Care Home: Thornlea

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What the care home does well Residents at the home were being cared for and supported well by the registered manager and her staff. Residents spoken to said the quality of care provided was good. Residents said staff spoke to them respectfully and maintained their dignity, particularly when personal care was being given. Comments made included: `the staff speak to me in a nice way and I am happy about how they look after me`, `they are kind and helpful and help me to do things`, `the carers always help me to do the things I can`t do and speak to me properly`, `I feel that I am spoken to properly by everybody here, they are very good`. What has improved since the last inspection? The way residents care records are written has improved. They now contain more information which enables staff to better understand exactly what the care and support needs of their residents are and what actions they need to take to meet those needs. The range of training provided for staff (and the way it is recorded) has also improved. Both improvements mean that the quality of the support provided gets better. What the care home could do better: It is recommended that all entries in the daily communication records (in residents care records) are signed properly and not merely initialled by staff. This is to ensure staff who make such entries can be easily identified if required. (We were informed that the home had stopped taking new admissions because there are plans to completely re-develop the Thornlea site and that a planning permission application has been submitted to the Local Authority to build a new care home on the existing site. We were also informed by the registered manager that a decision in respect of this application is expected in June 2010. If granted a period of consultation will begin with residents, staff and their supporters (including Manchester Social Services). The owners of the home have already informed all parties at meetings held in March 2010 of their intentions in respect of the re-development). Key inspection report Care homes for older people Name: Address: Thornlea 198 Charlestown Road Blackley Manchester M9 7ED     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Michael Murphy     Date: 0 5 0 5 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 23 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 23 Information about the care home Name of care home: Address: Thornlea 198 Charlestown Road Blackley Manchester M9 7ED 01617408378 01617407598 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Inspirit Care Limited Name of registered manager (if applicable) Anna Elizabeth Dimond Type of registration: Number of places registered: care home 40 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The registered person may provide the following category of service only: Care home only Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 40 Date of last inspection Brief description of the care home Thornlea is a purpose built care home managed and registered in the name of Inspirit Care Limited a subsidiary of Community Integrated Care CIC , a registered charity. The home provides accommodation and personal care for up to 40 people. The home is in the north of Manchester City centre. It is located close to public transport links into the city centre, local markets and shopping facilities. The home is set in its own grounds with car parking facilities to the side and on the main road at the front of the building. The current range of accommodation fees charged is between GBP382. 98 and Care Homes for Older People Page 4 of 23 Over 65 40 0 Brief description of the care home GBP468.65. Those items not included in the fees are Newspapers, hairdressing, private treatments, some transport costs. Care Homes for Older People Page 5 of 23 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection included an unannounced visit to the home on the 5th of May 2010. During the visit we talked to residents, relatives, staff and the registered home manager. We also looked at documents and records the home have to keep such as residents care records, medicine records, written policies and other records. Before the inspection, we also asked the registered home manager to complete a form called an Annual Quality Assurance Assessment (AQAA) to tell us what they felt they did well, and what they needed to do better. This helps us to determine if the management of the home sees the service they provide the same way that we see the service. We felt this form had been completed in sufficient detail and provided useful information. Care Homes for Older People Page 6 of 23 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 7 of 23 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 23 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Before being admitted to the home residents had their care and support needs assessed to make sure the home is able to meet their needs. Evidence: We were informed that the home had stopped taking new admissions because there are plans to completely re-develop the Thornlea site and that a planning permission application has been submitted to the Local Authority to build a new care home on the existing site. We were also informed by the registered manager that a decision in respect of this application is expected in June 2010. If granted a period of consultation will begin with residents and their supporters (including Manchester Social Services). The owners of the home have already informed all parties (including staff) at meetings held in March 2010 of their intentions in respect of the re-development. Residents admitted since the last inspection had a pre-admission assessment before a decision was made about them entering the home. This assessment was conducted by Care Homes for Older People Page 9 of 23 Evidence: the appropriately qualified and experienced registered manager of the home. The purpose of this assessment is to decide if the home will be able to meet the potential residents care and support needs properly. It also helps prospective residents and their relatives in their decision of how appropriate