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Inspection on 29/11/07 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 29th November 2007.

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

What has improved since the last inspection?

Steps have been taken to improve the fire safety of the home. Improvements have been made to the records around staff recruitment. There have been improvements to the induction training being provided to staff and further staff are undertaking relevant training in care of the elderly. The manager has started training to assist them in their role.

What the care home could do better:

The manager of the home needs to improve their knowledge of management and the National Minimum Standards for Care Homes for Older People in order to be able to demonstrate that they have the skills necessary to manage the home. A clear record needs to be made of all medication received into the home to ensure that all medication is accounted for and there is no mishandling. An assessment of the current staffing levels in the evening needs to take place to ensure that at all times a sufficient number of staff are available to meet the needs of the residents living at the home. A safe environment needs to be provided at the home at all times. Portable appliances need to be regularly checked by a person who is qualified to do so, so as to ensure that these appliances are safe for use. It is of concern that this requirement was not met following the last inspection. The quality assurance systems in place would be improved if the registered person consistently produced a written report of their findings following their statutory visits to the home. A written report must be made available as this provides evidence that the registered person who has the ultimate responsibility for the home is overseeing its operation. This requirement is outstanding from previous inspections and the CSCI will be meeting with the registered person to address this.Residents would benefit from 50% of staff having an appropriate qualification in Care of Older People.

CARE HOMES FOR OLDER PEOPLE Pines Residential Home (The) 106 Vyner Road South Birkenhead Wirral CH43 7PT Lead Inspector Beate Roth Key Unannounced Inspection 11:10 29 November and 6th December 2007 th 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.V338469.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 Residential Home (The) DS0000060687.V338469.R01.S.doc Version 5.2 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 Hodge & Wilson Ltd Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Pines Residential Home (The) DS0000060687.V338469.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only: Code PC, to people of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other categories: Code OP The maximum number of people who can be accommodated is: 24. Date of last inspection 20th February 2007 Brief Description of the Service: The Pines is registered to accommodate 24 elderly people. Residents are accommodated in single bedrooms, most of which have en-suite facilities. Bedrooms are available on the ground and first floors. There is a passenger lift. There are two comfortably furnished living rooms and a dining room available for residents. There are two bathrooms on the ground floor and a bathroom on the first floor. Bathing aids are provided. At the front of the home is a large landscaped garden with lawns, flowerbeds and mature trees. Seating is available in the garden. 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. At the time of this inspection, the weekly fees for the home ranged from £365.00 to £595.00. Additional charges are made for medical requisites, other than by prescription, chiropody, hair, dentist, optician, newspapers, clothing and other items of a personal nature. A service user guide and a statement of purpose, which describe the services offered at The Pines is made available to new residents, their relatives and professionals before a resident comes to live at the home. A copy of the most recent inspection report can be obtained from the manager. Pines Residential Home (The) DS0000060687.V338469.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over 6 hours and is based on two visits to the home. The inspection is also informed by information received about the service since the last inspection and by questionnaires completed by the residents, their relatives, staff and health professionals who visit the home. During the site visit to the home time was spent in the office looking at a sample of records and policies and procedures and talking to the manager and operational manager. A tour of the home was undertaken. The inspector spoke with residents and staff and made observations of the care given by staff. We requested that an Annual Quality Assurance Assessment (AQAA) be completed by June 2007. It is a legal requirement that this information be made available; as it is the main way that the registered persons let the CSCI know how well a service is delivering good outcomes. The AQAA has not been returned to the CSCI. The CSCI will be meeting with the registered person to address this. What the service does well: Residents have their needs appropriately assessed before moving to the home, which, ensures that a service is only offered to people whose needs can be met. Residents’ benefit from being able to make trial visits. This assists residents to make a decision about whether the home is right for them. Staff are aware of the needs of residents and how to meet them. Residents spoken with reported that a good standard of care is provided. Some comments made were I am very happy at this home.” “I am extremely happy with all aspects.” “I am well cared for here, the staff are wonderful, especially the managers.” Relatives and health professionals reported that staff are caring and have a good understanding of the care needs of residents. Some comments made were “care staff provide excellent care with a cheerful and affectionate attitude.” “The staff are excellent – always kind and helpful.” “We are more than satisfied that our relative is well cared for.” Observations and discussions with residents indicated