Inspection on 11/08/05 for Pinehurst Care Centre

This inspection was carried out on 11th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Pinehurst Care Centre 17/11/08

Pinehurst Care Centre 30/11/06

Pinehurst Care Centre 19/12/05

Pinehurst Care Centre 09/01/05

Pinehurst Care Centre 08/07/04

Pinehurst Care Centre 18/02/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE PINEHURST 38 - 44 Dukes Ride Crowthorne Berkshire RG45 6ND Lead Inspector Debbie Willcox Unannounced 11 August 2005 @ 09:50 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 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. PINEHURST H51-H01 S11081 Pinehurst V234523 110805 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Pinehurst Address 38 - 44 Dukes Ride Crowthorne Berkshire RG45 6ND 01344 774233 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) Pinehurst Care Limited Mrs Christine Hazlewood Care Home 50 Category(ies) of Older Person OP registration, with number of places PINEHURST H51-H01 S11081 Pinehurst V234523 110805 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 09/01/05 Brief Description of the Service: Pinehurst is a registered care home with 50 beds providing a residential care service for older people over the age of 65. Pinehust is located within Crowthorne close to the High Street and local amentities. The home consists of four houses - Pine House, Fern House, Cedar House and Hurst House all located on one site. PINEHURST H51-H01 S11081 Pinehurst V234523 110805 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection conducted by one inspector and carried out on a weekday morning and lasted six hours. The majority of time during this inspection was spent talking with people who live in this home as well as time spent with the manager, proprietor and staff. Records relating to pre-admission assessment, care planning and recruitment were viewed. Since the last inspection the homes manager has left and the previous registered manager is back in post until a new manager is recruited. What the service does well: What has improved since the last inspection? Carpeting and furniture throughout communal areas has been replaced which has enhanced the environment for people living within this home. There have been ongoing improvements to record keeping such as care planning. PINEHURST H51-H01 S11081 Pinehurst V234523 110805 Stage 4.doc Version 1.30 Page 6 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. PINEHURST H51-H01 S11081 Pinehurst V234523 110805 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection PINEHURST H51-H01 S11081 Pinehurst V234523 110805 Stage 4.doc Version 1.30 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 standard(s) 2,3,4,5, Service users can be assured that their needs will be assessed and have opportunities to visit prior to moving into this home. EVIDENCE: Several service users were spoken with regarding opportunities to visit the home prior to admission. Most people spoken with said they had visited the home prior to admission and if not this was due to either coming to the home from hospital or family visiting the home on their behalf. Each service user is issued with a contract, which is signed, by both the service user or representative and the home. One service user with a primary diagnosis of dementia had recently been admitted to the home on a trial basis with the consent of the Commission for Social Care Inspection to assess how well the home could meet the needs of this person. There was evidence of a review and an extension to this trial period had been agreed. Concerns relating to the security of the environment and the longterm needs of this person were highlighted by the inspector and brought to the attention of the manager and proprietor. PINEHURST H51-H01 S11081 Pinehurst V234523 110805 Stage 4.doc Version 1.30 Page 9 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 standard(s) 7,8,9,10,11 Safeguards must be put in place and guidance for staff recorded in care plans to ensure the safety of service users prone to absconding and aggression. Service users in this home can be assured that they will be treated with dignity and respect and their health care needs met. Service users can be assured that their wishes in the event of death will be upheld. Further work could be done to ensure that service users are fully informed when a death occurs in the home and opportunities presented to attend funerals. The home must ensure that staff do not conduct secondary dispensing of medication. EVIDENCE: Records relating to care planning and assessment were viewed at this inspection. A comprehensive care plan is provided for each service user. There was no evidence that service users receive a copy of their care plan or sign agreement of their plan. PINEHURST H51-H01 S11081 Pinehurst V234523 110805 Stage 4.doc Version 1.30 Page 10 For two service users prone to aggression and wandering, instructions within care plans had not been provided for staff highlighting how best to deal with these situations. There is a need for the home to ensure that risk assessments have a date set for review. There was evidence that reviewing of care plans is carried out but