Inspection on 26/10/05 for Pines Care Home

This inspection was carried out on 26th October 2005.

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 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 12/09/06

Pines Care Home 10/01/06

Similar services:

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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 David White Unannounced Inspection 26th October 2005 09:00 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.V257770.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. Pines Care Home DS0000063852.V257770.R01.S.doc Version 5.0 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 Mrs Anne Elizabeth Winterburn 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.V257770.R01.S.doc Version 5.0 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 26/01/05 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 within reasonable walking distance of 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. Since the previous inspection Queensland Care Ltd have taken over ownership of the home. Pines Care Home DS0000063852.V257770.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 7 hours. The premises were looked at and four residents, a relative and four members of staff including two care staff were spoken to. The care records of four residents were inspected along with a number of other records. What the service does well: Residents said that the staff were “kind and helpful”. Residents felt that the variety and quality of the food at the home was “good”. Residents said that the staff team were always polite and respectful. A range of training is provided to enable staff to have the knowledge and skills to meet resident needs. Staff felt that the number and quality of aids and equipment in the home was good and this supported them in meeting resident’s needs. A relative said that he was always made to feel welcome when visiting the home. The registered manager or the deputy carries out an assessment of residents before they come into the home to make sure the home has staff and equipment to care for them properly. Care plans contained detailed information about how physical care needs were to be met. Pines Care Home DS0000063852.V257770.R01.S.doc Version 5.0 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. Pines Care Home DS0000063852.V257770.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 Pines Care Home DS0000063852.V257770.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): Standards 3 and 6 There are good assessments of residents before they are admitted to the home and they receive clear information about the care and services provided. EVIDENCE: Prospective residents and their relatives are given an information booklet about the home prior to admission. Residents and a relative spoken to said they were offered the chance to visit the home prior to making a decision about moving into the home. The admission procedure makes sure that residents are properly assessed and that staff are fully aware of their needs. Information is gathered from residents’ relatives and other care professionals such as care managers and doctors as part of the assessment process. Any risks are identified as part of the pre-admission process. Staff had a good understanding of the needs of the residents and received a range of training specific to the needs of the residents in their care. Pines Care Home DS0000063852.V257770.R01.S.doc Version 5.0 Page 9 One resident spoken to was receiving intermediate care. The resident expressed satisfaction with the care provided and said that due to the progress made she no longer required nursing care and was about to move into a residential home. Pines Care Home DS0000063852.V257770.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): Standards 7, 8, 9 and 10 There are good care plan systems in place to make sure that resident healthcare needs are met. The individual care plans need more detail to ensure that all needs are identified and addressed. EVIDENCE: The records of four residents were inspected and all had detailed care plans in place. The care planning documentation included information about the assessed needs of each individual and how these were to be met. A number of risk assessments were in place to cover a number of aspects of daily living to promote independence and safety. The risk assessments in reducing the risk from falls were very specific in saying how residents should be assisted with their mobility and other risk assessments were in place in relation to nutrition, mental health, prevention of pressure sores and the use of bedrails. The care plans focused mainly on the physical healthcare needs of the resident and did not include any information about the social care needs of each resident and actions to be taken to meet these. Referrals to other health agencies were clearly recorded. All the residents spoken to and a relative said that the care was “good” and one resident said staff were “always kind and helpful“. Staff Pines Care Home DS0000063852.V257770.R01.S.doc Version 5.0 Page 11 could be seen treating residents in a respectful manner and addressed the residents by their preferred names. Each resident spoken to felt that the staff team were respectful and polite. Proper medication procedures were in place for the administration, recording, storing and return of medication. The Medication Administration Records were accurate and up to date and a check of the controlled drugs stock tallied with the records. Pines Care Home DS0000063852.V257770.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): Standards 12, 13, 14 and 15 Social activities are poor in the home. Flexible visiting hours enable family and friends to maintain good contact with family and friends. The meals provided are of good quality and varied to suit different tastes. EVIDENCE: The home does not have activities organiser to co-ordinate any social activities in the home. Entertainers are invited to attend the home but these visits are not regular. Residents are able to attend a weekly physical exercise class if they choose to do so. One resident commented that she spent a lot of time in her bedroom as there was “very little to do” and said she would welcome “more companionship”. A number of residents were seen sat around the home sleeping and residents said they only tended to go out with their relatives as their was very little opportunity to go out at other times. Residents care plans described in pre-admission assessments relative referred