Care Home: Thorntree Farm Nursing Home

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What the care home does well The home has good pre-admission procedures. People`s needs are assessed before they move in and they are given the opportunity to visit the home to see if it is the right place for them. People are involved in drawing up their care plans and the plans give good clear information on how people`s needs are to be met. People`s health care needs are identified and met. People are encouraged to be involved in the local community and told us about some of the social events they attend at the local village hall, Bingo being a clear favourite. The staff team know people well and understand their needs. They are sensitive to people`s state of mind and show a genuine concern for the welfare of the people living in the home.Health care professionals told us the home is "fully co-operative with mental health services" and "respectful of clients". Another said it is the only home in the area for people with mental health care needs that provide activities each day as a matter of course. They said this could be excellent for motivation. What has improved since the last inspection? Many parts of the home have been redecorated creating a brighter and more pleasant place for people to live. What the care home could do better: The home needs to develop and maintain a formal quality assurance system. So that people using the service have the opportunity to contribute to its development and improvement. More could be done to give people a greater say in the day-to-day running of the home. This could help people to gain more confidence in the ability to make decisions and help to prepare them for "moving on". The home provides a structured environment and this works well for people that need the stability and security that this provides. However, this approach is not suitable for everyone. A more flexible approach could help to make the service appropriate to a wider range of people. The strict adherence to routines can sometimes cause families and health and social care professionals to feel it is not easy for them to have contact with people living in the home. This is a family business and the owners are very involved with all aspects of the running of the home. They have an impressive knowledge of the people they care for. However, they have a tendency to be protective of people and while this is without doubt well intentioned it can sometimes cause people visiting the home to feel they are not being open and transparent. CARE HOME ADULTS 18-65 Thorntree Farm Nursing Home Low Lane Clayton Bradford West Yorkshire BD14 6QA Lead Inspector Mary Bentley Key Unannounced Inspection 12th March 2008 10:00a Thorntree Farm Nursing Home DS0000019903.V360731.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Thorntree Farm Nursing Home DS0000019903.V360731.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Thorntree Farm Nursing Home DS0000019903.V360731.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Thorntree Farm Nursing Home Address Low Lane Clayton Bradford West Yorkshire BD14 6QA 01274 817523 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) Mr Sikandar Divan Mrs Sheila Divan Mrs Sheila Divan Care Home 20 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (20) of places Thorntree Farm Nursing Home DS0000019903.V360731.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th June 2007 Brief Description of the Service: Thorntree Farm provides nursing care and accommodation for up to 20 people of mixed ages with a mental health illness. Most are physically active and can self- care, with prompting and support, and all are independently mobile. The home is located in a semi- rural position between the villages of Clayton and Thornton and, for people with reasonable mobility, is within walking distance of bus routes. The home uses the community transport bus, and its own vehicle for transport as required. The home is a renovated farmhouse, which has 4 shared and 6 single rooms. There is an extension (known in the home as the cottage), and a renovated farm building, which provides a three-bedroom bungalow. The bungalow is designed to support people with rehabilitation and to help them prepare for moving out and living independently. There are plenty of communal rooms including four lounges, dining/kitchen areas, a designated smoking lounge, and a games room. The home has a nice garden and there is a greenhouse which people are encouraged to use to grow plants and vegetables. From April 2008 the weekly fees are £551.00. This does not include the cost of transport, holidays, or organised outings. Thorntree Farm Nursing Home DS0000019903.V360731.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. The inspection process included looking at the information we have received about the home since the last key inspection. In that time some concerns have been raised about the way people are cared for at Thorntree Farm. The purpose of this visit was to look at how the needs of the people living there now are being met. We did this unannounced inspection in one day; we were in the home for approximately 5 hours. We were accompanied by an “expert by experience” from the organisation Mind. An “expert by experience” is a person who, because of their shared experience of using services, is able to help us get a better picture of what it is actually like for people using services. During the visit the “expert” looked around the home and spoke to some of the people living there. The feedback he gave us has been incorporated into this report. During the visit we spoke to people living in the home, staff and management. We looked at various records including care records and looked at some parts of the building. Before the visit we sent surveys to people living in the home, staff and health care professionals involved with the home. In total 18 surveys were returned and the information is included in this report. On this occasion we did not ask