Care Home: Pinewood

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What the care home does well People`s needs are thoroughly assessed before they move into the home. This helps to assure people that the home will be able to meet their needs. The manager makes sure people who live in the home are involved in making decisions about their lives. These are set out in clear care and support plans, which helps staff to provide the support that people need. People take part in a range of activities they enjoy and are supported to choose what they take part in. Staff provide personal care in a dignified way that protects people`s privacy. People are supported to attend the health services they need and take their medication safely. There are good systems for dealing with complaints and protecting people from abuse. This gives people confidence that any complaints will be taken seriously and responded to. The home is well maintained and provides a clean, comfortable and safe environment for people.Staff are well trained, which helps to ensure they have the skills to meet people`s needs. The home is well managed and people are regularly asked what improvements they think are needed. What has improved since the last inspection? This is the first inspection of Pinewood since it was registered. CARE HOME ADULTS 18-65 Pinewood 63 Locks Road Locksheath Southampton Hampshire SO31 6NS Lead Inspector Craig Willis Key Unannounced Inspection 9th May 2008 2:00 Pinewood DS0000071298.V363449.R01.S.doc Version 5.2 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 Pinewood DS0000071298.V363449.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 Adults 18-65. 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. Pinewood DS0000071298.V363449.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Pinewood Address 63 Locks Road Locksheath Southampton Hampshire SO31 6NS 023 8087 4300 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) www.hantspt.nhs.uk Hampshire Partnership NHS Trust Mrs Patricia Warwick Care Home 4 Category(ies) of Learning disability (0) registration, with number of places Pinewood DS0000071298.V363449.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Learning disability (LD). The maximum number of service users to be accommodated is 4. Date of last inspection Brief Description of the Service: Pinewood is registered to provide care and accommodation for four people with learning disabilities. The home is situated in a residential road close to the centre off Locksheath. Each person has their own bedroom and shares the use of a bathrooms, lounge, kitchen and dining room. There is a garden, which is accessible to people with physical disabilities. The Providers are Hampshire Partnership NHS Trust. Pinewood DS0000071298.V363449.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The evidence used to write this report was gained from a review of the information the provider sent to us since the home was registered. This information included an annual quality assurance assessment completed by the manager. A site visit to the home was made on 9 May 2008, with a follow up visit on 13 May 2008 to meet with the manager who was not present during the first visit. During the visit we met both people who live in the home and observed their interactions with staff. We received comments from a relative of a person who lives in the home and spoke with the manager and staff on duty. The communal areas of the building were viewed and documents relating to the running of the home were inspected during the visit. What the service does well: People’s needs are thoroughly assessed before they move into the home. This helps to assure people that the home will be able to meet their needs. The manager makes sure people who live in the home are involved in making decisions about their lives. These are set out in clear care and support plans, which helps staff to provide the support that people need. People take part in a range of activities they enjoy and are supported to choose what they take part in. Staff provide personal care in a dignified way that protects people’s privacy. People are supported to attend the health services they need and take their medication safely. There are good systems for dealing with complaints and protecting people from abuse. This gives people confidence that any complaints will be taken seriously and responded to. The home is well maintained and provides a clean, comfortable and safe environment for people. Pinewood DS0000071298.V363449.R01.S.doc Version 5.2 Page 6 Staff are well trained, which helps to ensure they have the skills to meet people’s needs. The home is well managed and people are regularly asked what improvements they think are needed. 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. Pinewood DS0000071298.V363449.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Pinewood DS0000071298.V363449.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good systems to assess people’s needs before they move into the home. This reassures people that the home will be able to meet their needs. EVIDENCE: Both of the people who use the service moved into Pinewood when it opened from another home also run by Hampshire Partnership NHS Trust. The staff team have supported the two people in their previous home and also transferred when this home opened. People’s needs had been thoroughly assessed at their previous home. The assessments were updated prior to moving to Pinewood, to ensure that the new environment would be suitable to meet their needs. The home currently has two vacancies and the manager reported that they are in the process of assessing someone to see whether they will be able to meet their needs. This assessment process includes an opportunity for the person to visit the home and meet staff and other people who live there. The home has information about the services that people interested in living there can read. This has been made available in a more accessible format, to aid understanding. The Trust has a policy and procedure on the assessment of people who may use the service, which the manager was aware of. Pinewood DS0000071298.V363449.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 and 9. