Inspection on 12/09/06 for Pines Care Home

This inspection was carried out on 12th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Pines Care Home 08/01/09

Pines Care Home 04/09/07

Pines Care Home 10/01/06

Pines Care Home 26/10/05

Similar services:

Abbey The

Snydale Care Home

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Pines Care Home 56-57 Harlow Moor Drive Harrogate North Yorkshire HG2 0LE Lead Inspector John McGarva Key Unannounced Inspection 12th September 2006 09:30 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 Pines Care Home DS0000063852.V321048.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 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. Pines Care Home DS0000063852.V321048.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Pines Care Home Address 56-57 Harlow Moor Drive Harrogate North Yorkshire HG2 0LE 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) 01423 565633 Queensland Care Limited Post Vacant Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26), Physical disability (26) of places Pines Care Home DS0000063852.V321048.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Any service users in the category of (PD) must be:1. aged over 50 years 2. require nursing care 10th January 2006 Date of last inspection Brief Description of the Service: The Pines is a care home offering nursing and personal care to 26 residents. It is two converted Victorian semi-detached houses on four floors including basement. It is close to Harrogate town centre and a shorter walk away to local shops and amenities. It is set in a quiet residential area facing the green space of Harlow Moor Drive. The fees charged at 08/06/06 are £450 - £650 per week. Pines Care Home DS0000063852.V321048.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report relates to an unannounced inspection that took place on Tuesday 12th September 2006. The inspection lasted 5.5 hrs (10am to 3.30 pm). There were 18 residents in the home, all of whom were in receipt of nursing care. The inspection focused on the key standards and some areas of concern identified at the last inspection. An inspection of the premises took place, including a number of bedrooms, bathrooms, and lounge and dining areas. The newly appointed manager, Mrs Fiona Taylor was present throughout and discussions took place with nurses, care staff and several residents. The residents appeared content and several made favourable comments about the care they receive from all the staff. What the service does well: What has improved since the last inspection? The morale of the staff seems to have improved since the appointment of the new manager. A new activities organiser has been appointed for ten hours per week. There have been improvements to the environment since the new proprietors took over including: Provision of new dining room, decoration of the dining room, lounge, some bedrooms, as well as an increase in en-suite facilities and relocation of the medication room. Pines Care Home DS0000063852.V321048.R01.S.doc Version 5.2 Page 6 There are plans to convert the bathroom in the basement into an assisted shower in the future. Fire safety door guards have been provided for the resident’s room doors. 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. The summary of this inspection report can be made available in other formats on request. Pines Care Home DS0000063852.V321048.R01.S.doc Version 5.2 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 Pines Care Home DS0000063852.V321048.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The resident’s needs are sufficiently assessed thereby providing the foundation on which the care plans can be developed. EVIDENCE: Evidence from the case tracked residents records confirmed that pre-admission assessment sheets are completed prior to admission. The manager or undertakes these either in hospital or the resident’s place of residence prior to admission. The assessments included issues relating to orientation, communication, memory, mental state, skin, vision, hearing etc. Intermediate Care (Standard 6) is not provided in this home. Pines Care Home DS0000063852.V321048.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10. Quality in this outcome area is Adequate. This judgement has been made using available evidence including a visit to this service. A good standard of care is being provided by staff that is well-motivated and more content. A wash hand sink must be provided in the medication room. EVIDENCE: The newly appointed manager has made good progress in improving the general standard of the documentation and the care staff as well as the nurses is encouraged to make the appropriate records of any interventions, which they make. The timings of the daily statements are recorded utilising the 24hr clock. Pines Care Home DS0000063852.V321048.R01.S.doc Version 5.2 Page 10 Each of the residents now have a new individual folder into which all documentation relating to their care is kept and this is located in their own rooms for easy access. The records of three residents were inspected and all had appropriate care plans in place with monthly reviews recorded in accordance with recommended