Inspection on 03/08/05 for Pinetum Nursing Home

This inspection was carried out on 3rd August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Pinetum Nursing Home 12/02/07

Pinetum Nursing Home 06/01/06

Pinetum Nursing Home 16/12/04

Pinetum Nursing Home 08/06/04

Pinetum Nursing Home 11/03/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Pinetum Nursing Home Valley Drive Countess of Chester Health Park, Liverpool Road, Chester CH2 1UA Lead Inspector Gill Matthewson Announced 03 August 2005 09:30 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 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. Pinetum Nursing Home v233921 f51 f01 s18814 pinetum v233921 030805 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Pinetum Nursing Home Address Valley Drive Countess of Chester Health Park Liverpool Road Chester CH2 1UA 01244 380731 01244 380789 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) Mr N J Farmer/Community Health Services Ltd Ms Anne Hughes Care home with nursing 48 Category(ies) of Old age, not fall within any other category - 48 registration, with number Physical disability - 5 of places Pinetum Nursing Home v233921 f51 f01 s18814 pinetum v233921 030805 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 48 service users including: Up to 48 service users in the category of OP (old age not falling within any other category) Within the maximum of 48, up to 5 service users may be in the category of PD (physical disability) over 48 years of age 2. The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection Date of last inspection 16 December 2004 Brief Description of the Service: The Pinetum Care Home provides nursing care and accommodation for up to 48 older people and up to 5 people over 48 years of age with a physical disability.The Pinetum Nursing Home is a detached, purpose built property situated within the grounds of the Countess of Chester Health Park near to the centre of the city of Chester and local shops and amenities. There is good access to public transport.The home was first opened in 1991. Bedroom accommodation is provided in single rooms that have hand washbasins. There are no en-suite facilities. Bedrooms are on two floors with a passenger lift and staircases to both levels. There are two main communal lounge areas with two additional sitting areas. There is a dining room on each floor. Pinetum Nursing Home v233921 f51 f01 s18814 pinetum v233921 030805 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The lead inspector spent two hours planning the inspection by reviewing previous inspection reports and the service history over the last twelve months. The inspection took place over six hours and include a tour of the building, inspection of records and discussion with six residents, one relative and four staff. Comment cards were received from three relatives, one social worker, a physiotherapist, an NHS continuing health care manager and the transitional care managers. Feedback was given to the Registered Manager and Regional Manager immediately following the inspection. What the service does well: The manager gives clear direction and leadership to the staff. There is a very good staff training programme in place. Most residents spoken with liked the staff and felt they worked hard to meet their needs. One relative’s comment card stated ‘This home cares’ and another said ‘We are totally at ease with the care. Management and staff leave nothing to be desired.’ The NHS continuing health care manager said that the NHS contracted a number of beds and overall they have been satisfied with the delivery of care. Residents can choose from a varied menu and a range of activities. Complaints are dealt with quickly and efficiently. Pinetum Nursing Home v233921 f51 f01 s18814 pinetum v233921 030805 stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? 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. Pinetum Nursing Home v233921 f51 f01 s18814 pinetum v233921 030805 stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Pinetum Nursing Home v233921 f51 f01 s18814 pinetum v233921 030805 stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 Prospective residents are assessed prior to being offered a place, to ensure that the home can meet their needs. EVIDENCE: All service users were assessed by either the manager or her deputy prior to their admission to the home. The pre-admission assessment documentation contained all the details required by this standard. The pre-admission assessments examined during the inspection had been completed in full. Pinetum Nursing Home v233921 f51 f01 s18814 pinetum v233921 030805 stage 4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,&9. Residents are consulted and have individual plans of care that in the main contain detailed instructions to ensure that all residents’ needs are met. The home’s procedures ensure that medicines are stored safely and that residents are given their medicines as prescribed. EVIDENCE: Each resident case tracked had plans of care, which were based on a full needs assessment. Care plans set out the actions needed to meet the nursing and personal needs of the resident. These were comprehensive, in the main, but two care files did not contain a plan of care for one of each resident’s identified needs. This was pointed out to the manager at the time. (See Requirement 1.) A document had been incorporated into the care plans to demonstrate that the service user, and/or their relatives, had been consulted and involved in the care planning process. Pinetum Nursing Home v233921 f51 f01 s18814 pinetum v233921 030805 stage 4.doc Version 1.30 Page 10 There was evidence from meeting residents and from records maintained that their personal care needs were met by the home’s care staff. Pressure sore risk assessments were recorded in the care plans and pressure relieving equipment was seen to be in use. Detailed records were maintained regarding the treatment of a resident who had been admitted with pressure sores, and there was evidence that the tissue viability nurse had been consulted. Residents were assessed in relation to nutrition. One resident had been identified as being at high risk of malnutrition, but had not been weighed from January to July, when she had lost approximately half a stone. (See Recommendation 1.) Residents with continence needs had been assessed by the continence advisor and the appropriate aids were supplied. The home was successfully providing care for some residents with a very high level of need, including one person who required the use of a ventilator. Bed rails were in use for some service users who had been identified as being at risk of falling out of bed. There was evidence from care plans, and from speaking to staff and service users, that the home provides access to a full range of medical and health services. Appropriate policies and procedures were in place. All records required, including those for controlled drugs, were maintained to a satisfactory standard. The storage of medicines was also in accordance with requirements. The home manager carried out a regular audits of the medication records, the latest having been done on 23rd June 2005. Pinetum Nursing Home v233921 f51 f01 s18814 pinetum v233921 030805 stage 4.