Inspection on 08/01/09 for Pines Care Home

This inspection was carried out on 8th January 2009.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Pines Care Home 04/09/07

Pines Care Home 12/09/06

Pines Care Home 10/01/06

Pines Care Home 26/10/05

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Hawkhills

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Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Pines Care Home 56-57 Harlow Moor Drive Harrogate North Yorkshire HG2 0LE     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Bridgit Stockton     Date: 1 5 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 03000 616161 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Pines Care Home 56-57 Harlow Moor Drive Harrogate North Yorkshire HG2 0LE 01423565633 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Queensland Care Limited Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 26 Number of places (if applicable): Under 65 Over 65 26 0 old age, not falling within any other category physical disability Additional conditions: 0 26 Any service users in the category of (PD) must be:- 1. aged over 50 years 2. require nursing care Date of last inspection Brief description of the care home The Pines is a care home offering nursing and personal care for up to 26 people. It is two converted Victorian semi-detached houses providing accommodation on four floors including the basement. Each floor is accessible by a passenger lift. There is seating to the front of the building and an outside area at the rear of the building where people may sit out. It is close to Harrogate town centre and a short walk to local shops and amenities. It is set in a quiet residential area affording nice views over the green space of Harlow Moor Drive. Information about the service is provided in the form of a brochure and `service user guide?. All prospective residents and their families are invited to look around the home before moving in. The most recent copy of the Care Homes for Older People Page 4 of 25 Brief description of the care home Commission for Social Care Inspection report is available at the home for people to look at. Individual copies are available on request. The fees charged at 04/09/07 were #450 - #600 per week. This charge does not include personal toiletries, hairdressing, chiropody or newspapers and magazines. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The purpose of this inspection was to assess the quality of the care and support received by the people who live at The Pines Care Home. The methods I used to gather information included a visit to the home, conversations with the people who live there, their relatives, healthcare professionals and the staff. I looked in detail at the care and records of four people, examined other records and looked around the home. I spent six hours at the home. The manager also completed some paperwork for us called an annual quality assurance assessment. This provides valuable information to help me form a judgement about the quality of service offered at the home Care Homes for Older People Page 6 of 25 Care Homes for Older People Page 7 of 25 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –03000 616161. Care Homes for Older People Page 8 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are properly assessed prior to admission to the home. Evidence: The care plans I looked at showed that comprehensive preadmission assessments had been carried out before offering someone a place. This is to make sure that the home can meet the persons needs. A senior member of staff (usually the manager) visits the person at home, or in hospital to discuss their care needs. Social Services assessments are also used to determine this as well; these were also available to look at. People are welcome to visit the home before reaching a decision. I spoke to one person who had recently been admitted to the home. They told me they had been made to feel very welcome and settled quickly. The person was keen to point out that they had received a lovely bouquet of flowers upon there admission from the staff and residents welcoming them to the home. Care Homes for Older People Page 10 of 25 Care Homes for Older People Page 11 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Lack of detail in peoples care plans coupled with some poor practice in the administration of medication could potentially put some peoples health and welfare at risk. Evidence: I looked two care plans of people who live at the home. They were not written in sufficient detail to ensure that peoples identified needs were being met fully. For example, in one persons room there was some documentation regarding how this person should be moved safely. Upon checking the care plan it was totally different. Staff confirmed the one in the persons bedroom was the most accurate. Another care plan was examined it did not contain enough information about wound dressings this person required. It did not state the frequency of when the dressings required changing and did not give any base line measurements of the wound to monitor any improvement or decline. The medication administration records were examined and there were gaps in the recording of when some medication had been given. One person had returned from Care Homes for Older People Page 12 of 25 Evidence: hospital the previous day to the home. Their medication had not been recorded onto the medication administration record and the tablets were still in the bag from hospital. Due to the lack of accurate recording I was unable to ascertain if this person had received any of the medication.The manager assured me that the person had. The drug storage fridge was rusty and the seal on the fridge door broken. This needs replacing. In the fridge was an unlabeled urine specimen. The fridge also contained several insulin pens none of these were labeled. The practice of crushing tablets and giving medication covertly was evident. The manager to me that there was in place a risk assessment for this. It is recommended that a full review of this practice takes place and all relevant healthcare professionals involved in the care of this person are involved in the decision regarding giving medication covertly. This needs to be documented fully in the persons plan of care. Care Homes for Older People Page 13 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The recreational and social needs of people are well catered for which enables them to make daily choices and promotes independence. Evidence: During my visit the atmosphere in the home was friendly and welcoming, with visitors coming and going throughout the day. Some people were enjoying chatting with each other; some were listing to music or else reading. An activities program was on display. The program was varied and included church services, bingo and sing-a-longs. People told me that