the home would be for them. A record of the pre-admission assessment is kept in each residents care records and identifies what care and support they will need. Other pre-admission assessments conducted by social workers and health care workers were also kept in the care records. Discussion with residents indicated that their views were taken into account before admission to the home. The home does not provide intermediate care. Care Homes for Older People Page 10 of 23 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents health and personal care needs were being properly met and their privacy and dignity were respected by the staff. Evidence: The care records of three residents were looked at on this occasion. These were organized and contained care plans that set out the action that needed to be taken by the care staff to ensure the health, personal and social care needs of residents are met. Care plans were written in a way that reflected the very specific care and support needs of each resident. The care records also contained risk assessments that identified possible threats to a residents health and safety and described things that needed to be done to keep them safe at the same time as maintaining their freedom and independence. For example risk assessments had been done with regard to residents mobility and nutrition needs and the condition of their skin. Care records had been kept up to date. However it is recommended that all entries in the daily communication records (in residents care records) are signed properly and not merely initialled by staff. This is to ensure staff who make such entries can be easily identified if required. Care Homes for Older People Page 11 of 23 Evidence: Arrangements had been made to register all residents with a local GP. Information in the care records and discussion with residents and staff indicated residents were able to access health care services appropriately. A record of all such access was kept. The way residents medicines are looked after in the home was secure and organized. There were appropriate policies and procedures relating to medicines at the home that help to ensure they are safely managed. The way medicines are managed are regularly checked (audited) to ensure this continues. The senior staff at the home look after the medicines and have had recent training in respect of this. Residents said staff spoke to them respectfully and maintained their dignity, particularly when personal care was being given. Comments made included the staff speak to me in a nice way and I am happy about how they look after me, they are kind and helpful and help me to do things, the carers always help me to do the things I cant do and speak to me properly, I feel that I am spoken to properly by everybody here, they are very good. At the time of our visit staff were observed to care for and support residents properly and speak to them in a kindly and unhurried way. Care Homes for Older People Page 12 of 23 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents were helped to enjoy a stimulating lifestyle and access a wide range of leisure and social activities. Residents were encouraged to make as many personal choices in their daily lives as possible, and the general view of food provision was positive. Evidence: The routines of daily living and the social activities available were flexible and varied and meet residents expectations, preferences and capacities. Residents were supported to access a range of social and leisure activities, entertainments and outings. Forthcoming events, activities and entertainments were prominently displayed. Residents said they enjoyed the programme of activities available. Residents were able to follow their own religious practices and as in other areas of life in the home were are able to exercise their own personal choices in respect of this. Residents and relatives spoken to said there were no unreasonable restrictions on visiting at the home. Residents may receive their visitors in the privacy of their own room or quieter area of the home if preferred. Residents also said they were able to exercise choice and independence in their daily lives. Comments made included: I can chose what time I can get up and go to bed, I am able to choose what clothes I wear and how I spend my day, the staff help me to go out when I want to, I am able to Care Homes for Older People Page 13 of 23 Evidence: go to my room and spend time there whenever I want, I choose what activities to join in, you are not made to join in if you dont want. Menus were prominently displayed in the home and were varied, balanced and provided choice. Residents said they can always request an alternative from the menu if they wish. Comments regarding the food included: the food is very good, there is always plenty to eat and drink, the meals are brilliant and you always get a choice, it is good plain cooking and I really enjoy it. Lunch was observed during our visit. This was a hot and substantial meal. Staff served and assisted residents appropriately and sensitively. The dining area was suitably furnished and appropriate for residents to take their meals in. Care Homes for Older People Page 14 of 23 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There were clear and accessible procedure in place to respond to any complaints. All staff have been provided with safeguarding training and there are policies in place that describe how to protect residents and keep them safe. Evidence: Information on how to make a complaint was prominently displayed in the home. This information detailed who to contact and how the complaint would be dealt with. A complaints record is kept by the home. Complaints appeared to have been dealt with properly. Discussion with residents and staff indicated that the manager or senior staff are always available and that any issues raised are dealt with promptly and rarely need to become formal complaints. The home operates safeguarding and whistle-blowing policies (including those developed locally and operated by Manchester social services) that seek to keep residents safe. Staff spoken to were aware of the importance of safeguarding and