Inspection on 20/04/05 for The Pines Nursing Home

This inspection was carried out on 20th April 2005.

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 Nursing Home 29/11/06

The Pines Nursing Home 08/11/05

The Pines Nursing Home 29/11/04

The Pines Nursing Home 10/09/04

The Pines Nursing Home 19/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE The Pines Nursing Home Furze Hill Hove East Sussex BN3 1PT Lead Inspector Penny Bailey Unannounced 20 April 2005 09:30 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Pines Nursing Home H59_S37262_Thepines_V215694_200405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Pines Address Furze Hill Hove East sussex BN3 1PT 01273 820275 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) The Royal United Beneficent Association Janis Anne Weir Care Home with Nursing 36 Category(ies) of Old Age, not falling within any other category registration, with number (OP) 36 of places The Pines Nursing Home H59_S37262_Thepines_V215694_200405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users must be aged sixty-five (65) years and over on admission. 2. The maximum number of service users to be accommodated is thirty-six (36). 3. Only older service users who have been assessed as requiring nursing/residential care are to be accommodated. Date of last inspection 29 November 2004 Brief Description of the Service: The Pines provides personal and nursing care for up to thirty-six older people. The home is owned by Independent Age (The Royal United Kingdom Beneficent Association). The Pines is purpose built and provides a passenger lift, enabling access for residents to all parts of the home. The home is situated in a residential area of Hove, East Sussex, and is within walking distance of the seafront. The home also has access at the rear to a local park, St Anne’s Well. The town centres of Brighton and Hove are a short distance away, with many amenities and access to local transport. Accommodation is provided in thirtyfive single rooms, thirty of which have en-suite facilities. There is one shared room. Communal space is provided in a lounge/conservatory, quiet lounge and large dining area, and there is an Activities room on the first floor. There is a small, well-maintained garden that is accessible to residents. Car parking is available at the front of the home for approximately eight cars. The Pines Nursing Home H59_S37262_Thepines_V215694_200405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place between 9.30 a.m. and 4.00 p.m., and formed part of the annual inspection plan for this home. A tour of the premises took place and records relating to care and the home’s maintenance were inspected. The Inspector spoke with eight residents and five members of staff, and would like to thank the residents, staff and Manager for their hospitality and co-operation during the inspection. What the service does well: What has improved since the last inspection? Areas of concern noted during previous inspections have been addressed. The Pines Nursing Home H59_S37262_Thepines_V215694_200405 Stage 4.doc Version 1.30 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Pines Nursing Home H59_S37262_Thepines_V215694_200405 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection The Pines Nursing Home H59_S37262_Thepines_V215694_200405 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 3, 4 & 5 The home provides comprehensive information to allow residents to make a positive choice whether The Pines is the type of home in which they wish to live. The home makes every effort to ensure that they have sufficient knowledge, and employ staff with enough experience to be able to look after the resident once they arrive at the home. Prospective residents are assessed before they move in, to ensure that the home is able to offer the care needed. EVIDENCE: The Registered Manager visits prospective residents either at home or in hospital to tell them about the home, and make an assessment to ensure that their care needs can be met. Information about their needs is gathered from a variety of sources including the resident, their representatives and health care professionals. The needs assessment then forms the basis of the resident’s plan of care. Residents or their relatives are able to visit The Pines and talk to people living in the home before deciding whether they wish to live there, and are admitted for a month’s trial period to ensure that their placement is satisfactory. The Pines Nursing Home H59_S37262_Thepines_V215694_200405 Stage 4.doc Version 1.30 Page 9 Staff receive training regarding the health and social needs of older people, and this is updated on a regular basis. The Pines Nursing Home H59_S37262_Thepines_V215694_200405 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 & 10 The Manager and staff at the home are knowledgeable about the care of the residents and records identify this. Care outcomes for residents were good, and all residents appeared well cared for on the day of the inspection. Staff must ensure that where bed rails are in place, that a signed consent form is obtained. The home must ensure that care plans are drawn up with the resident or their representative as soon as is practicable following admission to the home, and that such plans are reviewed and updated at least once a month as required. EVIDENCE: An individual plan of care is in place for each resident, and these provide a comprehensive assessment and plans for meeting each residents physical care needs. Three individual plans of care were inspected. These comprised of many documents including needs assessments, personal information, daily notes and a plan of care, and provided the information necessary to guide staff to meet the needs of residents. It was noted that consent