they consider they are treated with respect. The wellbeing of residents is promoted by the flexibility of the daily routines, visitors being made welcome to the home and the provision of well balanced, appealing meals. Activities are available for residents to take part in should they so wish. Pines Residential Home (The) DS0000060687.V338469.R01.S.doc Version 5.2 Page 6 The home has a satisfactory complaints system which residents know how to access. The procedures at the home and training provided to staff around adult protection safeguard residents. The home is clean and well presented and provides a comfortable and pleasant atmosphere. A number of staff have worked at the home for several years and know the needs of the residents well. What has improved since the last inspection? What they could do better: The manager of the home needs to improve their knowledge of management and the National Minimum Standards for Care Homes for Older People in order to be able to demonstrate that they have the skills necessary to manage the home. A clear record needs to be made of all medication received into the home to ensure that all medication is accounted for and there is no mishandling. An assessment of the current staffing levels in the evening needs to take place to ensure that at all times a sufficient number of staff are available to meet the needs of the residents living at the home. A safe environment needs to be provided at the home at all times. Portable appliances need to be regularly checked by a person who is qualified to do so, so as to ensure that these appliances are safe for use. It is of concern that this requirement was not met following the last inspection. The quality assurance systems in place would be improved if the registered person consistently produced a written report of their findings following their statutory visits to the home. A written report must be made available as this provides evidence that the registered person who has the ultimate responsibility for the home is overseeing its operation. This requirement is outstanding from previous inspections and the CSCI will be meeting with the registered person to address this. Pines Residential Home (The) DS0000060687.V338469.R01.S.doc Version 5.2 Page 7 Residents would benefit from 50 of staff having an appropriate qualification in Care of Older People. 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 Residential Home (The) DS0000060687.V338469.R01.S.doc Version 5.2 Page 8 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.V338469.R01.S.doc Version 5.2 Page 9 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): 1, 2, 3 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can make an informed choice about whether the home is right for them and they can be confident that the home can meet their needs. EVIDENCE: A Statement of Purpose and a Service User Guide are available. These documents provide information on the services provided for prospective residents and/or their relatives to refer to. The documents give a good overview of the home, the accommodation, the staff and qualifications, the meals, social activities, a copy of the contract (terms and conditions) and what Pines Residential Home (The) DS0000060687.V338469.R01.S.doc Version 5.2 Page 10 to do if there are any concerns/complaints about the service. The brochure is given to all new enquirers. Prospective residents and their relatives are encouraged to visit the home prior to admission to view the premises and talk to residents. They can visit as often as they wish and the manager stated that they are able to have a meal and take part in any of the activities before they decide whether to move in. The home also offers a respite service prior to commitment. Residents spoken with and those who returned questionnaires had made visits to the home before moving in where possible. A sample of new residents’ files were seen. There was evidence of appropriate assessments being carried out before new residents move to the home. There was also evidence that information is gathered from social workers and health professionals to inform the assessment. New residents spoken with said they had been asked about their needs during the assessment. A relative who returned a questionnaire said, “The managers took great trouble to show us the home, find out about my relative and her needs and offered a 2 week respite to see if she liked the home.” The initial assessments cover the religious, cultural and linguistic needs of residents. Contracts between the home and three residents were seen. The contracts cover the rights of the resident, services provided and terms and conditions of residence. Residents spoken with said that they have received a contract. 4 out of the 5 residents who returned questionnaires stated that they had received a contract. The manager was asked to check that all the residents have access to a contract between them and the homeowner. The home does not offer intermediate care. Pines Residential Home (The) DS0000060687.V338469.R01.S.doc Version 5.2 Page 11 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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are treated with respect and their health and personal care needs are well met. The management of medication in general supports the well being of residents. EVIDENCE: A sample of care plans were seen. The care plans identify the current needs of the residents and provide sufficient information. The staff spoken with were aware of the needs of the residents whose records were inspected, and how to meet these needs. Fact sheets around health conditions were available on resident’s files. Staff reported that they access this information as needed. It continues to be recommended that this information be written in to the care Pines Residential Home (The) DS0000060687.V338469.R01.S.doc Version 5.2 Page 12 plan to provide easier reference for staff. This should identify how symptoms present themselves and the action to be taken by staff. Some residents at the home are showing signs of confusion. Staff are currently attending training around dementia care in preparation for the changing needs of residents coming to live