Pine Martin Grange

Pine Martin Grange is a residential care home providing personal and nursing care for up to 64 people. The service provides support to older adults, some of whom live with a dementia. At the time of our inspection there were 55 people using the service. The home is purpose built and provides accommodation and specialist equipment designed to meet people’s support needs and maximise their independence.

People’s experience of using this service and what we found

People were supported by enough staff who had been recruited safely and had the skills and experience needed to meet their care and support needs. People felt safe and staff understood their role in recognising and acting on concerns of abuse or poor practice. People had their medicines managed safely. Risks to people were assessed, monitored and regularly reviewed. Staff knew people well and understood the actions needed to mitigate the risk of harm whilst respecting people’s rights and freedoms. Infection prevention and control processes were in line with government guidance.

People, their families and the staff team consistently spoke positively about the management of the service, open culture, teamwork and visible leadership. Staff were clear about their roles, and felt involved in the service, listened to and appreciated. Quality assurance processes were robust and used to drive improvements. Learning was shared with staff. Links with other professional bodies had been established which supported up to date best practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection and update

The last rating for this service was good (published 1 September 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained good based on the findings of this inspection.

Please see the safe and well-led relevant key question sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Pine Martin Grange on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Pine Martin Grange is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Pine Martin Grange is a large detached property in Wareham. The home provides long term and respite accommodation for up to 64 older people with personal care and nursing care needs. At the time of our inspection 22 people were living at the home.

The service did not have a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission 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. The registered manager had handed in their notice four days prior to our inspection. The regional director explained that the current deputy home manager was acting up and had started the registration process with us.

People, staff and relatives told us they felt there weren’t enough staff which left people at potential risk of harm. At times where people requiring two staff are receiving personal care and the team leaders or seniors are completing paperwork or administering medicines there is no staff member on the floor supporting others. The regional director and deputy home manager acknowledged our concerns and by the end of day two told us that they had agreed with the provider to increase staffing levels by 12 hours per day over the next three months when it would be reviewed again.

People, relatives, health professionals and staff told us that Pine Martin Grange was a safe home. Safeguarding alerts were being managed and lessons learnt by the home. Staff were able to tell us how they would report and recognise signs of abuse and had received training in safeguarding. Medicines were managed safely, securely stored, correctly recorded and only administered by staff that were trained and assessed as competent to give medicines.

People were supported by staff who understood the risks they faced and valued their right to live full lives. Risk assessments in relation to people’s care and treatment were completed, regularly reviewed and up to date.

Care plans were in place which detailed the care and support people needed to remain safe whilst having control and making choices about their lives. Each person had a care plan and associated files which included guidelines to make sure staff supported people in a way they preferred. Staff were able to access care plans and guidance on the go via their hand held devices.

Staff had a good knowledge of people’s support needs and received regular local mandatory training as well as training in response to people’s changing needs. Staff told us they received regular supervisions which were carried out by the management team. Staff told us that they found these useful. We reviewed records which confirmed this.

Staff were aware of the Mental Capacity Act and training records showed that they had received training in this. Capacity assessments and best interest decision paperwork had not always been completed correctly. The management team were reviewing this.

People and relatives told us that the food was good. We reviewed the menu which showed that people were offered a variety of healthy meals. The head chef told us that the menu was reviewed every four weeks with people’s input.

People were supported to access healthcare appointments as and when required and staff followed professional’s advice when supporting people with ongoing care needs. Records we reviewed showed that people had recently seen the GP, district nurses and a chiropodist.

People, professionals and relatives told us that staff were caring. We observed positive interactions between staff, managers and people. This showed us that people felt comfortable with the staff supporting them.

Staff treated people in a dignified manner. Staff had a good understanding of people’s likes, dislikes and interests. This meant that people were supported by staff who knew them well.

People had their care and support needs assessed before being admitted to the service and care packages reflected needs identified in these. We saw that these were regularly reviewed by the service with people, families and health professionals when available.

People were encouraged to feedback. Regular relative and resident meetings took place.

There was an active system in place for recording complaints which captured the detail and evidenced steps taken to address them. Outcomes were not always clearly recorded and we were told this would be reviewed. The deputy home manager told us that lessons were learnt and shared with staff in meetings. This demonstrated that the service was open to people’s comments and acted promptly when concerns were raised.

Staff had a good understanding of their roles and responsibilities. Information was shared with staff so that they had a good understanding of what was expected from them. Staff told us they felt recognised.

People, relatives, professionals and staff felt that the service was well led. There had been a number of management changes over the past 12 months however; staff told us they felt the management of the home was now stable. The deputy home manager and regional director both encouraged an open working environment.

The service understood its reporting responsibilities to CQC and other regulatory bodies they provided information in a timely way.

Quality monitoring systems within the home were robust and effective. Audits and additional checks were completed by the regional director. The management team analysed the detail and identified trends, actions and learning which was then shared as appropriate.

The service worked in partnership with other agencies. Professionals told us that communication and information sharing with the home was good.