Inspection on 28/07/05 for Pinhay House

This inspection was carried out on 28th July 2005.

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

Pinhay House 21/09/07

Pinhay House 23/06/06

Pinhay House 04/01/06

Pinhay House 20/01/05

Pinhay House 29/07/04

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 Pinhay House Rousdon Lyme Regis Dorset DT7 3RQ Lead Inspector Anita Sutcliffe Unannounced 28th. July 2005 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. Pinhay House D54-D06 S22010 Pinhay V232098 280705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Pinhay House Address Rousdon Lyme Regis, Dorset, DT7 3RQ 01297 445626 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) The Pinhay Partnership Mrs Carole Jane Hodges Care Home 25 Category(ies) of DE(E) Dementia - over 65(25) registration, with number OP Old Age (25) of places Pinhay House D54-D06 S22010 Pinhay V232098 280705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 20/01/05 Brief Description of the Service: Pinhay House provides accommodation and personal care for up to 25 older people who may suffer from mild to moderate dementia. The home is unable to care for people with severe dementia, or people who may display aggressive or unsociable behaviour. It is owned by The Pinhay Partnership. The property is a large converted Grade II listed mansion house standing at the end of a long drive approximately 2 miles from Lyme Regis. Bedroom accommodation is situated on the ground and first floors. There is a stair lift to the first floor but there are further steps that service users may have to negotiate. There are sea views to the front of the house and other rooms overlook the surrounding countryside. There is a large entrance hall, lounge/dining room and various quiet sitting areas throughout. Many of the rooms retain interesting period features and are large, bright and airy. Pinhay House D54-D06 S22010 Pinhay V232098 280705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place between 11 am and 4 pm. The care of 3 of the 20 residents was tracked. This involved meeting them, reading their care records, visiting their room and talking to them and staff about their needs. All residents were met during the inspection, and most of the home visited. Different activities were observed and the home’s medication arrangements were examined in detail. CSCI information and contact leaflets were left around the home. What the service does well: What has improved since the last inspection? What they could do better: Risk assessments have not been undertaken and this must now be addressed as a priority. The water at a bath was extremely hot, suggesting that the control valve was faulty. In addition, the thermometer in use was faulty, and so increasing the possibility of injury. In some ways the staff approach to dignity is very good, as residents are treated as real people, consulted and given choice. In other ways their approach is poor. This is probably indicative of old habits rather than a lack of respect for residents. A member of staff entered a bedroom without regard for private space, and residents were spoken to in language inappropriate to their age and status. Pinhay House D54-D06 S22010 Pinhay V232098 280705 Stage 4.doc Version 1.30 Page 6 It was confirmed that staff are trained to assist residents to move safely, but out of date practice was seen in use. Care plans must include a falls risk assessment for each resident. None were seen despite the risk being identified at 2 residents’ assessments. However, care plans contained some excellent and detailed information. Medicines were methodically and thoughtfully managed, but there were several areas that need change, the most important being the use of prescribed creams and lotions by other residents. 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. Pinhay House D54-D06 S22010 Pinhay V232098 280705 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 Pinhay House D54-D06 S22010 Pinhay V232098 280705 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 & 6 Care needs are met following thorough assessment. Pinhay House does not provide Intermediate Care. EVIDENCE: Pre admission assessment records included those from health and social services. They provided good detail from which to plan the care of a newly admitted resident. Pinhay House D54-D06 S22010 Pinhay V232098 280705 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 &10 Health and care needs are fully met by staff, but plans of care lack the detail needed to assure safety and consistency. The management of medication was safe, but some areas need to be addressed. Privacy and dignity are not upheld. EVIDENCE: The written plans of how to provide care were mostly satisfactory. However, where a history of falls had been identified at assessment, this had not been risk assessed so that measures could be identified and put in place to reduce the hazard. Other care plans were not fully up to date. In contrast, social care planning was excellent and end of life wishes had been well addressed. Residents said their health care needs were met. They talked of health care workers and complimentary therapists who visit. A visiting occupational therapist said that staff are keen to provide good care, and are receptive to further learning. Staff said that the district nursing service were very supportive and helpful. Pinhay House D54-D06 S22010 Pinhay V232098 280705 Stage 4.doc Version 1.30 Page 10 Medication is handled in a thorough and methodical way. Storage was safe and well organised. Senior staff have received training in how to handle medicines safely. However, staff have used creams and lotions for residents for whom they were not prescribed. When taking medicines around the home to administer them they are carried in an open box, which would leave them unsafely stored should an emergency arise and they have to be left unattended. Some good practice recommendations have been made to improve the handling of medication at the home. Staff were observed entering a resident’s bedroom without waiting to be invited in. Other staff were observed using age-inappropriate language to residents. Pinhay House D54-D06 S22010 Pinhay V232098 280705 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 & 14 Residents benefit from a daily life where social need and individual preference is recognised and very well met. EVIDENCE: The home provides activities to a commendable standard. There are regular events at the home which help residents to stay both physically and mentally fit. Residents were engaged in a quiz during the inspection. They also attend local community events, and spoke of a recent village fete. Many forthcoming events were advertised. Evidence of the desire to provide