at the home. Additional information should be included in the care plans around meeting the needs of people with confusion following the completion of this training. The residents spoken to said that they are well cared for at the home. When asked about the care they receive from staff, residents said they always get the care and support required and staff are always there when needed. Residents who returned questionnaires were generally very positive about the service provided, some comments made were “I am very happy at this home I have been here for almost a year.” “I am extremely happy with all aspects.” “I am well cared for here, the staff are wonderful, especially the managers.” Questionnaires returned by relatives indicated that the staff are caring and helpful. Some comments made were “care staff provide excellent care with a cheerful and affectionate attitude.” “The staff are excellent – always kind and helpful.” “Care staff are approachable and well informed.” “We are more than satisfied that our relative is well cared for.” The records at the home indicated that referrals are made to health professionals in accordance with the needs of residents. A record is made of visits by health professionals and the outcome is documented. Residents spoken with said that their health needs are well met. A questionnaire was returned by a GP who described the service as “well managed” and said that the staff have a good understanding of the care needs of residents, medication is appropriately managed and that the manager and staff always seeks advice and act upon it. A sample of medications and the corresponding records were examined and were in general found to be in order. A clear record was not available of the amount of some medication received into the home. This record needs to be made to ensure that all medication is accounted for and there is no mishandling. All staff who administer medication have completed an intermediate certificate in the safe handling of medications. In addition, the pharmacist for the home has trained all staff who administer medication. It continues to be 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 that the home is complying with legal requirements. A risk assessment was available for a resident who administers their medication. At induction training staff are provided with guidance on how to meet a residents needs in a dignified manner and how to respect their privacy. A Pines Residential Home (The) DS0000060687.V338469.R01.S.doc Version 5.2 Page 13 policy is also available to provide guidance to staff entitled “maintaining dignity, respect and polite behaviour.” Staff were observed to treat residents with respect. Staff were observed to speak to residents in a respectful manner and were sensitive when responding to the residents needs. The residents interviewed said that the staff are “polite,” “friendly,” “helpful” and “kind.” Pines Residential Home (The) DS0000060687.V338469.R01.S.doc Version 5.2 Page 14 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): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The wellbeing of residents is promoted by the flexibility of the daily routines, visitors being made welcome to the home and the provision of well balanced, appealing meals. EVIDENCE: Observations and a discussion with staff and residents indicated that the routines of daily living are flexible. Residents said they choose what time they get up and go to bed, whether to socialise or stay in their rooms and what to do each day. There is a list of weekly activities that has been drawn up following consultation with residents. The activities include flower arranging, armchair aerobics, singing with an entertainer, bingo, coffee mornings to which relatives Pines Residential Home (The) DS0000060687.V338469.R01.S.doc Version 5.2 Page 15 are invited and board games. A resident organises a quiz on a monthly basis. Residents spoken with and the residents who returned questionnaires said that they enjoy the activities provided and that enough activities are available. On the day of the visit a singing group was at the home entertaining the residents and some residents had spent the morning making Christmas cards. The residents 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 also visits the home. A number of residents regularly go out with their families and friends. Observations of the dining area indicated that a pleasant environment is provided for residents to have their meals. The food being prepared looked appetising. Lunchtime menus are displayed in a book in the main reception for residents and their visitors to view. Visitors may eat with the person they are visiting as long as sufficient notice is provided. Breakfasts are provided following consultation with each resident and are served in the bedrooms on request. A choice of evening meals is 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 residents care plan. When asked about the food provided, residents described the food as “excellent” and said it is of a “good quality.” Pines Residential Home (The) DS0000060687.V338469.R01.S.doc Version 5.2 Page 16 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): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents are safeguarded. Residents know how to make a complaint. Staff know how to manage complaints and adult protection matters. EVIDENCE: The home has a complaint procedure. A leaflet advising residents 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 resident or visitor wished to make a complaint. Residents spoken with only had positive comments to make about the home but said that if they needed to complain they would speak to the manager or operational manager. Residents and relatives who returned questionnaires said that they knew how to make a complaint about the operation of the home and one relative who had said that these concerns had been appropriately responded to. Information about advocacy services is available for residents in the complaints procedure. Pines Residential Home (The) DS0000060687.V338469.R01.S.doc Version 5.2 Page 17 The induction for staff covers the adult protection procedure. The majority of staff have attended adult