Inspection on 29/11/06 for The Pines Nursing Home

This inspection was carried out on 29th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 08/11/05

The Pines Nursing Home 20/04/05

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 Linda Boereboom Key Unannounced Inspection 29th November 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Pines Nursing Home DS0000037262.V319075.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Pines Nursing Home DS0000037262.V319075.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Pines Nursing Home Address Furze Hill Hove East Sussex BN3 1PT 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) 01273 820275 joann.bendingndependentage.org.uk The Royal United Beneficient Association Janis Anne Weir Care Home 36 Category(ies) of Old age, not falling within any other category registration, with number (36) of places The Pines Nursing Home DS0000037262.V319075.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. That the maximum number of service users accommodated is thirtysix (36). That service users are over the age of sixty-five (65) years of age on admission. That one named service user under the age of sixty-five (65) years on admission may be accommodated. 8th November 2005 Date of last inspection Brief Description of the Service: The Pines provides personal and nursing care for up to thirty-six older people. It 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 and the shopping centres of Brighton and Hove that are linked by Western Road that has many shops and access to local transport including both Brighton and Hove mainline stations. The home also has access at the rear to St Annes Well Gardens, a popular local park which provides a pleasant view to some service users rooms. Accommodation is provided in thirty-five single rooms, thirty of which have en-suite facilities. There is one shared room for the use of a married couple or long-term friends. Communal space is provided in a lounge/conservatory, quiet lounge and large dining area, and there is a well- equipped Activities room on the first floor. There is a small, wellmaintained garden that is accessible to residents. Car parking is available at the front of the home for approximately eight cars. The Pines Nursing Home DS0000037262.V319075.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over a period of three partdays. The Inspection was facilitated by Mrs Janice Weir the Registered Manager for the home with the help of both care and administrative staff. During the Inspection the Inspector was able to meet with two relatives of service users, with a further two relatives giving their comments by email from abroad. Ten service user surveys were sent by the Commission for Social Care Inspection to service users in the home and nine returned. In addition the Inspector was able to speak with four of the staff and three service users, nine other service users having gone on a Christmas shopping trip and lunch out at the Holmbush shopping centre in Shoreham by Sea however she was able to meet with some of them on the second day of the inspection. The Inspector also toured the premises and spent time looking at the home’s administrative procedures including service user and staff files. The current scale of charges in the home is £745 to £834 per week although Local Authority rates apply in some cases. Feedback was given to Mrs Weir at the end of the inspection, which was both positive and enjoyable, and at a later date the Inspector spoke with the care Director for the Organisation, also about the outcome of the inspection. The Inspector would like to thank Mrs Weir and the staff for their helpfulness and hospitality throughout. What the service does well: As with the last inspection in November 2005, the Inspector found that the standard of care given in The Pines to be of a good standard with emphasis on ensuring that service users felt ‘at home’. Residents appeared to be very well cared for and happy and those spoken with made comments that included ‘It’s lovely here and I’m very happy’, ‘the staff are so kind, the Girls are lovely, they don’t mind what they do for you’, another said ‘there is always someone tidying and cleaning!’. Activities in the home are excellent and on the first day of Inspection nine service users were out on a shopping trip including lunch. The home also has a cat and a small dog that visits daily with its owner. The Inspector toured the premises and found them to be clean, tidy and homely with all facilities to help them feel ‘at home’. Staff spoken with by the Inspector all expressed that they were well supported by the management and felt comfortable giving their views or going to the Registered Manager with any concerns they might have. Whilst walking round the home the Inspector noted that care and nursing staff were polite and respectful and seemed to enjoy comfortable and friendly relationships with the service users. The Pines Nursing Home DS0000037262.V319075.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. The Pines Nursing Home DS0000037262.V319075.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Pines Nursing Home DS0000037262.V319075.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users and their relatives receive sufficient information about The Pines, prior to admission to enable them to make an informed choice about whether or not it is suitable for them. All prospective service users are assessed prior to admission and the policies and procedures in the home ensure that the staff employed are able to meet the needs of the service users. EVIDENCE: The statement of purpose and service user guide had been recently updated at the time of inspection. Relatives spoken with by the Inspector confirmed they had been given information prior to helping make the choice home. All service users, or their relatives are given terms and conditions of residency usually within two days of moving into the home. Information relating to the home along with the latest inspection report are available in the main reception area for anyone to read. The Pines Nursing Home DS0000037262.V319075.R01.S.doc Version 5.2 Page 9 The Registered Manager told the Inspector that either she or the Deputy Manager both undertake pre-admission assessments either in a prospective service user’s place of residency or hospital, these assessments form the basis of care planning. This was confirmed during conversations the Inspector had whilst in the home with service users and also relatives. All residents enter the home for a month’s trial period and are encouraged to visit the home prior to admission if possible to enable them to meet the staff and other service users and look at the environment. All staff in the home receive training in the care, diseases and needs of the elderly and to help with the specialist needs of service users the home has support and guidance from other agencies in the community e.g. the wound care tissue viability nurse, respiratory nurse, and the older persons nursing specialist team that includes a psychiatric nurse and physiotherapist. The home is not registered for intermediate care. The Pines Nursing Home DS0000037262.V319075.