sporadic. There was evidence from discussions with people living within the home, records and observation that service users are enabled opportunities to access health care services such as GP and District nursing support, chiropody, sight and hearing tests. Weight monitoring charts were seen in service users files. However for one service user assessed, as at risk from weight loss with written instructions from the GP to monitor this had no weight recorded for the last 3 month period. There was evidence from observation of interactions between staff and service users that staff treat residents with dignity and respect. This was further evidenced from discussions with service users where all spoken with commented on the respectful manner in which staff speak to residents and also commented on the dignity with which they carry out personal care tasks. One service user commented that ‘They place very few restrictions on you here, when I first came here it felt like I was coming into a happy family’. It was apparent from discussions with service users that they are not always informed when a death occurs within the home and given opportunities to attend funerals and arrange collections for flowers and said they would like to be more informed. It was evident from files seen that service users wishes in the event of death had been recorded. Medication storage and recording within two houses was viewed. For one service user staying at the home on a respite care basis had medication secondary dispensed by the family into a dossette box for staff to administer. This unsafe practice was brought to the attention of the manager. Marr sheets for two service users where medication had not been given did not detail the reasons for non-administration. Eye drops needing to be stored at between 2c – 8c were found in the storage cupboard and not the fridge as needed. Discussions with staff evidenced that staff are provided with medication administration training in house and competency assessments are conducted. PINEHURST H51-H01 S11081 Pinehurst V234523 110805 Stage 4.doc Version 1.30 Page 11 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 standard(s) 12,13,14,15 Service users are supported to maintain contact with family and friends and exercise choice and control over how they live their lives. Service users receive a wholesome diet but more opportunities to enable service users to be involved in menu planning could be provided. EVIDENCE: There were mixed opinions from service users as to the availability of social activities and social events. The home does not have a plan of social activities and outings. However there was evidence that staff organise card games, bingo and other activities on an ad hoc basis. A recent boat trip had been organised and very much enjoyed by those residents attending. One service user said she would like staff to help her get out for walks and be given more opportunities to go shopping. Some service users organise outings independently of staff, as they were able to. All service users spoken with said that staff enable and support them to exercise choice as to how they live their lives including times for rising and going to bed. PINEHURST H51-H01 S11081 Pinehurst V234523 110805 Stage 4.doc Version 1.30 Page 12 In the main service user comments regarding the quality of the food was positive. There was evidence that opinions on the planning of menus is sought informally however service users said they would like to meet the management on a regular basis to discuss food quality and menus. One service user said she did not like tin peas and had asked for frozen peas to be provided. The inspector joined a group of residents for the midday meal. Most people were positive about the quality of the meal provided. It was brought to the attention of the manager that for one service user who was seen to be having difficulty with eating her meal that her care plan stated that all meals should be liquidised and this was not the case on this occasion. Menus are printed and distributed to service users for them to highlight their choices on a weekly basis and was appreciated by service users. Fresh fruit bowls were seen to be provided in communal lounges. PINEHURST H51-H01 S11081 Pinehurst V234523 110805 Stage 4.doc Version 1.30 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 standard(s) EVIDENCE: Not assessed at this inspection. PINEHURST H51-H01 S11081 Pinehurst V234523 110805 Stage 4.doc Version 1.30 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 standard(s) 19,20,25,26, Pinehurst is well maintained, clean and homely. Adequate hand washing facilities must be provided to ensure control of infection throughout. EVIDENCE: Two of the four houses communal areas and bathrooms were inspected on this occasion. There has been replacement of carpeting and chairs in lounges. This has enhanced the homely feel of communal areas. The houses seen were clean and fresh smelling. Not all bathrooms and toilets had provision of liquid soap for hand washing. One bathroom contained bars of communal soap. PINEHURST H51-H01 S11081 Pinehurst V234523 110805 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 29,30 