Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 14/12/05 for Pines Residential Home (The)

Also see our care home review for Pines Residential Home (The) for more information

This inspection was carried out on 14th December 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

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

What the care home does well

The assessments undertaken ensure that the home can fully meet the needs of service users before they come to live at the home. The health care needs of service users are well met. Activities are provided that would meet a variety of recreational and social interests. Service users are provided with appealing, balanced meals in pleasing surroundings. Service users commented positively on the food provided. The home has a satisfactory complaints system which service users know how to access. The procedures at the home and training provided to staff around adult protection safeguard service users. The home is clean and well presented and provides a comfortable and pleasant atmosphere. There are enough staff to meet the needs of service users. At the time of the inspection staff were observed to treat service users in a respectful and polite manner.

What has improved since the last inspection?

There have been further improvements to the training provided to staff. The majority of staff have completed training around the protection of vulnerable adults. Further staff are undertaking a National Vocational Qualification in care of the elderly which will enable the recommended target of 50% of all staff holding this qualification to be met. Additional staff are completing an intermediate certificate in the safe handling of medications qualification.

CARE HOMES FOR OLDER PEOPLE Pines Residential Home (The) 106 Vyner Road South Birkenhead Wirral CH43 7PT Lead Inspector Beate Roth Unannounced Inspection 14th December 2005 1:00 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 Residential Home (The) DS0000060687.V272562.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 Residential Home (The) DS0000060687.V272562.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Pines Residential Home (The) Address 106 Vyner Road South Birkenhead Wirral CH43 7PT 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) 0151 653 7258 0151 653 7258 Hodge & Wilson Ltd Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Pines Residential Home (The) DS0000060687.V272562.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th June 2005 Brief Description of the Service: The Pines is registered to accommodate 20 elderly people. Service users are accommodated in single bedrooms, most of which have en-suite facilities. Bedrooms are available on the ground and first floors. There are two comfortably furnished living rooms and a dining room available for service users. There is a bathroom on the ground and first floor. A lift and bathing aids are provided. At the front of the home is a large landscaped garden with lawns, flowerbeds and mature trees. Seating is provided. Parking is available at the rear of the building. There is access to a bus service from the home. Upton and Claughton Village provide a selection of shops and amenities and are a short bus ride away. Pines Residential Home (The) DS0000060687.V272562.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over an afternoon. During the inspection time was spent in the office examining records and policies and procedures and talking to the deputy manager. A tour of the home was undertaken. Staff were observed delivering care to service users. The inspector spoke to service users and to staff. What the service does well: What has improved since the last inspection? What they could do better: The quality assurance systems in place would be improved if the proprietor produced a written report of their findings following their statutory visits to the home. An application to register a manager for the service needs to be made in order to ensure that the service fully meets the needs of service users. Service users would benefit from new staff receiving foundation training that meets the National Training Organisation (NTO) workforce training targets. Improvements should be made to aspects of recording around medication management. Pines Residential Home (The) DS0000060687.V272562.R01.S.doc Version 5.0 Page 6 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 Residential Home (The) DS0000060687.V272562.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 Residential Home (The) DS0000060687.V272562.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): 2, 3 and 5 New service users are fully assessed before they are admitted to the home in order to ensure their needs are met. EVIDENCE: A sample of new service users files were examined. There was evidence of appropriate assessments being carried out before new service users move to the home. There was also evidence that information is gathered from social workers and health professionals to inform the assessment. Prospective service users are visited at hospital or at home by the deputy manager. During this visit the services that can be offered are discussed and whether The Pines is suitable for the service user is assessed. Prospective service users and their relatives are invited to make as many visits to the home as they would like before deciding whether to move in for a 28 day trial period. It is recommended that further information is recorded in the initial assessment and care plans around the social history of service users where this is possible. Pines Residential Home (The) DS0000060687.V272562.R01.S.doc Version 5.0 Page 9 The sample of service users files viewed contained contracts. Each service user is provided with a contract within 4 weeks of admission. The contract contains all the required information. Pines Residential Home (The) DS0000060687.V272562.