend most of the time in their own rooms. The manager has encouraged residents to suggest activities during residents meetings. The records of activities enjoyed have been kept for people on the dementia unit, this is a useful way of deciding which activities are successful and demonstrated that there are a range of activities provided. Birthdays and special days are celebrated. On the day of the visit to the home St Georges day was being celebrated with decorations and a special menu. Some residents on the dementia unit were enjoying icing biscuits with the England Flag. The home has good links with local churches. Regular visits are made by the Roman Catholic, Church of England and Methodist ministers. The religious preferences of residents are recorded on admission. The manager is aware of the need to promote equality and respect the diversity of residents at the home. All staff are made aware of the policies of the home regarding equality of opportunity and respect for the individuality of residents during their induction, through discussion and training. Visitors and friends are welcome at the home at any reasonable time. There is a range of communal areas in the home which visitors may use as well as the private accommodation of the resident. The choices of residents are recorded and respected. The manager does not hold any responsibility for the finances of the residents. If a resident is not able to administer his or her own financial affairs, then a representative or agent is appointed. Residents are able to bring their own furniture and possessions to the home, and are encouraged to make their bedrooms their own personal space. The meals at Thistleton Lodge were considered to be of good quality and residents were pleased with the choice of meals. The chef has produced a varied menu and ensures that special occasions and celebrations are reflected in the meals on offer. The special dietary requirements of residents are noted and provided for. The chef is qualified and the home has recently won an award from the local council and Food Standards Agency for providing a ‘Standard of Excellence for Catering in Care’. Ten staff are to attend a course in Nutrition and Diet in care homes which in being provided by the Lancashire Workforce Development Partnership. Three of the catering staff are undertaking National Vocational Qualifications in catering. Thistleton Lodge Care Home DS0000006089.V359576.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. The complaints and safeguarding policies in place are understood by residents and staff and this ensures that the welfare of residents is promoted and protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There have been no complaints received by Thistleton lodge since the last inspection. The residents and representatives spoken with during the site visit were confident that any concerns or complaints they may have would be sorted out. Staff spoken with understood how to deal with complaints. The manager has demonstrated that she is able to act in situations to safeguard the welfare of residents. She is aware of local procedures. The manager understands the need to maintain accurate records and to share information with relevant agencies. Staff spoken with were also aware of how to act in any case of suspected abuse. Some staff have completed training in Adult Protection through their National Vocational Qualification studies and further training, for all new staff the policy and procedures of the home are covered during induction. Thistleton Lodge Care Home DS0000006089.V359576.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 Quality in this outcome area is good. The home was clean and the redecoration and refurbishment programme is on going, this ensures that Thistleton Lodge provides a pleasant place in which to live. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The refurbishment and redecoration of the home is on going. The home employs three domestics. Residents and relatives thought that the home was clean and well maintained. Resident’s rooms are decorated to their taste. As rooms become vacant they are redecorated. Some carpets have been replaced. The appearance of the dementia unit has continued to improve. There have been successful efforts to orientate people to their environment, by putting pictures and names on bedroom doors in the dementia unit. The bathroom has been retiled. The manager is aware of the need to up grade bathroom fittings. The sensory room has provided an alternative communal environment to the Thistleton Lodge Care Home DS0000006089.V359576.R01.S.doc Version 5.2 Page 17 dining/ sitting room in the dementia unit. Recent training undertaken by the manager of the unit included consideration of the environment and she is keen to implement some of the ideas suggested. Infection control procedures are in place. Gloves, aprons and hand washing facilities were available. The home has recently had to deal with an infectious outbreak and staff demonstrated that they understood the need to ensure that infection control procedures are followed. Daily notes demonstrated that advice given by health protection professionals was followed. The manager demonstrated that she understood the need to act on an outbreak and to liaise with the health professionals involved to ensure that the correct steps were taken. She also showed that she was able to act in the best interests of residents by ensuring that any restrictions imposed to confine infection were reviewed regularly and did not have a negative impact on daily life. The home has a laundry area. Several residents commented on the high standard of laundry service provided by the staff of the home. Thistleton Lodge Care Home DS0000006089.V359576.