Inspection on 19/01/09 for Pinxton Manor Nursing Home

This inspection was carried out on 19th January 2009.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Pinxton Manor Nursing Home 14/11/06

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 13/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Pinxton Manor Nursing Home Church Street West Pinxton Nottingham NG16 6PX     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Angela Kennedy     Date: 1 9 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 31 Information about the care home Name of care home: Address: Pinxton Manor Nursing Home Church Street West Pinxton Nottingham NG16 6PX 01773819191 Telephone number: Fax number: Email address: Provider web address: pinxman@hotmail.com Name of registered provider(s): Name of registered manager (if applicable) Mrs Shona Akbar Type of registration: Number of places registered: Pinxton Manor Ltd care home 40 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Pinxton Manor Limited is registered to provide nursing, personal care and accommodation for service users whose primary needs fall within the following categories :- Old age not falling within any other category (OP) 40 Dementia aged 65 years and over DE(E) 6 The maximum number of persons to be accommodated at Pinxton Manor is 40 Date of last inspection Brief description of the care home 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. At the time of this visit the fees ranged from £336.42 to £465 for residential care. For nursing care the fees ranged Care Homes for Older People Page 4 of 31 Over 65 6 40 0 0 Brief description of the care home from £466.57 to £568. Further information can be obtained in the homes Statement of Purpose and Service User Guide and by contacting the Registered Manager. Care Homes for Older People Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The last key inspection of this service was undertaken on the 14th November 2006. This key inspection was unannounced and took place over eight hours. Key inspections take into account a wide range of information and commence before the site visit by examining previous reports and information such as any reported incidents. The site visit is used to see how the service is performing in practice and to meet with the people using the service. The focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for people using the service and their views on the service provided. This process considers the providers and registered managers capacity to meet Care Homes for Older People Page 6 of 31 regulatory requirements, minimum standards of practice and focuses on aspects of service provision that need further development. An Annual Quality Assurance Assessment (AQAA) had been completed by the service. This is a self-assessment for providers which is a legal requirement. This assessment gives the provider and registered manager an opportunity to let us know about their service and how well they think they are performing. The information provided in the AQAA is reflected within this report. At this inspection visit three people were case tracked. Case tracking is a method used to track the care of individuals from the assessments undertaken before they are admitted to a service through to the care and support they receive on a daily basis. This includes looking at care plans and other documents relating to that persons care, talking to staff regarding the care they provide and if possible talking to the individual. Two people case tracked were able to express their views of the service and the support it provided. Other people living at the home that were not case tracked were also spoken with. Their views of the service and the care and support provided are included within this report. Two members of staff were spoken with at some length and their views and opinions of the care provided, the support and training given to them is included within this report. The comments provided within three surveys received from the people living at the home, seven relatives surveys and five staff surveys are also reflected throughout this report. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get Care Homes for Older People Page 8 of 31 printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 31 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Assessments are undertaken prior to admission to ensure individuals needs can be met by the service. Evidence: The records of three people living at Pinxton Manor were looked at. All three had records in place to demonstrate that an assessment of their needs had been undertaken before admission to the service was agreed.This enabled the home to ascertain that they could meet individuals needs before admission was agreed. The records seen included assessments that had been undertaken by the hospital or social services for individuals whose care was funded. For people who were privately funded an assessment was undertaken by the manager of the home prior to admission. The homes assessment covered all areas of daily living and the support that was required. Care Homes for Older People Page 11 of 31 Evidence: From the initial assessments undertaken care plans and assessments had been developed to ensure individuals were supported appropriately to enable their needs to be met. As stated in the pre-inspection self-assessment some of the people spoken with confirmed that they were able to visit the home prior to admission. This gave them an opportunity to meet some of the staff and other people living at the home and an a chance to look around the home at the decor and facilities available. From the comments received by the people using the service it was confirmed that they had received enough information about the home to enable them to make a decision about its suitability for them. One person spoken with confirmed this by saying, yes I had plenty of information, Im glad I chose here its the best thing I ever did, I think its great