Inspection on 10/07/07 for The Pines

This inspection was carried out on 10th July 2007.

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

The Pines 09/05/06

The Pines 01/11/05

The Pines 25/05/05

The Pines 15/11/04

The Pines 22/06/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Pines (The) 39 Portchester Road Charminster Bournemouth Dorset BH8 8JU Lead Inspector Tracey Cockburn Key Unannounced Inspection 10th July 2007 10:00 Pines (The) DS0000003994.V344434.R01.S.doc Version 5.2 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 Pines (The) DS0000003994.V344434.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 Adults 18-65. 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. Pines (The) DS0000003994.V344434.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Pines (The) Address 39 Portchester Road Charminster Bournemouth Dorset BH8 8JU 01202 555048 01202 567682 the.pines@ntlworld.com 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) Sandbourne House Ltd Vacant Care Home 13 Category(ies) of Learning disability (13), Learning disability over registration, with number 65 years of age (13), Physical disability (1) of places Pines (The) DS0000003994.V344434.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. A service may be provided to people in the category of PD in the respite room only. The Manager must complete the Registered Managers Award by 31.12.05. A job description must be in place clarifying the roles and responsibilities of the Manager. 9th May 2006 Date of last inspection Brief Description of the Service: The Pines accommodates 13 adults, with the purpose of providing care and support to residents who have a learning disability. The home was first registered in 1986, and in February 2002 a new provider, Sandbourne House Ltd took over the service. . The Pines is a large converted family house. It is a detached property and occupies a corner plot in a residential area of Charminster. Bournemouth town centre, local shops and various community amenities are within easy reach of the home. The home is situated on a bus route. Residents accommodation is provided in two double and eight single bedrooms. Communal facilities comprise a separate lounge and dining room on the ground floor and an activities room in the garden, which is accessed via a walkway from the kitchen. Two bathrooms and WCs are located on the first floor, one shower and WC on the ground and a further WC on the top floor. An internal staircase accesses all floors. There is a large office on the ground floor with staff sleeping in facilities. The registered persons have now converted the previous owners accommodation into a respite room with en suite facilities. This can be separated from the main accommodation by an internal corridor and its own external access if necessary, which is accessible to wheelchair users. Outside there is a large, well-maintained garden with patio area and a further tarmac area providing car parking facilities. The home is staffed 24 hours of the day and is able to provide a comprehensive range of daytime pursuits for those residents not engaged in activities outside the home. The weekly fees range from £230 to £905. Additional charges are made for hairdressing, toiletries, chiropody, clubs, magazines/papers, transport and holidays. For further information on fees and contracts the office of Fair Trading has advice on their website: www.oft.gov.uk Pines (The) DS0000003994.V344434.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place without warning and lasted over 4 hours. It was a key inspection. This was only part of the inspection before going out on the site visit work was done on reviewing information about the home and the service it provides, this included reviewing documentation sent by the home advising the commission of any changes such as a manager leaving. All notifications sent by the home were reviewed to see if there was a pattern, which could cause concern. The manager was present throughout the inspection. 4 people who live there were present at the time of the visit. Staff were in training and 1 other member of staff was on duty. Survey forms were left at the time of the inspection. A tour of the premises took place; discussion took place with the manager, staff and residents. Care files, staff files, records, policies and recruitment practice were reviewed. What the service does well: People who use this service have their needs fully assessed before moving in. They have individual plans of care which means the people who support them know how to do this in the way they prefer. People who live in the home say that they are able to make decisions about their daily lives such as when to get up what to have for lunch. People are supported to take risks as part of an independent lifestyle. People who live in the home say they are able to participate in activities, which interest them in the local community. They also say they are able to keep in touch with the people who are important to them. People say they feel respected. People also say that they like the food and decide what they want to eat. Information on how people like to be supported is recorded. The people who live there also say that they are supported to attend appointments and when they say they are unwell staff listen to them. Policies and procedures in the home are adhered to especially with regard to medication. This means that the people who live in the home are protected. The home has a concerns and complaints policy, which is in an accessible format. People say they are listened to if they have concerns. The home is comfortable and clean and well maintained. The management take infection control seriously and have good procedures in place. The home is clean. There is a good training plan for staff, which means they receive the training, they need to do the job well. Pines (The) DS0000003994.V344434.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Pines (The) DS0000003994.V344434.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Pines (The) DS0000003994.V344434.