Pine Lodge

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs. At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant people’s needs were not always met.
 

This service scored 43 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not consistently ensure people were at the centre of decisions about their care, support and treatment. Inspection identified inaccuracies, omissions and inconsistencies within care plans, risk assessments and supporting documentation, reducing assurance that support was always based on people's current needs, wishes and preferences.
We identified examples where care planning and support arrangements had not been reviewed and adapted appropriately when concerns emerged. For example, one service user experienced repeated behavioural incidents during respite stays, resulting in the provider later concluding that Pine Lodge was not an appropriate environment to meet their needs. Despite the recurring incidents, records did not demonstrate robust review of the person's support arrangements, adaptation of care planning, or evidence that alternative approaches had been explored at an earlier stage. This reduced assurance that the person's changing needs were recognised and responded to in a person-centred way.
Family feedback also identified examples where agreed approaches to supporting individuals, including medication administration, dietary requirements and established routines, were not consistently followed. Relatives described occasions where staff did not always understand what was important to the person or how they preferred to be supported.
Although many families spoke positively about regular staff and their knowledge of individuals, the provider could not consistently demonstrate that care was planned, reviewed and delivered in partnership with people or adapted promptly when needs changed. As a result, people did not always receive support that reflected their current needs, preferences and circumstances, limiting opportunities for genuinely person-centred care.
 

The provider did not consistently ensure care was coordinated, joined up or delivered in a way that promoted continuity. Family feedback identified concerns regarding inconsistent communication between the service, families and partner organisations, and highlighted that care could vary depending on which staff were supporting people.
We identified examples where information necessary to support continuity of care was either incomplete, inaccurate or not maintained. Daily records were missing for some respite stays, reducing assurance that important information about people's experiences, health, wellbeing and support needs was available to inform future admissions. We also identified assessments and care planning documentation that contained contradictory information or referred to different individuals, reducing assurance that staff could rely upon records to provide consistent support across successive respite stays.
We further identified that records did not always demonstrate regular review of people's placements, support arrangements and changing needs. This reduced assurance that information gathered from incidents, healthcare involvement, previous respite stays and family feedback was being used to coordinate and improve future care.
Although regular staff were often described positively and there was evidence of communication with healthcare professionals, the provider could not demonstrate that information was consistently shared, maintained and acted upon to support seamless, coordinated care. As a result, people could not always be assured of continuity, consistency and integration of care and support across respite stays and between different services.
 

The provider did not always ensure people, relatives and professionals received appropriate, accurate and up-to-date information. Family feedback identified concerns regarding communication arrangements, including communication books that were not consistently completed and uncertainty regarding respite arrangements and future bookings. We also identified inconsistencies between different records, reducing assurance that information available to staff, families and professionals was always accurate and current. However, many relatives told us regular staff were approachable and willing to discuss people's needs and experiences during their stay. Families generally felt able to contact the service and obtain information when required. Whilst information was often available, the provider could not consistently demonstrate that it was always accurate, maintained and shared in a timely way.

The provider did not always make it easy for people and those important to them to be involved in decisions or to feel confident that their feedback would result in meaningful change. Family feedback identified occasions where concerns had to be raised more than once before improvements were seen and where agreed actions were not always followed through consistently. Some relatives described having to repeatedly pursue information or updates, whilst others felt concerns had remained unresolved for prolonged periods. However, many relatives told us they found staff approachable and felt comfortable raising concerns directly with the service. Families generally felt listened to by frontline staff and some described improvements being made following issues raised. Whilst opportunities existed for people and relatives to provide feedback, the provider could not consistently demonstrate that concerns, suggestions and experiences were always acted upon promptly or used to drive sustained improvements.

The provider did not always ensure people could access respite care and support when it had been booked in advance. Family feedback identified a recurring pattern of short notice respite cancellations which impacted people and their carers. Relatives described cancellations disrupting family plans, reducing opportunities for respite and causing frustration and uncertainty. Some families also reported difficulties obtaining confirmation of future bookings and felt communication regarding alternative arrangements was not always timely. However, families generally valued the service and many described Pine Lodge as an important source of support. People continued to access respite services and many relatives reported that their family member enjoyed attending. Whilst people were usually able to access support, recurring cancellations and communication difficulties reduced assurance that access to respite care was equitable, reliable and responsive to people's needs. Repeated cancellations had a significant impact on families' ability to plan respite arrangements and reduced confidence that support would be available when needed.

The provider did not always ensure people experienced consistent outcomes regardless of who was supporting them. Family feedback identified differences between support provided by regular staff and that provided by agency or unfamiliar staff. Relatives described occasions where agreed routines, communication approaches and support arrangements were not consistently followed, increasing the risk that people's experiences varied depending on the staff available. We also identified concerns regarding documentation, communication and continuity of information which reduced assurance that all staff had access to the information necessary to provide consistent support. However, many relatives spoke positively about regular staff and described them as understanding what was important to people and providing support tailored to individual needs. Whilst positive outcomes were frequently achieved, the provider could not consistently demonstrate that people received the same quality and consistency of support across all staff groups and respite stays.

The provider did not consistently support people to plan for future changes in their care and support needs or ensure that information required to promote continuity of care was accurate, complete and regularly reviewed. We found significant concerns regarding the quality and accuracy of care planning documentation, including incomplete assessments, inconsistent records and care plans containing inaccurate information. These concerns reduced assurance that important information would be available to support future decision-making, particularly when people returned for respite or were supported by unfamiliar staff. There was limited evidence of end-of-life planning within care records. Where people had health conditions that may require future planning, records did not consistently demonstrate that wishes, preferences and future care arrangements had been explored or documented. Family feedback also highlighted concerns regarding continuity of information and care planning. As a result, people could not always be assured that future care and support would reflect their wishes, preferences and changing needs.