Inspection on 14/11/06 for Pinxton Manor Nursing Home

This inspection was carried out on 14th November 2006.

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

Pinxton Manor Nursing Home 19/01/09

Pinxton Manor Nursing Home 08/09/05

Pinxton Manor Nursing Home 04/07/05

Pinxton Manor Nursing Home 23/11/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Pinxton Manor Care Home Church Street West Pinxton Derbyshire NG16 6NA Lead Inspector Rose Veale Unannounced Inspection 14th November 2006 10:00 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 Pinxton Manor Care Home DS0000062064.V318979.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. Pinxton Manor Care Home DS0000062064.V318979.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Pinxton Manor Care Home Address Church Street West Pinxton Derbyshire NG16 6NA 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) 01773 819191 pinxman@hotmail.com Pinxton Manor Ltd Mrs. Shona Akbar Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Pinxton Manor Care Home DS0000062064.V318979.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th September 2005 Brief Description of the Service: Pinxton Manor is situated in the village of Pinxton, close to Junction 28 of the M1, on the boundaries of Derbyshire and Nottinghamshire. The home is modern and purpose built. Accommodation for residents is on the ground and first floors of the home. There is a garden and large patio area accessible to residents. The home provides personal care and nursing care for up to 40 older people. The fees range from £308.50 to £340.10 per week for residents assessed as requiring personal care, and from £387.15 to £480.15 for residents assessed as requiring nursing care. This information was provided by the home’s administrator on 17/11/06. Pinxton Manor Care Home DS0000062064.V318979.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 took place over 7 hours. The inspection visit focused on assessing compliance to requirements made at the previous inspection and on assessing all the key standards. There were 40 residents accommodated in the home on the day of the inspection, including 19 residents assessed as needing nursing care. 4 residents, 3 visitors and 6 staff were spoken with during the visit, plus the registered manager and the administrative manager. Some residents were unable to contribute directly to the inspection process because of communication difficulties, but they were observed during the visit to see how well their needs were met by staff. Records were examined, including care records, staff records, maintenance, and health and safety records. A tour of the building was carried out. A questionnaire had been completed and returned by the home prior to the inspection. Surveys were sent out to a sample of residents and 5 of these were returned. Information from the questionnaire and surveys has been included in the body of this report. The inspection visit included a thematic enquiry. This consisted of asking a number of standardised questions to a sample of residents / their representatives. This was part of a national pilot scheme. The registered manager was informed and the agreement of residents / their representatives was sought in advance of asking the questions about the care they receive. What the service does well: What has improved since the last inspection? Pinxton Manor Care Home DS0000062064.V318979.R01.S.doc Version 5.2 Page 6 All of the requirements made at the last inspection had been met. This had resulted in improvements to care records, staff training and staff records. New staff had been recruited and staffing levels had been improved. Work had been carried out to improve the décor and furnishing of the home, and also to improve the bathrooms and toilets. There was a clear commitment from the provider to ensure the home was well maintained. 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. Pinxton Manor Care Home DS0000062064.V318979.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 Pinxton Manor Care Home DS0000062064.V318979.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): 1, 2, 3 and 6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The information available about the home and the needs assessment process was sufficient to ensure residents had confidence that the home could meet their needs. EVIDENCE: The Service User Guide for the home was in the ground floor office at the home and was said to be available to residents / their representatives on request. Individual copies had not been provided. None of the residents / their representatives spoken with were aware of the Service User Guide. Individual contracts / statements of terms and conditions were seen in residents’ records. The 4 contracts seen had been signed by the resident’s representative. The contracts included all the required information, except a breakdown of the fees payable to show the amount for nursing care. The contracts were amended during the inspection visit to include this information. Pinxton Manor Care Home DS0000062064.V318979.R01.S.doc Version 5.2 Page 9 None of the residents spoken with were aware of the contract as all said they relied on a relative to deal with contracts and fees. 1 of the residents’ representatives spoken with was aware of the contract. 3 of the residents / their representatives said they had been informed of annual changes in the fees payable. 1 resident had recently moved into the home and so had not been affected by changes in fees. The care records of 4 residents were examined. All the records included assessments of the needs of the residents, including assessments from hospital or social services. The home had completed assessments including manual handling, nutrition, tissue viability, oral health, and risk assessments where appropriate. The assessments seen had been regularly reviewed and updated, mostly monthly – this was an improvement since the last inspection when it was found that some assessments had not been completed or reviewed. Each record had a care plan produced from the assessment information. Residents / their representatives spoken with said that their needs had been assessed before coming to the home. All said that this was by hospital staff or the care manager. All said that their needs were met at the home. Standard 6 does not apply to this service. Pinxton Manor Care Home DS0000062064.V318979.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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There were good care records and effective staff training so that residents’ health and personal care needs were met, including promotion of their privacy and dignity. EVIDENCE: The 4 care records examined each included a care plan. 2 of the care plans seen covered all of the assessed needs of residents. 