Inspection on 10/12/09 for Pine House

This is the latest available inspection report for this service, carried out on 10th December 2009.

CQC found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Extracts from inspection reports are licensed from CQC, this page was updated on 14/03/2010.

Key inspection report Care homes for adults (18-65 years) Name: Address: Pine House 14 Shelbourne Road Haringey London London N17 0JX     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: Lea Alexander     Date: 1 0 1 2 2 0 0 9 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 Adults (18-65 years) Page 2 of 26 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 Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The 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) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Pine House 14 Shelbourne Road Haringey London London N17 0JX 02088048101 02083662638 tim@conniferscare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Connifers Care Limited Name of registered manager (if applicable) Mrs Sanjanah Soobdhan Type of registration: Number of places registered: care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: Three The Registered Person may provide the following category of service only: Care Home only--PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Code LD--Learning disabilities Date of last inspection Brief description of the care home 3 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was the homes first inspection since registering with the Commission in September 2009. At the time of this inspection one person was residing at the home. One inspector visited the home over the course of the late morning and early afternoon. We met with the manager, the care worker on duty and the person using the service. We also examined the residents personal file and staff personnel files as well as other relevant documentation relating to the running of the service. Care Homes for Adults (18-65 years) Page 5 of 26 What the care home does well: What has improved since the last inspection? What they could do better: Two requirements and one good practise recommendation are made as a result of this inspection. The homes complaints policy requires revision to ensure that all references to the National Care Standards Commission (NCSC) are updated to the Care Quality Commission (CQC). The home must also update its safeguarding policy to clearly state that all safeguarding concerns should be reported to the local authority safeguarding team who will determine who should take the lead in investigating if the police are not involved. The home should develop their care planning processes to include information relating to issues of capacity and consent and the residents ability to make decisions in their everyday lives. Care Homes for Adults (18-65 years) Page 6 of 26 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 Adults (18-65 years) Page 7 of 26 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service understands the importance of having sufficient information when choosing a care home. Admissions are not made to the home until a full needs assessment has been undertaken and it has been established that the service can meet the needs of the prospective resident. Evidence: At the time of this inspection the home had one resident. They had transferred into the home from another placement within the organisation in October 2009. The home has produced a statement of purpose and service users guide that reflect the service provided. The home has also produced the service users guide in an easy read format. We looked at the personal file for the homes resident. This evidenced that they were assessed by the home prior to their moving in, and that the resident had also had the opportunity to visit the home before coming to live there. Care Homes for Adults (18-65 years) Page 9 of 26 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans are person centred and agreed with the individual. The plan is a working document that is regularly reviewed with the resident, and includes a risk assessment. Evidence: At the time of this inspection the home had one resident. We spoke with them, with the manager and the care worker on duty. We also looked at their personal file. These evidenced that the home has developed a clearly laid out individual plan with the resident that addresses a range of their, personal, social and healthcare needs. It was also evidenced that these plans are reviewed with the resident during weekly key working sessions. We found the plans to be person centred and to contain some life story work. We noted that the home provides a service to adults with learning difficulties, however, we did not find evidence of issues around capacity and consent and the residents ability to make decisions around their everyday life reflected in their individual plan. We would recommend that this is an area of good practise the home Care Homes for Adults (18-65 years) Page 10 of 26 Evidence: could develop. From our discussions with the resident and the care worker on duty we evidenced that the resident took the lead in deciding how to spend their day, and deciding what their activities and routine would be. The resident we case tracked is supported to manage their finances. The nature of this assistance is detailed in their care plan. We looked at the records the home maintains relating to residents finances. Money held on behalf of residents is kept in a locked safe. A log book contains details of the date, amount and nature of each expenditure and deposit. Each entry is signed by staff and the resident. We evidenced that the home had identified potential risks in the individual plan, and completed a seperate risk assessment and management plan for these. The home has developed an unexplained absences policy. We looked at this and found that it complied with National Minimum Standards. Care Homes for Adults (18-65 years) Page 11 of 26 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are able to enjoy a full and stimulating lifestyle with a variety of options to choose from. The homes routines and activities are individualised, and person centred. Meals are well balanced and nutritious. Evidence: We spoke with one resident and looked at their personal file. The resident told us that they were very happy with their current activities. We also spoke with the manager and the care worker on duty and looked at the activity log. These evidenced that the resident is involved in a range of community and social activities. In the two months they had been living at the home the resident was evidenced as having regularly attended an activities programme at another residential home within the group, having lunch out and attending the cinema. They were also evidenced as visiting the local park for walks and to play football, and attending the local swimming pool. Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: In addition the resident was evidenced as developing their activities of daily living through shopping and cooking activities. We also noted that information about local community activities was prominently displayed on notice boards in the shared parts of the home. Discussion with people who use the service and sampling of personal files evidenced that residents are supported to maintain contact with their families. We looked at the log of meals provided to residents. This evidenced that a range of nutritious and varied meals are provided. We also spoke to the resident who told us that they enjoyed their meals, and that the menu reflected their preferences and wishes. Care Homes for Adults (18-65 years) Page 13 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Personal support is varied and responsive to the individual needs of people who use the service. Residents are supported to access healthcare services. The home has sound medication practises. Evidence: Discussion with the person who uses the service and the care worker on duty evidenced that the resident chooses their own clothes, and that their appearance reflects their personality. We looked at the residents personal file and spoke with