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13 &15 Social activities are well organised, creative and provide stimulation and interest for people living in the home. Residents are able to maintain contact with family and friends and can choose from a varied menu. EVIDENCE: There was choice in routines of daily living and religious observances were supported. The home had an activity organiser who had completed social profiles on all the residents and devised a social care plan. All activities participated in were recorded. The activity programme included quizzes, bingo, poetry readings, reminiscence, indoor games, beauty therapy, pet therapy, relaxation, film shows, music and movement and pampering sessions. Residents confirmed that there were no restrictions on visiting other than those imposed by the individual resident themselves. The menu had recently been reviewed following consultation with residents. There were four meals a day served at 9am, 12md, 4.30pm and 8pm with snacks and drinks provided in between. The main meal was at lunchtime, with a lighter meal in the evening. Residents could choose from two main courses at lunchtime, with sweet and soup and a hot snack or sandwich at teatime, also Pinetum Nursing Home v233921 f51 f01 s18814 pinetum v233921 030805 stage 4.doc Version 1.30 Page 12 with a sweet. They could also request an omelette or salad if they didn’t like what was on the menu, and fruit, yogurt and ice cream were always available. Lunch on the day of inspection was roast chicken dinner or egg, chips and beans, followed by marble cake with chocolate sauce. Tea was sausage rolls and sandwiches, followed by mousse. Residents confirmed that they had choice at mealtimes both of meals and where they ate. Pinetum Nursing Home v233921 f51 f01 s18814 pinetum v233921 030805 stage 4.doc Version 1.30 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 Complaints were taken seriously and acted upon. EVIDENCE: The home’s complaints policy and procedure met this standard. A copy of the complaints procedure was displayed in each bedroom and in the entrance hall and was also contained in the Statement of Purpose and Service Users’ Guide. Complaints were recorded, together with details of the investigation and any action taken as a result. The home had received three complaints since the last inspection, one of which was substantiated. One resident spoken with and her husband were not happy with the care provided in the home. They had not expressed their concerns to the manager, but agreed to do so. The manager was requested to discuss the matter with them and look into their concerns. A relative who completed a comment card said that she had previously made a complaint but it was dealt with quickly and to her satisfaction. Pinetum Nursing Home v233921 f51 f01 s18814 pinetum v233921 030805 stage 4.doc Version 1.30 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19&26 The home provides a safe, comfortable and clean environment for residents. EVIDENCE: The home was purpose built and all areas were accessible to residents, including wheelchair users, apart from the kitchen and laundry. There were also accessible outdoor sitting areas. A programme of routine maintenance and renewal of the fabric and decoration of the premises was in place. The bathrooms had been redecorated since the last inspection. Grounds were tidy and attractive. The garden was well maintained, with attractive flowerbeds and garden furniture. The fence had been repainted. The home was clean and tidy at the time of the inspection. The laundry, hand washing and sluicing facilities were satisfactory. There were policies and procedures in place to assist with the prevention of cross-infection. Pinetum Nursing Home v233921 f51 f01 s18814 pinetum v233921 030805 stage 4.doc Version 1.30 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29&30. Recruitment practices, staffing levels and staff training are sufficient to ensure that residents are protected and their needs can be met. EVIDENCE: On the day of inspection there were 44 people in residence. Staffing consisted of four registered nurses and seven care assistants in the morning, three registered nurses and six care assistants in the afternoon and evening, and two registered nurses and three care assistants at night. The number and skill mix of staff was sufficient to meet the residents’ needs. Twenty nine percent of care staff had obtained an NVQ Level 2 or 3 in Care. Other care staff were working towards the qualification, and when completed would increase the percentage to 75 . Some ancillary staff had undertaken NVQs in catering and cleaning. Four staff files were reviewed. All contained the required information and documents to ensure residents’ protection. The home’s induction met Sills for Care workforce training targets. Other training in 2005 had included diabetes management, wound care, protection of vulnerable adults, gastrostomy feeding and care, palliative care, pressure area care, care planning and documentation and motor neurone disease awareness. For training in safe working practices, see Standard 38. Pinetum Nursing Home v233921 f51 f01 s18814 pinetum v233921 030805 stage 4.doc Version 1.30 Page 16 Pinetum Nursing Home v233921 f51 f01 s18814 pinetum v233921 030805 stage 4.doc Version 1.30 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32 &36. The manager creates a clear sense of direction and leadership, which staff and residents understand. EVIDENCE: Pinetum Nursing Home v233921 f51 f01 s18814 pinetum v233921 030805 stage 4.doc Version 1.30 Page 18 The manager held monthly staff meetings and quarterly residents’ meetings. Minutes were taken and retained. Innovation, creativity and development were encouraged within the company and quarterly professional network meetings were held. There was a satisfactory policy on diversity and a recruitment monitoring procedure. Residents spoken with said that the manager was approachable and staff said they found her very supportive. Examination of records and discussions with staff confirmed that all care staff received supervision on a regular basis and annual appraisals. All other staff received annual appraisals. There were no volunteers working at the home at the time of the inspection. Pinetum Nursing Home v233921 f51 f01 s18814 pinetum v233921 030805 stage 4.doc Version 1.30 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 2 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x 3 x x x 3 x x Pinetum Nursing Home v233921 f51 f01 s18814 pinetum v233921 030805 stage 4.doc Version 1.30 Page 20 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. Standard OP7 Regulation 15 Requirement The registered person must ensure that residents have a plan of care for all identified needs. Timescale for action 3.09.05 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 Residents should be weighed at least monthly. Pinetum Nursing Home v233921 f51 f01 s18814 pinetum v233921 030805 stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Unit D, Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Pinetum Nursing Home v233921 f51 f01 s18814 pinetum v233921 030805 stage 4.doc Version 1.30 Page 22 - 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. 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