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is good. The staffing levels at the home are satisfactory and this means the personal care needs of residents can be consistently met. The recruitment procedures are being followed consistently and this mean that the welfare of residents is being protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is staffed in line with the dependency needs of the residents. The changes to staffing levels made at the last inspection have been maintained. The introduction of a system that ensures a member of staff is assigned to a group of residents each shift ensures that all residents have their needs identified and met. The residents spoken with felt that usually there were enough staff on duty, although at times the time taken to answer the buzzer could be a problem. The manager is aware of the need to ensure that the home is adequately staffed at all times. The home has 13 staff who have now achieved a National Vocational Qualification in Care at level 2 or above, this is just below the recommended 50 . There are also a number of staff who are about to complete this qualification and other staff who are about to begin. The recruitment records of new staff were looked at during the visit to the home, these showed that all required checks had been obtained including Thistleton Lodge Care Home DS0000006089.V359576.R01.S.doc Version 5.2 Page 19 written references and Criminal Record Bureau Disclosures. A recently employed member of staff confirmed that she had completed a period of induction before working alone. This included shadowing an experienced member of staff and becoming familiar with the policies and procedures of the home. She confirmed that she had been encouraged to get to know the residents and had spent time becoming familiar with their care needs. The manager has a training programme planned, which ensures that all members of staff have three paid days training each year. The manager has registered the care home with Skills for Care and has secured funding for a range of courses for the coming year including Common Induction Standards, Alzheimer and Dementia Awareness and Load Management. The manager is also hoping to secure funding for five members of staff to attend a specialist course in working with people who have dementia. Thistleton Lodge Care Home DS0000006089.V359576.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is good. The manager is considered by residents and staff to be approachable and active in promoting good standards of care at the home; this helps to ensure that the home is run in the best interests of the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager is experienced and has completed the Registered Managers Award and a National Vocational Qualification level 4 in Care and Management. She is considered to be approachable and effective by residents and staff members. She is supported in her role by a senior staff team. The home has achieved Investors in People Award and this will be renewed later in the year. There is an annual survey of residents and relatives views of Thistleton Lodge Care Home DS0000006089.V359576.R01.S.doc Version 5.2 Page 21 the quality of service at the home, this includes gathering views on staffing levels, cleanliness and food. The current survey results were not available at the time of the visit to the care home. Residents who were spoken with and who completed surveys felt that their views were listened to. The representative of the company, which owns Thistleton Lodge, has submitted reports required by regulation to show that he is aware of the standards in the care home. These reports have at times been very brief and have not always been provided to the Commission. It is important that these visits are consistently carried out as this provides a way in which quality at the home is monitored and ensures that the company directors are regularly appraised of events at the care home. All residents at Thistleton Lodge retain control over their own finances. If it is not possible for a resident to administer his or her own finances then a representative is appointed. The manager does not act as appointee for any resident. The staff training programme includes health and safety training and it is important that this is regularly refreshed. All senior staff have First Aid Training, this ensures that there is at least one qualified first aider on duty at all times. The Annual Quality Assurance Assessment indicates that all required health and safety checks have been completed and are up to date. The accident book contained records of all accidents at the home, the manager regularly monitors the pattern and frequency of accidents to identify any required action to minimise the risk of accidents. Thistleton Lodge Care Home DS0000006089.V359576.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Thistleton Lodge Care Home DS0000006089.V359576.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO 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. Standard Regulation Requirement Timescale for action 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. 2 3 Refer to Standard OP28 OP7 OP33 Good Practice Recommendations The registered provider should ensure that at least 50 of care staff are trained to NVQ2. The care plan should include assessments devised in response to any risks identified. The reports required under regulation 26, should contain sufficient detail to show that the standard of care, events at the home and the premises have been assessed. Copies of the reports produced should be provided for the commission. Thistleton Lodge Care Home DS0000006089.V359576.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway 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. Extracts may not be used or reproduced without the express permission of CSCI Thistleton Lodge Care Home DS0000006089.V359576.R01.S.doc Version 5.2 Page 25 - 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. 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