Inspection on 11/07/06 for Pinehurst Residential Home, Dawlish

This inspection was carried out on 11th July 2006.

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 Residential Home,... 29/10/07

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

CARE HOME ADULTS 18-65 Pinehurst Residential Home 1-2 Haldon Terrace Dawlish Devon EX7 9LN Lead Inspector Peter Wood Unannounced Inspection 11 & 12 July 2006 10:00 Pinehurst Residential Home DS0000067247.V300741.R01.S.doc Version 5.2 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 Residential Home DS0000067247.V300741.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Pinehurst Residential Home DS0000067247.V300741.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Pinehurst Residential Home Address 1-2 Haldon Terrace Dawlish Devon EX7 9LN 01626 863500 01626 863500 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) Pinehurst Partners Limited Mr Anthony Squire Care Home 20 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (20), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (20) Pinehurst Residential Home DS0000067247.V300741.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The home is registered for 20 service users in the category Mental Disorder MD. The home is registered for 20 service users in the category Mental Disorder over 65 years of age MD(E) Minimum age group 40 years. Date of last inspection 05/04/05 Brief Description of the Service: Pinehurst is a care home providing personal care and accommodation for 20 adults aged between 40 to 65 years and above, with a mental health problem. Mr and Mrs Samiotis & Mr and Mrs Squire have run this care home since 1994, taking over the running from the parents of Mr Squire and Mrs Samiotis. Latterly the two couples have run the home through their limited company, Pinehurst Partners Limited, and the home has recently been registered in the name of the company. Pinehurst Partners Limited has also recently purchased Ralmar, the care home next door. Mr Antony Squire is the Registered Manager of Pinehurst and the Responsible Individual in respect of Ralmar, Mr James Samiotis is the Responsible Individual in respect of Pinehurst and the Registered Manager of Ralmar. The home is a large grade II listed building forming part of a terrace of houses in a private road, close to Dawlish town centre, with shops, public houses, a post office, a railway station and other amenities. There is easy access into the city of Exeter, by a regular bus and train service. The accommodation is on three floors with access via the main staircase to all floors. The ground floor consists of 3 single bedrooms, 2 lounges (smoking is permitted in one of these lounges) and a third smaller, more private, lounge area. The first floor has 9 single bedrooms and 1 double bedroom. There are 6 single bedrooms on the second floor. Bathrooms and toilets are located on all floors. At the front of the property there is a veranda with seating. There is also a very pleasant courtyard with potting shed, potted plants, and some seating. Fees range from £350 to £475 based on the care needs of the residents. Pinehurst Residential Home DS0000067247.V300741.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and undertaken over one and a half days in July 2006. The focus of this inspection was to inspect all key standards and to seek the views of residents, staff, relatives and professional visitors to the home, the latter using comment cards, survey forms and follow-up telephone calls. Nine staff returned the “Care Workers Survey” form. One “Health and Social Care Professionals in Contact with the Care Home” returned a form with that title and five “Relatives / Visitors Comment Cards were returned. Five relatives agreed to a telephone consultation. Considerable time was spent with the registered manager and responsible individual examining documentation, particularly that relating to client assessment and care planning, staffing and health and safety. A handover meeting was witnessed and staff on duty consulted briefly. Residents who were at the home were consulted. A full tour of the public parts of the building was undertaken. What the service does well: This home aims to give their clients a good quality of life as close as possible to a normal home environment without too many restrictions. The familyowned home is run as a family as much as possible. This home sees itself very much as part of the community of local professionals working together to improve the lives of people with mental health problems. The home has a good reputation with the care management team, local psychiatric facilities and community mental health team whose staff know the sort of client Pinehurst can help best. Staff work closely with such health care professionals. This was well demonstrated as both a psychiatrist and a community psychiatric nurse were at the home at the beginning of this unannounced inspection. The home has a well-trained and motivated staff team whom the service users described as being very kind and caring. Service users described living at Pinehurst as “good” and “what I need at this time”. Service users praised the food with varied, well-balanced meals. Service users expressed that they feel safe at Pinehurst, aware that the home provides a home for life if the client wishes that, or support to move on to more independent living if that is a realistic opportunity. A professional visitor described staff as confident and courteous to our professionals and clients, always present at CPA reviews and at other times to ensure the best care package is provided within a seamless service. One relative described the home as “definitely the best house [my relative] has ever lived in. The staff are very caring and loving. It is a very happy place.” Care workers described the home as being like a family. Pinehurst Residential Home DS0000067247.V300741.