CARE HOME ADULTS 18-65
Pine Lodge Motala Close Corby Northants NN18 9EJ Lead Inspector
Mrs Sara Morrison Unannounced Inspection 15th November 2005 01:20 Pine Lodge DS0000033595.V265829.R01.S.doc Version 5.0 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 Pine Lodge DS0000033595.V265829.R01.S.doc Version 5.0 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. Pine Lodge DS0000033595.V265829.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Pine Lodge Address Motala Close Corby Northants NN18 9EJ 01536 742043 01536 747780 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) www.northampton.gov.uk Northamptonshire County Council Ms Jean Elizabeth Winters Care Home 15 Category(ies) of Physical disability (15) registration, with number of places Pine Lodge DS0000033595.V265829.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. The home is registered to accommodate 15 people in the category PD (18 - 65 years) for a maximum period of 6 months. A maximum of 4 people may be accommodated who have a physical disability and a learniing disability. (PD/LD). A maximum of 1 person who has a physical disability or physical disability/learning disability and is over the age of 65 years (PD(E) & PD/LD(E)) may be accommodated at any one time. The three bedrooms in flat 3 that are less than 12 square metres must not be used to accommodate wheelchair users. The total number of service users must not exceed 15. 4. 5. Date of last inspection Brief Description of the Service: Pine Lodge is a home run by the local authority. The home currently offers rehabilitation and respite care to people with a physical disability and can accommodate up to 4 people who have a physical disability and an associated learning disability. All accommodation is ground floor. The unit is divided into three flats two designated to respite care the other to rehabilitation for a maximum stay of six months. Extensive work has been carried out to upgrade the building and the home now has accessible facilities for wheelchair users. Each flat has a lounge /dining area and kitchenette. There is a communal area used by all three flats and a main kitchen and laundry. Service users access local day/work placements or stay within the home during the day. The home is close to local amenities such as the post office, shops and library. There is a social club nearby that is used by service users. Pine Lodge DS0000033595.V265829.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over four hours during the afternoon, was carried out as part of the regular inspection visits required by law and was unannounced. Prior to the inspection time was taken to review the information gathered since the last inspection and plan this inspection visit. The focus of the inspection was the assessment/re-habilitation/preparation unit in flat 4 and did not include the two respite flats. The inspection included a tour of the majority of the communal areas in flat 4; inspection of some records, discussion with two of the staff, several service users and the manager. The method of inspection was to track the lives of several service users. This was achieved by speaking to them about the service they receive, talking to staff who provide their care and reviewing their records. No requirements or recommendations were made at this inspection. What the service does well:
The comments made in the report of the last inspection remain relevant to this inspection. Service users said that the attitude and approach of the staff is very good, that staff are very kind and supportive. The rights of the service user are at the heart of what the home provides. Service users are encouraged to take charge of their lives and live life to the full. Staff enable people to do things for themselves rather than taking over. One service user said “I’m the boss”. Service users said that the staff are very kind and helpful and the food is excellent. The wife of one person who had received a respite service had written to say how pleased she and her husband were with everything about Pine Lodge. She said that she ran a carers group and had always been wary of respite care however she was delighted with the service they received which had benefited herself and her husband, she said she wanted to use the service again. The home is well-managed and run, staff and service users said that the manager is very approachable and will sort out any problems that arise. Pine Lodge DS0000033595.V265829.R01.S.doc Version 5.0 Page 6 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. Pine Lodge DS0000033595.V265829.R01.S.doc Version 5.0 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 Pine Lodge DS0000033595.V265829.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 & 5 There is a thorough assessment process that ensures the right people are admitted to the home. EVIDENCE: The assessment/re-habilitation/preparation unit is now being fully utilized and care managers on service users’ behalf are making referrals. One of the senior staff has responsibility for this unit and the manager said that she intends to give this person more time to dedicate to the development of this service. This will include a review of the statement of purpose to ensure it accurately sets out what the home does. Documentation for the single assessment process was on service users’ files. The manager said that whilst most people are subject to this process of assessment the home also carries out its own assessment. There was information on file that demonstrated that the home continues to assess each person during the first week of his or her stay. Staff said that the re-organisation of the rota to ensure specific staff are working in the unit has created more continuity and more opportunities for staff to get to know service users well. All service users staying in unit 4 now have a specific contract Service users understood the reason for their stay and knew the goals they are endeavouring
Pine Lodge DS0000033595.V265829.R01.S.doc Version 5.0 Page 9 to achieve and the time limitations on the stay. One service user said that when she came to the home she was not given a contract; she did not understand what her responsibilities were and expected that meals would be served to her. She said that she now knows what she must do for herself and what support staff will provide. It is concluded that the new contracts have clarified to service users what their responsibilities are, and the revised Statement of Purpose will further improve peoples understanding of what unit 4 is about. Pine Lodge DS0000033595.V265829.R01.S.doc Version 5.0 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 The care planning system is good. There was evidence of service users’ involvement and clear guidance for staff on the support required by each service user. EVIDENCE: One service user showed a copy of his care plan that he kept in his room. The care plan included a risk assessment and personal handling plan. Staff confirmed that they read the care plans and discuss any changes with the senior responsible for the unit. Staff said there is a good handover procedure and good communication between the five care staff who work in this unit. The care plans are well set out and give clear ‘at a glance’ guidance for staff’. Risks are assessed with action specified to reduce these. There is a moving and handling plan for each person. A weekly diary has been introduced which service users complete with staff support at the start of each week. This is an excellent idea and is used to enable service users to plan their week and for ensuring the correct deployment and availability of staff.
