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Inspection on 05/01/06 for Pinehurst House Nursing Home

Also see our care home review for Pinehurst House Nursing Home for more information

This inspection was carried out on 5th January 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Residents and the visitor spoken with were very complimentary about the home. Comments included "I`m settling in well"; "staff are all very kind and nice"; "it`s a very good home"; staff are excellent and always assist in a kind and cheerful manner". Despite the inspection being unannounced and the Registered Manager not being on site, there was a calm and tranquil atmosphere throughout the inspection visit.

What has improved since the last inspection?

Three of the four requirements made following the last inspection have been complied with. Substantial resources have been made available for building improvement works. So far this has resulted in ten bedrooms having been completely re-decorated, lounge/dining rooms and corridor carpets having been replaced; the courtyard has been completely levelled off and external pathways leading to and around the home have been improved and or replaced. Care staff continually strive to improve their record keeping skills with particular regard to the maintenance of care records.

What the care home could do better:

The stained bedroom carpets should be replaced in those rooms identified at this and the last inspection visit, as they do not promote a homely environment for the residents occupying these rooms.

CARE HOMES FOR OLDER PEOPLE Pinehurst House Nursing Home Pinehurst Off Filmer Lane Sevenoaks Kent TN14 5AQ Lead Inspector Elizabeth Baker Unannounced Inspection 5th January 2006 09:55 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 Pinehurst House Nursing Home DS0000026196.V272797.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. Pinehurst House Nursing Home DS0000026196.V272797.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Pinehurst House Nursing Home Address Pinehurst Off Filmer Lane Sevenoaks Kent TN14 5AQ 01732 762871 01732 763922 johnk4upa.com 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) BUPA Care Homes Limited Mrs Kerry Joanne John Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30), Physical disability (0), Terminally ill (0) of places Pinehurst House Nursing Home DS0000026196.V272797.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th June 2005 Brief Description of the Service: Pinehurst House Nursing Home is a care home providing nursing care for 30 Older People. BUPA Care Homes Limited is the registered provider. Pinehurst House is a purpose built establishment, which was first registered in 1986. Resident accommodation comprises thirty single bedrooms and three sitting/dining rooms all of which are on the ground floor. All bedrooms have a TV and telephone point. Bedrooms do not have ensuite facilities. All rooms used by residents are connected to the nurse call system. There is a central inner courtyard, which provides appropriate seating and a sensory garden. There is ample car parking. The home is located near to the main A25 trunk road and approximately two miles from Sevenoaks Town Centre. Sevenoaks has a good range of amenities including shops, banks, places of worship, restaurants, a cinema and theatre. Sevenoaks is well served by public transport. Pinehurst House Nursing Home DS0000026196.V272797.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on the 5 January 2006 and lasted just over five hours. Lead Inspector Elizabeth Baker carried out the inspection. A partial tour of the home took place. A number of residents were spoken with and two agreed to be interviewed in private. Staff were also spoken with and one visitor was spoken with in private. Registered Nurse/Training Coordinator Mrs B Clayton-Higgins assisted throughout the inspection process. Feedback was provided at the conclusion of the inspection. Some judgements about the quality of care, life and choices were taken from direct conversations with residents, the visitor and staff, direct observation and evidencing records held at the home. Some records were inspected as part of case tracking and to assess work on requirements made at the previous inspection. This is the second inspection of this home for the year 2005/06. Not all standards have been inspected on this occasion, where they were met at the first visit. The report should therefore be read in conjunction with the inspection report dated 14 June 2005 At the time of the visit 28 residents requiring nursing care were residing at the home and two residents were in hospital. What the service does well: What has improved since the last inspection? Three of the four requirements made following the last inspection have been complied with. Substantial resources have been made available for building improvement works. So far this has resulted in ten bedrooms having been completely re-decorated, lounge/dining rooms and corridor carpets having been replaced; the courtyard has been completely levelled off and external pathways leading to and around the home have been improved and or replaced. Care staff continually strive to improve their record keeping skills with particular regard to the maintenance of care records. Pinehurst House Nursing Home DS0000026196.V272797.R01.S.doc Version 5.0 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 House Nursing Home DS0000026196.V272797.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 Pinehurst House Nursing Home DS0000026196.V272797.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): 1 The home’s statement of purpose does not easily provide prospective or current residents and or their advocates with specific information about this home. EVIDENCE: The home is not registered for intermediate care. Standard 6 is not applicable. Standards 2, 3, 4 and 5 were inspected and met at the last visit. They have not been re-assessed on this visit. The home’s current Statement of Purpose was reviewed on this visit. The document generally follows the principles of Regulation 4. However there is a reliance on referring the reader to the organisation’s (BUPA) policies and manuals for additional information. This could prevent prospective and current residents and their advocates on easily accessing all the information they may require. To assist the manager in the review of the document, a copy of the Commission’s statement of purpose policy guidance has subsequently been sent to the home. Pinehurst House Nursing Home DS0000026196.V272797.R01.S.doc Version 5.0 Page 9 The provider has recently published a new brochure to reflect the facilities and services of Pinehurst House. A resident and visitor said they had obtained many “catalogues” from different homes as part of their research into finding a suitable home. Pinehurst House Nursing Home DS0000026196.V272797.