the home to complete a self-assessment form, however other information we asked for was provided. What the service does well: The home has good pre-admission procedures. People’s needs are assessed before they move in and they are given the opportunity to visit the home to see if it is the right place for them. People are involved in drawing up their care plans and the plans give good clear information on how people’s needs are to be met. People’s health care needs are identified and met. People are encouraged to be involved in the local community and told us about some of the social events they attend at the local village hall, Bingo being a clear favourite. The staff team know people well and understand their needs. They are sensitive to people’s state of mind and show a genuine concern for the welfare of the people living in the home. Thorntree Farm Nursing Home DS0000019903.V360731.R01.S.doc Version 5.2 Page 6 Health care professionals told us the home is “fully co-operative with mental health services” and “respectful of clients”. Another said it is the only home in the area for people with mental health care needs that provide activities each day as a matter of course. They said this could be excellent for motivation. 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. Thorntree Farm Nursing Home DS0000019903.V360731.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Thorntree Farm Nursing Home DS0000019903.V360731.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 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 are given information about the range of services offered and their needs are assessed before they move in. EVIDENCE: There were 12 people living in the home when we visited. Nine of them completed surveys for us. Eight people said they had been asked if they wanted to come to the home and said they had been given enough information to help them decide if it was the right place for them. One person said, “It was the best home my family saw”. The records showed that people’s needs are fully assessed before they move in. Health care professionals told us they are aware that Thorntree Farm is not suitable for everyone because of the fairly structured regime it offers. One person suggested a more flexible regime might open up more possibilities and enable the home to accommodate more people. Thorntree Farm Nursing Home DS0000019903.V360731.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 & 9 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 individual needs are identified, they are involved in developing their care plans, and there is good information for staff on how to address these needs. The home could do more to support people in gaining the skills and confidence they need to live more independently; this could be achieved by placing more emphasis on people’s goals and aspirations. EVIDENCE: Everyone living in the home has a care plan. People’s needs are assessed and the care plans include information on physical and mental health care needs as well as social care. The daily notes are detailed and give a good picture of how people are spending their time and their state of mind. Thorntree Farm Nursing Home DS0000019903.V360731.R01.S.doc Version 5.2 Page 10 We saw that the care plans are evaluated every month and there is evidence that people are involved in making decisions about how their care needs will be met. One person told us “I can speak up for myself at CPA (Care Programme Approach) meetings. I have a CPN (Community Psychiatrist Nurse) and I get on well with her”. Staff are aware of the importance of seeing people as individuals, one told us “Residents are treated individually, according to their needs privacy, and dignity are maintained, no racial differences identified”. Risks are identified and there is clear information on how they are to be managed. Any restrictions that are in place are clearly recorded and show the reason why they are needed. For example one person is asked to hand their cigarettes into the office at night. The records show why this is necessary, to reduce the risk to themselves and other people of fire, and acknowledge the fact that the person does not like this arrangement. Health care professionals told us they think the home usually supports people to live the life they choose. One said “I have found Mrs Divan to be very keen to assist him in the kind of life he chooses in and outside of Thorntree Farm”. They also said they thought better use could be made of the smaller units, such as the cottage and the bungalow, to give people more opportunities for independent living. One person said, “I would prefer to be in my own home, but I know I need support”. The “expert” who accompanied us felt more could be done to support people in becoming more independent and more emphasis should be placed on “moving people on”. Formal meetings (community meetings) for people living in the home take place about every 6 months. One of the staff said they thought that was because there isn’t much for people to decide about. However, there is evidence of individual and informal consultation. A more formal approach to giving people a say in the day-to-day running of the home could help people to gain more confidence in their ability to make decisions about their lives. Thorntree Farm Nursing Home DS0000019903.V360731.