here Standard 6 does not apply to this service. Care Homes for Older People Page 12 of 31 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health and personal support needs were met and the medication practices in place ensured that people were supported to take their medicines in a safe way. Evidence: The records of the three people case tracked included plans of care. As stated in the pre-inspection self-assessment the records demonstrated that care plans had been drawn up with the involvement of individual or their representatives. Signatures were in place to demonstrate this.The care plans seen had been reviewed on a monthly basis by the team leader or registered nurse and updated as required to reflect the changing needs of individuals. Two of the plans of care seen covered all areas of assessed needs.This included all areas of health care and personal support needs. The other persons records addressed most areas of assessed need but did not included specific details of the actions that staff needed to take to ensure this persons Care Homes for Older People Page 13 of 31 Evidence: nutritional requirements were maintained. The records held for this person clearly demonstrated that staff had been vigilant in recording the weight and nutritional intake of this person. However although they had clearly identified this and showed that there had been a gradual weight loss, no care plan or risk assessment had been drawn up to provide any actions or intervention that may be required to address this. As stated records of weight were in place. However it was noted that weight recording charts did not include a column that identified if the persons weight had remained consistence or if they had lost or gained any weight. This information would be useful in enabling and alerting staff to identify changes in weight that may occur over a period of time, which then would prompt a review of an individuals nutritional needs. Of the three peoples care records seen, one had a completed record of their life history. In the other two peoples records these forms were in place but had not been completed. The information seen in the completed form included details of place of birth and family life such as number of siblings, school life, and work history and information on marital status, children, grandchildren and hobbies and interests. It also included likes and dislikes. This provided staff with a much greater understanding of this person, which allowed them to identify this individuals holistic needs enabling a more person centred approach to care to be given. Comments from relatives indicated that the support provided was good, comments included help with personal care is very good and the staff are caring and the quality of care is second to none and has improved greatly over the years. I would have no hesitation recommending the home. The records seen demonstrated that peoples health care needs were met as required. Records seen showed that doctors, district nurses, dentists, chiropodists and other health care professionals were accessed as required. On the day of this visit one district nurse visiting the home was spoken with and said this is one of the best homes I come to. The staff are great, very helpful and work well with us Comments from people living at the home also confirmed that health care needs were met as required, one person said the doctor always visits when needed.Relatives also confirmed that any health concerns were promptly addressed by the home. Observations of staff with people living at the home demonstrated a respectful and dignified approach to the support given. People spoken with also confirmed that staff were respectful towards them. People were addressed by their preferred name. The Care Homes for Older People Page 14 of 31 Evidence: care plans seen made reference to the importance of providing support in a dignified and respectful way. The medication practices and records were looked at and found to be satisfactory.The registered nurse on duty administered all prescribed medications and the records seen demonstrated that medications were administered as prescribed. No errors were seen on administration records and medication was stored correctly.One person living at the home had chosen to store and administer some of their prescribed medication and a completed care plan and risk assessment was in place that demonstrated that their capacity to do so had been undertaken by a suitably qualified person. Records seen demonstrated that this was reviewed regularly to ensure a safe practice was maintained. Care Homes for Older People Page 15 of 31 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals social and recreational needs can not always be met due to limited resources. People are able to keep in touch with their family and friends and are provided with meals that are enjoyed. Evidence: Improvements have been made to the range of activities and social stimulation available to people living at the home. As stated in the pre-inspection self-assessment an activities coordinator was now in post on a part time basis. The pre inspection self assessment stated that this had improved the quality of individuals leisure time and encouraged them to participate in past activities they once enjoyed such as planting flower pots. This was confirmed with some of the people that were spoken with, who spoke highly of the activities that were provided. One person, said Im happy to join in with everything, I think its great. A list of scheduled activities for the month was in place in the porch area at the entrance to the home. The types of activities written on the notice board included, board games, quizzes, word searches, hairdresser, nail care,reminiscence activity, pat Care Homes for Older People Page 16 of 31 Evidence: the dog and outside entertainment such as quizzes and sing a longs. It was noted that activities were not recorded for every day. Discussions with the manager confirmed