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 and 11. Quality in this outcome area is Excellent. This judgement has been made using available evidence including a visit to this service. Care planning for service users is comprehensive and regularly reviewed by staff who are knowledgeable on the diseases and conditions of old age. The home has relevant policies and procedures in place to protect service users and in addition has an empathetic and sensitive approach to observing and managing service users wishes at the end of life. EVIDENCE: The Inspector looked at six service users care plans and also discussed care planning and reviewing with care staff. Staff confirmed that care plans are reviewed on a monthly basis or less if a service user’s condition changes. Relatives confirmed being involved in care planning reviews and said that they had been informed immediately of any change in condition of their parent in the home. All service users care plans included a photograph of the service user and details on maintaining a safe environment for each one, methods of communication, all health and personal care needs including care of skin and prevention of pressure areas, help required with bathing, mobility and managing risk, personal wishes at the end of life, a record of visits from healthcare professionals, information from other agencies and a list of property taken into the home. The Pines Nursing Home DS0000037262.V319075.R01.S.doc Version 5.2 Page 11 The Inspector looked at the methods of administration, storage and disposal of medication in the home and found the practices to comply with the policies and procedures. Each service users medication record showed a recent photograph plus information of any difficulty he/she may experience with swallowing. The medication room had suitable lockable storage with an additional cupboard for controlled medication. In place was an up to date register for all controlled medication. Records were kept of temperature checks and defrosting of the medication fridge; in addition the Inspector saw records of checks to the oxygen cylinders and the quality control records on the glucose blood testing machines. Additional information was also on view about medication/treatments/and storage of medication. The home complies with legislation on the de-naturing of controlled medication that is no longer required and the returning of medication to the local pharmacy. The staff nurse who assisted the inspector confirmed that there is no sharing of medication or creams between service users. The Inspector randomly looked at medication and sterile dressings and found them all to be in-date. The home also has a well-stocked first aid kit on site that is regularly checked. Service users confirmed they are given their medicines on time and the Registered Manager confirmed that at the time of inspection no service user self medicated. Service users spoken with by the Inspector said they were treated with respect and the Inspector noticed that staff were polite and knocked on doors before entering individual rooms. A ‘care in progress’ sign is put on service users doors to avoid disturbance when personal care is being given. Service users have access to cordless telephones within the home for private telephone calls and it is their choice to have their own telephone extension. The Inspector asked if they always had their own clothes returned from the laundry to wear and service users confirmed they did although they accepted that sometimes mistakes occur. The home has a death and dying policy in place and the Registered manager told the Inspector that at a suitable time service users personal wishes at the end of life are discussed with them including their wishes for resuscitation or admission to hospital, this was confirmed by relatives spoken with during the inspection. The Registered Manager told the Inspector that relatives are invited to be as involved as they wish and are able to share the home’s facilities at the end of life. Training has been completed for staff on the use of syringe drivers, pain control and medical emergencies especially related to palliative care. The Pines is now part of the Gold standard Framework for palliative care. One email from a relative abroad said ‘The staff are extremely caring and there seems to be good continuity as most of them seem to have been there for several years and give my mother affection and good care’. And another read ‘we are most content with the quality of care and the kindness shown to our The Pines Nursing Home DS0000037262.V319075.R01.S.doc Version 5.2 Page 12 mother’. One relative wrote in a survey ‘I know in my own mind **** receives the best care possible and the staff are always very good at communicating i.e. if she is unwell, needs a GP, they will always ring me and let me know’. The Pines Nursing Home DS0000037262.V319075.