Inspection on 05/02/07 for Pinetree Place

This inspection was carried out on 5th February 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 no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Pinetree Place 18/01/08

Pinetree Place 20/02/06

Pinetree Place 09/08/05

Pinetree Place 01/03/05

Pinetree Place 13/10/04

Pinetree Place 23/02/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Pinetree Place 36a-d Ashingdon Road Rochford Essex SS4 1NJ Lead Inspector Nicola Dowling Unannounced Inspection 5th February 2007 10:00 Pinetree Place DS0000015556.V329471.R01.S.doc Version 5.2 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 Pinetree Place DS0000015556.V329471.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 Adults 18-65. 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. Pinetree Place DS0000015556.V329471.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Pinetree Place Address 36a-d Ashingdon Road Rochford Essex SS4 1NJ 01702 540135 01702 543777 Telephone number Fax number Email address Provider Web address Name of registered provider Name of registered manager Type of registration No. of places registered (if applicable) Estuary Housing Association Limited John Bruce Wyatt Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Pinetree Place DS0000015556.V329471.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Excluding any person who is liable to be detained under the provision of the Mental Health Act 1983 20th February 2006 Date of last inspection Brief Description of the Service: Pinetree Place is a Care Home providing personal care for twelve residents with Learning Disabilities. The cost of care at this home is £1,724.96. It is situated near to Rochford town centre, local shops and amenities. There are local bus and train routes nearby. Pinetree Place is divided into four houses, referred to as House A, B, C and D, with D also known as the bungalow, being on one level. There are three residents in each house. Two offices are situated in another building, which was used previously as a day centre. Each resident has a single bedroom with a shared lounge, bathroom, toilet and kitchen facilities. Each house has their own garden with a security gate. A car park is situated between houses A, B, C and the bungalow and offices. Pinetree Place DS0000015556.V329471.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two inspectors undertook the key inspection site visit. The visit took place over a seven-hour period on one day. The site visit consisted of a tour of the home, talking with staff and residents, observing the care given and reading of documents. Most of the residents were seen and two were spoken to. In addition four survey forms and four relative questionnaires also contributed to this report. The pre-inspection questionnaire was not received back from this home therefore most information was gained at the inspection visit. This is the home’s first key inspection since the change of category from care home with nursing to care home with personal care. The inspectors would like to thank the staff and residents for their help and hospitality during this visit. What the service does well: What has improved since the last inspection? What they could do better: The management of the home is not robust enough. Pinetree Place DS0000015556.V329471.R01.S.doc Version 5.2 Page 6 Although verbal communication with residents is good, information that is written is generally in text format and is insufficient for many residents to understand. Areas of the home need redecoration. One part of the home had an odour, and was bare and uninviting. The furniture was damaged and was not homely like other areas of the home. 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. Pinetree Place DS0000015556.V329471.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Pinetree Place DS0000015556.V329471.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1. 2. 4. 5. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The communication of information that is presented in a text format does not meet the residents’ needs. There are procedures in place to ensure that individual needs are properly assessed. EVIDENCE: The statement of purpose and service user guide that were found on the residents files were presented in a text format. The complaints procedure was within these documents and was in a picture format and is more suitable for the residents to look at. The manager reported that the Service User Guide will be available in a DVD format in the future. There was documentary evidence that residence have a needs assessment undertaken by a team of professionals and that advocates are used. There have not been any new residents to the home since the last inspection in February 2006. In the Service User Guide there is a policy on introductory visits. One resident spoken to said they remembered visiting the home before they moved in. Contracts are available and are in picture format so that the residents can understand them better. Pinetree Place DS0000015556.V329471.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6. 7. 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff deliver the care well to the residents and support them to make decisions. EVIDENCE: Generally the care plans that were inspected were relevant to the residents needs, however they were all presented in a text format. One resident discussed the plan and was able to confirm the care written down took place. Saying “staff take me out”, “I like the staff here”. Another resident’s care plan recorded going out for a daily paper. This was validated as they were seen sitting looking at it. They also said that they went to the shops to get it. The care plans all had a risk assessment attached to them that were signed and regularly reviewed. One resident was aware of the risk assessments and new why they were in place. Residents are encouraged to make their own decisions. These decisions are made at different levels. For example residents choose their own colours for Pinetree Place DS0000015556.V329471.R01.S.doc Version 5.2 Page 10 their bedrooms to be redecorated and what food they would like to eat. However a team of professionals including the resident take financial decisions. For example purchases over fifty pounds have to be agreed. This is to ensure that resident’s money is spent appropriately. An advocacy service has made an agreement with Pinetree Place to visit on a two weekly basis to establish residents’ views. This is soon to start and will be an independent forum for residents to express their views. It is hoped that the results from these meetings will provide information on how to improve services at the home. Pinetree Place DS0000015556.V329471.