practice. Routine monthly weights are generally recorded for all the residents or at more frequent intervals when indicated by risk assessment. One of the tracked residents notes did not include a weight chart, but it was later explained that it had been not possible to take the weight due to moving and handling issues. Some means of realising the residents weight should be explored as she may be at risk due to weight problems. There were eighteen residents including one respite case, which would be permanent soon when procedures were completed. Many are very dependant although classified as medium dependency and fourteen were doubly incontinent. The nursing and care staff spoken to said, “things were getting better”, with more new staff and better routines and allocation of individual nursing and care staff to small groups of residents. There have been changes to the breakfast routines where two staff assists the residents out of bed and another two dealing with the breakfast delivery. The residents looked well cared f, with clean and fitting clothes and those spoken to made favourable comment such as “I like it here”, girls are lovely”, “the care staff from the Philippines are lovely, so sweet and gentle”. The medications have been moved from a small room at the home entrance to a larger more satisfactory room on the top floor. However there is no wash hand sink or any water supply to the room, which militates against good practice. The room in consequence does not meet the Royal Pharmaceutical Societies guidelines for the storage of medications. The controlled drug Temazepam stock was checked against the records and found to be correct A physiotherapist attends the home for 2.5 hours per week and is involved in the assessments of all new residents. Pines Care Home DS0000063852.V321048.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A heated trolley is needed to help keep the food warm whilst being transported. Daily routines enable the residents to have control over their own lives. The quality of the meals provided is good with the residents spoken to confirm this. EVIDENCE: The resident’s routines of daily living are tailored to their needs and choice and there is a new activities organiser for 10 hrs per week to assist with in social activities. Many of the resident’s are too frail to benefit from social activities as such but the residents spoken to appreciate the new member of staff employed to organise these. Visitors can attend at any time they choose, day or night with drinks provided for them routinely. Pines Care Home DS0000063852.V321048.R01.S.doc Version 5.2 Page 12 The residents were very complimentary about the quality of the food provided, and the indications are that there has been an improvement in this area. The staff spoken to confirmed that the new agency cook was “very good”. However, there is still no hot trolley to transport the meals between the three floors above the kitchen level, which is in the basement, and this is something that the manager is aware needs to be addressed. Many of the residents are rather frail and require assistance with their meals including liquidised meals. Pines Care Home DS0000063852.V321048.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a relevant complaints procedure and the staff has received abuse awareness training. EVIDENCE: The complaints procedure of the home meets the required standard. The care staff confirmed that they had received mandatory training including on adult abuse issues and they knew how to respond to any complaints made by either the residents or their representatives. There have been three complaints made to the CSCI, all of which were substantiated before this inspection and the new manager is addressing the issues identified during the investigations. Pines Care Home DS0000063852.V321048.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23, 24,25 and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Some improvements to the environment have been made. Further decoration and refurbishment to individual rooms is indicated. EVIDENCE: The home meets the environmental standards of home registered before 2002. The home has four floors, including basement where there are five resident’s rooms together with kitchen, laundry and staff toilet. Pines Care Home DS0000063852.V321048.R01.S.doc Version 5.2 Page 15 This configuration of rooms and displacement makes for hard work on behalf of the staff providing care to the residents two of whom were bedfast and another two mostly so. There is a vertical lift providing level access to all floors. There are twenty-two single rooms, eleven of which have en-suite toilet facilities and two shared rooms, which do not have such facilities. At the last inspection there were several residents rooms where the sink hot water temperatures were in excess of 60 degrees centigrade. The manager confirmed that mixer valves had been fitted and the temperatures checked during the inspection were within safe levels. There have been improvements to the environment since the new proprietors took over including: Provision of new dining room, decoration of the dining room, lounge, some bedrooms, as well as an increase in en-suite rooms and relocation of the medication room. There are plans to convert the bathroom in the basement into an assisted shower. There is a lack of storage space for equipment and wheelchairs and it is difficult to see how this issue can be resolved given the constraints of the building. Further redecoration and upgrading of individual rooms is required. The temperature of the kitchen during the inspection exceeds ‘Health & Safety at work’ regulations. The possibility of installing a two-way fan to the outside wall was discussed with the manager. A restrictor for the dining room window is required. Fire safety door guards have been provided for the resident’s room doors. Pines Care Home DS0000063852.V321048.