to the pastimes and hobbies of residents but nothing was then written in care plans or progress notes to show these were continued once residents were admitted to the home. Visiting times are flexible and a relative said that he was always made to feel welcome and kept informed about his relative’s progress. Pines Care Home DS0000063852.V257770.R01.S.doc Version 5.0 Page 13 Residents felt that they were able to carry out their preferred daily routines as they wished. One resident said it was their own choice as to when they got up and went to bed. Residents spoken to said they enjoyed the meals and felt that there was enough choice at mealtimes. The menus are varied and alternative meals are offered if a resident does not like the food options on the menu. Freshly baked cakes were being prepared for tea and drinks are provided between mealtimes. Residents’ weights are monitored on a monthly basis or more often if there are concerns about weight loss. Pines Care Home DS0000063852.V257770.R01.S.doc Version 5.0 Page 14 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): Standards 16 and 18 Complaints procedures are not being followed so people making complaints cannot have confidence that their concerns will be listened to, taken seriously and acted upon. Adult protection policies and procedures are in place to safeguard residents from abuse. EVIDENCE: The home has a complaints policy and procedure in place to deal with complaints and a copy of this was on display near the entrance to the home. The information within the complaints procedure does not make it clear that complainants can refer complaints to the Commission at any stage of the complaints process. The home had received some complaints about aspects of the service but no complaints records were available to confirm that the complaints procedure was being followed. Residents knew who they would see if they wished to raise any concerns about the home. The home has a good detailed policy and procedure, which covers all aspects of the protection of vulnerable adults. New staff received training about abuse and adult protection as part of their induction to the home and other staff receive an annual update from the home’s training manager. Pines Care Home DS0000063852.V257770.R01.S.doc Version 5.0 Page 15 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): Standards 19, 22, 25 and 26 There are a number of serious concerns which put people at risk of serious harm and do not provide safe and comfortable surroundings in which to live. EVIDENCE: The home is currently having staffing problems and does not have a housekeeper. This has meant that care staff having to carry out cleaning and laundry work as part of their duties. In general the home was clean but four residents rooms were inspected and all the carpets in these bedrooms were in need of vacuuming. There is a lounge and dining room in the home although these are not well used with many residents preferring to stay in their bedroom through choice. The home has shaft lifts that enable people to move about the home. Pines Care Home DS0000063852.V257770.R01.S.doc Version 5.0 Page 16 On the day of inspection there were a number of problems with the building. • • The carpet on the corridor near to bedroom 19 has become worn. This looks unsightly and could become a tripping hazard in the near future. Wheelchairs, aids and adaptations were being stored in the corridors of the home and this limited access to bathrooms and toilets and could potentially put residents at risk from tripping and falling. Random checks of the hot water temperatures were made throughout the home and temperatures in nineteen of the resident rooms were found to be above 50 degrees centigrade which put residents at risk from scalding. The maintenance man was at the home and took immediate measures to reduce the temperatures of the hot water. A plumber visited the home at the time of inspection and said that further work which could take up to two weeks to complete was required to make sure that the hot water temperatures from the sinks stayed within safe limits. Risk assessments were immediately carried out on each resident who could potentially be at risk from the excessive water temperatures and risk management plans were put in place. An immediate requirement notice was issued to address this matter. There were no records to evidence that hot water temperatures had been monitored since the new owners had taken over in May 2005. Laundry systems are in place for the upkeep of bedding, linen and personal clothing and there were plentiful supplies of aprons, hand paper towels and soap dispensers. The home has sluicing facilities and systems in place to deal with soiled items and to reduce risks from cross-contamination. Due to the staffing difficulties the care staff are currently undertaking the laundry duties. Pines Care Home DS0000063852.V257770.R01.S.doc Version 5.0 Page 17 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): Standards 27, 28, 29 and 30 Recruitment procedures are in place but in one case had not been followed so potentially putting residents at risk. Staffing levels are not adequate to meeting all of the needs of the residents. EVIDENCE: The home had 2 qualified nurses and 3 carers on duty in a morning to care for 23 residents. For an afternoon shift there is one nurse and two carers on duty and the same levels of staff are on duty at night. These staffing levels fall short of the requirements of the current staffing notice and are insufficient given the dependency levels of the residents in the home. A number of the residents need nursing in bed and require regular pressure care. Seven of the residents need assistance with eating. Many of the others need assistance with their mobility and bathing. Also the home currently has no housekeeper and is lacking in numbers of domestic staff so care staff are carrying out additional cleaning and laundry duties as part of their daily routine. The atmosphere in the home was subdued and staff spoken to said that morale was low. A number of staff have recently left the home and recruitment has been difficult although the vacant housekeeper and administrator posts have been filled and the new staff will be starting work at the home shortly. The home is dependent on agency staff to try to cover vacant care shifts and maintain minimum staffing levels. Residents said staff were “kind and helpful but always very busy”. Staff spoken to were committed towards providing a good quality of care for the residents