protection training provided by Wirral Borough Council. Two members of staff were interviewed and were very well aware of the procedure to follow should they suspect abuse. A copy of Wirral Borough Council’s adult protection procedures is available at the home. Pines Residential Home (The) DS0000060687.V338469.R01.S.doc Version 5.2 Page 18 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, 23, 24 and 26 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 maintained and there is a good standard of cleanliness and hygiene, providing residents with a pleasant environment to live in. EVIDENCE: Since the last inspection an extension has been built and 4 additional bedrooms with en-suite facilities provided. An additional ground floor bathroom has also been made available. A tour of the home showed that the home is well maintained and decorated to a high standard. The decoration in Pines Residential Home (The) DS0000060687.V338469.R01.S.doc Version 5.2 Page 19 the upstairs bathroom is showing some signs of wear and it is recommended that this be redecorated. The residents’ bedrooms seen were well decorated, nicely furnished and personalised by the occupant. Most of the bedrooms have en-suite facilities and were they do not they have a bathroom close to their bedrooms. During the visit residents expressed their satisfaction with the quality of the décor and facilities such as the en-suite bathrooms, which ensured their privacy. 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 residents 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. On the day of this inspection the premises were found to be very clean and malodour free. The domestic staff are to be commended for the levels of cleanliness achieved. Residents spoken with said that the home is kept very clean. Residents and relatives who returned questionnaires described the home as “very clean” and “well kept.” Pines Residential Home (The) DS0000060687.V338469.R01.S.doc Version 5.2 Page 20 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, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including visiting the service. In general staff are appropriately deployed to meet the needs of the residents. An assessment of the care staffing levels during the evening needs to be undertaken to ensure that they are sufficient. Residents would benefit from further staff having an appropriate qualification in care of older people. EVIDENCE: The rotas and a discussion with staff indicated that there are sufficient numbers of care staff, domestic and catering staff to meet the needs of the residents during the day. From 5pm there are two care staff on duty and the manager and staff reported that this is not always a sufficient number of staff given that the home has been extended and the needs of residents has changed, with residents being more dependent. Some staff did not consider the staffing situation to be problematic. An assessment of the current care staffing levels in the evening needs to be undertaken to ensure that there are sufficient numbers of staff available. Pines Residential Home (The) DS0000060687.V338469.R01.S.doc Version 5.2 Page 21 The recruitment records for the two new members of staff were seen. The required information was available. An application form is now being used by the home and so a record of the applicant’s work history and relevant experience is recorded. 5 out of 18 care staff hold an NVQ in Care of Older People. 3 members of staff are currently working towards this qualification. The National Minimum Standards for Care Homes for Older People recommends that at least 50 of staff hold this qualification. Work is taking place to encourage further staff to undertake this qualification. An induction programme that meets the Skills for Care workforce training targets is available and the manager reported that this is being worked through with new staff. The records relating to this had not been consistently completed. The individual providing the induction and the staff member should complete the induction training record as it provides evidence of the new member of staff’s understanding in each of the areas covered by the induction. The induction training is supplemented by training days around particular aspects of care of the elderly. At present 8 staff are undertaking a 12-week distance-learning course around dementia care. There was evidence that training around first aid, infection control, safe handling, medication management, food hygiene and protection of adults from abuse had been undertaken by staff in the last 12 months by some staff. Training in this area for staff who have not received it or need an update has been organised. Pines Residential Home (The) DS0000060687.V338469.R01.S.doc Version 5.2 Page 22 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, 33, 35, 36 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The arrangements for quality assurance, management of residents’ finances and supervision of staff need further improvement in order to ensure that the well being of residents is fully promoted. EVIDENCE: There is a manager who is in day-to-day control of the home and an operational manager who supports the manager and is responsible for service development. Both managers have been employed at the home for several years. Following the Pines Residential Home (The) DS0000060687.V338469.R01.S.doc Version 5.2 Page 23 last inspection, an application to register a manager for the service was made to CSCI. The manager was advised to re-submit an application when it could be demonstrated that they have greater knowledge of the National Minimum Standards for Care Homes for Older People and management of a care home. The manager is currently working towards an NVQ Level 4 in Care and Management. There are quality assurance systems in place. There are arrangements for obtaining the views of residents and their relatives. The views of residents are obtained through informal meetings and questionnaires. The views of relatives are obtained by encouraging them to make their views about the service known to the management team. 