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 & 17 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People are supported in a variety of social and leisure activities, inside and outside the home. Developing a more person centred approach would help to give people more opportunities for personal development. EVIDENCE: The home provides a structured environment and there is an expectation that people will take part in activities and take some responsibility for domestic duties, such as helping to prepare meals and do the washing up. One person told us they think the home is remarkable in the amount of activities it provides for people. This makes it particularly suitable for people that need the stability and security of a structured environment. However, they also said that this approach is not suitable for everyone and felt that individual development could, on occasions, be sacrificed to communal activity. Thorntree Farm Nursing Home DS0000019903.V360731.R01.S.doc Version 5.2 Page 12 The “expert” who accompanied us also referred to this, he said, “I was not convinced that all residents are engaged with useful, enjoyable activities”. Some people who no longer live in the home told us they sometimes felt the home was too controlling. For example they said they felt compelled to take part in activities and to do domestic tasks. Of the nine people who completed our surveys 7 said they could usually decide what they wanted to do each day, 2 said they could sometimes. One person told us “I work in a charity shop” and another said, “When I go out, it is often to the hairdresser’s or to buy myself clothes”. One person told us they go to stay with their family every weekend. A group of people regularly to go Bingo at the local village hall, they told us they have some “good wins”. People told us they could go out without fear of harassment, one person said, “we get no hassle when we go out shopping”. Staff told us “A few of the residents go to the local community centre on Thursday mornings for a keep-fit class. They are starting a social and lunch club there on Mondays soon and several residents are likely to be going to that” People told us they usually have cereal for breakfast, a snack such as soup or sandwiches at lunchtime and the main meal in the evening. They said staff take it turns to cook and some are better than others. Thorntree Farm Nursing Home DS0000019903.V360731.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 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 are consulted about how their personal and healthcare needs will be met and they are given appropriate support to meet these needs. EVIDENCE: The care plans have clear information about the level of support people need with personal care. The records also show that people have regular contact with psychiatrists, psychiatric nurses, and social workers. Details of visits to doctors, dentists, and opticians are recorded and show the reason for the visit and the outcome. Most people go out for these services and are sometimes accompanied by staff. One person told us “I go to my GP in Thornton (a nearby village) and one of the carers will take me there and come in with me if I want her to”. Nutritional screening is done and people’s weights are recorded every month. Risk assessments are done for other areas of health care including falls and pressure sores. Thorntree Farm Nursing Home DS0000019903.V360731.R01.S.doc Version 5.2 Page 14 We saw evidence of health promotion, for example one person is being supported to give up smoking by attending a clinic. Medicines are managed safely and any concerns about people not taking their medication are recorded. No one living in the home manages his or her own medication. Thorntree Farm Nursing Home DS0000019903.V360731.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 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 are satisfied their views are listened to and acted on. There are suitable working practices to make sure that people are protected from abuse, neglect or self-harm. EVIDENCE: People living in the home told us they know who to speak to if they are not happy and know how to make a complaint. Three people said they would speak to “the boss”. Feedback from health care professionals was mixed with regard to how well the home responds to complaints and/or concerns. One person said they usually responded appropriately and others said they found it difficult to deal with the owners when they had concerns. Staff told us they know what to do if people have concerns and they understand the importance of promoting people’s rights. They said “The service users at Thorntree Farm come first in all decisions that are made” and “Everyone’s individual rights are respected”. Since our last visit some concerns have been referred to the adult protection unit in Bradford and the investigation into these concerns is still going on. Thorntree Farm Nursing Home DS0000019903.V360731.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 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. The home provides a clean and comfortable place for people to live. The owners continue to make improvements to the environment to make sure it remains a pleasant place for people to live. EVIDENCE: The home is a converted farmhouse and from the outside there is nothing to distinguish it as a care home. People who need more support from staff live in the main part of the house, the old farmhouse. The four people who live in the “cottage” are more independent. For example, they do their own cleaning and at least once a week they organise and cook their own meals. Thorntree Farm Nursing Home DS0000019903.V360731.R01.S.doc Version 5.2 Page 17 The “cottage” has its own kitchen/dining room and lounge. People living there can also use the other communal rooms, which are in the main house and include a games room and a designated smoking area. An environmental health officer visited the home earlier this year and was satisfied that the smoking arrangements comply with the new law. There are steep stairs and several steps between the main house and the “cottage”. The home does not have a lift; people who are less mobile live on the ground floor of the main house. A lot of the home has been redecorated since our visit last year and this has made it appear brighter. The owners told us work is continuing to replace all the double glazed units. People told us their bedrooms are suitable to meet their needs and one person said, “I have my own things in my room”. The home was clean when we visited and people told us it is usually clean and fresh. The washing machine has a sluice cycle and there is a tumble dryer. Staff said they do all the washing. They said people prefer staff to do their washing although a domestic washing machine is available should people want to use it. The home has been given a 3 star rating (the maximum is 5) by environmental health for it’s standard of food safety and hygiene. The owners told us they are dealing with the issues that need to be addressed to improve the rating. Thorntree Farm Nursing Home DS0000019903.V360731.