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who are considering moving into this home have the information they need to make a decision. EVIDENCE: There has been 1 new admission since the last inspection. This file was looked at. There was a full assessment both by the home and a care management assessment. There was evidence of the person being involved in the process and in discussion with the resident they said they had been asked questions. The care plan contained information in the assessment. There were no restrictions on the individual’s freedom. The person concerned said they had much more freedom than in their previous placement and they enjoyed this. A service user guide has been produced in an accessible format to give service users further information about the services and facilities available. Pines (The) DS0000003994.V344434.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9,10 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who live in this service have their needs assessed and individual plans to meet those needs. EVIDENCE: The care plans reviewed contained information on the individual’s daily routine, what they needed support with, what they could do themselves with prompting and what they could do completely independently. The plan also detailed behaviour which caused anxiety and what action the staff need to take to support the individual. There was also a lifestyle plan, which contained information under headings such as: things that make me happy, things that make me sad, things that make me anxious. The lifestyle plan also contained information on; “things that make me cross”. “Things I am proud of” and “things I need to keep me safe”. The lifestyle plan Pines (The) DS0000003994.V344434.R01.S.doc Version 5.2 Page 10 is in an accessible format. There is a key worker system in the home and the person whose plan was looked at said they are happy with their key worker. The manager said that residents are able to change their key worker if they want. Evidence in the residents meeting minutes supported this. Observations throughout the visit showed people who live there were encouraged to make decisions in their daily lives. Examples include, choosing where to eat their meal, making drinks when they liked. Discussion with residents confirmed they felt they were able to make decisions including deciding on social events and activities and meal choices. Pines (The) DS0000003994.V344434.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People are able to live the life they want and participate in activities which interests them in the community. They are able to have relationships with people important to them and are supported to eat a healthy diet. EVIDENCE: Discussion with residents confirmed they had a variety of daytime activities and regularly accessed the community. For example service users told the inspector they liked going out such as getting the bus into “town” and looking round the shops, going to the library and going for walks. They also were involved with social groups such as the Gateway club and some residents were members of the Bournemouth Forum (a local service user advocacy group). There is clear guidance in the home about service users responsibilities for daily tasks. Rotas were observed sharing out some of the domestic tasks in the home. Observation during the inspection showed service users taking part Pines (The) DS0000003994.V344434.R01.S.doc Version 5.2 Page 12 in activities such as making drinks and helping with meal preparation. Discussions with residents showed that independent skills were promoted. A sample of menus was viewed as part of the inspection. A delegated member of staff is responsible for co-ordinating menus based on residents’ choices and to ensure a balanced and varied diet was offered to facilitate healthy eating. Service users likes and dislikes are also recorded in their files, as well as any health needs such as diabetes. Service users said the food was “very good” and observation on the day showed service users were encouraged to participate in meal preparation. Pines (The) DS0000003994.V344434.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who live in this service are supported to have their physical and emotional needs met. EVIDENCE: The majority of service users living in the home were mainly independent with their personal care with support consisting of monitoring and prompting where necessary. Service users confirmed routines in the home were flexible such as times for getting up/going to bed, meals and other activities. All service users have designated keyworkers and regular sessions were held with service users to discuss their preferences and facilitate continuity of support. There was written guidance for staff about the role of keyworker and staff spoken with were clear about their responsibilities. Observation showed that service users were treated with dignity and respect and their personal privacy was promoted. Pines (The) DS0000003994.V344434.R01.S.doc Version 5.2 Page 14 Details of all healthcare appointments were kept including G.P., dentists and nurse. There was further evidence of specialist input e.g. psychiatrist and psychologist and any assessments made by professionals were recorded and acted upon, e.g. managing aggressive behaviour. There was a satisfactory policy and procedure in place for the administration of medication. The home has a locked medicine cupboard in the office and uses a monitored dosage system. MAR sheets are kept with the medicines and these were checked and found to be up-to-date and accurate. Staff receive training in first aid and the administration of medication. Pines (The) DS0000003994.V344434.