Inspection on 28/04/05 for Pine Park House

This inspection was carried out on 28th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Pine Park House 23/11/06

Pine Park House 28/11/05

Pine Park House 09/02/05

Pine Park House 24/06/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Pine Park House Pine Park Road Honiton Devon EX14 2HR Lead Inspector Belinda Heginworth Announced 28 April 2005 th 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 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 Stationary 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 Park House D54 D06 S39273 Pine Park House V213000 280405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Pine Park House Address Pine Park Road Honiton EX14 2HR Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01404 42549 01404 42208 Devon County Council Mr Stephen Robinson CRH PC Care Home providing Personal Care 6 Category(ies) of LD Learning Disability [6] registration, with number PD Physical Disability [3] of places SI Sensory Impairment [3] Pine Park House D54 D06 S39273 Pine Park House V213000 280405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Any new respite service users aged 16 or 17 years can only be admitted if there are no service users aged 25 years or over in residence at the same time Date of last inspection 9th February 2005 Brief Description of the Service: Pine Park House provides respite care for up to six service users with a physical and learning disability, up to the age of 65. The home also caters for age groups from 16 and upward within a condition of registration. The home is a large detached property on the outskirts of Honiton. There is ramped access to the unit, a substantially adapted bathroom and WC, and a soft area with sensory stimulation equipment. It has 6 single bedrooms, a large lounge, kitchen and dining area. The unit is not intended to house long-stay residents. Devon County Council operates Pine Park House. Pine Park House D54 D06 S39273 Pine Park House V213000 280405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector spoke with two service users and two members of staff. This announced inspection took place over five hours with the manager, Steve Robinson being present throughout the day. The inspector looked around parts of the building and a number of records were inspected. What the service does well: What has improved since the last inspection? What they could do better: Improvements are needed in identifying service users’ personal goals. Assessments to reduce risks need to be completed for all potential areas of risk. Medicines that are bought “over the counter” and not prescribed by a GP should be included in the home’s relevant policy. Pine Park House D54 D06 S39273 Pine Park House V213000 280405 Stage 4.doc Version 1.30 Page 6 Staff training records should be accurate and should include training relating to child care issues and training that helps staff understand and meet service users’ needs. How the home carries out reviews of the quality of care delivered needs to be clear to all staff. 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 Park House D54 D06 S39273 Pine Park House V213000 280405 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Pine Park House D54 D06 S39273 Pine Park House V213000 280405 Stage 4.doc Version 1.30 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 standard(s) 2 The manager ensures that assessments on service users’ needs are completed prior to admission. EVIDENCE: The manager ensures that the home has the information they require before service users are admitted. Care managers complete an assessment in consultation with service users and relatives. The information provides the staff with the detail they require to ensure that the home can meet the service user’s need. Pine Park House D54 D06 S39273 Pine Park House V213000 280405 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 & 9 Care planning and risk assessments provide staff with some of the information they require to meet service users’ needs. Some improvements are needed to ensure service users’ needs are met safely taking into account personal goals. EVIDENCE: A service user said that staff were very supportive in all aspects of her life. She discussed how she was consulted and encouraged in independent living skills and making decisions about her life. Although she was aware there was a care plan she did not show much interest in it. The construction of care plans has improved, making them better organised and easier to read. Care plans did not always include service users’ goals. The home provides respite care only; therefore setting goals is not always appropriate. However, a service user talked about a personal goal she had achieved, with the help and support of staff, but it had not been identified as a goal or recorded in the care plan. This suggests an example of where goals can be identified despite service users coming in to the home for respite care only. Pine Park House D54 D06 S39273 Pine Park House V213000 280405 Stage 4.doc Version 1.30 Page 10 Potential hazards identified in the original information provided prior to admission, did not always have a risk assessment completed. For example, someone with poor eyesight or communication difficulties would require a risk assessment, setting out clear actions to minimise risks. Not all of the risk assessments provided this clear action. Staff demonstrated an excellent knowledge of the care plans, service users’ needs and risks. A requirement was made during the last inspection relating to the use of inappropriate listening devices being used to monitor health care needs of service users. On the day of this inspection appropriate monitoring devices were being installed. Pine Park House D54 D06 S39273 Pine Park House V213000 280405 Stage 4.doc Version 1.30 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 standard(s) 13, 15 & 16 Staff respect service users’ rights and choices, and encourage independent living skills. EVIDENCE: Service users discussed how they went to the local community for shopping and going to cafes. A service user said staff encouraged and supported her in independent living skills. An example of this was being able to wash her hair, which had been unable to do before. Her choice to manage her money herself was respected and she said staff encouraged her to make decisions about most aspects of her life. The majority of the service users that use the services of Pine Park House come from home, where they live with relatives or carers. The relationship between the relatives and the respite home is reportedly good. A working relationship is crucial to enable the home to meet the services users’ needs. Pine Park House D54 D06 S39273 Pine Park House V213000 280405 Stage 4.doc Version 1.30 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 standard(s) 19 & 20 Service users’ physical and emotional health needs are satisfactorily met. Medicines and administration are managed well. Improvements are needed in the policy relating to over the counter medicines and the identification of service users. EVIDENCE: Pine Park House D54 D06 S39273 Pine Park House V213000 280405 Stage 4.doc