but felt “under pressure” because of the present workload. Staff were seen to be working hurriedly and could be seen cleaning Pines Care Home DS0000063852.V257770.R01.S.doc Version 5.0 Page 18 and doing the laundry. Some bedroom carpets were in need of vacuuming and staff were having difficulties in trying to keep up to the laundry workload. There has been an increase in the number of complaints about the home and staff do not have the time to provide social stimulation for residents. Residents did say that call bells were always responded to within a short time. Staff said that the home has “plenty of equipment” to support them to be able to care for residents properly. The inspector looked at two staff files of recently appointed members of staff. The staff file of one staff member indicated that the home had not undertaken all the necessary pre-employment checks before the person had started working at the home. Only one written reference had been obtained and the member of staff had commenced work at the home before the necessary Protection of Vulnerable Adults (POVA) checks had been completed. The home has a training manager who organises a range of in-house training for all staff although due to the staffing shortages the training manager is currently working as part of the care team. New members of staff have an induction programme that includes information about safe working practices and knowing what to do if abuse was suspected. The training manager has organised a training programme specific to the needs of the residents and this covers aspects of care such as nutrition and exercise. The home has an ongoing programme of NVQ training for care staff. Staff are receiving formal supervision to support them in being able to carry out their jobs. Pines Care Home DS0000063852.V257770.R01.S.doc Version 5.0 Page 19 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): Standards 31, 33, 35 and 38 There are shortfalls in the management of the home. This results in practices that do not ensure the health, safety and welfare of the residents. EVIDENCE: The registered manager is experienced in managing the home and is a qualified nurse who has achieved the Registered Manager’s Award. The registered manager will be leaving the home shortly to take up another post and an advertisement has been put out for the manager’s post. There was no evidence that systems are in place to monitor the quality of the care provided at the home. Residents and staff meetings are not held and there are no formal arrangements for seeking the views of residents and relatives about the home. There were no complaints records available and staff spoken to said that most complaints were dealt with verbally. Pines Care Home DS0000063852.V257770.R01.S.doc Version 5.0 Page 20 The home does not hold any monies on behalf of residents. The petty cash monies were checked and these tallied with the records. Receipts from incoming and outgoing monies are kept and records were available for inspection. As detailed under the section of this report dealing with the home’s environment, to ensure residents safety:• • • • The carpet on the corridor near to bedroom 19 has become worn and is in need of repair. Wheelchairs, aids and adaptations must be stored safely. Hot water temperatures in areas accessed by residents must be kept within safe limits. Systems must be in place to monitor hot water temperatures. There was no evidence that fire drills regularly take place and staff spoken to were able to confirm this. A number of satisfactory safety records and certificates were seen relating to the premises. All the staff have attended health and safety training and receive regular updates. Pines Care Home DS0000063852.V257770.R01.S.doc Version 5.0 Page 21 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 1 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 1 17 X 18 3 1 X X 1 X X 1 3 STAFFING Standard No Score 27 1 28 2 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 1 X 3 X X 1 Pines Care Home DS0000063852.V257770.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? N/A 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 OP7 Regulation 12 Requirement Resident care plans must be in sufficient detail to provide guidance to staff on the actions taken to meet their social care needs. The registered provider must ensure there are sufficient suitable activities provided in the home to meet resident individual needs. The registered provider must make sure that records are kept of all complaints made and includes details of any investigation and action taken. The home’s complaints procedure must make clear to complainants that they may refer complaints to the Commission at any stage of the complaints process. The carpet on the corridor near bedroom 19 is in need of repair so that residents are not at risk of harm from tripping. Suitable storage areas must be provided for all aids, adaptations & equipment. Timescale for action 31/12/05 2 OP12 16 31/12/05 3 OP16 17 Sch 4 31/10/05 4 OP16 22 31/10/05 5 OP19 23 30/11/05 6 OP22 23 26/10/05 Pines Care Home DS0000063852.V257770.R01.S.doc Version 5.0 Page 23 7 OP25 13 The registered provider must undertake a risk assessment of the water temperatures in the bedrooms numbered 1-19 and 21. The registered provider must have systems in place to monitor hot water temperatures. Risk assessments and remidial action must be taken if temperatures exceed 43 degrees centigrade. 26/10/05 8 OP27 17,18 & Sch 4 7,9,19 & Sch 2 9 OP29 10 11 OP33 OP38 12 13 & 23 The staffing levels in the home must be maintained to at least the minimum requirements of the current staffing notice. The registered provider must ensure that two written references have been obtained and a police check has been received before new staff commence work. A more detailed quality assurance system needs to be put in place. The registered provider must make sure that firedrills are carried out at regular intervals so residents are aware of evacuation procedures in the event of fire. 26/10/05 26/10/05 31/12/05 30/11/05 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 OP28 Good Practice Recommendations The registered provider should have a minimum of 50 of care staff should be trained to NVQ level 2 by the end of 2005. Pines Care Home DS0000063852.V257770.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 Pines Care Home DS0000063852.V257770.R01.S.doc Version 5.0 Page 25 - 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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