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12. 13. 15. 16. 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents lead an active lifestyle and enjoy the food. EVIDENCE: Residents have the opportunity to take part in different activities that are suitable for their needs. For example some go to college, others to day centres and others have activities outside of the home tailored to their needs. Two residents spoken to said they “enjoyed going out with the staff” and sometimes they have “fish and chips on the way home”. Some residents are involved in the Estuary National Football Club (ENFC). There are trophies on display as a result of their achievements. Staff were observed to treat the residents with respect and spoke to them in their preferred ways. Staff were observed interacting with the residents and residents have free access within their home and garden. Staff encourage family contact and enable families to stay in touch. Families are able to visit Pinetree Place, and there is an open visitors policy. If a Pinetree Place DS0000015556.V329471.R01.S.doc Version 5.2 Page 12 relative is unable to visit the home staff will escort the resident to their relatives home for a visit. One relative via a feedback questionnaire confirmed this. Residents spoken to and feedback from the service user surveys all commented that they enjoyed the food. In some of the houses there were laminated pictures of the menus. This is good practice and a resident spoken to was able to understand the pictures. Meal times are flexible, for example on the day of inspection one resident was having toast and tea with a topping of their choice. Other residents reported that they also go out to eat. Pinetree Place DS0000015556.V329471.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18. 19. 20. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home could monitor health care better. However residents receive personal care in the way they choose and medication is administered appropriately. EVIDENCE: Personal support is administered in the way that the residents choose. For example female residents always receive personal care by a female member of staff. Female residents confirmed this. There is technical equipment for the use of the residents. This equipment has been purchased with the residents needs in mind. Professionals have also been involved to ensure that the wheelchairs used are correct for the residents needs. The home operates a keyworker system. One resident spoken to was able to talk about the keyworker and the work that they undertook to help. For example going out shopping for clothes. In most houses the health care monitoring systems were up to date. However in one house the health care monitoring sheets were not complete. In this same house there was no evidence of follow-up appointments regarding psychiatric reviews. The manager did think that appointments would not be Pinetree Place DS0000015556.V329471.R01.S.doc Version 5.2 Page 14 missed and that this information could be held else where. However on the day of inspection it could not be found. Medication records were checked and demonstrated clear procedures to follow. For example “as required medication”. No gaps were found in the medication records and the medication records were up to date. Staff receive training on this subject and this is updated annually. Pinetree Place DS0000015556.V329471.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22. 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints policy and adult protection policy are satisfactory EVIDENCE: There have not been any adult protection incidents at the home since the last inspection. One issue was raised, however following an investigation by social services there was no evidence found to support the accusation. The adult protection policy contains a clear procedure about what to do if abuse is suspected and there is evidence that staff including agency staff have had training on this topic. There have been no recorded complaints since the last inspection. Information on how to complain is displayed in the houses and is in picture format. Complaint information is also contained in the service user guide. Residents at this home are vulnerable and responsibility is placed on the staff to contact advocates should the need arise. A new forum is going to be established as described under the individual needs and choices section of the report. This will give residents an opportunity to express their concerns. From the service user surveys, feedback indicated that residents were happy to talk to staff and were aware of how to complain. Pinetree Place DS0000015556.V329471.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24. 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The premises meet the residents needs however some areas are not homely. EVIDENCE: There is a range of attention that is needed to the home to make the environment more homely and comfortable. General redecoration and maintenance are ongoing, however some parts of the home require it more than others. For example in one house a shower has been installed however there is nowhere for the residents to hang their towels up and the room is bare. In another part of the home there is an odour. Some furniture is fixed to the wall for security, and other pieces of furniture remain damaged. There has also been a new bath installed in the bungalow. However the bathroom still appears cold, uninviting and has an odour. In all of the houses there is a utility area. This area contains the washing machine, tumble drier and fridge and freezers. In some houses there are displayed protocols regarding when the laundering of clothes can be done. However these protocols were missing in the bungalow. Pinetree Place DS0000015556.V329471.R01.S.doc Version 5.2 Page 17 Most toilet and bathrooms that the residents use did not contain soap and hand towels. For the residents that are assisted by staff to use the toilet this issue is not as great as those that can use the toilet independently. The lack of soap and hand towels does not encourage good hand hygiene practice. Pinetree Place DS0000015556.V329471.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32. 33. 34. 35. 36. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A good staff team supports the residents, however management could better support the staff team. EVIDENCE: There is inconsistent staff supervision. Staff spoken too said that they have supervision with their seniors. However when checking records it was found that the formal recording of supervision was incomplete. Some staff had a record, and other staff did not. Some staff records were last dated in May 2006, with out a follow up date. Staff have access to annual training in adult protection, manual handling, and other mandatory courses. The team leaders have the National Vocational Qualification (NVQ) to level 3 and are waiting to do level 4. A selection of recruitment files was checked. The recruitment documents were complete and contained references, criminal record bureau checks, and other documents requires by regulation. Some records did not show a completed induction. However the manager confirmed that new staff will be introduced to the home using the Skills for Care induction standards. Pinetree Place DS0000015556.V329471.R01.S.doc Version 5.2 Page 19 There are sufficient staff on duty to care for the residents. Staff reported that the amount of staff on duty increases when a resident needs to be escorted out to appointments or to activities. Staff spoken to were aware of their key worker roles and were able to explain the care that they delivered to the residents. Staff confirmed that they had staff meetings and this was supported by notes from these meetings. The home does use agency staff to cover gaps in the rota. There is a record of the agency staff used. The home use regular and familiar staff to ensure consistent care to the residents. Pinetree Place DS0000015556.V329471.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37. 38. 39. 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The management systems need to improve to ensure residents health and safety. EVIDENCE: There are no available regulation 26 reports at the home. The manager reported that there has not been a regulation 26 visit in the last six months. No pre-inspection questionnaire was received from this service despite two being sent. There is a clear management structure in place. However management responsibilities have been dispersed and cascaded down leaving team leaders with much responsibility. As yet team leaders do not hold a management certificate. However in some areas this is working well. For example the team leaders are knowledgeable about the residents in their care. However there would appear to be a culture that they undertake all Pinetree Place DS0000015556.V329471.R01.S.doc Version 5.2 Page 21 management tasks that really are the registered managers responsibilities to oversee. For example the house team leaders provide supervision to staff that work in their house and are responsible for keeping checks on fire and other safety procedures. In some houses this is working well however in other houses there have been slippages of recorded supervision and confusion about which documentation should be used to record for example fire drills and fire checks. The registered manager was unaware of these events that could result in health and safety issues. Also the registered manager was not sufficiently informed of the care of the residents when a team leader is away from work due to ill health. For example when a residents care file was inspected it was found that there was no followup appointment or feedback from a psychiatrist appointment. It is therefore unclear if an appointment had been missed and what the result of the visit was. Also some health records in the file had not been completed. The registered manager is in a position to oversee all aspects of practice in the home and should not pass over responsibility to team leaders especially when they are not in a position to act on them. The creation of documents in a user-friendly format for the residents was briefly discussed. Estuary Housing have suggested using the Widget system of communication for the residents. However as yet there have not been any plans by the home to move forward with this. This leaves the resident with mainly text documents to read, which for some residents is inappropriate. The residents at Pinetree Place do take part in quality assurance reviews that are undertaken by Estuary Housing. This often results in a yearly outing that the residents choose. Also as stated earlier the home are about to use an advocacy service to facilitate a meeting for the residents. It will be conducted on a two weekly basis so that residents can express their views about the development of the home. Pinetree Place DS0000015556.V329471.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 2 3 3 x 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 x 26 x 27 x 28 x 29 x 30 2 STAFFING Standard No Score 31 x 32 3 33 3 34 2 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 x 3 1 3 x x 2 x Pinetree Place DS0000015556.V329471.R01.S.doc Version 5.2 Page 23 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2. 3. 4. Standard YA19 YA24 YA30 YA36 Regulation Schedule 3. (3)(k) 23(2)(d) 16(2)(k) 18(2) Requirement The Registered Person must ensure that health care records are completed. The Registered Person must ensure that the home is kept in a good state of repair. The Registered Person must ensure that the odour in the bungalow is dispelled. The Registered Person must ensure that formal staff supervision is undertaken at least six times a year. The management of the home must be robust. With responsibility falling to the registered manager and the responsible individual. The Registered Person must ensure that fire safety checks do not lapse and are recorded Timescale for action 02/04/07 02/04/07 02/04/07 02/04/07 5. YA38 26 02/04/07 6. YA42 23(4) 02/04/07 Pinetree Place DS0000015556.V329471.R01.S.doc Version 5.2 Page 24 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 1 Refer to Standard YA1 YA34 Good Practice Recommendations It is good practice for the statement of purpose to be in a format suitable for the residents. The Registered Person should ensure that any new staff complete the new skills for care induction standards. Pinetree Place DS0000015556.V329471.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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. Extracts may not be used or reproduced without the express permission of CSCI Pinetree Place DS0000015556.V329471.R01.S.doc Version 5.2 Page 26 - 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!