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15. Quality in this outcome area is Excellent. This judgement has been made using available evidence including a visit to this service. Service users have the opportunity to join in a variety of activities within the home and are encouraged to maintain friendships and relationships from their previous lives. The home encourages relatives to visit as often as they wish. The home caters well for all dietary needs and service users are offered balanced and varied meals that can be eaten in pleasant surroundings. EVIDENCE: The Pines offers an excellent range of activities for service users including trips outside the home. On the day of the inspection nine service users were out on a Christmas shopping trip that included lunch. There is an activities coordinator in post that organises activities either on a one to one basis or from the well-equipped activities room. Activities for the Christmas period include, a buffet lunch to which guests and relatives are invited, a bazaar (preparations for which were seen by the Inspector) that included a craft stall selling cards made by service users, an annual Christmas carol concert and assisting to decorate the three Christmas trees in the home. In addition to these activities the home has singers who visit and are know as, music for health and music for movement. A local artist also provides an art class that is well attended and service users are encouraged to hang their paintings in the home. There The Pines Nursing Home DS0000037262.V319075.R01.S.doc Version 5.2 Page 14 is a message board for advertising activities some of which include quizzes, a weekly library trolley and visits out to the library, museums, garden centres and summer picnics in the park. There is also a monthly newsletter, to which anyone can subscribe, giving information on office hours, activity times and forthcoming events in the home. The November newsletter also included historical news of events that took place in Novembers past. The Registered Manager also uses it to alert service users staff and visitors of health and safety matters in the home. The Pines also has a ‘friends of the Pines’ voluntary group who make visits to the home, get to know the service users and also share some of the activities. Service users spoken with by the Inspector supported that they are able to go out if they so wish and that their visitors are always made welcome and offered refreshments when they arrive, meals are available as long as the kitchen staff are given prior warning, this was supported by relatives. One relative wrote ‘I usually have lunch with my mother during my time in UK and have found the food to be very, very good. I also attend the occupational therapist sessions and there is plenty of stimulation for the residents with painting, music, quizzes etc’. A service user commented in one survey ‘the activities are usually Monday to Friday, they are good and enjoyed by all who attend; this is a great asset’. The Inspector was provided with a copy of menus on offer with a choice of main meal, there was also a menu board on view in the home. Mealtimes are flexible and the Inspector found that most service users choose to eat lunch in the main dining room included with which are a choice of wine, sherry and beer. The Registered Manager told the Inspector that breakfast, either continental or cooked, is usually taken by choice in service users own rooms, and a supper club has been formed on Mondays through to Fridays for those who wish to attend. Snacks and drinks are available throughout the day with biscuits or cake with morning coffee and afternoon tea. Service users said they enjoyed the meals and were given more than enough to eat and drink and one service user wrote in a survey ‘the standard of food and the wide variation of meals are first class. Presentation goes a long way, well done all concerned’. The Kitchen staff undertake quality control measures in the kitchen for health and safety to ensure that service users are protected. The Pines Nursing Home DS0000037262.V319075.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has policies and procedures in place to protect residents against abuse and to ensure that any complaints made are acted upon. Residents’ legal rights are protected and the home operates in an open manner. EVIDENCE: The Inspector looked at the complaints recording in the home and found it to include details of each complaint, the action taken and the outcome; all were signed. The last recorded complaint was on 31/10/06. The pre-inspection questionnaire sent to the home prior to the inspection stated that eighteen complaints had been received since the last inspection in November 2005 and all had been responded to within the 28-day time frame. Service users and relatives said they would feel comfortable in going to the Registered Manager with a concern or complaint and that they were confident they would be listened to – this also applied to staff. One service user wrote in a survey ‘if the need arises problems can be resolved very quickly’. All staff receive training in the protection of vulnerable adults. The Registered Manager told the Inspector that she briefs all new staff initially and then full training is given at a later date from an external training organisation. The Inspector gave staff a protection of vulnerable adults scenario and they showed a common sense approach and confirmed they would report to the Registered Manager or person in charge. All staff in the home are CRB checked including ‘Friends of The Pines’. The Pines Nursing Home DS0000037262.V319075.R01.S.doc Version 5.2 Page 16 All service users are able to vote and it is their choice as to whether they use the postal voting system for which the home is registered or are accompanied to the local polling station. The Pines Nursing Home DS0000037262.V319075.