them, the care worker on duty and the manager. This evidenced that the resident is supported to access healthcare services and to keep medical appointments. We looked at the homes medication policy and found that this complied with National Minimum Standards. At the time of this inspection none of the homes residents were self medicating, or taking any controlled drugs. We looked at the medication available for one resident and at their Medication Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: Administration Record (MAR) sheet. We found that the two corresponded, and that the MAR sheet had been correctly completed and was in good order. Some medications that the resident had previously taken that were now discontinued had been appropriately deleted from the MAR sheet and remaining supplies were packed and identified for return to the pharmacy. Care Homes for Adults (18-65 years) Page 15 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has an open culture that allows residents to express their views. Staff demonstrate a good understanding of safeguarding issues. Evidence: We spoke with the manager, care staff on duty and the resident. We also looked at the homes complaints log. This evidenced that there have been no safeguarding concerns or complaints since the home opened. We looked at the homes complaints policy and found that it complied with National Minimum Standards. The policy requires minor revision to update references to the National Care Standards Commission (NCSC) to the Care Quality Commission (CQC). We also looked at the homes safeguarding policy and procedure. We found that this also required revision to comply with local multi agency safeguarding protocols and to clearly state that all safeguarding concerns should be reported to the local authority safeguarding team who will determine who should take the lead in investigating if the police are not involved. We spoke with the homes resident. They told us that they were very happy and had no complaints. They also told us that the homes complaints procedure had been explained to them, and that they knew what to do should they need to make a complaint. We also spoke with the care worker on duty and they demonstrated a sound understanding of safeguarding issues and their responsibilities should they have Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: any safeguarding concerns. Care Homes for Adults (18-65 years) Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean, safe and comfortable. Residents are encouraged to see the home as their own. The home is attractive and very well maintained and has good access to community services and facilities. Each resident has their own private bedroom that they can personalise. Evidence: The home is located in a terraced house in a residential location. A range of communal areas are provided, including a comfortable lounge with a range of seating, a TV and music stereo. There is also a well equipped kitchen with dining area. There are three bedrooms, one of which has an ensuite shower room. A communal bathroom is located on the ground floor along with one residents bedroom. The home has recently been refurbished to a high standard, and the accommodation is comfortable, suitable for its purpose and well maintained. There is off street parking to the front of the property, and a small garden to the rear. The resident we spoke to told us that they were very comfortable in their room and were pleased with the facilities within the house. During our visit to the home we found it be clean, tidy and free from offensive odours. Care Homes for Adults (18-65 years) Page 18 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have confidence in the staff that care for them. Staff members undertake external qualifications beyond basic requirements. The home has developed and implemented sound recruitment practises. Evidence: At the time of this inspection the home employed six care staff. Of these five are currently working towards NVQ levels 2 and 3 and one care worker has obtained NVQ level 3. The home operates two shifts over a 24 hour period. These run from 8am to 8pm for the day shift and 7.30pm to 8.30 am for a waking night shift. At the time of this inspection a single member of staff is rostered on duty for each shift. In addition the manager is on site each weekday from 9am to 5pm. We were told that the home would revise its staffing levels as additional residents moved into the home. We examined the personnel files for two care workers. These evidenced that two satisfactory references and a Criminal Records Bureau (CRB) are obtained by the home prior to carers commencing their employment. Copies of their employment terms and conditions are also given to staff. Care Homes for Adults (18-65 years) Page 19 of 26 Evidence: Sampling of personnel files evidenced that each member of staff received an induction to the home when starting their employment. The home has developed a mandatory rolling training programme that commenced in 2009 and is scheduled to continue throughout 2010. Training courses provided include infection control, food safety, first aid, fire safety, moving and transferring, safeguarding, challenging behaviour, risk assessment and management, epilepsy, care planning and report writing. Care Homes for Adults (18-65 years) Page 20 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager is suitably qualified and experienced and is highly competent to run the home. There is evidence of an open and transparent ethos within the home. The views of people who use the service and staff are listened to and valued. Evidence: The manager told us that they had successfully completed their Registered Managers Award and were awaiting receipt of their certificate. The staff that we spoke to told us that the manager was very approachable and helpful, and that they felt supported to carry out their duties within the home. The home had been operation for only a few weeks at the time of our visit and had not formally sought the feedback of residents or other stakeholders on the service provided. We looked at a range of health and safety records the home is required to maintain. These evidenced that daily fridge and freezer temperatures are taken and recorded. The records we saw evidenced that temperatures are maintained within acceptable parameters. We also looked at the homes fire records. We found that the home had completed a fire risk assessment, and that the London Fire & Emergency Planning Care Homes for Adults (18-65 years) Page 21 of 26 Evidence: Authority (LFEPA) had visited the home in May 2009 and found the premises in good order. The records we saw also evidenced that the home carries out weekly fire alarm and smoke alarm tests and appropriately maintains these systems. We also noted that two practise fire drills had been carried out by the home and recorded. Our discussions with the manager and sampling of other documentation evidenced that the home maintains appropriate accident and incident records. The home has obtained appropriate insurance cover, and a valid insurance certificate was displayed at the time of this inspection. Care Homes for Adults (18-65 years) Page 22 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 23 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 22 22 The homes complaints policy 31/03/2010 requires revision to ensure that all references to NCSC are updated to CQC. To ensure the safety and wellbeing of people who use the service. 2 23 13 The home must update its 31/03/2010 safeguarding policy to clearly state that all safeguarding concerns should be reported to the local authority safeguarding team who will determine who should take the lead in investigating if the police are not involved. To ensure the safety and wellbeing of people who use the service. Care Homes for Adults (18-65 years) Page 24 of 26 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 The home should develop their care planning processes to include information relating to issues of capacity and consent and the residents ability to make decisions in their everyday lives. Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!