Care Home: Thornton Hill

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What the care home does well Here is a selection of some of the comments people made about Thornton Hill: General comments included: "Sometimes there are activities I can join in with." "I have a choice of activities. I can join in if I want to." "I feel that the home gives excellent care and attention and my relative is very satisfied with everything." "Thornton Hill is like a combination of a holiday hotel and their own home." About cleanliness: "Definitely" the home is always clean and fresh. I am "satisfied with the homes domestics at keeping the home clean and tidy." "The home is always clean and fresh." "The cleanliness is brilliant." About health care: "I always get the medical support I need." "When I ask for the doctor they always get him for me." Staff "usually" has the right skills. Privacy and dignity is present when dealing with residents. "Some patients become ill and require hospital admission, but the home meets their needs. "I have never had a problem with medication. About the staff: I am "quite content, everyone is kind, enjoy getting together." "I would like to say thank you for your kindness." The staff are "very caring." Staff "always appear caring and professional." The staff team "liaise well with other agencies and have good communication links with other services." They are able to "accommodate clients in emergency situations." "The care home is absolutely brilliant so are all the staff." Comments from the staff team: We do everything possible "to make residents feel at home." "Thornton Hill is a happy house and I enjoy working in this environment." There is an "open door policy" from the manager. "We try to improve the lives of older people and help them get the best out of life." The views of people who use the service are taken into account when changes are being made in the home. This makes sure Thornton Hill remains a service, which is resident focused and puts the needs of people living there first. People who spoke to the inspector gave examples of how they maintain control over their lives, including what time they got up and went to bed, what to wear, choices of food and drink and activities. A good choice of food, snacks and drinks are available throughout the day. This makes sure people receive a varied and nutritious diet. On the day of the visit the weather was very hot. Staff were seen offering and giving cold drinks out throughout the day. There were drinks dispensers around the home for those who could help themselves. There are a variety of outings and activities which people can choose to join in. The home employs an activity organiser and this had been so successful they have arranged funding for an extra member of staff to be in post next year. Thornton Hill DS0000060215.V369096.R01.S.doc Version 5.2 Page 7The staff are provided with training, including moving and handling, dementia care and first aid, to improve their knowledge and skills. This means the staff team are well trained and that their practice is up to date. Staff are recruited in a way that makes sure only people who are suitable to work with vulnerable adults are employed, therefore ensuring the safety and protection of people who live at Thornton Hill. People are given enough information about the home before they move in. This enables them to make an informed decision as to whether Thornton Hill is the right place for them to live. The home is clean and comfortable. Staff were described in positive terms. Words such as "caring" and "kind" were used. People living in the home have good access to a range of health professionals ensuring that their health care needs are met. What has improved since the last inspection? There were five requirements made at the last inspection. These have all now been met by improvements being made around record keeping. What the care home could do better: There has been a lot of hard work over the last year in all aspects of the home and this has been beneficial for the people who use the service. All staff are working as a team and are proud of their contributions to life at Thornton Hill. No requirements were made as a result of this visit. CARE HOMES FOR OLDER PEOPLE Thornton Hill Church Road Thornton In Craven Skipton North Yorkshire BD23 3TR Lead Inspector Karen Westhead Key Unannounced Inspection 30th July 2008 09:15a 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 Thornton Hill DS0000060215.V369096.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. Thornton Hill DS0000060215.V369096.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Thornton Hill Address Church Road Thornton In Craven Skipton North Yorkshire BD23 3TR 01282 842023 01282 843959 angela.craven@anchor.org.uk www.anchor.org.uk Anchor Trust 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) Manager post vacant Care Home 52 Category(ies) of Dementia (52), Old age, not falling within any registration, with number other category (52) of places Thornton Hill DS0000060215.V369096.