forms in respect of the use of bed rails had not been signed by the resident or their representative in all cases. The care plan for a resident who had been recently admitted was not fully completed, although a good amount of information had been provided The Pines Nursing Home H59_S37262_Thepines_V215694_200405 Stage 4.doc Version 1.30 Page 11 by the home that had previously provided their care, to assist staff with such planning. Residents’ physical and medical needs are closely monitored, and the home calls in specialist services when necessary. Pressure relieving equipment was in place for those residents assessed as at risk from pressure damage, and a number of new pressure mattresses had been purchased since the last inspection. Residents confirmed that medical advice, or a visit from the General Practitioner, is sought promptly when required. All service users spoken with stated that staff treat them with courtesy, and respect their dignity. However, one resident commented that temporary agency staff recently employed at the home were not always as polite as the permanent staff. This concern was addressed to the Manager. The Inspector noted that “care in progress” signs were placed on residents doors when staff were providing personal care, to ensure that privacy was maintained. The Pines Nursing Home H59_S37262_Thepines_V215694_200405 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 & 15 Flexible routines are part of daily practice at the home. Residents find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests. Links with families are valued and supported by the home. Dietary needs are well catered for with a balanced and varied selection of food available that meets resident’s tastes and choices. EVIDENCE: The Pines employs an Activities Coordinator, who provides a range of activities throughout the week for both individuals and groups. A cookery session took place during the inspection, with residents preparing flapjacks. Upcoming activities are advertised on the residents message centre notice board, including planned monthly outings. An assessment of residents social care needs and preferred activities is completed by the Activities Coordinator, and a copy of this assessment is kept within the plan of care. The Friends of The Pines are a voluntary group who visit the home and participate in activities. They also provide a newsletter for residents. Communion services are held weekly at the home, and residents are supported to attend the local churches of their choice. Residents confirmed that their visitors are made welcome at the home, and that the daily routines are flexible The Pines Nursing Home H59_S37262_Thepines_V215694_200405 Stage 4.doc Version 1.30 Page 13 and take into account their personal choices as much as possible. Residents meetings are also held regularly, and minutes are kept, enabling residents to inform the way care and services are provided. Residents are encouraged to remain as independent as possible and maintain control over all aspects of their daily lives. The home has a pleasant dining room, where the majority of residents choose to take their meals. This is decorated and set to a high standard, with much thought given to providing a comfortable and pleasant environment in which to eat and socialise. Residents are also able to take their meals in their rooms, if this is their preference. A bowl of fresh fruit had recently been provided, as this had been requested at a residents meeting. Staff were seen to provide discreet assistance with meals where this was required. All of the residents who spoke with the inspector commented positively regarding the food provided, however, one resident reported that an alternative was not always provided if they could not eat the two choices of meal offered. The Manager and Chef were aware of this issue, and steps were being taken to address this. As part of the “Food as Treatment” plan, for those residents who have difficulty eating or have a poor appetite, the Chef prepares high protein drinks daily in line with guidance received from the Community Dietician. The Pines Nursing Home H59_S37262_Thepines_V215694_200405 Stage 4.doc Version 1.30 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 The Inspector judged that resident’s rights were upheld. The home operates in an open manner and complaints are handled objectively by the home. EVIDENCE: The home has a detailed complaints procedure, and the complaint records demonstrated that this is followed. No complaints have been received directly by CSCI since the last inspection. The complaints policy is available in the service user guide and contains information about how complaints will be investigated. Six complaints had been received at the home since the last inspection, and documentation showed that these had been handled objectively. The Pines Nursing Home H59_S37262_Thepines_V215694_200405 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 23, 24, 25 & 26 Residents live in a clean and homely environment with that is decorated and furnished to a high standard. The home ensures that service users private accommodation is equipped to provide comfort and privacy and to meet the assessed needs of those residing in the room. EVIDENCE: Bedrooms were observed to have been individualised by residents, and are provided with domestic style furniture and fittings of a good standard, together with bedding, carpeting or vinyl flooring and curtains. Bedroom doors have an appropriate lock fitted to enable residents to lock their rooms if desired. All bedrooms are currently used for single occupancy, but one room is available for shared occupancy if required. The majority of rooms have en-suite facilities that include a shower. Assisted bathing facilities are also provided. Grab