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Pinehurst Residential Home DS0000067247.V300741.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Pinehurst Residential Home DS0000067247.V300741.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service and takes into account the views and experiences of people using the service. Thorough assessments at the time of admission allow prospective residents and their relatives to be confident that their needs can be met. EVIDENCE: The home has a good reputation with the care management team, local psychiatric facilities and community mental health team whose staff know the sort of client Pinehurst can help best. Most referrals are from members of such specialist teams, sometimes using the Care Programme Approach and are therefore usually appropriate, made on the basis of professional assessment prior to admission. The home adds to these assessments to be as sure as possible that the home can meet the needs of prospective residents. These initial assessments are regularly reviewed, such as the Care Programme Approach review of one residents which was in progress at the start of the inspection. Pinehurst Residential Home DS0000067247.V300741.R01.S.doc Version 5.2 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 the following standard(s): 6,7,8,9, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service and takes into account the views and experiences of people using the service. The home is good at involving residents in their care plan and daily living choices, and gives them appropriate support. EVIDENCE: Residents confirmed the documentary evidence seen that they take full part in their assessments and care plans. They are consulted on all aspects of life in the home, informally and formally. During the inspection residents were observed to be consulted about menus and activities while one resident was observed seeking advice, guidance and support regarding the pros and cons of taking up an employment opportunity. Residents are also asked to complete a comprehensive (32 questions) annual satisfaction questionnaire so the owners can judge whether their residents remain satisfied with living at the home and are encouraged to make “any comment [they] may feel will be of help in improving the services and facilities provided in the home”. Pinehurst Residential Home DS0000067247.V300741.R01.S.doc Version 5.2 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service and takes into account the views and experiences of people using the service. Residents have considerable opportunities to engage in a range of activities including leisure activities as part of the local community to assist their personal development. Meals are nutritious and varied. EVIDENCE: The home has a notice board which displays a range of the activities available to residents. Residents confirmed that they are encouraged and enabled to make use of the opportunities they have for personal development, and some enjoy taking part in activities that are arranged by the owners and staff. One or two residents are able to undertake sheltered work for therapeutic earnings if they wish. On one of the days of the inspection a couple of residents made their own way to the Cornwall Air show. Others continue to take part in the activities they did before admission to the home. One or two lead an almost independent life during the day, returning home for meals. Some enjoy music or have other individual interests. However, it is proving hard to encourage some residents, some of whom are over retirement age, to take part in Pinehurst Residential Home DS0000067247.V300741.R01.S.doc Version 5.2 Page 11 activities. Friendships and family contact is encouraged. The owners and staff demonstrated the respect they have towards the residents and encourage residents to show respect for the property and person of their fellow residents. The menu indicates a balanced and nutritious diet. The meals observed and sampled in the pleasant dining room were well presented and tasty. Several residents opted for a cold salad rather than the hot meal on the very hot days of the inspection, indicating that choice is available. Pinehurst Residential Home DS0000067247.V300741.R01.S.doc Version 5.2 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service and takes into account the views and experiences of people using the service. Residents are well supported with their holistic health needs met. EVIDENCE: Residents reported that they feel safe and well supported living at Pinehurst. They feel respected and are encouraged and enabled to have as much control over their lives as possible. This includes varying degrees of control over their own medication as they wish, are sufficiently confident, and following an appropriate risk assessment. The owners and staff of Pinehurst see the home very much as part of the local circle of support for people with mental health problems, alongside (other) professionals such as GPs and particularly the team of various professionals in the community mental health team. Residents reported that they received as much support as they wished and needed. Records confirm that residents’ physical, mental and emotional health needs are assessed and attended to appropriately. The home has appropriate policies and procedures in respect to the receipt, storage, administration and disposal of medication. The home has a new medication cabinet and changed its monitored dosage system from the NOMAD weekly cassettes to the sessional blister pack cards as this system allows nearly all medications the home uses Pinehurst Residential Home DS0000067247.V300741.R01.S.doc Version 5.2 Page 13 to be within the system, reducing the number of separate packs of medications that need to be separately wrapped. This in turn reduces the likelihood of error. Pinehurst Residential Home DS0000067247.V300741.