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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; and Dementia - Code DE The maximum number of service users who can be accommodated is: 52 31st July 2007 2. Date of last inspection Brief Description of the Service: Thornton Hill is owned and run by Anchor Trust and is registered for up to 52 people. However, due to bedrooms being used for single occupancy; three used as double rooms; one bedroom is being refurbished; one is being used as an office and another as a hairdressing room, the home looks after up to 47 people. Within this total there is one bedroom used to for those wishing to come to the home on a short stay basis (respite). The home is a large converted manor house with a purpose built extension known as the Manor Wing. Thornton Hill is set in its own grounds and overlooks the valley. It is in the village of Thornton-in-Craven, which is approximately 8 miles from Skipton. Resident accommodation is on the ground and first floors only. There is a passenger lift to provide level access to the first floor. The laundry and some storage areas are in the basement. This area is restricted to staff only, who use a key to be able to the lift to the basement. The weekly fees range from £535.50 to £630.00. The amount charged is dependent on a financial assessment. This information was provided on the day of the visit. This does not include hairdressing, private chiropody treatments, newspapers (in addition to those provided by the home) and toiletries. The most up to date inspection report is available to those interested in reading it. A summary of the report is kept in the service user guide, which is available in every bedroom. Thornton Hill DS0000060215.V369096.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 3 star. This means the people who use this service experience excellent quality outcomes. The inspection process included looking at the information received about the home since the last key inspection on 31st July 2007. The Commission for Social Care Inspection (CSCI) have not had any complaints or concerns about the home since the last inspection. The purpose of this visit was to look at how the needs of people living at Thornton Hill are being met. This unannounced visit was done in one day; one inspector visited the home between the hours of 9.15am and 4.20pm. During the visit the inspector spoke with people living in the home, visitors, staff and management. Various records, including care plans, menus, accident reports and medication charts, were examined and parts of the building were looked at. The manager was not available as she was on annual leave at the time of the visit. The deputy manager assisted with the inspection. During the visit surveys were handed out to visitors and relatives. Stamped addressed envelopes were provided and people were asked to return the forms as soon as they could. In addition to this, surveys had already been sent to the home so that these could be distributed. At the time of writing this report a total of 21 surveys had been returned. These were from 11 people who use the service (7 had been helped by a member of staff to complete it); 4 staff; 2 relatives; 2 care managers and 2 health care professionals. A self-assessment form was sent to the home and it was returned to the CSCI. It was clear and contained all of the information asked for. Information from the surveys and the self-assessment form are included in this report. What the service does well: Here is a selection of some of the comments people made about Thornton Hill: General comments included: “Sometimes there are activities I can join in with.” “I have a choice of activities. I can join in if I want to.” “I feel that the home gives excellent care and attention and my relative is very satisfied with everything.” “Thornton Hill is like a combination of a holiday hotel and their own home.” Thornton Hill DS0000060215.V369096.R01.S.doc Version 5.2 Page 6 About cleanliness: “Definitely” the home is always clean and fresh. I am “satisfied with the homes domestics at keeping the home clean and tidy.” “The home is always clean and fresh.” “The cleanliness is brilliant.” About health care: “I always get the medical support I need.” “When I ask for the doctor they always get him for me.” Staff “usually” has the right skills. Privacy and dignity is present when dealing with residents. “Some patients become ill and require hospital admission, but the home meets their needs. “I have never had a problem with medication. About the staff: I am “quite content, everyone is kind, enjoy getting together.” “I would like to say thank you for your kindness.” The staff are “very caring.” Staff “always appear caring and professional.” The staff team “liaise well with other agencies and have good communication links with other services.” They are able to “accommodate clients in emergency situations.” “The care home is absolutely brilliant so are all the staff.” Comments from the staff team: We do everything possible “to make residents feel at home.” “Thornton Hill is a happy house and I enjoy working in this environment.” There is an “open door policy” from the manager. “We try to improve the lives of older people and help them get the best out of life.” The views of people who use the service are taken into account when changes are being made in the home. This makes sure Thornton Hill remains a service, which is resident focused and puts the needs of people living there first. People who spoke to the inspector gave examples of how they maintain control over their lives, including what time they got up and went to bed, what to wear, choices of food and drink and activities. A good choice of food, snacks and drinks are available throughout the