CARE HOMES FOR OLDER PEOPLE
Pine View Care Home 418-420 Hinckley Road Leicester Leicestershire LE3 0WA Lead Inspector
Kim Cowley Unannounced Inspection 22nd September 2005 1:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Pine View Care Home DS0000064266.V252637.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 Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Pine View Care Home DS0000064266.V252637.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Pine View Care Home Address 418-420 Hinckley Road Leicester Leicestershire LE3 0WA 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) 0116 2855868 Pine View Care Homes Ltd Care Home 15 Category(ies) of Dementia - over 65 years of age (4), Old age, registration, with number not falling within any other category (15) of places Pine View Care Home DS0000064266.V252637.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. No Service users in the category DE(E) shall be admitted to the home where there are already four service users in this category accommodated there. 13th May 2005 Date of last inspection Brief Description of the Service: Pine View is a 15-bedded residential care home situated on the Hinckley Road close to a range of local amenities. The home caters for older people, some of whom have dementia. There are nine single and three double bedrooms. The first floor is accessed by a passenger lift. On the ground floor there are two lounges, a dining room, and a conservatory. To the rear of the home is a large terraced garden with a patio and seating areas. Pine View Care Home DS0000064266.V252637.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on a weekday. When undertaking inspections, the Commission for Social Care Inspection (CSCI) focuses on the outcomes for residents living in a home. In order to do this, the inspector ‘case tracked’ three residents. This means the inspector checked their care records and met with them. In addition the inspector met a further four residents, and interviewed the Owner, the person in charge, and one of the carers. The premises were briefly toured. Further care and other records were examined. The admissions procedure, Owner, staff team, and staff training opportunities are commended. One Recommendation was made regarding the servicing of hoists. What the service does well: What has improved since the last inspection?
Pine View Care Home DS0000064266.V252637.R01.S.doc Version 5.0 Page 6 The Owner and the Care Manager have introduced formal staff supervision. This takes places six times a year and is based around actual tasks, eg personal care giving. The Owner said supervision means the quality of care can be assessed and improvements made where necessary. The Care Manager has one afternoon per week when she is supernumerary, and can attend to administrative and supervisory tasks. 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 View Care Home DS0000064266.V252637.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Pine View Care Home DS0000064266.V252637.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Staff ensure that residents’ needs are fully assessed prior to admission and prospective residents have the opportunity to visit and spend time in the home. EVIDENCE: The Owner explained the home’s admission policy to the inspector. Most admissions begin with a telephone enquiry and at this stage basic details about the prospective resident are taken. The Owner and Care Manager then visit the prospective resident in their own home or in hospital to carry out a written assessment of their needs. Other parties, including friends/family/social workers/nurses etc are consulted where necessary and asked to contribute to the assessment. Staff also get information about the prospective resident’s medication, contacting their own pharmacist if they need any further information about this.
Pine View Care Home DS0000064266.V252637.R01.S.doc Version 5.0 Page 9 The prospective resident is then invited to look round the home with, if they wish, their relatives/friends. The Owner said ‘They are welcome to look round as many times as they want. When they come I spend time talking to them and I show them the home’s inspection reports and also advise them to look at the CSCI website where they can research all homes in the area.’ Prospective residents are then invited to spend a half or full day in the home to help them decide if they want to move in permanently. During this time they have a meal and are introduced to the other residents and staff. I they do choose to move in there is a four week trial period. The home provides care for both private and social services residents. The Owner said ‘We have to be able to meet their prospective residents’ and we also have to be sure that they’ll fit in with out existing resident group.’ The home is commended for the care taken during the admission process to ensure the home is suitable for prospective residents. Pine View Care Home DS0000064266.V252637.R01.S.doc Version 5.0 Page 10 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9, 10 The home’s medication system is well organised and in the process of being further improved. Staff treat residents with respect and uphold their right to privacy. Residents with dementia are well cared for and staff are trained to work with this resident group. EVIDENCE: Staff are in the process of reorganising the home’s medication system. This is being done under the direction of the contract pharmacist with the intention of simplifying procedures to make them more effective for residents. Medication is kept securely in locked cupboards. The Owner oversees medication administration and monitors records on a weekly basis. One of the seniors has responsibility for ordering, booking in, and returning medication. Staff are trained in medication administration inhouse by the contract pharmacist, and medication is also covered in NVQ Level 2. The Owner said that further training will be provided when the new (blister pack) administration is introduced.