Pine Lodge DS0000033595.V265829.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): No standards in this section were assessed during this inspection. EVIDENCE: Pine Lodge DS0000033595.V265829.R01.S.doc Version 5.0 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Service users are encouraged to take control of their lives, support is provided by staff to ensure all health and personal care needs are met in the way in which service users prefer. EVIDENCE: One service user said, “I’m the boss”. He said that he is very independent and staff respect his wishes, he is not told what to do. This person was pleased to show the Inspector a fork with a knife attachment that can be used in one hand, he said that staff had got this aid for him, and this small thing had greatly improved his quality of life. This person also said that the senior has been very supportive and helpful in his planned move to his own home, she has enabled him to complete the necessary paperwork and purchase his furniture etc without undue worry to himself. Another service user said that she came to the home on an emergency basis and did not know much about it. She said that she was anxious at first however soon found that she could do what she liked and this is what she does. Service users said that their health needs are met and support is provided for visits to the doctor etc. Staff felt that because there is only a small group of staff allocated to work in flat 4 they are able to provide more continuity and consistency for service
Pine Lodge DS0000033595.V265829.R01.S.doc Version 5.0 Page 13 users. Service users felt that their dignity is preserved, and they are less embarrassed as there are fewer people providing them with intimate personal care. Service users are encouraged wherever possible to manage their own medication. One service user said that she informs staff when her tablets are due to run out and staff organise a repeat prescription, which they keep safely until she needs them. This person said she has a lockable facility in her room in which to keep her medication and has also been provided with a key to her room that she locks when she goes out. Pine Lodge DS0000033595.V265829.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Any concerns are properly and promptly dealt with, service users can be assured they will be listed to and action taken to rectify any issues. EVIDENCE: The service manager promptly and thoroughly dealt with a complaint made by a service user during the summer. The manager stated that the complainant had made some valid points and staff had learned a lot of lessons. Action had been taken in several areas to address the issues. For example a door has now been fixed onto the area by the public telephone, which means that service users can now make phone calls in private. One service user said that she knows that if she has any concerns she can go to the manager who will deal with it. She said that she had spoken to the manager on one occasion and was pleased that she had quickly responded to her. Staff said that they receive training in what to do if they suspect abuse. One person said that this isn’t discussed at staff meetings however gave a good account of what she would do if presented with a situation. Pine Lodge DS0000033595.V265829.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 The environment remains in excellent condition and provides a comfortable pleasant home. EVIDENCE: The building is a credit to service users and staff, everywhere is comfortable, clean and homely. Service users were very pleased with their accommodation one person said she could not believe how homely and accessible the building was when she came to stay. The re-focussing of flat 4 means that service users no longer congregate in the ‘square’ (that is also the designated smoking area) to eat their meals and generally use their own flats. One service user said that it can be difficult to fit more than three people especially if they are all using wheelchairs into the kitchen in flat 4 however in general people stagger their mealtimes so this does not cause a problem. A new walk in shower has been provided in flat 2 and all flats now have bathing and shower facilities. Pine Lodge DS0000033595.V265829.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 There is a dedicated staff team who are committed to providing good outcomes for service users. EVIDENCE: Everyone seemed very pleased with the new arrangements for flat 4. Staff felt that the dedicated staff team is a big improvement; they are able to get to know service users well and provide greater continuity. The senior who is responsible for flat 4 has attended a number of courses, for example she attended a course in benefits and living allowances in order to assist service users with their move to more independent living. For different but equally valid reasons two of the four seniors have left however new staff have been recruited to these posts. One service user said that she was on the informal interview panel for care and senior staff. She said she was part of a group of three who devised and asked their own questions and gave a score for each person that was submitted to the main panel. The only issue she raised was that the informal panel did not receive feedback about who had been appointed, but learned later from care staff. The manager may wish to consider this point. Pine Lodge DS0000033595.V265829.R01.S.doc Version 5.0 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): No standards in this section were reviewed at this inspection Staff felt that the dedicated staff team for unit 4 is a big improvement; they are able to get to know service users well and provide greater continuity. EVIDENCE: Pine Lodge DS0000033595.V265829.R01.S.doc Version 5.0 Page 18 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 x x 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X X X Standard No 24 25 26 27 28 29 30
STAFFING Score 4 X X X X X 4 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score 3 X X X X X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Pine Lodge Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score X X X X X X X DS0000033595.V265829.R01.S.doc Version 5.0 Page 19 NO Are there any outstanding requirements from the last inspection? 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 Pine Lodge DS0000033595.V265829.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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