Inspection on 22/11/06 for Pinewood Tower

This inspection was carried out on 22nd November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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.

Other inspections for this house

Pinewood Tower 29/11/05

Pinewood Tower 05/07/05

Pinewood Tower 28/01/05

Pinewood Tower 21/07/04

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

CARE HOMES FOR OLDER PEOPLE Pinewood Tower 30 Tower Road Branksome Park Poole Dorset BH13 6HZ Lead Inspector Sally Wernick Key Unannounced Inspection 22 November 2006 10:00a 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 DS0000004072.V320822.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. DS0000004072.V320822.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Pinewood Tower Address 30 Tower Road Branksome Park Poole Dorset BH13 6HZ 01202 762855 01202 762880 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) Mrs Gene Mangold Care Home 14 Category(ies) of Dementia - over 65 years of age (14), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (14) DS0000004072.V320822.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th November 2005 Brief Description of the Service: Pinewood Tower is a care home providing personal care and accommodation for 14 older people who have mental disorders or dementia. The home is situated in a quiet residential area of Branksome Park. The nearest amenities, including shops, banks, post office, churches and doctors surgeries etc, are approximately half a mile away in Westbourne. Car parking is provided for visitors to the home and further parking is available on nearby roads. A regular bus service goes from Westbourne into Bournemouth (approx 2 miles) and Poole (approx 3 miles). Pinewood Tower is a large detached property that has been adapted to provide residential care. The home is set back from the road in mature secluded grounds with a peaceful, enclosed area of garden where residents may sit and a separate activity area. Accommodation for residents is provided on the ground and first floors. There are ten single bedrooms and two providing shared accommodation. Access to the first floor is via the stairway as there is no passenger or stair lift. The home also has a lounge/dining room with patio doors to the garden. There are two bathrooms with W.C. and washbasin, and two separate W.C.s. Pinewood Tower provides 24-hour personal care, all meals, laundry and domestic services. The home offers stimulation in the form of regular daily activities. Pinewood Tower is owned and personally managed by Mrs Gene Mangold, assisted by an experienced team of staff. Fees range from: £472-£550.00 See the following website for further guidance on fees and contracts. http:/www.csci.org.uk/about_csci/press_releases/better_advice_for_people_ choos.aspx DS0000004072.V320822.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit was unannounced and began at 10.00am on Wednesday, 22nd November 2006. This was a ‘key inspection’ where the homes performance against the key National Minimum Standards was assessed alongside progress in meeting requirements made at the last inspection. The registered manager assisted the inspector, as did other members of care staff. Methodology used included a tour of the premises, review of records and discussions with staff. The inspector also reviewed the contact sheet for Pinewood Tower and documentation submitted by the registered manager in response to requirements made at the last inspection. A Pre-inspection questionnaire was also sent to the manager in order that information could be provided prior to the inspectors site visit. That information where relevant will be included in the main body of this report. What the service does well: What has improved since the last inspection? To ensure the safety and well being of residents the recruitment policy has been updated to reflect the impact of POVA. The recommended health and safety improvements, updating of the COSHH file and maintaining safe water temperatures have also been implemented. DS0000004072.V320822.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. DS0000004072.V320822.R01.S.doc Version 5.2 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 DS0000004072.V320822.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A good admissions procedure enables prospective residents and their supporters to make informed decisions about the home and ensure that only service users whose needs can be met by the home are offered places there. EVIDENCE: Two files of residents who had come to live at the home since the previous inspection were examined. Residents at Pinewood Tower are known to local psychiatric and health services and some have been referred to the home following admission into hospital. The Registered Manager has good links with all of the healthcare services locally and there was evidence of very good liaison with healthcare providers, care managers, families and the prospective service user. Pre-admission assessments were detailed with strategies for managing personal and healthcare needs and where relevant, files held copies of local authority assessment and care plans. DS0000004072.V320822.R01.S.doc Version 5.2 Page 9 In line with a previous requirement written confirmation as to the outcome of the assessment is provided to prospective service users and their supporters so that they can be fully assured that individual care needs can be met. Pinewood Tower does not provide intermediate care this standard therefore was not inspected. DS0000004072.V320822.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There is a good care planning system in place to ensure that staff has the information that they need to meet the needs of residents. The health needs of the residents are well met with evidence of good support from a range of community health professionals. The medication at the home is well managed promoting the good health and well being of residents. Residents are treated with respect and their privacy and dignity are promoted at all times. EVIDENCE: Three care plans were examined all were of a high standard. They followed on from the assessments made by the home, were easy to read and were full and informative about the needs of the resident and of how the home was to meet them. Information in the care plans was up to date with plans being reviewed DS0000004072.V320822.R01.S.doc Version 5.2 Page 11 weekly. Care plans echoed the ethos of the home to provide total person centred care to the individual and treat them with respect and dignity. Relatives are encouraged to contribute to the development of care plans especially by providing important background information such as social and life history. The registered manager confirmed that a copy of the plan is always provided to relatives. A key worker system is in place with care staff having particular duties for the individual residents