protecting residents and described their role in doing so. They confirmed they have been provided with safeguarding training. Inspection of training records (and information provided by the registered manager) revealed that safeguarding training has been provided to staff at the home. Care Homes for Older People Page 15 of 23 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. As identified by the home owners the home is in need of major refurbishment or redevelopment to ensure residents are provided with suitable and comfortable accommodation. Evidence: We were informed that the home had stopped taking new admissions because there are plans to completely re-develop the Thornlea site and that a planning permission application has been submitted to the Local Authority to build a new care home on the existing site. We were also informed by the registered manager that a decision in respect of this application is expected in June 2010. If granted a period of consultation will begin with residents and their supporters (including Manchester Social Services). The owners of the home have already informed all parties (including staff) at meetings held in March 2010 of their intentions in respect of the re-development. At the time of our visit the home was clean, warm and residents appeared to be comfortable. However, as acknowledged by the owners of the home, if the site was not re-developed a major programme of refurbishment would be required. Care Homes for Older People Page 16 of 23 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staffing provision, staff recruitment procedure and the staff training provided at the home seek to ensure residents are cared for and supported safely and appropriately. Evidence: The registered manager and staff spoken to on the day of inspection were of the view that staffing levels were meeting the care and support needs of the residents. Residents spoken to said that they were being properly cared for in a timely way. We also note there were adequate staffing arrangements in place to meet the administrative, catering, laundry and housekeeping requirements of the home. The registered manager informed us that due to the uncertain future of the home a number of staff had left in recent months. This has resulted in the use of agency care staff to ensure sufficient staff are caring for and supporting residents appropriately. However to minimise the impact of this the registered manager tries to ensure continuity of care by securing the services of the same agency staff on a regular basis. The home had a proper procedure in place for recruiting new staff. This is vital to ensure, as far as possible, that residents are being cared for and supported by suitable staff. The recruitment procedure included criminal records checks and another special check regarding the suitability of the applicant to work with vulnerable people. The programme of staff training ensures that staff are provided with the skills required to care for and support residents properly. Inspection of staff training records and Care Homes for Older People Page 17 of 23 Evidence: discussion with staff and the registered manager demonstrated that staff training (including regular updates) is organised and appropriate. Training is provided by trainers employed by the home and the local authority training partnership. Over 50 of the care staff have obtained a national vocational qualification in care (NVQ). Care Homes for Older People Page 18 of 23 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was being managed effectively by the registered manager and her senior team. This is particularly vital at a time of uncertainty about the future development of the home. Evidence: The registered manager is a suitably qualified person and experienced in managing care services for older people. Discussion with residents and staff revealed that the manager creates a positive, inclusive and open atmosphere at the home. There is also a commitment to ensure the quality of the service provided to residents is of a suitable standard. The registered manager and owner of the home regularly obtain the views of residents and staff in respect of this. Discussion with these groups of people showed that the manager and owners listen to any issues/suggestions raised and take any necessary action. As detailed earlier in this report major changes were proposed in regard to the re-development of the Thornlea site in the near future. If planning permission is granted a period of consultation will begin with residents and their supporters (including Manchester Social Services). The owners of the home have Care Homes for Older People Page 19 of 23 Evidence: already informed all parties (including staff) at meetings held in March 2010 of their intentions in respect of the re-development. The manager also conducts checks (audits) on how well the home is run. For example regular checks are made in respect of residents medicines, and the condition of equipment in the home. The arrangements to support residents with their money (personal allowances only) were secure and appropriately documented. The arrangements for the health and safety of residents (and others) in the home were adequate and appropriate. Staff are provided with regular training in respect of moving and handling, fire safety, food hygiene and the prevention of infection. Hazardous substances were being securely stored and gas and electrical systems had been checked/certificated regularly, we were informed hot water temperatures in resident areas are appropriately controlled. Procedures were in place for the appropriate reporting of accidents, illnesses and injuries. Care Homes for Older People Page 20 of 23 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 21 of 23 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 7 That all entries in the daily communication records (in residents care records) are signed properly and not merely initialled by staff. This is to ensure staff who make such entries can be easily identified if required. Care Homes for Older People Page 22 of 23 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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