day. This makes sure people receive a varied and nutritious diet. On the day of the visit the weather was very hot. Staff were seen offering and giving cold drinks out throughout the day. There were drinks dispensers around the home for those who could help themselves. There are a variety of outings and activities which people can choose to join in. The home employs an activity organiser and this had been so successful they have arranged funding for an extra member of staff to be in post next year. Thornton Hill DS0000060215.V369096.R01.S.doc Version 5.2 Page 7 The staff are provided with training, including moving and handling, dementia care and first aid, to improve their knowledge and skills. This means the staff team are well trained and that their practice is up to date. Staff are recruited in a way that makes sure only people who are suitable to work with vulnerable adults are employed, therefore ensuring the safety and protection of people who live at Thornton Hill. People are given enough information about the home before they move in. This enables them to make an informed decision as to whether Thornton Hill is the right place for them to live. The home is clean and comfortable. Staff were described in positive terms. Words such as “caring” and “kind” were used. People living in the home have good access to a range of health professionals ensuring that their health care needs are met. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Thornton Hill DS0000060215.V369096.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 Thornton Hill DS0000060215.V369096.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): 1, 2, 3 and 5. Standard 6 does not apply to this service. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People’s needs are assessed before they move in and whenever possible they are involved in deciding if the home is right for them. The personalised needs assessment ensures that the diverse needs of people moving into Thornton Hill are identified and planned for before admission. EVIDENCE: The records seen, in a random selection of 9 files, showed that people’s needs are fully assessed before they move into the home. The deputy manager said that people are encouraged to visit before making a decision about moving in. In most cases it is relatives who visit on behalf of the person needing care. Thornton Hill DS0000060215.V369096.R01.S.doc Version 5.2 Page 10 Information about the service offered is available in every bedroom. The home also has a brochure, which gives an overall picture about Anchor Trust, including an audio version, the home then personalises this by including looseleaf sheets about the care home. One person living at Thornton Hill said, “my daughter found this place for me. I am so glad she did.” One relative said they had visited 16 other places before they found Thornton Hill. Thornton Hill DS0000060215.V369096.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 and 10 People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People’s personal, social and healthcare needs are met appropriately. Needs are met in a sensitive way which takes into account the persons dignity and privacy. EVIDENCE: Everyone living at the home has a care plan. A random selection of care plans were looked at. On the whole the care plans seen were person centred. They identify people’s abilities or the areas where they need support to carry out daily activities. Whilst talking to the inspector one person said, “It is just like being in your own home here.” Another person said they liked it at Thornton Hill because they could “make friends and mix with people of a similar age.” Another person said, I feel “glad I can live here. I am very happy here and I would not Thornton Hill DS0000060215.V369096.R01.S.doc Version 5.2 Page 12 like to move.” They treat residents with “individuality.” When receiving medical attention staff “respect a persons autonomy.” It was clear from what staff told the inspector that people living in the home are looked after very well and information is passed between staff so that staff are aware of what has been happening and what care people need to make sure they are comfortable. Staff are very alert to changes in mood, behaviour and general wellbeing and fully understand how they should respond and take action. Doctors visit on request and according to one survey completed, “The staff ask if the resident want to see the doctor alone. People are always seen in private.” Any medical advice I give is “always acted upon.” The home supports self-medicating if this is possible. Everyone is given the opportunity to let staff take over this task if they feel unable to do so. If selfmedicating is considered to be possible then a form is completed and authority is sought from the persons doctor if required. The medication system and facilities were inspected. Medication is stored in a locked trolley and the home operates a monitored dosage system. Proper procedures were in place for the administration and storage of medication and a random check of medication supplies tallied with records. The medication administration records were up to date. All care staff who administer medication have received the appropriate training so that they are all competent in this area. The procedures for reordering medication make sure no one runs out of their prescribed medication and is well organised. Risk