Inspection on 09/11/05 for Pinewood Nursing Home

This inspection was carried out on 9th November 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

Pinewood Nursing Home 06/10/08

Pinewood Nursing Home 22/11/06

Pinewood Nursing Home 11/07/05

Pinewood Nursing Home 06/10/04

Pinewood Nursing Home 20/04/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Pinewood Nursing Home 33 Victoria Place Budleigh Salterton Devon EX9 6JP Lead Inspector Anita Sutcliffe Unannounced Inspection 9th November 2005 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Pinewood Nursing Home DS0000058891.V265392.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Pinewood Nursing Home DS0000058891.V265392.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Pinewood Nursing Home Address 33 Victoria Place Budleigh Salterton Devon EX9 6JP 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) 01395 446309 01395 443096 Elmwood Nursing Home Ltd Mrs Eileen Lesley Enever Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Pinewood Nursing Home DS0000058891.V265392.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. This variation allows admission of one named person, outside the categories of registration as detailed in the notice dated 13 July 2004 The maximum number of persons accommodated at the home, including the named service user will remain at 28. On the termination of the placement of the named service user, or when he attains his 65th birthday, the registered person will notify the Commission in writing and the particulars and conditions of this registration will revert to those normally held. That the new accommodation will not be brought into use until the Commission for Social Care Inspection has received written confirmation that Planning Department, Building Control, Environmental Health Department and Devon Fire and Rescue Service requirements have been met. That the new accommodation will not be brought into use until an inspector has visited to confirm that it is ready for occupation and has been built according to plans which have been agreed with the Commission The manager must obtain the Registered Manager’s Award by September 2006. 11th July 2005 4. 5. 6. Date of last inspection Brief Description of the Service: Pinewood Nursing Home provides 24-hour care and accommodation for up to 28 older people with nursing care needs. It is owned by Elmwood Nursing Home Ltd. and managed by a registered nurse manager. The Home is a detached property standing in its own grounds, approached by way of a steep hill, situated in a residential area close to Budleigh Salterton town centre and the sea front. It is currently undergoing refurbishment and enlargement. The home is sited on four floors with lift access to each. Twelve of the rooms have en suite facilities. There is a main lounge, a second quiet lounge and a dining room. There are grounds and gardens, with areas that are easily accessible to service users. The home employs a physical therapist, activities coordinator and has shared use of a mini bus. Pinewood Nursing Home DS0000058891.V265392.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was the second in this inspection year and was unannounced. It took place between 9 am and 4:20 pm on a weekday and covered key standards not inspected at the previous inspection, plus those where the home had room for improvement. The persons-in-charge of care during the inspection were registered nurses, and the company representative was present throughout and received the inspection feedback. The majority of the inspection involved speaking with service users (residents) care and nursing staff, the cook, activities organiser and a resident’s visitor. A podiatrist and Church of England lay worker, both who visit regularly, provided information. Three bedrooms, large and small sitting rooms, the dining room, medication storage, bathrooms and nursing office were visited. Records read included medication, fire safety and training. The medicines policy and two care plans were examined. Information and contact details for the Commission for Social Care Inspection were left for residents at the home. What the service does well: What has improved since the last inspection? Residents and staff are excited by the recruitment of a new activities coordinator, who visits 2 or 3 times a week “with her little dog”. She facilitates group activities or spends time with individuals in their room. Money has been provided to buy activity materials and equipment, and she is developing her role by getting to know people and what interests them. Pinewood Nursing Home DS0000058891.V265392.R01.S.doc Version 5.0 Page 6 Movement around the home has been improved through the installation of a new lift between floors, and the window in a bedroom has been lowered to extend the view and increase ventilation, as particularly desired by one resident: “you’ve only got to ask and things will be changed to your advantage”. Two new bedrooms have been brought into use, and very much liked by the one occupant spoken with. There is now a medicines policy clearly written to provide factual information to staff and increase safety. 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. Pinewood Nursing Home DS0000058891.V265392.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Pinewood Nursing Home DS0000058891.V265392.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 The assessment of need prior to admission provides assurance that the home can meet resident’s needs and is a basis for good care planning. EVIDENCE: Assessment is always undertaken prior to admission and provides information from which nursing and care are planned. A recently admitted resident was very satisfied with the way her admission to the home had been managed. Pinewood Nursing Home DS0000058891.V265392.R01.S.doc Version 5.0 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 the following standard(s): 8, 9 & 10 Health care needs are met through the skill, experience and professionalism of care and nursing staff. Residents are treated with respect, but not always with full regard for their privacy and dignity. The handling of medication at the home has much improved. EVIDENCE: Residents and family expressed their confidence in the nursing and care provided. Very frail residents looked well cared for with frequent review of their needs. Staff are proud of the standard of care with other routine and specialist care arranged as necessary. All residents spoken with said they are treated with respect and their privacy is upheld. Staff were observed knocking before entering bedrooms, and the new bedrooms have lockable doors providing the option of further privacy. However, communal space at Pinewood is limited and a resident was receiving communion in the lounge, which was noisy, and with staff having to work around her. (See also Standard 20). Pinewood Nursing Home DS0000058891.V265392.R01.S.doc Version 5.0 Page 10 Medication was examined in detail; most previous concerns had been addressed and there is now written policy and instruction on how staff are to manage medicines. However, staff continue to hand write some entries on the medicines administration record with no second person checking accuracy. This