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 and 29. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is sufficient staff to provide personal care to the residents and satisfactory recruitment practices are followed. EVIDENCE: The staff spoken to felt that they were able to provide a good level of personal care and that there were enough staff to provide adequate care for the numbers of residents at the present time. They felt that “since the appointment of the new manager things were getting better”. Residents spoken to made very favourable comments about the staff and how kind they were. The numbers of care staff with NVQ qualifications is three out of the ten locally recruited staff. Additionally there is four care staff from the Philippines who have NVQ Level 3 equivalent qualifications, two of whom are qualified nurses. Pines Care Home DS0000063852.V321048.R01.S.doc Version 5.2 Page 17 The numbers of care staff with NVQ qualifications is therefore 70 of the total, thereby exceeding the 50 CSCI recommended standard. There is a key worker and named nurse system on place whereby there is identified staff allocated to particular residents and helps ensure the continuity of care. A dedicated activities person is provided for 10 hrs per week. There is a physiotherapist who attends the home for 2.5 hours per week and is involved in the assessments of all new residents. The recruitment procedures at the home meet the required standard including Criminal Record Bureau (CRB) checks. Pines Care Home DS0000063852.V321048.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32, 33, 36, 37 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed by a manager who enjoys the support and confidence of the staff. EVIDENCE: A new manager has been appointed and is soon to submit her application for approval with the CSCI. She was the manager of another home in Harrogate prior to this appointment. She is a First level nurse with many years of experience in caring for the elderly and also has the NVQ Level 4 Management award. Pines Care Home DS0000063852.V321048.R01.S.doc Version 5.2 Page 19 She has made good progress in introducing improved documentation and in responding to the issues relating to low morale in the home. Staff spoken to felt that things were getting better with improved routines, more staff, and said that they “all worked as a team”. A resident’s satisfaction survey took place in January 2006 and one relating to catering had occurred in February, which were positive. Staff confirmed that there is a system of formal staff supervision taking place and they had found this to be useful and supportive. The nursing and care staff confirmed that they had received statutory training in episodes in Fire Safety, First aid, Basic food hygeine,Moving & Handling and Abuse awareness. There are readily accessible service records relating to servicing of the hoists, gas appliances, lifts etc. Pines Care Home DS0000063852.V321048.R01.S.doc Version 5.2 Page 20 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 2 2 2 3 3 STAFFING Standard No Score 27 3 28 2 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 3 3 3 Pines Care Home DS0000063852.V321048.R01.S.doc Version 5.2 Page 21 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 2. Standard OP9 OP15 Regulation 13 (2) 16 (2) (i) Requirement The medication room must be provided with hand washing facilities. The method of transporting hot cooked food to service users, must be reviewed. Previous inspection requirement not met. The registered provider must ensure that suitable storage areas are allocated for all aids, adaptations and equipment. Previous inspection requirement not met. The registered provider must ensure that the manager completes the application form to become registered manager and submits this to the Commission for Social Care Inspection, for consideration. The ventilation in the kitchen must be improved. Timescale for action 01/04/07 01/01/07 3. OP22 23 01/04/07 4. OP31 9 01/01/07 5 OP38 1976 H & Safety @ Work act 01/04/07 Pines Care Home DS0000063852.V321048.R01.S.doc Version 5.2 Page 22 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 OP19 OP38 Good Practice Recommendations Further redecoration and upgrading of individual rooms and corridors should be undertaken. A restrictor for the dining room window should be fitted. Pines Care Home DS0000063852.V321048.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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