that are their responsibility, including reviewing their care, updating their records and life histories and monitoring their physical and mental well-being. Language used in care plans is sensitive and respectful referring to the need for staff to ‘explain, prompt, encourage and reassure’. Observation of the care being delivered as well as the appearance and general demeanour of the residents demonstrated that these plans are put into action and people are very well cared for. Records evidenced and daily notes support regular liaison and referral to G.P’s, district nurses, community psychiatric nurses, occupational therapy as well as opticians, dentists and chiropodists. Risk assessments are carried out for each resident and appropriate steps taken to minimise any risks identified. A good system for the ordering, administering and recording of medication is in place at the home and only staff members that have completed a course in ‘giving medication safely’ are able to carry out this task. Medicines were safely stored and countersigned where necessary. Staff were observed throughout the inspection to be treating residents with courtesy, patience, kindness and respect and it was apparent that real care is taken to maintain privacy and dignity. DS0000004072.V320822.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents lives are enriched by the activities on offer at the home, the choices made available to them and the social opportunities afforded by spending time with other residents, the staff and family and friends who are able to visit at a time that is individually suited. Residents are helped and encouraged to exercise choice in their daily lives at the home. The meals are good, nutritionally varied and served in a pleasant environment. EVIDENCE: Pinewood Tower is very much a home of the residents and is run in a manner that supports them to live their lives making the choices they can. Information is collected where possible about residents’ interests, life histories and previous occupations. Activities are structured but informal and planned around individual likes and dislikes and what residents themselves want to do on that day. Some choose to go out with family and friends’ for others there is always an available member of staff for an accompanied walk or shopping trip. DS0000004072.V320822.R01.S.doc Version 5.2 Page 13 Residents are stimulated mentally with appropriate games and are encouraged to interact socially with each other and with staff. Each resident has an individual memory box, which they can look at with their key worker and time is specifically put aside daily to talk to residents about their individual interests. The emphasis is always on the individual and this was observed throughout the inspection. One resident was enjoying a song another artwork. A priest from the local church was visiting to support some residents. Two members of staff supported four other residents in a shared activity. Other residents preferred to sit quietly. The visitor’s book confirmed the number and range of visitors to the home who are able to visit at times, which are suited to each individual resident. Residents are able to see their visitors in the lounge/dining room or their own rooms as they wish. Some residents are visited by family members and go out with them as and when they choose. A tour of the premises evidenced that residents are able to bring personal possessions with them into the home. When people move into the home they and their families are asked about what the resident likes to eat and menus are based around known likes and dislikes and on providing a good wholesome diet. On the day of the inspection there was a choice of meat and fish with a range of vegetables and dessert. Some residents need assistance at mealtimes and this was provided unobtrusively with staff showing patience and kindness. Finger food and drinks are available from staff 24 hours a day and in order to assist some residents in making menu choices large print and picture boards are used. Some residents choose to eat in the lounge others in their rooms. The lunchtime meal was seen by the inspector to be relaxed and unhurried. Comprehensive records are kept of meals, further demonstrating the variety and choice available. DS0000004072.V320822.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A system is in place to deal with any complaints that might be made about the home to ensure that concerns will be listened to and investigated. Service users are safeguarded by staff’s knowledge of adult protection procedures and written policy. EVIDENCE: The home has a complaints policy and procedure, which is included in the information given to residents and their supporters during the pre-admission assessment. No complaints have been received about the home during this inspection period. The home as an up to date adult protection policy and staff records evidenced that all staff has received adult protection training. Three staff members spoken to during the inspection all confirmed that they had received training and would know the necessary action to take in the event of an incident or if they had any concerns about the treatment or care of a resident. DS0000004072.V320822.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Pinewood Tower provides a well-maintained, comfortable, safe and homely environment for residents with access to indoor and outdoor communal facilities. The home is kept clean and there are no unpleasant smells, making daily life for all in the home more pleasant. EVIDENCE: Pinewood Tower is a clean comfortable well maintained home. Communal areas and bedrooms are well decorated and residents have personalised their rooms with items of furniture and their own belongings. Each resident’s bedroom has his or her photograph on the door. Some are recent photographs and others were taken when the resident was much younger. This makes bedrooms easier to find and helps to maintain each resident’s independence. Each resident’s room has a pin board on the wall with photographs of people and places that are important to them. DS0000004072.V320822.R01.S.doc Version 5.2 Page 16 There is a comfortable communal lounge/dining room on the ground floor with easy access through patio doors to an enclosed garden with a variety of seating. Another area is set aside for activities, with a goal net for football. The home also has a swimming pool, which is fenced and may be used by residents in the warm weather under supervision. Communal bathrooms have been decorated with a nautical theme in order to make bathing a more welcoming and pleasurable experience for residents. Bathrooms and WC’s are well signed using pictures and words, so that residents may identify these facilities more easily. There are laundry facilities and all personal items are laundered within the home. Key workers have the responsibility of maintaining and organising residents clothes. The home is clean throughout and there are no unpleasant odours. DS0000004072.V320822.