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): 8, 9 and 10 The health care needs of service users are met and their wellbeing is supported by the home’s medication procedures. Service users are treated with respect. EVIDENCE: The records at the home indicated that referrals are made to health professionals in accordance with the needs of service users. A record is made of visits by health professionals and the outcome is documented. Service users said that their health needs are well met. A sample of medications and the corresponding records were examined and found to be in order. The deputy manager and several staff have completed an intermediate certificate in the safe handling of medications. Since the last inspection, further care staff have completed this course. In addition, all staff who administer medication have been trained by the pharmacist for the home or received instruction from the deputy manager of the home who has received appropriate training. It is recommended that the competence of staff to administer medication be recorded in staff training records. The pharmacist who supplies medication to the home visits to audit the medication and ensure Pines Residential Home (The) DS0000060687.V272562.R01.S.doc Version 5.0 Page 11 that the home is complying with legal requirements. A risk assessment was available for a service user who administers their medication. It is recommended that when changes to medication are made by a GP over the telephone, a record of the change is made by two staff. It would be good practice if the GP could provide written confirmation around medication changes. At induction and in follow on training staff are provided with guidance on how to meet a service users needs in a dignified manner and how to respect their privacy. A policy is also available to provide guidance to staff entitled “maintaining dignity, respect and polite behaviour.” The staff were observed to address service users in a respectful and polite manner. The service users spoken with said “staff are friendly and polite” and “ staff respect my privacy.” Pines Residential Home (The) DS0000060687.V272562.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): 12, 13 and 15 The routines of daily living are flexible and activities are available that reflect needs and preferences. Service users receive appealing, well-balanced meals in pleasant surroundings. EVIDENCE: Observations and a discussion with staff and service users indicated that the routines of daily living are flexible. There is a list of weekly activities that has been drawn up following consultation with service users. The activities since mid – November have included flower arranging, visit to a musical, armchair aerobics, singing with an entertainer, coffee mornings to which relatives are invited and board games. The home encourages service users to carry on with the interests and activities they enjoyed whilst living in their own homes rather than providing a range of group activities. The deputy manager reported that this is in accordance with the wishes of service users. This has been confirmed by service users at previous inspections. At this inspection service users were observed to be reading, listening to the radio, knitting and playing a card game. The service users spoken with said that their friends and relatives are able to visit them whenever they wish and that they are always made to feel very welcome by the staff. Representatives from local churches visit the home, religious services are provided at the home, a mobile library and clothes shop Pines Residential Home (The) DS0000060687.V272562.R01.S.doc Version 5.0 Page 13 also visits the home. In addition, a number of service users go out with their families and friends. Observations of the dining area indicated that a pleasant environment is provided for service users to have their meals. The food being prepared looked appetising and a sample tasted was of a good quality. Lunchtime menus are displayed in a book in the main reception for service users and their visitors to view. Visitors may eat with the person they are visiting as long as sufficient notice is provided. Arrangements have been made for service users to invite a friend or relative for Christmas dinner, where appropriate. Breakfasts are provided following consultation with each service user and are served in the bedrooms. A choice of evening meals are provided. The records of menus indicated that a variety of meals that would provide a balanced diet are available. Any special dietary needs are written in to a service users care plan. At the last inspection the cook reported that she is informed about any dietary needs and ensures these are taken into account when meal planning. When asked about the food provided, service users described the food as “excellent” and said it is of a “good quality and a variety is offered.” Pines Residential Home (The) DS0000060687.V272562.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): 16 and 18 The home has a satisfactory complaints system which service users know how to access. The procedures at the home and training provided to staff around adult protection safeguard service users. EVIDENCE: The home has a complaint procedure that provides the required information. A leaflet advising service users and their visitors about how to make comments and complaints about the home is prominently displayed in the reception area. Staff spoken to were aware of the complaint procedure and what to do if a service user or visitor wished to make a complaint. Service users spoken with only had positive comments to make about the home but said that if they needed to complain they would speak to the deputy manager or the owner. There have been no complaints made to the home and appropriate action has been taken to address a complaint made to CSCI about the home that was upheld. Information about advocacy services is available for service users in the complaints procedure. Since the last inspection the majority of staff have attended adult protection training provided by Wirral Borough Council. A member of staff spoken to said that as a result of this her knowledge about how to respond to adult protection issues is much clearer. A copy of Wirral Borough Council’s adult protection procedures is available at the home. Pines Residential Home (The) DS0000060687.V272562.