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Pines offers a pleasant, safe and well-maintained environment for service users that is kept clean and tidy. Service users rooms are comfortable and they are able to have their own possessions around them. EVIDENCE: The home has a maintenance person who takes responsibility for the general maintenance to the home. There is a lift that covers all three floors and a ‘dumb waiter’ for the transportation of food from the kitchen. The Registered Manager told the Inspector that a smoke detector will be installed in the lift shaft in the near future and the lift will be out of use for up to forty eight hours, this being the case she has put plans in place for the comfort of the service users and will advise the fire service once a date has been made. There are CCTV cameras in the grounds of the home but not internally. The home has fire safe doors and electronic door closures in case of fire. A general programme of renewal and maintenance is kept. Following the inspection, the The Pines Nursing Home DS0000037262.V319075.R01.S.doc Version 5.2 Page 18 Inspector spoke with the Care Director to ensure that no radiator or hot water pipe had omitted to be covered in The Pines. The rooms in the home are for single use with the exception of one that can be used for a married couple or close friends, however the Registered Manager confirmed that she would also let it on a single basis should the opportunity arise. All rooms have a hand-wash basin and twenty-six of the rooms have a full ensuite facility. There are accessible toilet, washing and bathing facilities on each floor. Service users have any specialist equipment they require to help maximise their independence and an occupational therapist is available within the National Health Framework. Service users in the home seemed happy in their environment and the Inspector saw that care had been taken to make them feel at home by personalising their individual rooms. At the last inspection the Registered Manager told the inspector that although the flooring in service users rooms is not carpet, for hygiene and easier use of equipment however service users might have a carpet if they so wish. The home has a pleasant dining room and sitting room/conservatory as well as a quiet room. Residents are also able to entertain their visitors in their individual rooms. Both the interior of the home and exterior grounds are suitable for service users with a disability. Although the home does not have a large garden, it does back on to St Anne’s Well Park, which provides a good view from some rooms. The home received the RHS Hampton Court display of ‘The Well Garden’, which was opened in October 2006 and occupies the quadrangle area at the side of the home at the rear of the kitchen. The lighting in the home is domestic in character and the home is centrally heated. The home’s water supply is regularly tested by a designated company to ensure the water is safe for use, in addition the maintenance person regularly checks water temperatures. The home is kept clean and hygienic and staff are trained in the control of infection and health and safety. Laundry and sluicing facilities are kept away from the kitchen area and protective clothing is available for staff. The Pines Nursing Home DS0000037262.V319075.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has sufficient staff on duty each day to meet the needs of the service users. Recruitment is thorough and undertaken in a way that protects service users. Staff training is taken seriously and ongoing to ensure staff are able to undertake the duties for which they are employed. EVIDENCE: On the days in which the inspection took place the home was well staffed and the Inspector was able to speak with them throughout the day as well as speak with four in a group. She also observed those working whilst touring the premises. The Registered Manager and Inspector discussed daily rotas and it was revealed that on a daily basis between 8am and 5pm there is always the Registered Manager and/or Deputy Manager on site with two trained nursing staff and seven senior care staff, in addition there is a full compliment of housekeeping, kitchen and administrative staff (one in the office, and one at the reception desk in the main entrance hall). Between 2pm and 8pm a trained member of the nursing staff is on duty with five carers and one person from the kitchen. Night duty consists of one trained nursing staff and four care staff. The Registered Manager confirmed that there is always someone on call to the home 24 hours a day. The Inspector asked about extra staff should a service user require extra care and support and was told that should this be the case extra staff are provided during the ‘crisis’ period to relieve pressure on the existing staff. Occasionally the home requires agency staff but ensures The Pines Nursing Home DS0000037262.V319075.R01.S.doc Version 5.2 Page 20 that only those familiar with the home, who understand the way in which its works are employed and during the inspection the Inspector was able to speak with a qualified nurse from a local agency who is often employed by the home. It was confirmed during conversation that the agency nurses working in the home are invited to attend any training sessions that are being undertaken by the existing the staff; also included, as a matter of course is the maintenance person. The home employs eleven first level registered nurses and twenty-one care staff in addition there are ten ancillary staff who cover the kitchen and housekeeping duties. Many of the staff are from Eastern Europe and the Inspector spoke with some of them about their training and work in the home. The Registered Manager said that all staff are Criminal Records Bureau checked prior to employment, this was later confirmed by the staff and also when the Inspector looked at staff files. All staff receive an induction and the home operates a ‘buddy’ system during the induction period. Staff files looked at by the Inspector were well presented and informative and showed that the recruitment process is thorough with relevant information available. Training records are also kept as well as records of yearly reviews/appraisal and orientation. Staff training is on going and at the time of inspection 48 of the care staff had achieved NVQ 2 or above, twenty-seven had a current first aid certificate. Staff training consists of all subjects included in health and safety with additional training in nutrition, wound care, pressure area care, basic personal care, care planning documentation, palliative care and emergencies, adult basic life support, managing complaints and time management. Staff employed from abroad are also able to attend English classes to support their existing knowledge should they consider it necessary. The Inspector asked staff their views on the home and one replied ‘It is good, functional and purpose built and the nicest I have worked in’, another said ‘service users have whatever they want, there are plenty of choices and activities available’. The Pines Nursing Home DS0000037262.V319075.