Care Home: Pine Lodge

What the care home does well Care plans are being updated to include good information for staff to ensure that they support people in the right way. Staff have received training on moving and handling and the administration of medicationand training has been arranged on pressure area care. The acting manager demonstrated a good awareness of the areas that require improvement and had already taken steps to address some of the shortfalls. People staying at the home spoke highly of the staff. What the care home could do better: Where people have specific health needs due to epilepsy, their care plan must include detailed instructions to staff on how they should support and care for people before, during and after a seizure as well as noting any known triggers. Care plans need to be evaluated to ensure that they continue to reflect the care and support that people require. The homes statement of purpose should be reviewed to ensure that it accurately reflects the service offered. People`s needs must be fully assessed before they stay at Pine Lodge to ensure that the service can meet their needs. Quality monitoring visits as required by regulation 26 of the Care Homes regulations 2001 need to take place monthly in order to monitor the improvements and areas that require development within the service. Risk assessments need to detail the risks to people living at the home, staff and others and clearly state what staff need to do to reduce the risk to an acceptable level. Random inspection report Care homes for adults (18-65 years) Name: Address: Pine Lodge Motala Close Corby Northants NN18 9EJ two star good service 03/02/2009 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Catherine Perrins Date: 2 2 0 1 2 0 1 0 Information about the care home Name of care home: Address: Pine Lodge Motala Close Corby Northants NN18 9EJ 01536742043 01536742043 jwinters@northamptonshire.gov.uk www.northamptonshire.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Northamptonshire County Council Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 15 Number of places (if applicable): Under 65 Over 65 0 physical disability Conditions of registration: 15 A maximum of 1 person who has a physical disability or physical disability/learning disability and is over the age of 65 years (PD(E) & PD/LD(E)) may be accommodated at any one time. A maximum of 4 people may be accommodated who have a physical disability and a learniing disability. (PD/LD). The home is registered to accommodate 15 people in the category PD (18 - 65 years) for a maximum period of 6 months. The three bedrooms in flat 3 that are less than 12 square metres must not be used to accommodate wheelchair users. The total number of service users must not exceed 15. Date of last inspection Care Homes for Adults (18-65 years) 0 3 0 2 2 0 0 9 Page 2 of 10 Brief description of the care home Pine Lodge is a home run by the local authority. The home currently offers rehabilitation and respite care to people with a physical disability and can accommodate up to 4 people who have a physical disability and an associated learning disability. All accommodation is on the ground floor. The unit is divided into three flats two are designated for respite care, the others are for rehabilitation with a maximum stay of six months. Each flat has a lounge /dining area and kitchenette. There is a communal area used by all three flats and a main kitchen and laundry. Service users access local day/work placements or stay within the home during the day. The home is close to local amenities such as the post office, shops and library. There is a social club nearby that is used by service users. Fees range between 47 pounds per week and 673 pounds per week; fees are dependent upon indivdual circumstances and are arranged with Northamptonshire County Council. Items that are not included in the fees are personal services such as hairdressing and personal items such as toiletries and clothing. Care Homes for Adults (18-65 years) Page 3 of 10 What we found: This was an unannounced random inspection which focused on the administration of medication and care planning. Prior to the inspection we reviewed the information that we have received from the service, this included notifications of incidents and an action plan that the service have drawn up to show how they are addressing concerns raised. We also looked at information that we have received from other sources such as a recent investigation by the safeguarding adults team. The inspection visit lasted five and a half hours during the morning and afternoon of a weekday. During the inspection two people were case tracked. This involves looking in detail at all aspects of their care and experiences at Pine Lodge, including looking as their individual plans of care and other records, talking to them and talking to their care staff. A manager from another Northamptonshire County Council service who is providing cover for Pine Lodge was present for the majority of the inspection. At the time of inspection the registered manager was suspended from work by Northamptonshire County Council while they investigate concerns about the management of Pine Lodge. The home has a Statement of Purpose which gives people good information about Pine Lodge and the services it offers. The Statement of Purpose states that the service offers rehabilitation to people for up to six months. It was noted that some of the people staying at the home had been there for a year and a half. Each person staying at Pine Lodge has an individual plan of care. This contains their care plans and other information that staff need to care for them in the right way. Care plans seen covered areas such as personal care, mobility, health and continence. They contained some detail about peoples preferences such as what time they liked to get up and go to bed. The care plan for one person gave staff clear information about the support he needed support to transfer from his chair to his bed or to another chair and how he needed to be helped with personal care. Care plans contained an evaluation sheet for staff to note any observations or comments about the care plan. These had not been completed for the care plans seen. Not all of