Archived: Pinehurst Care Home

Updated 11 June 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was carried out to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014. We also checked that remedial action had been taken to address shortfalls identified at our last inspection in December 2014.

This inspection was carried out on 04 and 05 April 2016 and was unannounced. The inspection team consisted of four inspectors.

The provider had completed a Provider Information Return (PIR) prior to our inspection. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We considered the PIR and looked at records that were sent to us by the registered manager and the local authority to inform us of significant changes and events.

We looked at 15 sets of records which included those related to people’s care and medicines. We looked at people’s assessments of needs and care plans and made observations to check that their care and treatment was delivered consistently with these records. We reviewed documentation that related to staff management and six staff recruitment files. We looked at records concerning the monitoring, safety and quality of the service, menus and the activities programme. We sampled the services’ policies and procedures.

We spoke with 19 people who lived in the service and seven of their relatives to gather their feedback. We spoke with the regional manager, the registered manager, the deputy manager, three nurses, six care workers, the activities co-ordinator, the maintenance manager, a chef, and two housekeeping staff. We talked to a nurse from the local hospice team and contacted two local case managers who oversaw people’s care in the home. We obtained their feedback about their experience of the service.

Updated 11 June 2016

Pinehurst House Nursing Home provides accommodation and nursing care for up to 30 older people in Sevenoaks. There were 30 people living there at the time of

our inspection, some of whom lived with diagnosed dementia. All of the people living in the service were able to converse with us.

This inspection was carried out over two days by four inspectors on 04 and 05 April 2016. It was an unannounced inspection. As part of our comprehensive inspection, we checked that remedial action had been taken to address shortfalls identified at our last inspection in December 2014, in regard to staffing levels and documentation relevant to the administration of medicines. All remedial action had been taken to achieve compliance with relevant regulations.

There was a manager in post who was registered with the Care Quality Commission (CQC) since 2010. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff knew how to recognise signs of abuse and how to raise an alert if they had any concerns. Risk assessments were centred on the needs of the individual. Each risk assessment included clear measures to reduce identified risks and guidance for staff to follow or make sure people were protected from harm. Accidents and incidents were recorded and monitored to identify how the risks of recurrence could be reduced.

People, relatives and staff told us there was a sufficient number of staff deployed to consistently meet people’s needs. Staffing levels had been calculated taking into account people’s specific needs.There were thorough recruitment procedures in place which included the checking of references.

Medicines were stored, administered, recorded and disposed of safely and correctly. Staff were trained in the safe administration of medicines and kept relevant records that were accurate.

Staff knew each person well and understood how to meet their support and communication needs. Staff communicated effectively with people and treated them with kindness and respect.

Staff had received all essential training and were scheduled for refresher courses. All members of care and nursing staff received regular one to one supervision sessions. Staff reported feeling well supported in their roles.

The CQC is required by law to monitor the operation of Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Appropriate applications to restrict people’s freedom had been submitted and the least restrictive options had been considered.

Staff sought and obtained people’s consent before they helped them. People’s mental capacity was assessed when necessary about particular decisions. Meetings with appropriate parties were held and recorded to make decisions in people’s best interest, as per the requirements of the Mental Capacity Act 2005.

The staff provided meals that were in sufficient quantity and met people’s needs and choices. People praised the food they received and they enjoyed their meal times. Staff knew about and provided for people’s dietary preferences and restrictions.

People’s individual assessments and care plans were reviewed monthly or when their needs changed.

Clear information about the service, the facilities, and how to complain was provided to people and visitors.

People were promptly referred to health care professionals when needed. Personal records included people’s individual plans of care, life history, likes and dislikes and preferred activities. The staff promoted people’s independence and encouraged people to do as much as possible for themselves.

People were involved in the planning of activities that responded to their individual needs. People’s feedback was actively sought at relatives and residents meetings.

Staff told us they felt valued by the registered manager and they had full confidence in her leadership. The registered manager was open and transparent in their approach. They placed emphasis on continuous improvement of the service.

There was a system of monitoring checks and audits to identify the improvements that needed to be made. The registered manager acted on the results of these checks to improve the quality of the service and care.

We made a recommendation about the storage of cleaning equipment and about suitable décor for people living with dementia.