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Inspection on 09/08/05 for Pinetree Place

Also see our care home review for Pinetree Place for more information

This inspection was carried out on 9th August 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 residents have a lot of different activities to do throughout the week. These activities were planned around the resident and what they can cope with. The staff at the home were knowledgeable about the residents that they looked after and spent time with them. There is a menu and some residents plan their own meals for the week. Most residents said they liked the food and where they lived. One resident was unhappy with this and the staff are aware of her likes and dislikes. Pinetree Place has various methods to make sure the residents of the home are listened to. This involves one-to-one work, reviews and taking part in the Estuary Housing Association quality review network that finds out what residents` think of the homes` they live in and the life-style that they lead.

What has improved since the last inspection?

Since the last inspection there have been many improvements in the home. Each house now has a Team Leader who takes responsibility for the residents in their house. For the residents this means that a familiar member of staff is there to look after them. Agency staff are still used, however the home make sure that it is the same staff that work in the home, so that the residents get used to them. Many residents were unable to talk however their behaviour showed that they were happy and comfortable in the staff`s company. One resident said that she was very happy at the home and didn`t want to change anything about where she lived. The staff said that there was now more scope to do things with the residents. The record keeping was good regarding care, and there was proof that the residents had choice. One resident had a new floor in his bedroom. The residents were enjoying the new garden furniture and the residents of one house had planted flowers, which improved the appearance of their garden.

What the care home could do better:

There are many areas of the home that have not been maintained well. There is a plan to improve the environment however as yet the residents are still waiting for this work to start. The hygiene practice in one resident`s room was poor, and some rooms had a bad odour to them. Adult protection incidents periodically occur at this home and there is currently one under investigation at the moment. There is no current up to date medication policy in the home and errors were found on a medicine chart. Such errors can leave the residents at risk of deterioration in their medical conditions.