assessments are in place for falls, nutrition, and the risk of developing pressure sores. Visits by GPs, community psychiatric nurses and other health and social care professionals are recorded and it was evident that people have chiropody and regular eye tests. At the time of the visit CSCI were not aware of any adult protection matters affecting people living at Thornton Hill. During the visit staff were observed to be warm, friendly and respectful to people in the home, they knew them well and were aware of their personal preferences. The home has a call bell system and people who live there confirmed that call bell requests were attended to quickly. When asked about using the call bell one person said “when I ring somebody comes to assist me and they listen to my problem. There is a range of aids and adaptations, which encourage maximum independence for people living in the home. Specialist training is provided to make sure equipment is being used effectively. Thornton Hill DS0000060215.V369096.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 and 15 People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People’s individual social and leisure needs are met and people are supported to keep in touch with family and friends. EVIDENCE: People living at the home, who were able to share their views, said they are able to get up and go to bed as and when they wish and that daily routines are flexible. One member of staff told the inspector that the home runs over 24 hours and as such there was no pressure for night staff to get people up in a morning before their shift finished or for day staff to make sure people were in bed before the night staff started. One person said they preferred to get up at 6am as they were used to that when they lived at home and liked to get up and take their time to get ready before breakfast was served. Thornton Hill employs an activities organiser who works 20 hours per week. People living at the home said that they have the opportunity to join in lots of different activities and some outings. Thornton Hill DS0000060215.V369096.R01.S.doc Version 5.2 Page 14 There was plenty of evidence of people choosing different things to do as people were observed in the morning reading magazines or a newspaper. One person was sat with their visitors. Other people were sat chatting in a lounge whilst having a hot drink and biscuits. One group were singing along to songs playing on a music centre. In the main dining room there were cold drinks available through out the day from a drinks dispenser. Through out the day there were several visitors to the home. Visiting arrangements were flexible and people spoken to said that they could see family and friends whenever they want and were always made to feel welcome. One visitor said they appreciated the coffee and biscuits that were available on the reception area. One visitor said they thought that Thornton Hill was an excellent place to live and that they couldn’t fault the staff or what was provided. Three relatives thought the home could provide better facilities for those who did not want to join in the organised activities and that there should be more outings. On the day of the visit the activity organiser was on annual leave. She had made arrangements for activities to continue, despite her absence. Two staff thought the “lack” of “staff specifically assigned for activities” was problematic as “there isn’t always time for normal staff to participate in some activities.” The deputy manager confirmed that they had secured funding for the coming year for an additional activity organiser. The lunchtime routine was observed in the main house and people were offered choices of what they wanted for lunch. To help people decide which dish they wanted they were shown both main courses served on a plate. This was particularly useful for those with limited communication skills or understanding. The menu for the meal was displayed. People spoken to and those who completed a survey were positive about the food at Thornton Hill. Comments made were: The food is “excellent.” “Sometimes” I enjoy the meals. I “always find the menu has a good choice and alternatives.” “It is usually to my taste and most of the time I enjoy the meals I have.” “The food is brilliant.” People were offered a cold drink with their meal and a hot drink afterwards. The meal was nicely presented, it looked and smelt appetising. The inspector sampled the two main hot dishes and one of the cold puddings. It was flavoursome and well cooked. The meal was served and eaten in a relaxed and unhurried manner, giving people time to eat at their own pace. If, for example for reasons of dignity, meals are served away from the main dining area, this is identified in the persons care plan. One care plan was Thornton Hill DS0000060215.V369096.R01.S.doc Version 5.2 Page 15 checked for this reason. The details gave a summary of a discussion with the person, why the decision had been made and in this instance it was with the full agreement of the person involved. Staff were seen to carry out their jobs in a polite and competent way. They were kind and respectful to people, there was also a warmth in the way they approached and spoke to people. There was also a friendly and courteous atmosphere between staff. Staff did not ignore anyone they came across in the course of their work; a gentle smile or greeting was given to each