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 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 living in the home are supported by a well trained and competent staff team. EVIDENCE: There are usually 3 staff on duty until 4.00pm. Between 4.00pm and 9.00am there are 2 staff on duty. These numbers include nursing staff; there is always one nurse on duty. The nurse on nights works a 17-hour shift, from 4.00pm to 9.00am. This is a long time for one person to be on duty and although the owners say it has always worked well for the home it may not be in the best interests of the nurse or the people living in the home. Many of the staff have worked in the home for several years, they know people well and have a good understanding of their needs. This was evident in the interactions between staff and people living in the home. The staff we observed were kind and sensitive and showed a genuine concern for the welfare of people in their care. Thorntree Farm Nursing Home DS0000019903.V360731.R01.S.doc Version 5.2 Page 19 Most people living in the home said that staff treat them well and take notice of what they say. Staff told us they have an annual appraisal but there is no system for regular supervision, they said they can request supervision if they feel they need it. However, comments from staff showed they feel they get the support they need, for example • “I have worked at TF for nearly 17 months. It is so nice to work for a company where you know you are not going to be short staffed.” • “I have worked here for many years and I know I can get support from the owners and other staff members when required”. • “It’s good to see staff & management discussing everyday issues”. The home has not employed any new staff since our last visit. The recruitment records we looked at last year showed that the home carries out all the required checks before new staff are employed. Staff told us they get the training they need to help them meet people’s needs. The training records showed that since our last visit a number of staff have done training on the protection of vulnerable adults and infection control. Thorntree Farm Nursing Home DS0000019903.V360731.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 & 42 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 living in the home have confidence in the management team and told us they feel safe. However, more needs to be done to make sure people’s opinions are central to how the home develops and reviews their practice. EVIDENCE: The home is owned and managed by Mr and Mrs Divan; they are both qualified psychiatric nurses and Mr Divan is also a qualified Social Worker. They have many years experience in the care of people with mental health needs. Thorntree Farm is a family business and the owners tend to be rather protective of the people in their care. This is undoubtedly based on concerns Thorntree Farm Nursing Home DS0000019903.V360731.R01.S.doc Version 5.2 Page 21 about the welfare of people in their care however it can create the impression that the management approach is not open and transparent. For example, the “expert” who accompanied us said, “I was met at the door by one of the owners and led to a side room where I was gently interrogated about my role and the cause for the inspection. This was unprecedented for me and a little unpleasant. One or other or both of the owners were present during almost my entire visit, with the exception of conversations with two residents which were able to be conducted in more private circumstances”. Another health care professional commented along similar lines, they said that sometimes the home’s strict adherence to routines could make it difficult to get to see people. They felt this could be upsetting for families and other health and social care workers. The home has a quality assurance policy. People are involved in drawing up their care plans to some extent in making decisions about the day-to-day running of the home. The owners have devised questionnaires for people living in the home and their relatives. Since the inspection they told us they have started to give these out to people. The owners told us they would also send questionnaires to health and social care professionals involved with the service. This will help the home to identify areas of good practice and areas for improvement. We did not look at the maintenance records during this visit, when we last checked them they were up to date. Thorntree Farm Nursing Home DS0000019903.V360731.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 Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 2 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 2 2 X X 3 X Thorntree Farm Nursing Home DS0000019903.V360731.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. 1. Standard YA39 Regulation 24 Requirement An effective quality assurance and quality monitoring system must be put in place so that people using the service have the opportunity to give their views of the service and contribute to the improvement and development of the service. Timescale for action 30/10/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA32 Good Practice Recommendations The practice of nurses working 17-hour shifts, which include an overnight shift, should be reviewed. Thorntree Farm Nursing Home DS0000019903.V360731.R01.S.doc Version 5.2 Page 24 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 Thorntree Farm Nursing Home DS0000019903.V360731.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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