2 of the care plans included most of the assessed needs, 1 did not include specific details of the action staff needed to take regarding pressure area care, and 1 did not include details of the assistance required with maintaining oral health. All of the care plans had been reviewed at least monthly. There was evidence on 1 care plan that the resident’s relative had been involved in care planning and review. Residents and their relatives spoken with, and those who responded to the surveys, said that their needs were met at the home, and that staff were competent to meet their needs. The staff training records showed that staff Pinxton Manor Care Home DS0000062064.V318979.R01.S.doc Version 5.2 Page 11 had received a range of training appropriate to the needs of residents, such as moving and handling, oral health, dementia awareness, and safeguarding vulnerable adults. Staff spoken with were knowledgeable about the care needs and personal preferences of residents. Records were seen of the input of healthcare professionals, such as GP, District Nurse and chiropodist. Residents and their representatives said that the home contacted the GP when necessary and that other health services were made available to them, such as dentist and optician. Residents and relatives said staff respected their privacy and dignity, for example, by knocking on doors before entering and addressing residents by their preferred name. Staff were observed giving assistance in a sensitive way with eating and drinking and manual handling. There was a comprehensive policy for the safe handling of medication in the home. The registered nurse on duty administered medication for all residents in the home. Medication storage was satisfactory and records were seen of the receipt and disposal of medication. The Medication Administration Records, (MARs), were seen and were generally correctly completed. Some MARs had handwritten entries which had not been signed by the person writing them or signed by another member of staff to show the entry had been checked as correct. This is considered good practice as referred to in the Royal Pharmaceutical Society guidelines for the administration of medication in care homes. Pinxton Manor Care Home DS0000062064.V318979.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 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There was a limited range of activities and a lack of flexibility in routines so that residents’ needs and preferences were not fully met. EVIDENCE: The care records seen included details of activities residents had taken part in, such as trips out, a regular church service, and entertainers coming into the home. The home did not employ an activities coordinator and there was no structured approach to providing a range of activities to meet the needs of residents. Care assistants were encouraged to carry out activities, such as a game of dominoes or chatting with residents. Residents, their representatives and staff spoken with said the care staff did not usually have time to organise activities. One resident commented that they could get up and go to bed when they wanted to. One resident commented that they were able to choose what to eat and that staff helped them to choose what to wear each day. Residents were encouraged to bring their own possessions into the home to personalise their bedrooms. For residents who could not express their preferences, there Pinxton Manor Care Home DS0000062064.V318979.R01.S.doc Version 5.2 Page 13 was evidence of some lack of flexibility in routines. For example, one resident commented that residents were assisted to the dining rooms by staff sometimes 30 minutes before the meal was served; a comment was noted that some residents were assisted to bed soon after tea: another comment was that most residents were assisted to their bedrooms before the night staff came on duty at 8pm. Visitors spoken with said they were always made welcome and were able to visit at any reasonable time. One visitor was pleased that they were able to remain involved in the personal care of the resident. One visitor said that they were always greeted warmly by staff. Residents / their representatives said that meals at the home were good and that there was always a choice available. There was a dining room on each floor of the home. Most residents ate their main meals in the dining room, some chose to eat in their bedrooms. There were several residents who required assistance with eating and drinking. 3 residents / their representatives spoken with commented that care staff were very busy at lunchtimes. Kitchen staff spoken with were knowledgeable about the nutritional needs and preferences of the residents. Residents / their representatives were asked about meals as part of the home’s quality assurance process. Pinxton Manor Care Home DS0000062064.V318979.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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There were effective policies in place and good staff awareness so that residents were protected and their concerns properly dealt with. EVIDENCE: The complaints procedure was displayed in the main entrance area. Records were kept of complaints, though none had been received by the home since the last inspection. No complaints had been received by CSCI about the home since the last inspection. Residents / their representatives spoken with were aware of the complaints procedure but none had made a formal, written complaint. 2 representatives of residents had made complaints verbally to the staff or the manager. They said their complaints were dealt with promptly and effectively. The training records seen showed that most of the staff had received training in safeguarding vulnerable adults. Staff spoken with confirmed they had received training and were aware of the procedures to follow. Pinxton Manor Care Home DS0000062064.V318979.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 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was clean and well maintained so that residents lived in a safe and pleasant environment. EVIDENCE: Improvements had been made to the home since the last inspection, such as redecoration and new floor covering in toilets and bathrooms, new chairs provided in the lounges, and a new shower room created. Work was continuing on the day of the inspection visit to improve a ground floor bathroom. The manager said that there were plans to replace the carpet in the lounge and dining area on the ground floor. Safety magnetic catches had been installed to all doors leading to the stairs to reduce the risks to residents. A tour of the home was carried out, looking at some of the bedrooms, the communal areas, the laundry, bathrooms, toilets and sluices. The bedrooms Pinxton Manor Care Home DS0000062064.V318979.R01.S.doc Version 5.2 Page 16 seen were pleasant, comfortable and personalised with residents’ own possessions. The lounges and dining rooms were comfortable and homely. All areas of the home were clean and free from offensive odours. Residents and relatives spoken with, and responses from the surveys, said that the home was always clean. The laundry was suitably equipped and well organised. Staff had received training in the control of infection. During the inspection visit staff were observed to wear disposable gloves and aprons when assisting with personal care, and disposable aprons when assisting with meals. Pinxton Manor Care Home DS0000062064.V318979.