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36,37 and 38. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is well managed and the Registered Manager and staff ensure that it is run to ensure the best interests of the service users; there are clear lines of accountability throughout. EVIDENCE: The Registered Manager has a certificate in Health and Safety Welfare, a certificate in Business Management, is an NVQ`assessor and has the ENB 998 certificate in Supervision and Mentorship Training and Assessment. She has also completed the Registered Managers Award and is a Registered Nurse with seventeen years experience in caring for older people. She worked with the Independent Living group of Homes in a managerial position in a residential home prior to joining The Pines. There are clear lines of accountability throughout the home with a Deputy Manager in place who also has the The Pines Nursing Home DS0000037262.V319075.R01.S.doc Version 5.2 Page 22 Registered managers Award. The Registered Manager has an ‘open door’ policy that allows staff and visitors to speak to her when they wish, she also visits service users in their rooms on a daily basis. Staff spoken with by the Inspector said they felt well supported and expressed that they felt comfortable with the management style, feeling able to approach the Registered Manager and senior staff with any concerns they might have. Staff meetings take place on a regular basis, each Monday a meeting is booked for all qualified nursing staff and on the first Friday of each month for both qualified and care staff; all meetings are recorded. The Organisation has an equal opportunities policy in place. To ensure the quality of the service, quality questionnaires are sent out on a yearly basis to all service users. There is an internal auditing process that takes place within the Organisation and on a monthly basis the Care Director for the Organisation visits the home and completes a Regulation 26 report that has until recently been sent to the Commission for Social Care Inspection on a each month, however the Inspector requested that these be kept in the home where they would be looked at during the inspection process. All policies and procedures used within the home are regularly reviewed. Feedback received by the Inspector prior to, and during inspection, were overall positive; some comments have been reflected throughout this report. Service users are advised prior to admission to the home not to bring any excessive amounts of money or valuables with them. The home does provide a lockable facility in each room for personal valuables and spare keys are available in the event of loss. The home does not manage any personal finances for service users and hairdressing, chiropody and newspaper bills are included in each service users account. Staff confirmed they are able to see the Registered Manager at any time and have regular staff meetings however the Registered Manager confirmed that supervision on a one to one basis did not occur as often as she would like. The Inspector later discussed this with the Care Director for the Organisation and it was agreed that this would be addressed and help given with providing supervision for all staff in the home including the ancillary staff. There are records kept of all meetings with staff, and the Registered Manager and senior care staff are able to observe all staff working in the home during the working day. As there is an awareness of the necessity for more one to one supervision and a commitment to resolving the matter neither a requirement or recommendation will be made. The Inspector noted that all records in the home are kept securely. The home makes the health safety and welfare of service users and staff a priority. The Inspector saw a recent fire risk assessment undertaken by the Registered Manager that was comprehensive and included sources of The Pines Nursing Home DS0000037262.V319075.R01.S.doc Version 5.2 Page 23 ignition/fuel/risk to service users, staff and visitors/ structural features that may allow fire to spread/ means of escape/ fire detection/ equipment and management. The Registered Manager told the Inspector that she is communicating with a residential home and church nearby to make arrangements for service users to be carried to safety should it be necessary following outbreak of fire in the Pines. A log-book is kept for checking fire equipment and was seen to be up to date. The Organisation has a Business Continuity Planning Officer who assists in the planning for such an event. There is also a separate company that is employed to undertake regular fire safety checks on The Pines. Electrical equipment is tested for safety (portable appliance testing) and an additional record kept of all equipment in service users rooms. Water outlets are tested for temperature plus checks for water safety and cleanliness in water tanks, the Inspector was shown a water bacteriology report. The Registered Manager is pro-active in providing training in all aspects of health and safety for staff i.e. moving and handling, fire safety, first aid, food hygiene and infection control, she also downloads information on the website from the Food Standards Agency to support food hygiene information and from the Health Protection Agency relating to pandemic flu and the outbreak of the Norovirus. The Inspector noted that an accident recording system was in place and the Registered Manager makes a monthly audit of all accidents in the home to ensure the home manages risk and safety of service users and staff appropriately and avoids as far as possible subsequent accidents and incidents occurring. All service users have their own call alarm systems worn around their neck to ensure they are able to summon assistance at any time. The Pines Nursing Home DS0000037262.V319075.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 4 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 3 3 3 3 3 4 4 The Pines Nursing Home DS0000037262.V319075.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Pines Nursing Home DS0000037262.V319075.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Pines Nursing Home DS0000037262.V319075.R01.S.doc Version 5.2 Page 27 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!