that when the activities coordinator was not on duty scheduled activities did not take place. Some staff were seen chatting with individuals throughout the course of this visit but no group activities were observed and individuals were generally sitting either in communal areas or in their own bedrooms. As stated above some people openly welcomed activities and discussed some of the activities that they enjoyed. This included the chair excercise classes that were provided by an external person who provided mobility classes twice a month and craft work they had undertaken with the activities coordinator. Some people spoken with said that they didnt join in with activities as they preferred not to and stated that they would rather spend time in their room as they preferred their own company. Discussions with the registered manager regarding the availability of activities took place and it was agreed that additional hours for an activities coordinator would benefit those people who did enjoy participating or watching activities. The manager stated that the activities coordinator had been booked onto training that was specifically for activities coordinators to develop their skills and knowledge. People spoken with confirmed that the culture of the home enabled them to spend time where they preferred. As stated above some people preferred to spend most of their day in their room and the staff respected this, although records in care plans seen demonstrated that where this was identified staff were alerted to the risk of social isolation for these individuals and actions were put in place to manage this. For example two people spoken with confirmed that staff often visited them for a chat and to check they were o.k. They also confirmed that staff encouraged them to eat in the dining room. People spoken with confirmed that they were able to choose when they went to bed and the time they got up. One person said, I can pretty much suit myself, its not a problem here, theyre very good. Comments from relatives and friends confirmed that they were made welcome by the staff team and this was observed on the day of this visit.Comments from visitors included, there is a homely and friendly approach and friendly and approachable staff and the staff are approachable and open to comment or criticism. Positive comments regarding the quality, choice and variety of meals was made by everyone spoken with and in the surveys returned. The menus demonstrated that alternative dishes to the main meal were always available. One person spoken with said, The meals are very good, Im very fussy about what I eat but they always provide me with meals that I enjoy. Care Homes for Older People Page 17 of 31 Evidence: Specialist diets such as diabetic and soft diets were provided for people that required them. There was a dining room on both floors where the majority of people took their meals. However some people did prefer to eat their meals in their room and staff respected their wishes. One person spoken to confirmed this saying, I always prefer to eat alone, its what Im use to, the staff are very good and my meals are always nice. As stated in the pre-inspection self-assessment the birthdays of the people living at the home were always celebrated with a special cake and records of each persons birthday was seen in the managers office. This ensured everyone was remembered. Care Homes for Older People Page 18 of 31 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People at the home and their visitors know that any concerns they have will be addressed and actions taken to put things right. The practices in place safeguard the people at the home from abuse. Evidence: The home kept detailed and secure information on the complaints they had recieved since the last inspection visit. This included information on the actions they had taken and the outcome of the complaints. In the pre-inspection self-assessment the manager had stated that the home had recieved four complaints since the last inspection visit. All of these complaints had been addressed and the correct actions taken. We had two complaints since our last visit to the service and returned these to the provider to investigate. These two complaints are included in the four mentioned above and at the time of these complaints we recieved satisfactory responses from the service that demonstrated that these complaints had been thoroughly investigated. The complaints procedure for the service was displayed in the main entrance area and comments from people and visitors to the home confirmed that they knew how to make a complaint and were confident that any concerns or complaints they had would Care Homes for Older People Page 19 of 31 Evidence: be listened to and acted upon appropriately. One relative said, complaints are often dealt with there and then to a satisfactory outcome. Another relative said, if I raise any issues about my grandfathers needs they are seen to straight away. This demonstrates that any concerns raised are dealt with promptly and actions are taken to put things right. The training records demonstrated that staff undertook training in safeguarding adults at their induction and then at regular intervals to update their knowledge and practice. Staff spoken with had a good understanding of the procedures that should be followed in the event of any safeguarding concerns and confirmed that they had attended safeguarding training. The home has not made or had any safeguarding referrals or investigations since their last inspection visit. In the pre-inspection self-assessment the manager had stated that the homes policy on Safeguarding Adults and the prevention of abuse had been reviewed in August 2008. This indicates that the policy in place will ensure that up to date practices are in place for staff to follow. The safeguarding policy was not looked at during this inspection visit. Care Homes for Older People Page 20 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean and well maintained home that generally meets their needs. Evidence: The home appeared clean, tidy and well maintained throughout. Since the last key inspection at the service the home has varied their registration to include 6 beds for people with dementia in the older persons category.At the time of this variation to their registration it was identified by us that some areas required further development to ensure the service was suitable for people with dementia. This included further development to the environment such as visual cues and signs to assist people with dementia to enable them to recognise their environment and enhance their orientation to time and place. The manager confirmed that signs had been put on toilets and bathrooms to assist people with dementia and that the lightimg in the corridors had been improved. Discussions took place regarding the various ways that the environment could be further developed to enhance the environment for people with dementia. The garden was accessed via the front basement entrance. The garden was safe and secure and where previously side areas had been open, these had now been secured with panelled fencing and a secure rear gate.The manager discussed plans to secure the front entrance to the home. Care Homes for Older People Page 21 of 31 Evidence: In the pre-inspection self-assessment the manager had stated that in the last twelve months the home had purchased new profiling beds and accessories, bedroom chairs including recliners and bed tables. Other new equipment included a new washing machine, a large screen tv/dvd and music centre. All of these were seen during a tour of the building. The laundry area was visited, this contained suitable equipment to ensure the laundering needs of the people living at the home could be met . The laundry was staffed every morning including weekends. It was confirmed that the care team supported the laundry staff at other times to ensure all garments were laundered efficiently. People spoken with were happy with the laundry service provided.One person commented, clothes are are always well laundered. Communal lounges seen provided comfortable chairs for people to sit in and were pleasantly decorated. The manager discussed ideas to convert certain areas of the home to enable smaller lounge areas to be provided to enable a more homely environment for individuals who may prefer to sit with smaller groups of people. Some people were visited in their bedrooms. The bedrooms seen were attractively decorated and had been personalised to reflect each persons own preferences and tastes. The kitchen was visited and appeared well organised, clean and tidy. Information regarding special diets was made available to the catering team and from discussions with the cook it was evident that she had a good understanding of the dietary needs and requirements of the people she prepared and cooked meals for. Training records demonstrated that staff had undertaken training in infection control and the practices observed throughout the day demonstrated that staff were aware of the need to use personal protective equipment when undertaking cerrtain tasks, such as personal care support and food preparation. Comments from people living at the home and their relatives confirmed that the home was maintained to a good standard of cleanliness. Comments included, good housekeeping, uncluttered areas, well maintained and the appearance of the rooms is good as are the hygiene standards and dads room is clean and well decorated Care Homes for Older People Page 22 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by a trained and competent staff team. The recruitment practices in place ensure that people are supported by staff that are suitable to care for them. Evidence: The staffing rotas for the last month, including the week of this visit were looked at. The rotas demonstrated that there was usually a total of seven staff on duty in the mornings, six in the afternoon and early evening and 4 night staff. These figures included a registered nurse on each shift. Staff comments indicated that they felt the staffing levels were generally adequate to meet peoples needs although some staff did comment that additional staff would benefit individuals as staff would have more time to spend with each person.The manager confirmed that she had been given additional hours for a full time registered nurse which would benefit staffing levels and the support provided to care staff. From the comments made on the day of this visit and in the surveys returned by the people living at the home and their relatives no comments regarding the staffing levels were made. People that were asked said they felt there was enough staff on duty to meet peoples needs. Comments regarding the staff team included, theres a low turn over of staff, particularly in nursing staff which reflects the standard of care and Care Homes for Older People Page 23 of 31 Evidence: attentive and conscientious nursing and care staff. The recruitment records for three members of staff were looked at and all had the required documents in place to demonstrate that a thorough recruitment practice was in place at the home. All of the checks and records required by law were in place to ensure the staff employed were safe to care for the people living at the home. Training information was in place within the staff files seen and this included induction training, mandatory training, and training that was relevant to the needs of the people living at the home.The training undertaken included moving and handling, safeguarding adults, fire safety, first aid, person centred care, diabetes and dementia awareness. NVQ certificates were also on file to evidence staff qualifications.As stated in the pre-inspection self-assessment, improvements had been made to the induction training provided and evidence was in place to demonstrate that this had been undertaken within 6 weeks of