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Action has been taken to ensure that people who live in this service are protected by the home training, procedures and policies. EVIDENCE: A complaints procedure is in place, which has been produced using clip art to convey the information in a way that is clear and easy for service users to follow. Service users confirmed they knew how to make a complaint and who they could talk to e.g. their social worker or the inspector. Some service users were members of a local service user led advocacy group. There is an open door policy in the office and service users are encouraged to raise issues so they can be dealt with before they develop into major problems. Observation and discussion with service users provided further evidence that they felt confident in speaking out. The home has policies and procedures in place concerned with the protection of vulnerable adults. These included Awareness and Prevention of Abuse, Aggression towards staff, Bullying, Management of Service Users money and Whistle blowing. The manager confirmed his knowledge of local procedures. Most staff have undertaken training in the Awareness of Abuse. Pines (The) DS0000003994.V344434.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People live in a homely, comfortable and safe environment which they take pride in. EVIDENCE: A tour of the premises was carried out as part of the inspection. All communal rooms were seen including the lounge, dining room, kitchen and laundry room and 1 person who lives in the home long term said the inspector could come into their room. The bedroom was personalised to the persons taste with plenty of space for personal possessions. The garden has plenty of space for sitting out and relaxing. Service users spoke very positively about the home and all service users spoken with told the inspector they liked their rooms. The premises were well maintained and decorated in a comfortable, homely way. Pines (The) DS0000003994.V344434.R01.S.doc Version 5.2 Page 17 The premises were found to be clean and hygienic with good procedures in place to prevent the spread of infection, e.g. hand wash was available by the door for all visitors to use prior to entering the home. Pines (The) DS0000003994.V344434.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who live in this service have their need addressed by people who are trained and competent to do their job. EVIDENCE: The staff team consists of both male and female workers of a mixed age range and ethnic background. The home does not currently use any agency staff. Analysis of the rota and observation during the inspection indicated there were sufficient staff on duty at all times to meet residents’ needs. The inspector talked to two members of care staff who spoke enthusiastically about working in the home. They said the Pines provided a good working environment and they felt well supported. Residents also spoke positively about the staff team and it was clear from observed practice that staff knew the residents well and positive relationships had been formed. The home has a good training plan and discussion with staff confirmed they had attended a number of training courses including first aid, health and Pines (The) DS0000003994.V344434.R01.S.doc Version 5.2 Page 19 safety, food hygiene, fire training, prevention of abuse, medication, manual handling, principles of care, infection control and risk assessments. At the time of the inspection care staff were undertaking a training session in the dining room run by an external trainer. The training was on medication. The trainer gave the inspector a copy of the training notes which covered key legislation, policy and procedures. The aims and objectives of the course were ‘ to enable healthcare workers to perform their duties safely and effectively when assisting clients or residents with their medication.’ At present there are 11 staff employed by the service of those 6 staff either have the qualification or are working towards it. Pines (The) DS0000003994.V344434.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home is run in the best interests of the people who live there. EVIDENCE: There is a new manager of the service who has only been in post a few months he is not yet registered with the commission. However he has worked in the home for a number of years and was the deputy manager before taking up his new post. The residents spoken to say they liked him. Staff spoken to say he was very supportive. He is currently undertaking his Registered Managers Award and hopes to be completed by the end of the year. Pines (The) DS0000003994.V344434.R01.S.doc Version 5.2 Page 21 Records showed that the home was meeting the requirements of other agencies such as Dorset Fire and Rescue Service and Environmental Health Department. Certificates were in place demonstrating that equipment and facilities were regularly serviced and maintained. A written health and safety policy for the home has been completed and safety procedures are displayed throughout the home. The manager confirmed his awareness of relevant legislation and certificates were in place showing staff had attended various training courses in safe working practices. Observation of practice demonstrated staff followed correct procedures and encouraged service users to work safely e.g. when helping with meal preparations. On the 1st and 2nd floor a toilet window and a bathroom window were found to be without restrictors. The manager was advised that a risk assessment should be completed and a decision taken as to whether or not these small windows needed restrictors. Since the site visit the manager has submitted an application to the commission to become the registered manager. Pines (The) DS0000003994.V344434.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 2 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 2 X Pines (The) DS0000003994.V344434.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA10 Good Practice Recommendations The registered provider should make sure that issues of confidentiality are discussed with residents so they can make an informed decision as to whether information is displayed on a wall in the kitchen. Risk assessments should be undertaken on the windows, which do not have restrictors on them. 2. 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