the food was lovely another person said I eat better here than I did at home. One person said they could have a sleep in when ever they liked and another person said the staff are smashing they really know how to cheer you up, I have spent a lot of time in bed and they always come by and have a chat with me, to make sure Im alright. Care Homes for Older People Page 14 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confidant that their concerns and complaints are dealt with appropriately and that safeguards are in place to protect them from abuse Evidence: There are adequate written policies and procedures in place to deal with complaints and the care staff spoken to confirm they were aware of these. Staff knowledge of these help ensure that they were able to address any issues or anxieties of the residents, relatives and visitors to the home. People who live at the home told me they would speak to the manager or any of the staff if they had any concerns or complaints. Staff told me that training has taken place in the protection of vulnerable adults in abuse. More training is planned for new staff. I looked at four personnel files and found that staff recruitment procedures were adequate and staff were employed and deployed following appropriate checks. The manager and staff team were clear and confident in the protection of vulnerable adult procedures. Care Homes for Older People Page 15 of 25 Care Homes for Older People Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a comfortable, well maintained and homely environment. Evidence: All the bedrooms that I saw reflect the persons individual preferences and taste. There is a programme of redecoration for the bedrooms, as well as for the rest of the home. Several bedrooms and some communal areas have recently been redecorated and look fresh and attractive. There is a lockable storage space in the bedrooms. This means that people can keep their belongings private and secure. The home is fresh, clean, comfortable and well looked after. The maintenance of fire fighting equipment was up to date and the home has a fire risk assessment in place, however on checking fire training records for staff some people needed to be up dated. All staff need training twice yearly and night staff require training updates three monthly. Care Homes for Older People Page 17 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are properly trained and skilled to do their job however, due to some domestic duties being carried out by care staff people are not getting there care needs properly attended to. Evidence: Rotas and staff numbers suggest that there are enough staff on duty to meet the minimum care needs of the people who live at the home. The home does not employ a laundress and care staff are now having to cover this as well as providing care. This means that care staff are depleted in numbers and the people who live at the home are not always having their care needs addressed promptly. One person said I often have to wait a long time for my bell to be answered, sometimes it is to late. Another person said, that care staff are thin on the ground. Another person told me staff are always in a hurry I always feel rushed and they never have time to spend with me. Its not their fault they have a lot to get through. The manager is working as the trained nurse during the day and is supported by four care assistants on a morning, two from mid afternoon until early evening and then one trained nurse and one care assistant during the night. The manager makes sure that staff have the necessary training to help them do their work as well as possible. There is a of training available and the records confirmed that Care Homes for Older People Page 18 of 25 Evidence: the staff are allowed the time to attend. Records demonstrated that staff had been recruited properly and appropriate checks had taken place before they were accepted to work at the home. Care Homes for Older People Page 19 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Whilst people are safe and systems are in place for people to have a say in how the home is run, staff and residents would benefit from the manager being given the time and opportunity to manager the home properly. Evidence: People would be better served if the manager was given the time to carry out her responsibilities properly and not have to work full time as the trained nurse on duty. This is the first managerial post she has undertaken. She has had very little time to learn how to manage the the home. She is supported by the area manager who is at the home most days. This will be until more trained nurses are recruited which in time will free up some time for her to manage the home. The home assists one person with their furnaces. These were checked and correct with proper accounting safeguards in place. Policies and procedures are kept up to date; to make sure they provide relevant Care Homes for Older People Page 20 of 25 Evidence: information to guide staff on how to act in every situation. All the regular health and safety checks for the home are carried out in a timely manner. Staff have basic health and safety training. All these measures make sure that the health, safety and welfare of the people who live at the home is promoted and safeguarded. Care Homes for Older People Page 21 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 13 Care plans must be written 18/05/2009 in sufficient detail to instruct staff on how people needs are to be me To ensure people receive proper planned care 2 9 13 The fridge that stores 18/05/2009 medication must be replaced To ensure that medication is stored properly at the correct temperature 3 9 13 Medication must be stored administered and recorded correctly. All staff who deal with peoples medication need to have refresher training in the homes policy and procedures surrounding medication To minimise the risk of harm to people and to keep people safe. 18/05/2009 Care Homes for Older People Page 23 of 25 4 19 23 staff must receive fire training in line with the guidance set by the fire and rescue service. In order to keep people safe 08/05/2009 5 27 18 Domestic staff must be provided in sufficient numbers. in order to meet the needs of the people who live at the home. 08/06/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 9 9 All equipment used in the administration of medication for individual use must be named. All specimens that require refrigeration must be labeled and include the name of the person whom the specimen belongs, the date and time when the specimen has been collected. it is recommended that the manager is given some supernumerary hours in order to complete some of her managerial duties it is recommended that the manager makes application to the Commission to become the registered manager of the home. 3 31 4 31 Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!