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): 19, 20 and 26 The home is well maintained and there is a good standard of cleanliness and hygiene, providing service users with a pleasant environment to live in. EVIDENCE: A tour of the home showed that in general the home is well maintained and decorated to a high standard. The decoration in the upstairs bathroom is showing some signs of wear. Records of maintenance and redecoration together with observations of the home showed that considerable work has taken place in the last 9 months to maintain standards. Communal space is provided in two lounges and a dining room. These rooms are well presented and well furnished. Sufficient communal space is provided. The service users spoken with said that they are very happy with the physical standards provided to them at the home. The private garden area of the home is well tended and provides a patio area and patio furniture. Service users described the garden as “lovely.” Considerable work takes place in maintaining the thoughtfully designed and well-presented garden which service users are free to use at any time. Pines Residential Home (The) DS0000060687.V272562.R01.S.doc Version 5.0 Page 16 On the day of this inspection the premises were found to be very clean and malodour free. Pines Residential Home (The) DS0000060687.V272562.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): 27, 28 and 30 There are sufficient numbers of staff to meet the needs of service users. Service users would benefit from new staff receiving foundation training that meets the National Training Organisation (NTO) workforce training targets. EVIDENCE: The rotas and a discussion with staff indicated that there are sufficient numbers of care staff to meet the needs of the service users. The rotas indicate that there are at least three care staff on duty in the morning and two on the afternoon and evening shifts. At night there is one sleeping in and one waking member of staff on duty. A sufficient number of domestic and catering hours are provided. No new staff have been employed since the last inspection. Records of staff training indicated that a brief induction is provided which is supplemented by training days around particular aspects of care of the elderly. There was evidence that training around first aid, medication management, food hygiene and protection of adults from abuse had been undertaken by staff in the last 12 months. The training programme for 2006 has been drawn up to reflect the current training needs of staff. At the last inspection there was evidence that there was an induction programme that meets the NTO workforce training targets. The deputy manager reported that she will begin this with new care staff employed. Work is taking place to develop foundation training that meets the NTO training Pines Residential Home (The) DS0000060687.V272562.R01.S.doc Version 5.0 Page 18 targets. 6 staff currently have an NVQ Level 2. Steps are being taken to ensure that 50 of staff hold this qualification. Pines Residential Home (The) DS0000060687.V272562.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): 31, 33 and 36 The needs of service users are not promoted by there being no registered manager at the home. EVIDENCE: Since the registered manager left the service 8 months ago, the deputy manager has been acting as the manager for the service. An application to register the acting manager has not been made to CSCI. An application to register a manager for the service needs to be made in order to ensure that the service fully meets the needs of service users. There are quality assurance systems in place. There are arrangements for obtaining the views of service users and their relatives. The deputy manager undertakes spot checks on staff to ensure the quality of the service that is being provided. A member of staff said that their views are taken into account in relation to the operation of the home. Staff meetings are held. The service Pines Residential Home (The) DS0000060687.V272562.R01.S.doc Version 5.0 Page 20 users were informed of this inspection and were encouraged to meet with the inspector. The quality assurance systems in place would be improved if the proprietor produced a written report of his findings following his statutory visits to the home. The deputy manager reported that supervision is provided to staff. The practices of staff are observed and the duties of staff and their training needs are discussed. A record is being made around training provided to staff. In order to fully meet the National Minimum Standards for Care Homes for Older People, it is recommended that a record be made of the other issues covered by the deputy manager within staff supervision. Pines Residential Home (The) DS0000060687.V272562.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 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X X 2 X X Pines Residential Home (The) DS0000060687.V272562.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP31 Regulation 8 Requirement Timescale for action 14/03/05 2 OP33 26 The registered provider must ensure that there is a manager who is in full-time day-to-day charge of the home (previous timescale of 07/09/05 not met). The registered provider must 14/12/05 prepare a monthly written report on the conduct of the care home. A copy of this is to be forwarded to the manager and to CSCI(previous timescale of 07/06/05 not met). 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 OP3 OP9 Good Practice Recommendations It is recommended that further information is recorded around the social history of service users where this is possible. It is recommended that the competence of staff to administer medication be recorded in staff training records. DS0000060687.V272562.R01.S.doc Version 5.0 Page 23 Pines Residential Home (The) 3 OP9 4 5 6 OP28 OP30 OP36 It is recommended that when changes to medication are made by a GP over the telephone, a record of the change is made by two staff. It would be good practice if the GP could provide written confirmation around any changes to medication. A minimum of 50 of staff are to hold an NVQ 2 by 2005. The foundation training is to meet all of the National Training Organisation targets. It is recommended that a record be made of all issues covered within staff supervision in accordance with the National Minimum Standards. Pines Residential Home (The) DS0000060687.V272562.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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 Residential Home (The) DS0000060687.V272562.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. 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!