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service and takes into account the views and experiences of people using the service. Complaints and suggestions from service users, relatives or other visitors to the home are treated seriously. Service users are listened to and issues resolved promptly. EVIDENCE: Residents reported that Pinehurst is their home and are confident through experience that their views are welcomed, encouraged, listened to and acted on. The home has policies and procedures to minimise the likelihood of abuse of residents in all its forms. The owners and staff have received training in issues relating to abuse and the protection of vulnerable adults and put into practice the correct procedure when it was thought that an allegation of abuse was being made, which in the event turned out not to be the case. A copy of the complaints procedure is available to all service users and visitors to the home and detailed in the home’s Statement of Purpose and Service User Guide. Pinehurst Residential Home DS0000067247.V300741.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service and takes into account the views and experiences of people using the service. Residents live in a pleasant, well-maintained home that is comfortable and which provides sufficient facilities to meet their needs. EVIDENCE: The home is family-run as much as possible as a large family. Pinehurst is as homely as possible, comfortable and safe. All communal rooms were reasonably decorated and furnished though the smoking lounge and surrounding area suffer from the heavy smoking of many of the residents. The home has a programme of planned refurbishment and further improvements to the building. The home was clean and tidy during the inspection visits and residents said that the home is always clean. The cleaner is recognised as a full member of staff with important interactions with residents. Therefore she is eager to undertake, NVQ in care! Pinehurst Residential Home DS0000067247.V300741.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35,36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service and takes into account the views and experiences of people using the service. Vulnerable residents are cared for by competent staff who are properly recruited to protect them. EVIDENCE: The home retains the prestigious “Investors in People” award, providing external evidence that residents are cared for by well-trained and motivated staff in sufficient numbers to meet the needs of those currently living in the home. Staff training records including evidence of NVQ, First Aid, food hygiene and fire safety. Staff files include evidence of references being obtained (two written references in respect of those more recently appointed) as well as CRB checks, terms and conditions, and job description. Although photographic proof of identity is always obtained in order to apply for the necessary Criminal Records Bureau Disclosure, such photographic proof is not always retained on file. It is recommended that the home retain photographs of staff and residents. Residents described the staff as very kind and caring and confirmed they responded promptly to requests for assistance. Comments from staff reflected their confidence, care for the residents and loyalty to the home. Staff report that they work as a team and spend quality time with residents, though would like to spend more time with clients inside and outside of the house rather than paperwork or cleaning. Most staff report they receive supervision. Pinehurst Residential Home DS0000067247.V300741.R01.S.doc Version 5.2 Page 17 However, comments such as “ I have been [fully or properly] trained so I don’t need supervision” suggests a misunderstanding of what supervision entails. Good supervision can greatly enhance staff’s professional work. Pinehurst Residential Home DS0000067247.V300741.R01.S.doc Version 5.2 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service and takes into account the views and experiences of people using the service. Pinehurst is a good, wellmanaged safe home run in the residents’ best interests. EVIDENCE: Interviews with and comment cards from residents, relatives and professional visitors provide evidence of the good management of this home. Examination of documentation including resident’s care files, satisfaction questionnaire, policies, procedures, risk assessments, accident book, fire log, and health and safety literature confirm that residents’ health, safety and welfare are promoted and protected. Residents report they are happy living here. They value their private and communal rooms, the management style of the owners, and the food. They know they can come and go as they wish, have confidence in the owners and staff, and most enjoy living with their fellow residents. All residents consulted expressed appreciation for being able to live here. Pinehurst Residential Home DS0000067247.V300741.R01.S.doc Version 5.2 Page 19 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Pinehurst Residential Home DS0000067247.V300741.R01.S.doc Version 5.2 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. 1 Refer to Standard YA12 YA14 Good Practice Recommendations Whilst commending the owners for their perseverance, the owners are urged to be more proactive in sourcing enjoyable and rewarding activities for the residents. Pinehurst Residential Home DS0000067247.V300741.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Residential Home DS0000067247.V300741.R01.S.doc Version 5.2 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. 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