the people staying at the home had an initial assessment on their file to show that their needs had been assessed before they moved to the home. Records were not always clear about the purpose of peoples stay at Pine Lodge and what they aimed to get out of their time there. Individual plans of care did include goals that people wanted to achieve during their stay but the goals for one person did not fully address one of the main reasons for his admission. The acting manager told us that the service is currently reviewing its admission process to ensure peoples needs are fully assessed before they move to Pine Lodge. One person who has epilepsy did have a recording chart on their file to record details of any seizures. There was also a general advice sheet for staff which told them what to do if someone has a seizure. There was no individual epilepsy care plan for the person so staff did not have any specific details, such as possible triggers for seizures, usual length of seizures or usual recovery time for that person. Care Homes for Adults (18-65 years) Page 4 of 10 The acting manager told us that she had carried out on audit of staff training and that all staff now have training in moving and handling. She stated that all staff are due to attend training in pressure area care in the near future. Records show that assessments are made of risks to the people staying at the home and to staff supporting them. Risk assessments seen contained some information about the risks, but did not fully detail all of the relevant information, such as measures in place to reduce the risks or clear instructions of what staff needed to do to keep themselves and others safe. It was noted in one persons file that they had told staff that they may harm themselves. Discussions with the acting manager suggested that the risk of this happening was low but this risk had not been formally assessed and documented. The administration of medication is generally well managed with all entries on the medication record being signed to show that people are receiving their medication as prescribed. Records show that one person regularly refused to take a pain killer that they have been prescribed suggesting that they may not need to be prescribed it as regular medication but as required. The acting manager told us that she had noted this and was going to discuss it with the prescribing doctor. The acting manager stated that she was conducting weekly audits of all of the medication in the home.The acting manager told us that staff in the home have recently received training on the administration of medication and that their competence to administer medication was going to be assessed through observation of their practice. The home conducts quality monitoring audits as required by regulation 26 of the Care Homes Regulations 2001.The acting manager stated that an audit of this kind had recently been carried out but the record was not available due to a problem with the computer system on the day of inspection. Records of previous visits show that these audits have not been being carried out monthly with the previous one being in November 2009 and then August 2009. People staying at the home spoke highly of the staff saying that they are very obliging and helpful and they come quickly if I ring the bell. People told us that the facilities at the home were not too bad. but went on to say that only having one shower in the home did cause some problems as most people preferred to shower rather than bath. It was also mentioned that some items in the kitchen, such as the microwave and plug for the kettle were not at an accessible height for people using wheelchairs. A recent inspection from the Fire Protection Officer highlighted several areas that the home must attend to to comply with legislation and to ensure peoples safety. These included servicing fire extinguishers and developing personal emergency evacuation plans for each of the people staying at the home. What the care home does well: Care plans are being updated to include good information for staff to ensure that they support people in the right way. Staff have received training on moving and handling and the administration of medication Care Homes for Adults (18-65 years) Page 5 of 10 and training has been arranged on pressure area care. The acting manager demonstrated a good awareness of the areas that require improvement and had already taken steps to address some of the shortfalls. People staying at the home spoke highly of the staff. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Adults (18-65 years) Page 6 of 10 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 7 of 10 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 2 14 An assessment of peoples needs must be undertaken before they stay at Pine Lodge. To ensure that the service can meet their needs 31/03/2010 2 6 15 Care plans must be evaluated and updated on a regular basis to ensure that they reflect peoples current needs and give clear information to staff on how peoples needs should be met. To ensure that staff have the relevant information to meet the needs of people using the service. 31/03/2010 3 6 12 Where people have specific health needs their care plan must include detailed instructions to staff should support and care for them. To ensure that people receive the appropriate care and support. 31/03/2010 Care Homes for Adults (18-65 years) Page 8 of 10 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 4 9 13 Risk assessments need to 31/03/2010 detail the risks to people living at the home, staff and others and clearly state what staff need to do to reduce the risk to an acceptable level. To ensure the health and safety of all. 5 39 26 Quality monitoring visits as required by regulation 26 of the Care Homes regulations 2001 need to take place monthly. To monitor the improvements and areas that require development within the service. 28/02/2010 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 1 The homes statement of purpose should be reviewed to ensure that it accurately reflects the service offered. Care Homes for Adults (18-65 years) Page 9 of 10 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. 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