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There are excellent care planning and risk assessment systems, which involve people in making decisions about their lives where possible and helps staff to provide the support that people need. EVIDENCE: The records of both people who live in the home were inspected during the visit. People had a care and support plan, which set out how their assessed needs should be met. The plans seen contained very detailed information about how staff should provide support to meet people’s needs and aspirations. Plans are reviewed every two months and there was clear evidence that plans had been amended where people’s needs have changed. Plans include support that is needed to develop skills, for example household jobs. People who live in the home are encouraged to participate in reviewing their plans and are able to invite representatives to help them, for example family members. Pinewood DS0000071298.V363449.R01.S.doc Version 5.2 Page 10 Details of how people should be supported to make decisions are set out in the care plans. Staff have supported people to make choice cards, which are laminated and attached to a key ring to make them easy to take out with people. People are able to use these cards to communicate their choices, for example what activities to participate in or choices about food. Each day staff complete a participation record, which records how people were supported to participate in activities and make choices. One relative who completed a survey form for us commented, “there is a strong ethos of choice…every effort is always made to maximise [their relative’s] choices and enjoyment of life”. Risk assessments have been completed for both people living in the home and include clear information about how to minimise the identified hazards. These assessments are reviewed regularly and had been amended where assessed as necessary. Staff spoken with demonstrated a good understanding of people’s needs and the importance of supporting people to make decisions about their lives. Pinewood DS0000071298.V363449.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides good support for people to take part in a range of activities, to maintain contact with family and friends and to maintain a healthy diet. EVIDENCE: People are supported to take part in a range of activities, including day services, visits to the local pub and shops, bowling and bingo. The manager reported that she is currently trying to secure funding for people to transfer from their old day service, which is approximately 10 miles away, to one that is approximately 5 minutes walk from Pinewood. Currently staff are providing transport to the old day service in the home’s minibus, but it is felt that this is not meeting people’s needs. The manager reported that she is researching alternative activities for people within the local community, for example evening activities. Pinewood DS0000071298.V363449.R01.S.doc Version 5.2 Page 12 People are supported to maintain contact with their friends and family, with staff providing support for people to visit family where necessary. On the day of the visit, one person was supported to go and visit a relative at their house. During the visit, staff were seen to be respecting people’s right to privacy by knocking on bedroom doors and waiting for a reply before entering and by allowing people to spend time alone. Staff were observed interacting with people who live in the home in a relaxed, friendly and respectful manner. The daily records showed staff respect people’s wishes when they communicate that they do not want to take part in an activity. The home has a planned four-week menu, which is based on people’s likes and dislikes. The menu is displayed in a pictorial format to help people understand it and alternatives are available from a well-stocked kitchen. People are supported to choose their own breakfast and lunch, with help from staff to provide a balanced diet. People are encouraged to take part in meal preparation. Mealtimes are flexible to fit round activities and snacks are available at any time. One relative who completed a survey for us said their relative’s “diet is very good, with lots of fruit and vegetables”. Pinewood DS0000071298.V363449.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s personal and health care is well met by staff who know their needs. There is a good system to safely store and administer people’s medication. EVIDENCE: Care plans contain details of the personal care support people need and how it should be provided, including details of gender specific care. The relative who completed a survey for us said that their daughter’s privacy and dignity are always respected. Staff spoken with demonstrated a good understanding of people’s personal care needs and how they should be met. People are supported to attend a range of health services, including GP, nurse, dentist and optician. Details of consultations are recorded, including any advice given by the practitioner. Each person has a health action plan, which is reviewed every two months. This identifies whether people are receiving the health services they need. Pinewood DS0000071298.V363449.R01.S.doc Version 5.2 Page 14 Medication is securely stored in a locked cupboard in each person’s bedroom and tablets are supplied in a monitored dosage system. A record is kept of medication coming into the home and returned to the pharmacist for disposal. The medication administration record for the current month was inspected and had been fully completed. A record is available of medication that is returned to the pharmacist for disposal. All staff administering medication have received assessed training. Staff reported that neither of the people who live in the home are currently able to take their own tablets. Pinewood DS0000071298.V363449.