a good, quality service included, residents being asked if they wanted music or a ‘quiet time’ during lunch, dinner trays attractively and individually laid, and the lounge and dining areas being especially homely and comfortable. Many bedrooms were also very personalised. Residents’ care planning records contained very detailed information from which social, cultural, religious and recreational needs could be planned and met. Staff understood how residents liked to spend their day and assisted them to do so. However, it was said by residents and staff that there is less time available for them to chat that there used to be and they miss it. Visitors were made welcome and the atmosphere at the home was relaxed. Pinhay House D54-D06 S22010 Pinhay V232098 280705 Stage 4.doc Version 1.30 Page 12 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) These standards were not inspected on this occasion. EVIDENCE: Pinhay House D54-D06 S22010 Pinhay V232098 280705 Stage 4.doc Version 1.30 Page 13 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) 25 Residents were not protected from hot water or uncovered radiators. EVIDENCE: The home benefits from large windows and much natural light. It was warm and well ventilated. The previous requirement to cover radiators to prevent contact burns was within the agreed timescale, but only by one day. Many radiators had been covered, but there were still many to do. Bath hot water temperatures were taken with the home’s own thermometers. It was found to be very hot at one bath and the thermometer in use was faulty so staff were unable to take a true reading before bathing a resident. Staff said that there was a thermostatic temperature control valve in place to prevent the delivery of very hot water, and that it must have been faulty. They said the fault would be dealt with promptly and the thermometer replaced. Pinhay House D54-D06 S22010 Pinhay V232098 280705 Stage 4.doc Version 1.30 Page 14 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) These standards were not inspected on this occasion. EVIDENCE: Pinhay House D54-D06 S22010 Pinhay V232098 280705 Stage 4.doc Version 1.30 Page 15 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) 38 There are hazards and risks which are not managed adequately. EVIDENCE: This standard was not inspected in full. The fabric of the building and grounds was in a good state of repair. The home employs a maintenance person. The home is very unique and has some wonderful features. However, they present hazards, two of which are full-length doors with single pane non safety glass and first floor balconies. It was a previous requirement that these are risk assessed for the individual and in general. This has not been done. Bath water was extremely hot and the thermometer used to test the water was also faulty (see Standard 25). Where a particular risk had been identified, such as falls (see Standard 7) this had not been assessed. Plans were not in place to reduce the risk. Pinhay House D54-D06 S22010 Pinhay V232098 280705 Stage 4.doc Version 1.30 Page 16 Staff receive training in correct moving and handling technique but were observed using out of date practice when assisting residents from their chairs to go for lunch. Pinhay House D54-D06 S22010 Pinhay V232098 280705 Stage 4.doc Version 1.30 Page 17 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 1 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 x COMPLAINTS AND PROTECTION x x x x x x 2 x STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x x x x x x 1 Pinhay House D54-D06 S22010 Pinhay V232098 280705 Stage 4.doc Version 1.30 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 7 Regulation 15(1)(2) Timescale for action The registered person shall, after 16 consultation with the service September user, or a representative of his, 2005 prepare a written plan as to how the service users needs in respect of his health and welfare are to be met This refers to the need for risk assessment with particular attention to he prevention of falls (previous timescale not met). The registered person shall keep the service users plan under 28 July review. 2005 The registered person shall make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home this refers to: the practice of using prescribed creams and lotions on residents for whom they are not prescribed, and to whom they do not belong Pinhay House D54-D06 S22010 Pinhay V232098 280705 Stage 4.doc Requirement 2. 9 13(2) 28 July 2005 Version 1.30 Page 19 3. 10 12(4) 4. 25 13(4) 5. 38 13(4)(a) & (c) unsafe storage / handling due to carrying medicines in an unlocked container when taking them around the home. The registered person shall make suitable arrangements to ensure that the care home is conducted in a manner which respects the privacy and dignity of service users [this refers to staff not knocking and waiting to be invited into bedrooms, and the use of infantile language to service users] Radiators must be guarded to prevent the risk of accidental burns. (This requirement was still within timescale from previous inspection, but has been extended). The registered person shall ensure that all parts of the home which service users have access are so far as reasonably practicable free from hazards to their safety & unnecessary risks to the health and safety of service users are identified and so far as possible eliminated. This refers to: environmental hazards not being risk assessed in general and on an individual basis as appropriate (previous timescale of 31/03/05 not met) very hot bath water (temperature control valve faulty) and a faulty thermometer with which to test the water the use of out of date moving 16 September 2005 28 July 2005 31 Dec 2005 16 September 2005 12 August 2005 Pinhay House D54-D06 S22010 Pinhay V232098 280705 Stage 4.doc Version 1.30 Page 20 and handling practice when assisting service users to raise from their chair. 28 July 2005 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. 3. 4. 5. Refer to Standard 9 9 9 Good Practice Recommendations Hand written entries should be checked by 2 staff members and signed by both. Medicines should be returned to the pharmacy and not stored in case of further use; especially controlled drugs. Controlled drugs should be stored in a metal cupboard, which complies with the Misuse of Drigs (Safe Custody) Regulations 1973. Pinhay House D54-D06 S22010 Pinhay V232098 280705 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Suite 1, 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. Extracts may not be used or reproduced without the express permission of CSCI Pinhay House D54-D06 S22010 Pinhay V232098 280705 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. 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