Pine View Care Home DS0000064266.V252637.R01.S.doc Version 5.0 Page 11 Those residents interviewed said they were happy with the way their medication was managed. One resident said ‘I’m glad I don’t have to worry about when to take my tablets – the staff sort all that out for me.’ At present no residents self-medicate, although the Owner said they encouraged to do so wherever possible. The Owner said staff are trained to treat residents with dignity and respect during their ‘First Steps’ induction. This last six weeks and has sections on privacy, dignity, choice, prejudice, etc. In addition the staff personal care manual contains guidelines for delivering care sensitively, and the home has policies and procedures in place to emphasis the importance of this. Pine View Care Home DS0000064266.V252637.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These Standards were inspected at the home’s last inspection on 13.05.05. Pine View Care Home DS0000064266.V252637.R01.S.doc Version 5.0 Page 13 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These Standards were inspected at the home’s last inspection on 13.05.05. Pine View Care Home DS0000064266.V252637.R01.S.doc Version 5.0 Page 14 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These Standards were inspected at the home’s last inspection on 13.05.05. Pine View Care Home DS0000064266.V252637.R01.S.doc Version 5.0 Page 15 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28, 29, 30 The Owner and staff provide quality care. Sound recruitment procedures are in place to protect residents. The Owner supports the staff team by offering then good training opportunities and supervision. EVIDENCE: The Owner committed to providing quality care and supporting his staff team by offering them good training opportunities and supervision. All the residents interviewed spoke highly of the Owner and the staff at Pine View: ‘Excellent staff!’ ‘The staff do their best for us.’ ‘The staff are great fun.’ ‘We have a good boss and he’s a nice man.’ ‘Dinesh (the Owner) is a lovely man. He is always asking me how I am.’ ‘Dinesh talks to us every morning, he always comes and asks us how we are and if everything’s OK.’ The Owner and the staff team are commended. Staff are advertised for locally and have an equal opportunities interview with the Owner prior to commencing work. The Owner insists that staff having two satisfactory written references and CRB checks before they start work permanently in the home. If they start without these they work under supervision at all times, have a telephone or fax reference, and sign a criminal
Pine View Care Home DS0000064266.V252637.R01.S.doc Version 5.0 Page 16 records declaration. Staff have a four weeks probationary period and all staff have a contract. The Owner oversees staff training. Most staff have NVQ Level 2 and one is doing Level 3. The Owner is doing NVQ Level 4/the Registered Managers Award. Records showed that staff have taken a range of courses including Challenging Behaviour, Fire Safety, First Aid, Moving and Handling, and Food Hygiene. Earlier this year the home’s registration was changed to enable up to four residents with dementia to be admitted. To help meet these residents’ needs all staff have completed a 12-week ‘Dementia Care’ course. The Owner said ‘This course has changed and improved the way our staff care for residents with dementia. We are building up life histories of residents, which helps staff to see them as individuals. If residents become agitated we remind them of their past and of who they are, this helps to calm them.’ One member of staff said ‘I’ve done this course and it opened my eyes about caring for residents with dementia. It’s a very good course.’ The mix of residents in the home appears to work well and non-confused residents were seen helping and socialising with residents with dementia. Staff training opportunities are commended. Since the last inspection the Owner and the Care Manager have introduced formal staff supervision. This takes places six times a year and is based around actual tasks, eg giving personal care. The Owner said supervision means the quality of care giving can be assessed and improvements made where necessary. The Care Manager has one afternoon per week when she is supernumerary and can attend to administrative and supervisory tasks. Pine View Care Home DS0000064266.V252637.R01.S.doc Version 5.0 Page 17 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35, 38 The Owner safeguards residents’ financial interests. Good policies and procedures are in place to promote and protect the health and safety of staff and residents. EVIDENCE: The home looks after small amounts of money for some residents who are not able to look after it themselves. Appropriate records are kept and statements issued every six weeks. The Owner said residents are occasionally reminded that they do have money so they can spend it and enjoy it if they wish. Other residents have their money looked after by their relatives or solicitors. Social workers are involved if there are any concerns about how a residents’ money is being managed. Pine View Care Home DS0000064266.V252637.R01.S.doc Version 5.0 Page 18 A senior member of staff is in charge of health and safety in the home. She carries out an audit of the building every month and keeps records of this which are passed to the Owner who takes action where necessary. Contractors do the servicing and maintenance of appliances in the home. At present moving and handling equipment is checked by a competent person once a year. This should be done every six months. The home had a fire inspection on 13.04.05 when recommendations were made. The Owner said these have been or are being carried out. The Environmental Health Officer inspected the home on 10.08.05 and following their recommendation the Owner purchased a new fridge for the kitchen. Pine View Care Home DS0000064266.V252637.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 4 X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 X 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X 3 Pine View Care Home DS0000064266.V252637.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard OP38 Good Practice Recommendations Moving and handling equipment should be checked for safety by a competent person every six months. 1 Pine View Care Home DS0000064266.V252637.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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