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good systems for dealing with complaints and responding to allegations of abuse. This gives people confidence that any complaints will be taken seriously and responded to. EVIDENCE: The home has a complaints procedure, which is provided to all people living at the home in a pictorial format to make it more accessible. The manager reported in the annual quality assurance assessment that the home has not received any complaints. We have not received any complaints about the home since it opened. The relative who completed a survey for us said “the manager acts immediately to any concerns I may have and ensures that they are corrected / addressed”. Staff have completed training in safeguarding adults. Staff spoken with demonstrated a good understanding of different types of abuse and the action they should take if abuse is witnessed, reported or suspected. There is a policy and procedure on safeguarding adults and the prevention of abuse, which staff and the manager demonstrated a good understanding of. The Trust has a system for reviewing any incidents and ensuring any changes that need to be made across all their services are communicated to staff. Pinewood DS0000071298.V363449.R01.S.doc Version 5.2 Page 16 The finance records of both people were inspected during the visit. Records matched the cash held for both. Cash was held in locked tins in a safe. Receipts were obtained where staff had spent money on people’s behalf. Pinewood DS0000071298.V363449.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 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 is well maintained and provides a clean, comfortable and safe environment for people. EVIDENCE: All of the home’s communal areas were viewed during the visit. The home was refurbished throughout before opening and is maintained to a high standard, with good quality, domestic furniture and fittings. People living in the home have access to a lounge, kitchen and dining room. Staff reported that there have been some difficulties with maintenance since the home opened, but these are mostly resolved. There is a bathroom on the ground floor, which is fitted with an assisted bath suitable to meet people’s needs. There is an additional bathroom on the first floor. There is a garden to the rear of the home, which people were using during the visit. Adaptations and aids have been fitted to meet people’s specific needs, for example, one person has a music system in their bedroom that is operated by large buttons fixed to the wall by their bed. This means the person is able to control the music herself. Pinewood DS0000071298.V363449.R01.S.doc Version 5.2 Page 18 The home has a separate laundry room that is fitted with machines capable of hygienically washing soiled clothing. The home is clean throughout. Hand washing facilities are suitably situated in the kitchen, laundry, toilets and bathrooms. Pinewood DS0000071298.V363449.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are well trained and there are good systems to check staff before they work in the home. This helps to keep people safe and ensure staff can meet their needs. EVIDENCE: The manager reported in the annual quality assurance assessment that seven of the eight staff have achieved the National Vocational Qualification (NVQ) at level 3 and one is currently completing the award. Staff members were observed spending time listening to and interacting with people who live in the home. The relative who completed a survey for us reported that some of the staff were “exceptionally good”, although others needed support from the manager. Staff spoken with said they felt there were sufficient staff on each shift to provide the support that people need. The manager reported in the annual quality assurance assessment that all staff who have worked in the home over the last twelve months have had satisfactory pre-employment checks. The files of three members of staff were inspected. All had written references on file and confirmation that a Criminal Records Bureau (CRB) disclosure had been obtained. Pinewood DS0000071298.V363449.R01.S.doc Version 5.2 Page 20 The home has an on-going training programme and staff reported that they receive good training, which helps them meet people’s needs. Staff training records indicated people had completed an induction and courses including medication administration, first aid, safeguarding adults, food hygiene, strategies for crisis intervention and prevention, moving and handling and fire safety. The manager has identified staff members’ training needs with them individually and planned courses throughout the year. Pinewood DS0000071298.V363449.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed, which helps to keep people safe and there are good systems to make improvements to the service based on the views of people who live there. EVIDENCE: The manager has completed the NVQ 4 in care and the registered manager’s award. Staff spoken with said they thought the manager was very supportive. The manager reported that she was retiring at the end of May 2008 and the Trust is in the process of recruiting a new manager. A locality manager visits the home every month and assesses the quality of the service that is being provided. Reports of these visits are made and sent to the manager and the responsible individual in the Trust. The reports contain a Pinewood DS0000071298.V363449.R01.S.doc Version 5.2 Page 22 list of any actions that are needed and an update of actions that were required in the previous report. There are regular audits of the service, including a ‘property hazard report’ and the self-assessment the manager completed for us before this visit. There is an annual survey of people who live in the home, staff and other stakeholders. The responses to these surveys are collated and used to plan improvements to the service. The home has an annual development plan, which highlights three areas for improvement and sets out how to measure whether the improvements have been successful. In addition to these local improvement plans, the Trust has a strategic plan to improve the quality of the service provided. The manager reported in the annual quality assurance assessment that the electrical system, fire detection and fighting equipment and gas system are regularly serviced and maintained. These records were sampled during the visit and confirmed the manager’s report. Pinewood DS0000071298.V363449.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 4 X X 3 X Pinewood DS0000071298.V363449.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? N/A 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 Pinewood DS0000071298.V363449.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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. 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