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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There were thorough recruitment practices, a good staff training programme and adequate staffing levels so that residents were protected and well supported. EVIDENCE: The staff rotas were seen. The planned staffing levels of 6 care assistants on duty between 8am and 8pm had been achieved for most days in the last month. Staff spoken with confirmed that there were usually 6 care assistants on duty during the day. They said that it was usually possible to cover shifts when required, except for sickness at very short notice. This had happened the previous weekend. Staff spoken with said that staffing levels had improved since the last inspection as new staff had been recruited and an additional care assistant was on duty from 2 – 8pm, (previously there had been 5 care assistants on duty at this time). At the last inspection it was found that some staff were working long stretches of shifts without a break. This was not seen on the staff rotas at this inspection and staff spoken with confirmed that this did not happen now. Residents / their representatives spoken with, and those responding to the surveys, said that there were generally enough staff on duty to meet their Pinxton Manor Care Home DS0000062064.V318979.R01.S.doc Version 5.2 Page 18 needs. There were 3 comments that staff were particularly busy at mealtimes because there were several residents needing assistance with eating. There was 1 comment that the resident had to wait sometimes for assistance to use the toilet as staff were so busy. Care staff spoken with agreed that that mealtimes and the morning shift were usually very busy. They said they would like more time to spend on giving residents individual attention. The records of 4 members of staff were seen. All the records seen included the required information, and also individual training information. A detailed record was kept of all the training carried out so that gaps and training due were clear. Staff recruitment and training records had improved since the last inspection. Staff induction records were included in the staff files seen and had been completed for 3 members of staff. The induction record for 1 member of staff had not been completed and it was explained that this was because the formal induction process did not commenced until staff had been in post for about 3 months. The National Minimum Standard (30) is that staff should receive induction training within 6 weeks of appointment to their posts. Staff training records showed that all the required training was up to date, such as manual handling, first aid and basic food hygiene. Some staff had received other training specific to the needs of residents, such as dementia awareness and oral health care. More than 50 of the care staff were working towards or had already achieved NVQs in care. Staff spoken with were pleased with the training programme at the home. Pinxton Manor Care Home DS0000062064.V318979.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 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was well organised and there were good systems in place so that the health, safety and welfare of residents was promoted and protected. EVIDENCE: The manager is a registered nurse and has several years management experience. The rota for the manager and the nurses showed that the manager continued to work as the nurse in charge for 3 or 4 shifts each week. This had improved since the last inspection when the manager was regularly working between 5 and 8 shifts as the nurse in charge. The manager had more supernumerary time to complete necessary managerial and administrative tasks and this would be improved by having a nurse in charge on duty for all shifts. Pinxton Manor Care Home DS0000062064.V318979.R01.S.doc Version 5.2 Page 20 There was a quality assurance system in place. Surveys were sent to residents, relatives, staff and visiting healthcare professionals to assess satisfaction with the service. The results were analysed and an annual development plan written. The annual development plan had been reviewed and updated. The results had not been made available to residents / their representatives. The provider visited the home regularly and produced monthly reports. Most of the residents had some personal money held by the home to pay for items such as toiletries, hairdressing and chiropody. Records and receipts were kept of all transactions. The money was held securely and accessible only to the manager and administration manager. Records relating to health and safety and maintenance were sampled. The records seen were well kept and up to date. The manager had recently carried out an audit of accident records, looking at the incidence of falls and the action to reduce risks. Since the last inspection, all staff had received training in manual handling and the home’s policy had been reviewed and updated. Pinxton Manor Care Home DS0000062064.V318979.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 2 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 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 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Pinxton Manor Care Home DS0000062064.V318979.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO 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 OP1 OP9 Good Practice Recommendations Residents / their representatives should be made aware of how obtain a copy of the Service User Guide. Handwritten entries on Medication Administration Records, (MARs), should be signed by the person making the entry then countersigned by another person who has checked the entry as correct. A structured programme of activities should be developed in consultation with residents / their representatives to ensure their needs and preferences are met. An activities coordinator should be appointed to facilitate the activities programme. All staff should receive induction training to Skills for Care specification within 6 weeks of appointment to their posts. A report of the findings of the quality assurance surveys with details of the action to be taken to address issues raised should be made available to residents / their representatives. DS0000062064.V318979.R01.S.doc Version 5.2 Page 23 3. 4. 5. 6. OP12 OP12 OP30 OP33 Pinxton Manor Care Home Pinxton Manor Care Home DS0000062064.V318979.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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. Extracts may not be used or reproduced without the express permission of CSCI Pinxton Manor Care Home DS0000062064.V318979.R01.S.doc Version 5.2 Page 25 - 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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