person to acknowledge them or reassure them of the time or event about to take place. This made people feel included and helped orientate those who were unsure. Two people told the inspector that if staff said they would do something “they never forgot to do it.” Thornton Hill DS0000060215.V369096.R01.S.doc Version 5.2 Page 16 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 and 18 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Complaints are taken seriously and acted on. People are protected from abuse and staff have been trained in the protection of vulnerable adult procedures. EVIDENCE: Information about the complaints procedure is available in the home and is also contained in the service user guide. People living in the home, who completed the survey or talked to the inspector, said they know who to speak to if they are not happy. One person said, “If I have a complaint I go and talk to the staff.” Another person said, “I do not know how to complain, because I haven’t had reason to.” A record is kept of all complaints. One record is for ‘informal complaints’, which can be dealt with in house and are usually of a minor nature. A more formal record is also kept of any complaints, which need to be dealt with by senior managers. Three had been received and dealt with by the home in 2007. A more recent complaint from a relative had been dealt with in June 2008 and the relative was satisfied with the outcome. CSCI has not been contacted directly about any complaints or concerns. Thornton Hill DS0000060215.V369096.R01.S.doc Version 5.2 Page 17 The home has a policy on the protection of vulnerable adults, (safeguarding). Staff spoken with during the visit said they had received formal training on safeguarding. The deputy manager confirmed this. All staff have induction training, where safeguarding is referred to. Staff spoken to had a good understanding of their responsibilities to protect people and an in depth knowledge of what they would do if they had any concerns about a person’s welfare. Thornton Hill DS0000060215.V369096.R01.S.doc Version 5.2 Page 18 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, 21 and 26 People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People live in a clean, comfortable and pleasant environment, which is well equipped to meet their needs. EVIDENCE: Thornton Hill is an old adapted manor house and has kept most of its original features. The main entrance, known as the House, opens up to a wooden gallery staircase and people like to sit on the comfortable leather sofas and chairs in this area. Throughout the day different groups of people were found to have congregated in this area for coffee, tea or just a social chat with others. The Manor Wing is a separate part of the house, joined by a covered walkway, which also has pleasant seating areas such as a conservatory and lounge. Staff have made good use of small areas by putting easy chairs and Thornton Hill DS0000060215.V369096.R01.S.doc Version 5.2 Page 19 coffee tables so that people can also meet in small groups or sit quietly if that is what they wish. The home was clean, tidy and odour free on the day of the visit. People living in the home said it is always clean and fresh. There is an ongoing programme of refurbishment and redecoration. Fresh flowers in vases and use of pictures and ornaments add detail to the environment, which gives a homely feel. The Manor Wing is secure and entry and exit is by a digital lock. Once in the unit, it is a safe environment and people with dementia are able to walk around freely and are able to have a choice of where to sit. People had lots of their personal belongings in their bedrooms. This was important to some of the people spoken to. Staff felt this gave people a “real sense of home.” People are made to feel this is their home and are encouraged to bring cherished items with them when they move in. There is a restriction on space but staff were said to “help all they can” to make the transition from home to care home as pleasant as possible. Some people said to the inspector that they felt lucky to have been able to move into Thornton Hill and staff made them feel welcome. They thought they went “the extra mile to make it special.” The home is well equipped to meet the needs of people with physical disabilities. All but two bedrooms have ensuite facilities. There is a passenger lift which residents can use to gain access to the ground and first floor. On the day of the visit the lift was out of order. There has been a problem over recent weeks and the home has been able to put plans into action so that people in the home have not been too inconvenienced. Risk assessments are in place for those using the staircases. The contractor was on site and was confident that the repair would be finished within five days. All areas of the home were well furnished. There are a number of areas for people to sit, including quiet areas such as the library or conservatory. The home does all the laundry, including linen and towels. Every person spoken to said the laundry was good, that their clothing was returned to them within 24 hours and rarely did anything go missing. Service users have access to a call bell system, which they can use to summon help from staff. It was heard during the day and staff attended to all calls within a short space of time. Thornton Hill DS0000060215.V369096.R01.S.doc Version 