CARE HOME ADULTS 18-65 Pinetree Place 36a-d Ashingdon Road Rochford Essex SS4 1NJ Lead Inspector Nicola Dowling Unannounced 9 August 2005 th 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 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 Stationary 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 I56-I06 S15556 Pinetree Place V243820 090805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Pinetree Place Address 36a-d Ashingdon Road Rochford Essex SS2 5TE 01702 540135 01702 543777 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Estuary Housing Association Limited Mr John Wyatt CRH Care Home 12 Category(ies) of LD Learning disability (12) registration, with number of places Pinetree Place I56-I06 S15556 Pinetree Place V243820 090805 Stage 4.doc Version 1.40 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 Date of last inspection 1st March 2005 Brief Description of the Service: Pinetree Place is a Care Home with Nursing for twelve residents with Learning Disabilities. 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 I56-I06 S15556 Pinetree Place V243820 090805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over one day. The inspection consisted of a tour of the home, talking with staff and residents, observing the care given, and reading of documents. As there were no relatives at the home during the inspection their views have not contributed to this inspection report. Currently the home is undergoing a process of change. Estuary Housing Association have submitted an application to change the registration of Pinetree Place from Care Home with Nursing to Care Home with Personal Care. To maintain the quality of care for the residents Estuary Housing Association are in the process of fulfilling a year-long development plan. This is to ensure that care staff can look after the resident’s needs when the qualified nurses are withdrawn from the home. The plan consists of a new staffing structure and a lot of training in various topics. So far this plan is on target and staff are enthusiastic about their new responsibilities A thank you is extended to the staff and service users who took part in the inspection and for their help and hospitality. What the service does well: What has improved since the last inspection? Since the last inspection there have been many improvements in the home. Each house now has a Team Leader who takes responsibility for the residents in their house. For the residents this means that a familiar member of staff is there to look after them. Agency staff are still used, however the home make Pinetree Place I56-I06 S15556 Pinetree Place V243820 090805 Stage 4.doc Version 1.40 Page 6 sure that it is the same staff that work in the home, so that the residents get used to them. Many residents were unable to talk however their behaviour showed that they were happy and comfortable in the staff’s company. One resident said that she was very happy at the home and didn’t want to change anything about where she lived. The staff said that there was now more scope to do things with the residents. The record keeping was good regarding care, and there was proof that the residents had choice. One resident had a new floor in his bedroom. The residents were enjoying the new garden furniture and the residents of one house had planted flowers, which improved the appearance of their garden. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Pinetree Place I56-I06 S15556 Pinetree Place V243820 090805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Pinetree Place I56-I06 S15556 Pinetree Place V243820 090805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 and 5 There is good information on how the residents are assessed and on the terms and conditions of stay. EVIDENCE: A sample of contracts was inspected and all were in a format suitable to the residents needs. The format was simple with pictures helping to explain the writing. No new residents have been admitted to the home since the last inspection. The information available to new residents is the same. The service user guide explains the steps the home will take before a resident visits the home and also explains what sort of visits the resident can have to the home. For example to visit for a meal. Pinetree Place I56-I06 S15556 Pinetree Place V243820 090805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7 and 9 Staff are good at helping residents make decisions about their lives and risk is well managed. EVIDENCE: Staff assess risk for the many activities that the residents take part in and this is recorded on the risk plans. This makes sure that the activities that the resident does is safely managed. The staff spend time with the residents to help them choose what they want to do. For example, sitting down with a resident and choosing their meals or what they like to watch on the television, selecting their own clothes. One resident spoken with confirmed that she could please herself regarding when she got up or when she went to bed. Pinetree Place I56-I06 S15556 Pinetree Place V243820 090805 Stage 4.doc Version 1.40 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 15and 16 There is a variety food and of different activities that are based on the residents enjoyment of them. Good family contact is maintained. EVIDENCE: Some residents go out to different day care centres. Others have activities planned in the home. One resident is due to start at a local college, others have massage treatment, go out for walks and drives. On the evening of the day of inspection some residents’ were off to either take part in or watch a football game. Menus offer a variety of food and a choice. One resident had gone out for fish and chips yesterday and said how much she enjoyed it. Each house arranges the meals differently, however meals are flexible and arranged around the residents. For example in one house all the residents like to sit together to eat, in another residents had their meal in the garden. No family members were at the inspection however staff said that families were very involved in their relatives care. Some family members visit the home whilst others go out to their relative’s houses and one receives a regular Pinetree Place I56-I06 S15556 Pinetree Place V243820 090805 Stage 4.doc Version 1.40 Page 11 daily telephone call. Two residents at the home that live in different houses invite each other over for tea as they have formed a friendship and like each other’s company. Pinetree Place I56-I06 S15556 Pinetree Place V243820 090805 Stage 4.doc Version 1.40 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 