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): 7 and 8 The health needs of residents are met with evidence of good multi-disciplinary working taking place on a regular basis. EVIDENCE: Three care records were inspected as part of the case tracking process. Care records comprise care plans and supporting clinical risk assessments, including falls prevention, moving and handling, nutrition, skin integrity (Waterlow model) and pain, as well as health and safety risk assessments. However a review of two of the three Waterlow assessments identified inaccurate scores and one of the care plans did not contain upto date details of the resident now having a sacrum sore, although this information was recorded in a separate risk assessment file held in the resident’s bedroom. A risk assessment referring to a resident who smokes was not complete of their current condition in that it did not refer to the resident’s impaired dexterity. The assessment did not identify whether protective fire safety apparel had been considered or indeed offered to the resident. It was a concern that a plastic bin liner was positioned next to the resident who is mainly chair-bound. A particular resident described their important night routines, which are now in place to minimise their anxieties. Although reference to this was seen in the daily Pinehurst House Nursing Home DS0000026196.V272797.R01.S.doc Version 5.0 Page 11 record book, the matter had not been crossed referenced to the care plan. The care plan did not state the resident’s preference for wearing gloves in bed, although this is very important to the resident. It was again noted that the available nursing notes are not complete of the residents’ medical diagnosis on admission, as these particulars are filed away separately. The current model of care records does not require the information be recorded. This situation prevents a complete picture of the residents’ needs being easily accessible on a need to know basis. Following changes in regulations for the disposal of waste medicines, the home has acquired an appropriate contract with a Waste Disposal company in order to comply. Standards 9, 10 and 11 were inspected and met at the last inspection. They have not been reassessed on this occasion. Pinehurst House Nursing Home DS0000026196.V272797.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: The above standards were met at the last inspection. They have not therefore been re-assessed on this occasion. Pinehurst House Nursing Home DS0000026196.V272797.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: The key standards were met at the last inspection. They have not been reassessed on this occasion. Pinehurst House Nursing Home DS0000026196.V272797.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): 19, 20, 23, 24 and 26 The home’s environment has greatly improved making it a safer and homely placer to live. EVIDENCE: The home was clean, warm, tidy and odour free. Since the last inspection much work has been done externally and internally to improve the home’s safety and appearance. This includes replacing ramps, levelling out the grounds, making a better access into the home, redecorating bedrooms and renewing communal carpets. Bedrooms are individualised with personal effects, including small table lamps, which made the rooms cosier on a particular grey and dull weather day. Sadly though the stained carpets in the two bedrooms identified in such condition at the last inspection have not been renewed. All bedrooms are for single occupancy and vary in shape and size. Each room has lockable facility for the safe storage of medicines or items of importance. Indeed one resident said how this was important to them. Some bedrooms are Pinehurst House Nursing Home DS0000026196.V272797.R01.S.doc Version 5.0 Page 15 arranged so bedfast residents can look out into the gardens and enjoy watching the wildlife. In common with many former nursing homes, it has not been the norm for bedroom doors to be lockable. The maintenance man said all bedroom doors are being replaced as part of the home’s upgrading programme. Installing lockable doors, which meet the requirements of the Fire Safety and Rescue Service, would provide greater choice to residents if they wished to have increased security or more privacy. The home has a range of beds and pressure relieving equipment, which is provided to residents on an assessed needs basis. Pinehurst House Nursing Home DS0000026196.V272797.R01.S.doc Version 5.0 Page 16 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): EVIDENCE: The above standards were all met at the last inspection. They have not been reassessed on this occasion. Pinehurst House Nursing Home DS0000026196.V272797.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): 34 and 37 The home is well resourced to carryout improvements. Displaying staff information compromises their confidentiality. EVIDENCE: Standards 31, 32, 33, 35, 36 and 38 were assessed and met at the last inspection. They have not been reassessed on this occasion. Substantial resources have been made available by the provider in order to carry out works to the home. A current employer’s liability insurance certificate is publicly displayed in the main reception room. Care and staff files are kept in lockable facilities when not in use for security purposes. However a list containing important information in respect of Pinehurst House Nursing Home DS0000026196.V272797.R01.S.doc Version 5.0 Page 18 Registered Nurses was seen displayed in an office, which at the time of the visit was left open when not in use. This situation could jeopardise and or compromise the confidentiality and identification of those staff. Pinehurst House Nursing Home DS0000026196.V272797.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 2 X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 X 10 X 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 3 3 X X 2 3 X 3 STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X 3 X 2 X X Pinehurst House Nursing Home DS0000026196.V272797.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? Yes 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 OP19 Regulation 23 Requirement A programme of carpet deep cleaning or replacement must be instigated. (Timescale 31/08/05 not totally met with regard to residents’ bedrooms.) The statement of purpose must be individualised to reflect Pinehurst House Nursing Home. Timescale for action 30/06/06 2 OP1 4 30/06/06 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 Refer to Standard OP7 OP8 OP36 Good Practice Recommendations Care plans must be complete of all assessed medical and social care needs and problems. Skin integrity assessments must be accurate. Confidential information in respect of staff must be kept secure. Pinehurst House Nursing Home DS0000026196.V272797.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 House Nursing Home DS0000026196.V272797.R01.S.doc Version 5.0 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. 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