Care Home: Pinetrees

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What the care home does well Records show that people contribute to their care plans with information about their likes and dislikes and what they hope to learn and achieve. People also sign their care plans to show that they agree with what is written. People have active lives with a good range of activities to participate in. Records show that the complaints procedure is explained to people soon after they move into the home. Staff were observed to have a good relationship with people living in the home. One person told us "I get on with staff like anything. I love living here." People have a spacious and well maintained home. What has improved since the last inspection? This is the first key inspection since the home was registered with the Care Quality Commission. What the care home could do better: Develop a service user guide to present information about the home in an accessible manner to people who live there and people who may want to consider moving there. Some of the records relating to the management of risks were not comprehensive enough to ensure that staff members had all of the information they needed to support people in the right way to ensure the safety of all. The address of the Care Quality Commission should be included in the complaints procedure. The current manager needs to register with the Care Quality Commission. Key inspection report Care homes for adults (18-65 years) Name: Address: Pinetrees Pinetrees The Avenue Dallington Northampton Northants NN5 7HA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Catherine Perrins     Date: 0 1 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Pinetrees Pinetrees The Avenue Dallington Northampton Northants NN5 7HA Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Christopher Perks Type of registration: Number of places registered: care home 6 Alkare Ltd Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is 6. The registered person may provide the following category of service only: Care home only - Code PC. To service users of the following gender: either. Whose primary care needs on admission to the home are within the following categories, Mental Disorder, excluding Learning Disability or Dementia - code MD, Learning Disability - code LD. Date of last inspection Brief description of the care home Pinetrees is a large detached property in the Dallington area of Northampton. It has has been recently renovated to provide comfortable and spacious accommodation for up to six people with learning disabilities and / or mental ill health, including people Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 0 6 6 Brief description of the care home who have supervised discharge under the Mental Health Act 1983. Pinetrees was registered as a care home 23/7/09. Alkare, the registered provider is part of a larger company called Tracscare. The provider has other properties in Northampton. The home has good bus links and is within walking distance of facilities such as shops, a doctors surgery and pubs. Part of the property has been converted into a self contained one bedroom flat which has its own lounge, kitchen and bathroom. The fees for the home are assessed on individual need and are in the region of 1800 per week. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is two star. This means the people who use this service experience good quality outcomes. This was an unannounced key inspection which means that we focused on the key national standards. The key standards are those considered by the Commission to have the most impact on outcomes for people using the service. This is the first key inspection that the home has had since it was registered with the Care Quality Commission on 23rd July 2009. As part of the preparation for this inspection a period of two hours were spent reviewing the information that CQC has about this service. We looked at all the information that we have received, or asked for, since the service registered with us. This included: Care Homes for Adults (18-65 years) Page 6 of 28 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. Information we have about how the service has managed any complaints. What the service has told us about things that have happened in the service, these are called notifications and are a legal requirement. The registration reports and documentation. Relevant information from other organisations. The inspection visit lasted four hours during the morning and afternoon of a weekday. During the inspection one person was case tracked. This involves looking in detail at all aspects of their care and experiences at Pinetrees, including looking as their individual plans of care and other records, talking to them and talking to their care staff. A sample of staff files were also viewed as part of the inspection. The manager was present for some of the inspection. Care Homes for Adults (18-65 years) Page 7 of 28 What the care home does well: What has improved since the last inspection? 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are appropriately assessed before they move in to ensure that the home is right for them. Evidence: The home has a statement of purpose which gives people information about the home and the services it offers. The manager explained that this was currently being updated to ensure that it contained accurate and current information. The manager explained that the home does not currently have a service user guide but that one is being developed. This will present information about the home in a way that is more accessible to anyone living at the home or who may be considering moving to the home. Records show that peoples needs are assessed before they move to Pinetrees to make sure that the home is right for them. The manager explained that people are able to visit the home and stay overnight Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: before they move in to help them decide if it is the right move for them. This also gives the other people living at the home the chance to meet anyone considering moving there. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with opportunities to make everyday choices and are supported in living as independent a lifestyle as possible. Evidence: Each person who lives at the home has an individual plan of care. This contains their care plans and other information that staff need to support people in the right way. Care plans seen covered areas such as communication, personal care, mobility, culture and religion, leisure and vocational activities and health. Records show that people contribute to their care plans with information about their likes and dislikes and what they hope to learn and achieve. People also sign their care plans to show that they agree with what is written. One person told us what I like about this place is that I can look at my notes when I want to - this stops me being anxious and worrying about what is written about me. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: People who live at Pinetrees contribute to the running of the home by for example, taking responsibility for cleaning their bedrooms and doing their laundry with staff support as required. Records show that any risks to the people living at Pinetrees, their support staff or others have been assessed and measures put in place to make sure that any risks identified are minimised to an acceptable level. Some of the records relating to the management of risks were not comprehensive enough to ensure that staff members had all of the information they needed to support people in the right way to ensure the safety of all. Some specific examples of this were discussed with the manager during the inspection. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People enjoy active lives both within the home and within their community. Evidence: One person told us that he likes to keep busy saying that he attends a work placement, goes to the gym, goes swimming and goes out to the local pubs. On the day of inspection he was going horse riding which he told us he enjoyed. One person told us how the staff support him to keep in contact with his family by phone and visits. One person explained that he liked computers. Staff explained that he was going to produce a newsletter for all of the local homes within the provider group. The menu was viewed and looked nutritious and varied. One person explained that he Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: was able to chose what he wanted to eat so did not always have what is on the menu. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples personal care and health care needs are being met by staff who understand their needs and deliver care in a respectful manner. Evidence: Records show that people have access to a range of health and social care professionals appropriate to their needs, for example general practitioners, specialist nurses, dentists, podiatrists and opticians. Records show that people are supported to remain in good health for example by having regular reviews of their medication and being offered flu vaccinations. Individual plans of care detail how people are encouraged to be as independent as possible with their personal care and that they are able supported to buy their choice of toiletries. 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. Medication is stored securely and in line with current laws and regulations. Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: Staff explained that, where they are able to, people are encouraged to take responsibility for their own medication. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are protected by the homes policies, procedures and practises. Evidence: The home has a complaints procedure which outlines what people should do if they wish to raise a concern about the home and the response that they can expect. The contact details for the Care Quality Commission were not included in the complaints procedure. The manager said that the home has not received any complaints since the last inspection. Records show that the complaints procedure is explained to people soon after they move into the home. One person told that he would speak to the staff, manager or his care manager if he had any concerns. There have not been any alerts about the home made to the Local Authority under the locally agreed safeguarding adults procedure. Staff spoken to knew how to raise any concerns that they may have and were aware of their responsibilities to safeguard people from harm. The home has not made any applications to the Local Authority under the deprivation Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: of liberty safeguards. Information was available to staff detailing the process to follow should they feel that such an application was necessary. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from living in a spacious, well maintained and comfortable home. Evidence: Pinetrees is a detached property which has been recently renovated to provide comfortable and spacious accommodation. Communal areas consist of a large lounge, a dining room and large kitchen. Part of the property has been converted into a self contained one bedroom flat which has its own lounge, kitchen and bathroom. There are a further five bedrooms, two downstairs and three upstairs. All of the bedrooms have an en suite shower room. There is also a communal bathroom. There is no lift at the property so people accessing the upstairs bedrooms would need to be able to walk up and down the stairs. People are able to personalise their bedrooms with their own belongings. One person told us I wouldnt change my room for anything. I love my room. The property also has a laundry room, office and training room. The property is well maintained and in good decorative order. Communal areas have some pictures and ornaments to make them feel more homely. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: Outside the property there is a garden with an area for people to sit in the warmer weather. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by a staff team who are competent and have a good understanding of peoples needs and preferences. Evidence: The recruitment of staff is well managed with all of the necessary pre recruitment checks being carried out to ensure that staff are suitable to work with people with learning disabilities or mental health conditions. Staff told us that they had an induction when they first started working at the home which included completing a workbook, attending training courses and working alongside an experienced colleague to make sure that they had all of the information that they need to do their job in the right way. The manager explained that staff are assessed to ensure they are competent before they can complete their induction. Staff explained that they attend training courses such as food hygiene, safeguarding of adults, infection control, fire safety and moving and handling. Staff spoken to had a good knowledge of how to safeguard adults and their responsibilities under the locally agreed procedures, however not all staff has received training on safeguarding adults. Staff told us that this training had been arranged for a Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: future date. Staff were observed to have a good relationship with people living in the home. One person told us I get on with staff like anything. I love living here. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is being managed in the best interests of the people who live there and the new manager is putting systems into place to ensure the home runs effectively. Evidence: The home has recently appointed a new manager. He told us that he will be registering with the Care Quality Commission as the registered manager for the home. This is important as all health and social care services must meet the registration requirement for the new Health and Social Care Act 2008, coming into force next year. The manager explained that a number of regular audits are carried out to ensure quality and standards within the home. These included health and safety audits, medication audit and a Information Technology audit. Records show that the necessary safety checks such as fire checks, checks on the water system and portable appliance testing have all been carried out recently. Records show that people living in the home as well as staff receive instruction about what to do in the event of a fire. The manager told us that the home plans to carry out a satisfaction survey once a Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: year. Care Homes for Adults (18-65 years) Page 25 of 28 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, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 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, Care Homes 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 9 13 Risk management plans must detail all of the identified risks posed to or by an individual and the measures put in place to reduce the risk to an acceptable level. To ensure that staff members have all of the information they need to support people in the right way to ensure the safety of all. 13/01/2010 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 2 22 37 The address of the Care Quality Commission should be included in the complaints procedure. The current manager needs to register with the Care Quality Commission. Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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