could lead to mistakes. When creams or eye drops are opened they are not dated so that staff will know their shelf life. Stock levels continue to be high, it was said because more than one person may make an order, suggesting the home’s procedure is not always followed. Pinewood Nursing Home DS0000058891.V265392.R01.S.doc Version 5.0 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 the following standard(s): 12, 13, 14 & 15 Residents benefit from a relaxed atmosphere, regular activities and support to lead fulfilled lives. They receive a nutritious, but for some an unappetising diet. EVIDENCE: Residents said that they exercise control over their lives; staff help them to maintain contact with friends and family. The atmosphere in the home is relaxed. Residents and staff were enthusiastic about the recently recruited activities coordinator, who is looking at ways to develop her role. To this end new equipment and materials have been ordered. Hobbies and interests are encouraged; many residents were observed reading. Residents also have the opportunity to use the minibus and some had recently visited a circus. Care plans showed little record of residents’ interests or social history, and personal and social need was not included in the care planning. Well being through personal fulfilment needs to be considered and planned for. This will be examined in detail at the next inspection under Standard 7. Pinewood Nursing Home DS0000058891.V265392.R01.S.doc Version 5.0 Page 12 Residents nutritional needs are met through assessment, monitoring, a varied menu and assistance with eating when required. Opinion on meals varied, but most residents are very happy with them, agreeing there was plenty with choice always available. Pure′d foods, used for residents with swallowing difficulties, were mixed together in a bowl; this looked unappetising and did not allow a variety of tastes as enjoyed by other residents. Pinewood Nursing Home DS0000058891.V265392.R01.S.doc Version 5.0 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 the following standard(s): 16 The owners and manager are open and receptive to complaints. EVIDENCE: Residents said they would take any complaint to the nurse on duty, manager or company representative. Most residents felt confident about doing so. Staff confirmed that complaints would be quickly and effectively managed, as the one complaint to the home had been. No complaints have been received by the CSCI. Pinewood Nursing Home DS0000058891.V265392.R01.S.doc Version 5.0 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 the following standard(s): 19, 20, 24 & 26 Residents enjoy a clean, homely environment, adapted to their individual needs, but daily lifestyle is adversely affected through limited space. EVIDENCE: The home was warm, clean and pleasant. Residents’ rooms were comfortable and personalised. Residents spoken with liked their accommodation, which in one case has been adapted to provide a better view. Communal space at Pinewood is limited. A resident receiving Communion in the lounge had staff working around her and it was noisy. (See also Standard 10). It become apparent that neither she nor the activities coordinator were aware the quiet lounge existed, and when visited it was clear that it is being used by staff, some of whom were also unaware that it is for residents’ use. The storage of equipment poses a problem, with wheelchairs, hoists and seated weighing scales being stored in corridors and on stairs landings. Plans for the new extension include additional storage space, which should reduce or remove this problem. Pinewood Nursing Home DS0000058891.V265392.R01.S.doc Version 5.0 Page 15 To ensure safety from fire the home has added extra smoke alarms. However, fire safety checks have not been undertaken on a routine basis. The owner’s representative said that they would train a second person to prevent reoccurrence. Pinewood Nursing Home DS0000058891.V265392.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 & 30 Residents’ needs are met through the numbers, knowledge, experience and dedication of staff. EVIDENCE: It was said that recently it had been difficult staffing the home, but both residents and staff agreed that needs had been met even so. Recruitment continues, and shortfalls in staffing have been met by existing staff, although the option of using agency staff had been available. Residents benefit from both male and female staff working at the home, which also employs from outside the United Kingdom. Training records were examined and staff also confirmed training had been received, including in depth induction for a new staff member recruited from abroad. Pinewood Nursing Home DS0000058891.V265392.R01.S.doc Version 5.0 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35, 37 & 38 The home is well managed, and run in the best interests of residents, whose financial interests are safeguarded. Health and safety are maintained at the home. EVIDENCE: Residents confirmed that they are able to look after their own financial affairs if they wish to. Otherwise the home generally invoices their account when money is needed. Policies and procedures are now being reviewed and updated so that staff are well informed on how to provide a consistent and safe service to residents; the medicines policy is now clear and informative. Health and safety training is undertaken, but at this time no staff have completed first aid training, although it is planned. Equipment at the home is Pinewood Nursing Home DS0000058891.V265392.R01.S.doc Version 5.0 Page 18 serviced and the fabric of the home well maintained, which protect residents and staff alike. Pinewood Nursing Home DS0000058891.V265392.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 2 X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X 3 2 Pinewood Nursing Home DS0000058891.V265392.R01.S.doc Version 5.0 Page 20 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. Standard Regulation Requirement Timescale for action 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 OP9 OP9 Good Practice Recommendations A record should be made of the opening date of a medication (ointments, creams, lotions) so that its date of expiry will be known. Nursing staff should meet the Nursing and Midwifery Council guidelines on medication and record keeping by ensuring that hand written entries on medication records are signed, dated, and then a second person should check it. Food should be presented so that it looks and tastes appetising [this refers to pure′d foods mixed together in one bowl] Communal space must be available which includes rooms in which a variety of social, cultural and religious activities can take place; and residents can meet visitors in private [this refers to the room registered as a sitting room not being available as such, with people unaware of its existence or offered the option to use it] DS0000058891.V265392.R01.S.doc Version 5.0 Page 21 3 4 OP15 OP20 Pinewood Nursing Home 5 OP38 Staff should receive training in first aid. Pinewood Nursing Home DS0000058891.V265392.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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. 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