Version 1.30 Page 13 Health care needs are covered by the main carer; any appointments needed during stays at the home are arranged through the care manager or carer. Parents of service users under the age of 18 arrange and consent for all treatments and appointments necessary. There is a GP registered to provide on call medical requirements at the home. Such visits are carried out in private. Systems are in place to record all accidents and incidents, in accordance with the Devon County Council policy. The main carers provide medication for service users. It comes in clearly labelled bottles, boxes or liquids. It is stored in an appropriate metal cupboard fixed securely to the wall. The home has had a number of medication errors in the last year. The CSCI pharmacy inspector visited the home and provided advice on guidance to reduce mistakes. The guidance has been implemented. The home provides a limited amount of over the counter medicines and has a policy for the safe administration (Homely Remedy Policy) of these. However the policy did not name the medicines that can be used. The home normally has photographs of service users to make identification safe. This is particularly important when giving out medication. On the day of the inspection the photographs of the two service users staying in the unit could not be found. After receiving consent from service users, photographs were obtained on that day. Staff responsible for administering medication have recently completed appropriate training. Pine Park House D54 D06 S39273 Pine Park House V213000 280405 Stage 4.doc Version 1.30 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 standard(s) 23 Financial procedures protect service users from financial abuse. EVIDENCE: Recruitment files were not inspected on this occasion. Financial records are clear and monies were accurate. Two signatures were obtained for each transaction. The home ensures that monies are correct by checking the balance held when money is used, and having periodic checks with staff signing to confirm balances are correct. It was recommended that the home numbers receipts to cross-reference with the page number, and the actual amount of money spent be recorded. Full child protection training has been completed for all staff. The home has good information about child protection and has a copy of the local Area Child Protection Committee (ACPC) procedures. The home has obtained the “No Secrets” video to use as part of in-house induction and up date training. Pine Park House D54 D06 S39273 Pine Park House V213000 280405 Stage 4.doc Version 1.30 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 standard(s) 24 The home is homely, comfortable and safe. EVIDENCE: The home is bright, airy and comfortable, and is decorated in a homely fashion, with furniture and fittings of a good standard. Adaptations have been made to the downstairs areas to accommodate physically disabled service users. This includes ramped access into the home and overhead tracking for a hoist leading from two of the bedrooms going into the shared ensuite facilities. The large lounge has plenty of comfortable chairs and sofas, including a soft area with sensory lights and vibrating pads for disabled service users. All of the bedrooms are of a good size and meet the current standard. All bedrooms have a lock but the keys are not in the door, they are kept in the office. Service users are asked if they would like a key, as part of the admission procedure, and record and risk assess as necessary. A service user confirmed this happened. The home has an area for service users to study if they choose and have quiet time away from other people. Pine Park House D54 D06 S39273 Pine Park House V213000 280405 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 Residents are supported by an effective, competent and experienced staff team. Improvements are needed in how the home monitors staff training. EVIDENCE: Any new staff joining the team use the Learning Disability Award Framework (LDAF) for induction and foundation training. This provides underpinning knowledge for progress towards achieving NVQs. A number of staff have achieved NVQ qualifications. The home has a good record of staff training. The recording method of staff training is very good, however in some cases it was not clear who had received training and who had not. It was recommended that staff should attend training relating to child care issues and training directly relating to service users’ needs. For example, total communication training. The manager uses team meetings and supervision to provide training, guidance and clear direction to staff to help protect and meet service users’ needs, safety and welfare. Pine Park House D54 D06 S39273 Pine Park House V213000 280405 Stage 4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 The home regularly reviews its performance through a good programme of self -assessment that includes seeking the views of relatives. EVIDENCE: The home has quality assurance standards that include information about staff training and supervision, and other practices carried out in the home to ensure that good quality care is delivered. The manager needs to develop this further as part of a continuous improvement programme and to ensure that all staff are aware of the standards and time scales. Pine Park House D54 D06 S39273 Pine Park House V213000 280405 Stage 4.doc Version 1.30 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 x 3 x x x Standard No 22 23 ENVIRONMENT Score x 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 4 x x x x x x Standard No 11 12 13 14 15 16 17 x x 3 x 3 3 x Standard No 31 32 33 34 35 36 Score x x x x 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Pine Park House Score x 3 2 x Standard No 37 38 39 40 41 42 43 Score x x 2 x x x x D54 D06 S39273 Pine Park House V213000 280405 Stage 4.doc Version 1.30 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. 1. Standard Regulation None 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. 1. 2. 3. 4. 5. Refer to Standard YA6 YA9 YA20 YA23 YA35 Good Practice Recommendations Care plans should include service users personal goals and have clear action and recording methods to monitor if goals are met. Risk assessments should be completed for all identified hazards and should be cross-referenced with care plan goals. Over the counter medication used in the home should be listed in the Homely Remedy Policy. Financial systems should ensure that monies spent are clearly identified with receipts included. The recording system for staff training should clearly identify training achieved. Training should include child care issues and further training to ensure service users needs can be met. The homes quality assurance plan should be developed further to include the standards used and time scales to make it clear for all staff to follow. 6. YA39 Pine Park House D54 D06 S39273 Pine Park House V213000 280405 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Suite 1, Renslade House Bonhay Road Exeter EX4 3AY National Enquiry Line: 0845 015 0120 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. 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