This home ensures that the recruitment of staff safeguards service users. Improvements in the induction process will provide evidence that staff have been trained to understand the workers role and the needs of older people. EVIDENCE: The files of two recently employed staff were viewed at this inspection. All checks required by regulation had been carried out prior to the start of employment. There was evidence of a general induction checklist. No evidence was provided that staff had been inducted in line with national foundations standards for induction as provided through TOPSS now Skills4care. The induction process for staff could be improved to ensure that staff receive induction training to the TOPSS five foundation standards within the first 6 weeks of employment. Staff are provided with a period of induction where they are supernumerary on the rota. The two staff recently employed had received dementia training and instructions regarding safe manual handling however were waiting for mandatory training, which would include formal safe manual handling training. The majority of training for staff is provided in-house as the home has a training and development manager who undertakes this responsibility. PINEHURST H51-H01 S11081 Pinehurst V234523 110805 Stage 4.doc Version 1.30 Page 16 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,35,38 This home is run in the best interests of service users and systems are in place to ensure the health and safety and financial interests of individuals is protected. Regular, planned residents meetings would enable greater opportunities for service users to air their views and be more involved in how the home is run. EVIDENCE: The homes manager has recently left and the previous registered manager is back in post. The home is currently looking to recruit a new manager but to date without success. The current registered manager will not be pursuing a management qualification enabling her to meet regulation requirements due to her leaving once a new manager is in post. PINEHURST H51-H01 S11081 Pinehurst V234523 110805 Stage 4.doc Version 1.30 Page 17 All service users spoken with said they would have no hesitation in approaching the management team if they had concerns and felt that issues would be dealt with appropriately. An annual questionnaire is provided for service users to feed back views regarding the running of the home. Service users spoken with said they would like to see more residents meetings provided on a regular basis to enable them opportunities to meet with the management of the home and feedback their views about the running of the home especially the provision of meals Not everyone spoken with knew who the manager of the home was but all were clear that the home had a team of managers who all felt were approachable and would deal with any concerns raised. The system for handling service users monies was inspected on this occasion. All accounts viewed were found to balance and transactions recorded appropriately. However it was highlighted that receipts for day care services are not currently provided and it was agreed by the manager to take this issue forward with the providing agency. Bath temperatures are recorded each time a bath is provided. Fridge temperatures within the two houses inspected had been recorded. Food in containers had been covered but dates of opening had not been provided. PINEHURST H51-H01 S11081 Pinehurst V234523 110805 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 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 3 3 x x x x 3 3 STAFFING Standard No Score 27 x 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 2 3 2 x 3 x x 3 PINEHURST H51-H01 S11081 Pinehurst V234523 110805 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 9 Regulation 13(2) Requirement The pratice of secondary dispensing of medication to cease. Medicines to be administered from original containers or Monitored Dosage System. Staff to be inducted into the TOPSS foundation standards within the first 6 weeks of employment. Hand washing faciltities to prevent cross infection to be provided throughtout the home. Food to be liquidised for service users in accordance with assessed needs. Timescale for action 01/09/05 2. 30 18 01/11/05 3. 4. 26 15 16(2)(j) 16(2)(i) 01/09/05 Immediate and ongoing. 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. Refer to Standard 33 10 Good Practice Recommendations Regular planned service user forum meetings to be provided to enable service users to air their views with management. Service users to be informed when a death occurs in the home and supported to attend funerals if appropriate. H51-H01 S11081 Pinehurst V234523 110805 Stage 4.doc Version 1.30 Page 20 PINEHURST PINEHURST H51-H01 S11081 Pinehurst V234523 110805 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection 2nd Floor, 1015 Arlington Business Park Theale Berks RG7 4SA 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. Extracts may not be used or reproduced without the express permission of CSCI PINEHURST H51-H01 S11081 Pinehurst V234523 110805 Stage 4.doc Version 1.30 Page 22 - 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!