5.2 Page 20 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 and 30 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. There are enough suitably trained staff to meet people’s needs and people are protected because all the required employment checks are done before staff start work. EVIDENCE: Staff were seen to carry out their jobs in a polite and competent way. They were kind and respectful to people living in the home and each other. Service users spoken to said that staff were always available to provide appropriate support and that they felt safe living in the home. One service user spoken to said staff “were all very kind.” Feedback from surveys confirmed that staff are available and provide the care and support needed. One relative described staff as “brilliant.” The rota showed that at times the home runs with a minimum of three care staff plus one team leader in each of the units when there is a shortfall due to staff holidays or sickness. The preferred number is four care staff and one team leader. Now the home is operating with a higher percentage of occupancy the staffing levels must not fall below that which is required to meet Thornton Hill DS0000060215.V369096.R01.S.doc Version 5.2 Page 21 the needs of the residents. The deputy manager said this would be reviewed and adjusted according to the dependency levels of residents. At night there are two carers in each of the units and a team leader who works across the two units. There are staff vacancies on the night shift and the manager was to interview in the next few weeks to recruit additional staff. The home employs ancillary staff who work over seven days to provide domestic and catering cover. Staff files examined showed satisfactory recruitment procedures are in place. This means only those people suitable to work with vulnerable adults are employed. There is an induction programme that ensures new staff members are given the right information to be able to do their jobs properly. Staff spoken to said that the on going training programme is good, providing them with the skills and knowledge to meet service users needs. The training programme includes all the mandatory training needed to meet service users basic needs such as moving and handling, food hygiene, and health and safety. Specialist training provided includes dementia care, nutrition, continence and infection control. Staff said that they are able to identify their training needs in supervision sessions with their manager. A high percentage of staff have achieved National Vocational Qualifications level 2 or above. Some of the staff have worked at the home a significant length of time and this gives a stability to the team they have formed and means service users are able to build meaningful relationships with them and with this comes an element of trust. Two comments made in the surveys by staff were, “I am very happy working at Thornton Hill. It is the sort of place I would like my parents to be should the need arise.” And, we do all we can to “keep residents safe, well and happy.” Thornton Hill DS0000060215.V369096.R01.S.doc Version 5.2 Page 22 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, 32, 33, 35 and 38 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People benefit from a well managed home where their needs and wishes are put first. EVIDENCE: The home has a good and effective management team in place. The ethos of the home is open and positive. People who use the service, relatives and health and social care professionals all commented positively about the home. Staff comments included the following: “Since Jill Wiseman joined us as manager, we have had three recruitment days and are now fully staffed.” The manager is “very approachable and professional.” Thornton Hill DS0000060215.V369096.R01.S.doc Version 5.2 Page 23 An accident book is maintained in line with the requirements of Data Protection. People’s finances were not checked at this site visit. Historical evidence from previous reports gives evidence that people’s financial interests are safeguarded. The home employs an administrator. Finances and cash books are audited and procedures make sure there are regular checks on all transactions. Quality Assurance systems are in place. People living at the home are sent surveys annually for their views about the home. Regular residents meetings and staff meetings are held. The schemes manager carries out regular monthly visits to the home and reports are completed. Record keeping is of a consistently good standard and has improved since the last inspection. Information provided in the self-assessment form and the examination of some health and safety documents show that checks to electricity and fire safety equipment are regularly undertaken. Thornton Hill DS0000060215.V369096.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 3 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 4 3 X 4 4 X 4 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X X 3 Thornton Hill DS0000060215.V369096.R01.S.doc Version 5.2 Page 25 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. Refer to Standard Good Practice Recommendations Thornton Hill DS0000060215.V369096.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Thornton Hill DS0000060215.V369096.R01.S.doc Version 5.2 Page 27 - 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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