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The numbers and skill mix of staff are sufficient to ensure that the needs of residents are met. Robust recruitment procedures are in place to ensure the protection of residents living at the home. Residents are cared for by staff that mostly has relevant qualifications from abroad along with access to local training which enables them to do their jobs well. EVIDENCE: Clear staffing rosters are in place that show who is on duty, when and what jobs they do. Four care assistants were on duty during the inspection, which is the normal arrangement one member of staff was also working in the kitchen and there is a daily cleaner. The inspector observed that the staffing hours enabled staff to provide individual care and support to a number of service users. In line with a requirement made at the previous inspection well-ordered staff files demonstrated that a robust recruitment procedure is in place with criminal record and POVA 1st checks available for examination. The home’s recruitment policy had also been updated to include information on POVA. The home DS0000004072.V320822.R01.S.doc Version 5.2 Page 18 employs a number of workers from abroad. The files evidenced that the home was obtaining the right sort of information about people’s rights to work in the country and any restrictions on that work. Records are kept of training that staff undertake. These records showed that staff have access to a good range of training and receive their regular mandatory updates. Induction is delivered in line with skills for care and one member of staff spoken to confirmed that induction was both thorough and relevant. All staff had received training in dementia, person centred care and in supporting those with challenging behaviour. The Registered manager has very good links with local authority training providers and actively promotes staff learning and development. The way the staff were conducting themselves in the home and working with the residents on the day of the inspection demonstrated that the training had been understood and was being applied in practice. Five of the eight key care staff is qualified nurses in their home countries however none of the staff team has yet achieved NVQ. The registered manager confirmed that three are due to begin studying for this qualification within the next few weeks. DS0000004072.V320822.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 37 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home benefits from an experienced manager and team whose roles and responsibilities are clearly defined, which ensure that all aspects of the home are well covered. The home does review its performance through a programme of consultations, which include seeking the views of residents, staff, relatives and other visitors to Pinewood Tower to ensure the home is run in the best interests of residents. Residents are assured of sound management of their financial interests. The health, safety and welfare of service users and staff are promoted and protected. DS0000004072.V320822.R01.S.doc Version 5.2 Page 20 EVIDENCE: There are clear lines of accountability within the home. The registered manager is an experienced nurse and homeowner and ensures that her training is kept up to date alongside the staff team as evidenced in her staff file. Quality assurance questionnaires are distributed annually to relatives, G.P’s district nurses, community psychiatric nurses and care managers although very few of these are ever returned it is recommended therefore that this practice be repeated. Similarly staff views are sought through formal questionnaires, staff meetings and supervision. Resident’s views are sought in an informal manner through their key worker although these are not generally recorded. Given the frailty of most residents it would be difficult for them to express their views in a written document. The philosophy within the home is very much person centred and the registered manager confirmed that resident’s views are regularly sought to ensure the home is meeting their needs. The registered manger confirmed that in order to protect residents it is the policy of the home not to have any involvement in their finances. Therefore, all residents who are unable or do not wish to handle their own affairs, have a relative or other representative to deal with their finances. Residents are encouraged not to bring in items of value into the home. The home pays for services such as chiropody and hairdressing and this is then invoiced to residents, relatives or representatives for payment. The accident and injury book was inspected and it was clear that the home was notifying the commission for social care when there was a major incident within the home. However this must be extended to any incident, which may adversely affect the well-being or safety of any service user. All staff had undertaken fire safety training at the required intervals, and fire drills had included various scenarios. Staff had undertaken appropriate health and safety training including moving and handling and infection control. A tour of the premises demonstrated that routine maintenance and refurbishment work was being implemented. A recommendation made at previous inspections to monitor and maintain hot water temperatures to control the risk of Legionella has been regularly implemented and the COSHH manual has been updated. A recent environmental health inspection revealed no concerns and the registered manager confirmed that the fire safety report revealed good standards are maintained at the home. DS0000004072.V320822.R01.S.doc Version 5.2 Page 21 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 4 8 4 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 4 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 DS0000004072.V320822.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement A minimum of 50 of care staff employed by the home must have NVQ level 2 or equivalent. (repeated requirement from previous inspection remains ongoing) The home must give notice to the Commission of any significant events affecting residents. These must include serious falls and associated injuries. Timescale for action 1. OP28 18(1)(c) 22/06/07 2. OP37 37 22/12/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Registered manager should continue to develop quality assurance methods based upon seeking the views of service users and other interested parties, to ensure success in achieving the aims and objectives of the home. The outcomes of which should be provided to supporters and service users in a format, which can be easily understood. 1. OP33 DS0000004072.V320822.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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