rails, and a range of equipment and adaptations are provided to support residents in moving safely around the home. Call bells are provided in each room, and many residents were provided with a pendant style call bell. A high The Pines Nursing Home H59_S37262_Thepines_V215694_200405 Stage 4.doc Version 1.30 Page 16 standard of cleanliness was noted throughout, and the home was free from offensive odours. The home employs sufficient domestic staff to ensure that standards of hygiene and cleanliness are maintained. The home has a good range of infection control policies, and staff were seen to be wearing aprons and gloves where appropriate. Communal space is provided in a conservatory/sun lounge, dining area and activities room. The Pines Nursing Home H59_S37262_Thepines_V215694_200405 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 & 28 There are sufficient staff on duty on a daily basis to meet the needs of the residents, and further recruitment of staff is taking place. Staff training is continuing on a regular basis and therefore staff are knowledgeable regarding the conditions and treatment of the needs of the residents within their care. EVIDENCE: The home was well-staffed on the day of inspection, and rotas demonstrated that there are generally two Registered Nurses and seven carers during the morning shift, one Registered Nurse and five carers during the afternoon, and one Registered Nurse and three to four carers during the night. The Manager reported that extra staff are also employed on shift, where the needs of residents require this. One resident commented that a number of agency staff had recently been working at the home, the Manager confirmed this, and reported that the recruitment of permanent staff is ongoing. Three NVQ assessors are employed at the home, and six care staff are in the process of completing their NVQ Level 2. Two members of staff have completed this qualification. The Pines Nursing Home H59_S37262_Thepines_V215694_200405 Stage 4.doc Version 1.30 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34, 36, 37 & 38 The home is openly managed in the best interests of residents, and continues to benefit from a well-established and motivated Manager. Evidence of adequate health and safety measures are in place, and the home is run with the emphasis on the safety and well-being of the residents EVIDENCE: The Manager of The Pines has been in post since 2003, and is Registered with The Commission for Social Care Inspection (CSCI). She is a Registered Nurse, with fifteen years experience of caring for older people, and is currently studying for her Registered Managers Award. The home has a relaxed atmosphere, and both staff and residents indicated that they were happy to approach the Manager and senior staff with any concerns. A representative of the organisation that owns the home visits on a monthly basis, and a copy of their report is provided to CSCI. New staff employed by the home receive a comprehensive induction, and are closely supervised throughout this period. The Pines Nursing Home H59_S37262_Thepines_V215694_200405 Stage 4.doc Version 1.30 Page 19 Systems to support fire safety are in place. Regular fire alarms, emergency lighting checks and fire drills were recorded and up to date. Service contracts are in place for the fire detection and fighting equipment. Acoustically activated door guards have been fitted to some fire doors to enable them to be left open for ease of movement around the home. The Inspector was pleased to note that these had also been fitted to the doors of residents who prefer to have their doors remain open. Radiators have guaranteed low temperature surfaces, and hot water outlets had been regularly checked to ensure that safe temperatures were maintained. Annual checks of portable electrical appliances had also been completed. A record of accidents is kept, and was seen to be up to date with no specific patterns identified. The Pines Nursing Home H59_S37262_Thepines_V215694_200405 Stage 4.doc Version 1.30 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 3 3 3 x 3 3 3 The Pines Nursing Home H59_S37262_Thepines_V215694_200405 Stage 4.doc Version 1.30 Page 21 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 7 Regulation 15 (2) Requirement That each time a change of care is identified, or a particular need is assessed, that this information is written in the care plan and reflects all of the residents physical, psychological and social needs. That care plans be reviewed at least once a month, or more frequently as required, and updated to provide guidance for care staff on meeting all of the assessed needs of each service user. That evidence is provided within the care plan, that the plan has been drawn up with the involvement of the service user and/or their representative. That staff ensure that the care plan is drawn up as soon as possible following the admission of the service user. Timescale for action With immediate effect. 2. 7 15 (1) With immediate effect. The Pines Nursing Home H59_S37262_Thepines_V215694_200405 Stage 4.doc Version 1.30 Page 22 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard 7 7 7 Good Practice Recommendations All care plans should contain signed consent forms for the use of bedrails or lapstraps. That the member of staff completing assessment documentation sign and date each page. That inventories of service users personal possessions are signed and dated by the member of staff completing the record. The Pines Nursing Home H59_S37262_Thepines_V215694_200405 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Pines Nursing Home H59_S37262_Thepines_V215694_200405 Stage 4.doc Version 1.30 Page 24 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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