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 residents were informed of this inspection and were encouraged to meet with the inspector. At previous inspections it has been reported that the quality assurance systems in place would be improved if the registered person produced a written report of their findings following their statutory visits to the home. The registered person continues to make weekly visits to the service and provides verbal feedback to the manager. A written report is not always made available. A written report needs to be made available as this provides evidence that the operation of the home is being overseen by the organisation that has the ultimate responsibility for it. Consideration should be given to using a professionally recognised quality assurance system to monitor the service. The manager reported that the home looks after some monies deposited by relatives on behalf of the residents. Records are maintained of this, however all the money is kept together rather than being separately held so it was not possible to ascertain if the amount of money held for a resident corresponded to the records. This needs to be addressed in order to ensure that residents’ finances are appropriately safeguarded. The manager and staff reported that supervision is provided to staff on a regular basis. 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 strongly recommended that a record be made of the other issues covered within staff supervision. A sample of records of accidents were seen, these indicated that appropriate action had been taken when an accident had occurred. It is recommended that a monthly audit of accidents at the home is undertaken to enable any patterns to be identified and action to be taken where needed. Steps have been taken to ensure that a safe environment is provided. Water is regulated throughout the home to ensure that the temperature does not exceed 43 degrees centigrade. Regular checks of the water temperature are Pines Residential Home (The) DS0000060687.V338469.R01.S.doc Version 5.2 Page 24 undertaken. Radiators have radiator covers in accordance with a risk assessment. There are appropriate storage facilities. During a tour of the home any bedroom doors that were open had been fitted with an appropriate device that is approved by the fire service. A sample of safety check records were seen for servicing of the fire safety systems, electrical wiring, bathing aids and nurse calls and were appropriately maintained. Records of in-house checks of the fire alarm and emergency lighting were seen and were in order. There was no evidence of portable appliance tests being carried out at the home. A requirement was made at the last inspection in March 2007 that evidence be provided that portable appliances are safe for use. The manager reported that the portable appliances are to be tested in January 2008. Pines Residential Home (The) DS0000060687.V338469.R01.S.doc Version 5.2 Page 25 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 3 3 3 X 4 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X 3 4 X 4 STAFFING Standard No Score 27 2 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 2 2 X 2 Pines Residential Home (The) DS0000060687.V338469.R01.S.doc Version 5.2 Page 26 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 OP9 Regulation 13 Requirement The registered person must ensure that a clear audit is maintained of medication received into the home to ensure there is no mishandling. The registered person must ensure that an assessment of the care staffing levels available in the evening takes place to ensure that at all times a sufficient number of staff are available to meet the needs of the residents living at the home. The registered person must ensure that a further application to register a manager is submitted to CSCI. The proposed manager must be able to demonstrate that they have the necessary qualifications, skills and experience to manage the service. The registered person must prepare a monthly written report on the conduct of the care home (previous timescale of 07/06/05 DS0000060687.V338469.R01.S.doc Timescale for action 06/12/07 2. OP27 18 06/01/08 3. OP31 8 06/03/08 4. OP33 26 06/01/08 Pines Residential Home (The) Version 5.2 Page 27 not met). 5. OP35 17 The registered person must ensure that the practices around the management of residents’ finances fully safeguard the residents. The registered persons must provide evidence to CSCI that an individual who is qualified to do so has tested the portable appliances at the home and that these appliances are safe for use. (Previous timescale of 05/04/07 not met). 06/01/08 6. OP38 23 06/01/08 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 OP8 Good Practice Recommendations Information from fact sheets on specific health conditions should be written in to the care plan to provide easier reference for staff. This should identify how symptoms present themselves and the action to be taken by staff. It is recommended that the competence of staff to administer medication be recorded in staff training records. A minimum of 50 of staff are to hold an NVQ 2, or equivalent qualification. The individual providing the induction and the staff member should complete the induction training record as it provides evidence of the new member of staff’s understanding in each of the areas covered by the induction. DS0000060687.V338469.R01.S.doc Version 5.2 Page 28 2. OP9 3. 4. OP28 OP30 Pines Residential Home (The) 5. 6. OP31 OP36 The manager of the home is to hold an NVQ 4 or equivalent in care and management. It is recommended that a record be made of all issues covered within staff supervision in accordance with the National Minimum Standards. Consideration should be given to using a professionally recognised quality assurance system to monitor the service. It is recommended that a monthly audit of accidents is undertaken to enable any patterns to be identified and action to be taken where needed. 7. OP33 8. OP38 Pines Residential Home (The) DS0000060687.V338469.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Merseyside Area Office Burlington House Crosby Road North, Waterloo Liverpool L22 0LG 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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