employment. Information within one staff surveys stated, inductions are carried out by senior staff and everything is discussed and explained. Senior staff sign off when they feel staff are confident and this is countersigned by new staff, giving them a chance for any questions if they are unsure of anything. Training records showed when training had been undertaken and when it was due for renewal and this ensured staff remained up to date in their training needs.A list of forthcoming training and staff that were due to attend was seen in the managers office. Staff spoken with confirmed that the training provided was to a good standard and was provided on an ongoing basis. One survey said, the management provide all staff with the necessary training. All care staff had either done or were in the process of undertaking NVQ training except for new starters. All four of the team leaders had an NVQ4 in care along with three care staff and the remainder of care staff except for the four recently employed staff had an NVQ at level 2 in care. Staff spoken with on the day of this visit confirmed that they were encouraged to undertake their NVQ3 in care and supported to do this.This demonstrates that the staff team have the relevant training to enhance the support and care they provide to the people living at the home. Care Homes for Older People Page 24 of 31 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living at Pinxton Manor live in safe environment that is managed appropriately and in their best interests. Evidence: There is an experienced registered manager in post who is a registered nurse and has managed this service for several years. Comments from people living at the home indicated that the manager was highly thought of. From the rapport observed between the manager and the people living at the home it was apparent that she had an open and friendly relationship with them. The rotas demonstrated that the manager continued to work as the nurse in charge of a shift when required. Out of twenty of the managers working days, eight had been working as the nurse in charge of a shift, such as an early or a late shift and the other twelve shifts were supernumerary allowing the manager to focus on managerial tasks. As stated earlier in this report another registerd nurse has now been appointed which Care Homes for Older People Page 25 of 31 Evidence: should allow more supernumerary time for the manager. Staff spoken with also indicated that the manager was approachable and commented on her management style which they said was very fair and always ensured they were kept up to date with any changes. One staff survey said, we recieve a lot of support from matron and the nurse in charge Records were seen in staff files to demonstrate that staff were provided with regular supervision and staff spoken with confirmed this. This ensured that the staff team were provided with the support and guidance required to undertake their duties and support people effectively. Records of staff meetings were also in place and these records showed that staff were kept up to date with any issues or change in practice and provided staff with an opportunity to discuss and comment on any issues they had. As stated in the pre-inspection self-assessment a quality assurance system was in place. A published report was seen that demonstrated that surveys had been sent out to people living at the home, their representatives, the staff team and visiting professionals. The audited results of these surveys and the actions taken as a result were recorded within this document.This demonstrated that peoples views were listened to and acted upon to ensure the home is run in the best interests of those living there. The manager stated that these results were on display throughout the home and were available to any interested parties. The majority of people living at the home had some money that was held in safe keeping for them.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 fire safety checks, such as weekly fire alarm checks and weekly emergency lighting checks were seen and demonstrated that peoples safety was ensured through this health and safety practice. Information within the pre-inspection self-assessment confirmed that equipment used in the home, such as lifts, hoists, gas appliances and electrical equipment and circuits had been serviced or tested as recommended by the manufacturers or other regulatory bodies. This ensures that the environment remains safe for the people living at the home, staff and visitors. Care Homes for Older People Page 26 of 31 Evidence: Care Homes for Older People Page 27 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 28 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 Where a need is identified, such as a nutritional requirement a care plan and risk assessment must be undertaken To provide staff with information on the actions and interventions required to address this identified need. 20/03/2009 2 12 16 Activities must be available on a daily basis for people living at the home To ensure their well being is enhanced and their social and recreational needs are met. 20/07/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 Life historys should be sought and recorded for each person to ensure a more person centred approach to care can be given. Page 29 of 31 Care Homes for Older People 2 8 Weight recording charts should include a column to enable staff to identify if a persons weight has remained stable or altered. This will alert staff to any changes in weight a prompt a review of that persons nutritional needs. Additional signs, cues and other items, such as a simple calendar/ board where the day and date are recorded should be provided to enhance the well being of people with Dementia and increase their orientation to time and place. 3 22 Care Homes for Older People Page 30 of 31 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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