Care Home: Pinehurst Residential Home, Dawlish

Annual service review Name of Service: Pinehurst Residential Home, Dawlish The quality rating for this care home is: The rating was made on: two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection We do an annual service review when there has been no key inspection of the service in the last 12 months. It does not involve a visit to the service but is a summary of new information given to us, or collected by us, since the last key inspection or annual service review.   Has this annual service review changed our opinion of the service?   No You should read the last key inspection report for this service to get a full picture of how well outcomes for the people using the service are being met. The date by which we will do a key inspection: Name of inspector: Judith McGregor-Harper Date of this annual service review: 0 3 1 2 2 0 0 9 Annual Service Review Page 1 of 7 Information about the service Address of service: 1-2 Haldon Terrace Dawlish Devon EX7 9LN 01626863500 01626863500 pinnhurst@tiscali.co.uk Telephone number: Fax number: Email address: Provider web address:   Name of registered provider(s): Conditions of registration: Category(ies) : mental disorder, excluding learning disability or dementia Conditions of registration: Minimum age group 40 years. Pinehurst Partners Limited Number of places (if applicable): Under 65 Over 65 20 20 The home is registered for 20 service users in the category Mental Disorder MD. The home is registered for 20 service users in the category Mental Disorder over 65 years of age MD(E) Have there been any changes in the ownership, management or the No service’s registration details in the last 12 months? If yes, what have they been: Date of last key inspection: Date of last annual service review (if applicable): Brief description of the service Pinehurst is a care home providing personal care and accommodation for 20 adults aged between 40 to 65 years and above, with a mental health problem. Mr. Anthony Squire is the provider and registered manager of the service. The home is a large grade II listed building forming part of a terrace of houses in a private road, close to Dawlish town centre, with shops, public houses, a post office, a railway station and other amenities. There is easy access into the city of Exeter, by a regular bus and train service. The accommodation is on three floors with access via the main staircase to all floors. The ground floor consists of 3 single bedrooms, 2 lounges (smoking is permitted Annual Service Review Page 2 of 7 in one of these lounges) and a third smaller, more private, lounge area. The first floor has 9 single bedrooms and 1 double bedroom. There are 6 single bedrooms on the second floor. Bathrooms and toilets are located on all floors. At the front of the property there is a veranda with seating. There is also a very pleasant courtyard with potting shed, potted plants, and some seating. Please contact the provider for the current range of fees. At the last key inspection in 2007 the fees ranged from 350 - 475 pounds per week based on the care needs of the residents. Annual Service Review Page 3 of 7 Service update since the last key inspection or annual service review: What did we do for this annual service review? We looked at all the information that we have received, or asked for, since the last key inspection or annual service review. This included. 1/ The annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. 2/ Surveys returned to us by people using the service and from other people with an interest in the service. 3/ Information we have about how the service has managed any complaints. 4/ What the service has told us about things that have happened in the service, these are called notifications, and are a legal requirement. 5/ The previous key inspection and the results of any other visits that we have made to the service in the last 12 months. 6/ Relevant information from other organisations. 7/ What other people have told us about the service. What has this told us about the service? We received survey responses from ten people who live at the home. The tone of responses was positive. Two people said they completed surveys by themselves, others had assistance. We noticed that assistance was given by staff members to complete surveys. In order to demonstrate that survey responses cannot be construed as biased where people require assistance in completing a survey we advise the service to ensure that future survey returns solicit the assistance of advocates from outside of the employment of the service. Two people, in describing what the service does well wrote, everything and everything is fine. Two people mentioned menu changes would further improve the service. All people who responded indicated they were able to raise concerns in the home and knew whom to speak to. Two people told us they we not asked if they wanted to move into the home. Surveys told us that the staff and managers treat them well and that staff listen and act on what they say. One person said they think staff should have more time to spend with clients. We received survey returns from nine staff who work at the home. All staff told us preemployment checks were carried out before they started work. Staff told us they knew what to do if someone in the home had concerns. Staff said they received management support and either usually or always had information about the people who live at the service, to enable them to care for people living there. Five respondents said usually there were enough staff on duty; four staff said there were always enough staff on duty. Two staff said their induction mostly covered what they needed to know, other respondents said the induction covered what they needed to know very well. The home sent us their annual quality assurance assessment (AQAA) on time. The information provided in the AQAA differed little from that provided on the previous AQAA dated the 30/08/07. There was only brief information given regarding plans to develop the service during the next 12 months. Where plans are these focus on environmental upgrades and proposed leisure opportunities for people who live at the service. There were generalised comments concerning the encouragement of people to Annual Service Review Page 4 of 7 be involved in the service but there was scant evidence of examples and poor evidencing of outcomes from consultation with people who live at the service. The AQAA was completed neither correctly nor fully. The section asking the home to evidence Standards 1 - 6 Choice of Home listed in-house quality assurance processes and staff training statistics. In this section the AQAA did not provide us with the information we asked for. The AQAA failed to complete sections where we asked for information about in-house polices on staff induction and foundation training, the policy on an annual development plan for Quality Assurance processes, policies on emergencies and crises and physical intervention and restraint. Given the category of registration we would expect the service to have developed such polices. The AQAA also did not provide us information regarding peoples contract review nor whether CSCI/CQC inspection reports are made available to people who live at the service. We were given no information to how the service plans to deliver best practice in prevention and control of infection, and no information on nutritional screening and managing the risk of malnutrition. We were given no information in the AQAA confirming staff recruitment checks. The AQAA told us that they were sourcing staff training courses in mental health and that the home views this as a potential barrier to improvement. The same information was given to us in the 2007 AQAA. The AQAA does inform us, however that 90 of staff have achieved the NVQ award at level 2 or above. We were informed by the ex-responsible individual in October 2009 that they had left this position. They said they had left at the end of March 2009. The provider failed to put this in writing to us until the 20th October 2009 and to date no named person who will act as the responsible person for the service has been proposed to us. We are told by the home that they have received one complaint during the last 12 months and that this complaint has been investigated and was not upheld. We have not received any complaints directly about Pinehurst. We have received one notification from the home during 2009. Because some information has not been supplied that tells us that full staff recruitment checks have been carried out and some information is missing to whether there are robust internal processes for managing the control of infection, behaviours that may challenge, staff induction and quality assurance we cannot be sure that the service continues to provide a good quality service for people who live at the home. Due to these concerns we wrote to the homes manager and provider Mr. Squire to ask for reassurances on these matters. Mr. Squire responded to our letter in writing and we also had the opportunity to discuss these issues with Mr. Squire by telephone. We are now reassured and satisfied that the service continues to provide good quality outcomes for the people who live there. We advised Mr. Squire that he may benefit from discussing with industry associates how to better evidence outcomes for people linked to the National Minimum Standards for future Quality Assurance returns to the Commission. We have also now been advised that the responsible person for the home is Mr. Squire, as both proprietor and registered manager. What are we going to do as a result of this annual service review? Annual Service Review Page 5 of 7 We will carry out a key inspection for this service by 30th October 2010. We can, however, inspect the service at any time should we have concerns about outcomes for people living there. 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