20 The health needs of the residents are well met with evidence of multi disciplinary working however, areas of medication practice are poor. EVIDENCE: There is good evidence that reviews are regularly held. One the day of inspection reviews were done for some residents by a psychiatrist that visited the home. The staff are looking into well man and woman clinics. Health care appointments are documented and staff go with residents to these appointments. The home do not yet have the up to date Estuary Housing Association drugs policy to refer to. Gaps were also found on one medication card and there was no record in the daily care notes why the medication was not given. Pinetree Place I56-I06 S15556 Pinetree Place V243820 090805 Stage 4.doc Version 1.40 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 The complaints process is clear and residents are listened to. Residents cannot be fully assured that they are free from the risk of abuse despite a clear policy on adult protection. EVIDENCE: No complaints have been made since the last inspection. How to complain posters are sited throughout the home. Residents spoken with did not have any complaints, however if they were unhappy about something they are able to approached the staff about their concern. The home has the Estuary Housing Association policy on adult protection. Staff are aware of the policy and what to do if abuse is suspected. There is one adult protection incident ongoing at the home which is different from the previous incident mentioned in the last report. The previous incident concluded that no abuse had occurred. Pinetree Place I56-I06 S15556 Pinetree Place V243820 090805 Stage 4.doc Version 1.40 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 and 30 The standard of décor in some areas of the home is poor and some practices are unhygienic. EVIDENCE: House C was very homely warm and inviting in contrast to house D that had a lot of damage to the fixtures, fittings and furniture. Some rooms had an odour and a catheter bag and urinal was left in a resident’s hand basin. These items were immediately removed however this practice is unhygienic. The residents’ lounges were comfortable and the kitchens clean. House A had planted flowers in the garden that made it look attractive. Other houses had new garden furniture that the residents enjoyed using. There is a plan to do major improvement work at Pinetree Place, however as yet this hasn’t started. Pinetree Place I56-I06 S15556 Pinetree Place V243820 090805 Stage 4.doc Version 1.40 Page 15 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33 and 35 Relevant staff training and a regular staff team that are familiar with the residents are giving consistent care. EVIDENCE: Since the introduction of Team Leaders into the staffing structure of Pinetree Place there has been better consistency of care. The staff work only in the house that they are allocated to and this also applies to agency workers. Therefore the residents have come to know the staff better and this has made a positive impact on some resident’s behaviour. Currently there is a lot of training for staff to equip them with the skills they need to manage the individual houses. Training includes medication administration and how to manage specific medical conditions for example epilepsy. Staff that are undertaking this training were enthusiastic about the way they worked and felt it raised the residents’ quality of life. Pinetree Place I56-I06 S15556 Pinetree Place V243820 090805 Stage 4.doc Version 1.40 Page 16 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 The home is generally well managed, however the implementation of advice from the fire authority regarding improving fire safety is slow. EVIDENCE: A random sample of records was checked. All safety certificates were up to date. Doors were being wedged open despite advice from the fire authority that this was “unacceptable” practice. The home plan to install magnetic fire door closures however there is no date for this work to commence. Pinetree Place I56-I06 S15556 Pinetree Place V243820 090805 Stage 4.doc Version 1.40 Page 17 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x 3 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 2 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 x 3 Standard No 31 32 33 34 35 36 Score x 3 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Pinetree Place Score x 3 2 x Standard No 37 38 39 40 41 42 43 Score x x x x x 2 x I56-I06 S15556 Pinetree Place V243820 090805 Stage 4.doc Version 1.40 Page 18 yes 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. Standard 20 Regulation 13 (2) Requirement The registered person must obtain the up to date drugs policy issued by Estuary housing Association. Time scale of 9.05.05 not met The registered person must ensure that the administration of medicines are recorded properly. The registered person must ensure that residents are not placed at risk of harm or abuse The registered person must ensure that the home is maintained and kept in a good state of repair and redecoration. The registered person must dispell odours and maintain standars of hygiene. The registered person must ensure that all care workers are aware of the General Socila Care Council code of conduct. Not inspected The registered person must ensure all documents as set out in schedule 2 are available for inspecetion Not inspected The registered person must not wedge open fire doors and seek an alternative method to this Timescale for action 21.09.05 2. 3. 4. 20 23 24 13(2) 13(6) 23(2)(b) (d) 16(2) (j)(k) 18(4) 21.09.05 21.09.05 21.09.05 5. 6. 30 31 21.05.09 21.05.09 7. 34 Schedule 2 21.05.09 8. 42 23(4)(a) 21.05.0921 Pinetree Place I56-I06 S15556 Pinetree Place V243820 090805 Stage 4.doc Version 1.40 Page 19 practice as advised by the fire authority. 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 21 26 Good Practice Recommendations The home should maintain discussions with residents and their families regarding their views on serious illness. Not inspected The home should ensure that the furniture is robust and suitable for the residents needs Not inspected Pinetree Place I56-I06 S15556 Pinetree Place V243820 090805 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection Kingswood House Baxter Avenue Southend on Sea SS2 6BG 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 Pinetree Place I56-I06 S15556 Pinetree Place V243820 090805 Stage 4.doc Version 1.40 Page 21 - 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. 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