The Pines

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 58 (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 always ensure people received effective care and treatment. Staff did not consistently assess, discuss or review people’s health, wellbeing and communication needs with the skills required to do so safely.

Assessments were not always completed by staff with the appropriate training or competency. For example, we found staff were assessing and cleaning stoma sites without evidence they had been trained or assessed as competent in this high risk area of practice. This meant people were at risk of being inaccurately assessed or receiving unsafe care.

We saw that people’s care plans and risk assessments were being reviewed regularly. The provider described systems for assessing people’s needs before they moved into the service, and where health professionals requested observations, such as oxygen saturation monitoring, staff followed these up appropriately.

Although some processes were in place, the lack of skilled and competent staff completing assessments meant people could be exposed to avoidable harm. Inaccurate or incomplete assessments increase the risk of people’s needs being misunderstood, unmet or responded to unsafely.
 

The provider did not always plan and deliver people’s care and treatment in partnership with them. People were not consistently consulted about decisions affecting their care, including what was important and mattered to them.

We found the provider did not always involve people when changes were made to their medicine regimes. This meant people were not consistently included in discussions about their care or given the opportunity to express their preferences or views.

Care plans contained relevant information such as allergies, nutrition and hydration needs and associated risks. We saw that people’s health was monitored and, where concerns were identified, recognised tools such as the Malnutrition Universal Screening Tool (MUST) were used. The provider also told us about their processes for assessing people’s needs prior to them moving into the service.

Although the provider had systems for monitoring health needs, the lack of meaningful involvement in planning and decision making meant people were at risk of receiving care that did not fully reflect their wishes, needs or preferences. This reduced the effectiveness and person centred nature of care and treatment.
 

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

The provider told us they worked closely with the GP surgery to support people with their care and treatment. We found examples of this in people’s care records where community teams were involved in people’s care and provided home visits. We saw people were supported to access care and treatment from community diabetes nurses and were receiving vaccinations.

Staff told us, “We work well as a team, and we know about people’s needs. My colleagues are very supportive and answer what questions I have.”

One relative told us, “I regularly receive updates from the manager regarding my [relative’s] visits to the GP and dentist, as well as any orthopaedic care [they] receive.”
 

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and, where possible, reduce their future needs for care and support.

The provider told us they used guidance such as STOMP to reduce people’s medicine dosage; however, we found some evidence in this report which demonstrated this was not always followed. The provider supported another person to stop smoking. We saw that people had hospital passports in place to ensure information was available when they used external services.

The provider told us how they worked with healthcare professionals to customise people’s meals according to their individual needs. Staff also told us, “When there is a special reason, we are doing close 1:1 monitoring 1:1. During our [shift] routine duty, we are observing any changes to their health, and we report it. We observe for changes during personal care. If there is a special reason, we are closely monitoring according to the GP. For example, two residents had coughing. The paramedics and district nurse visited them to check the pulse, blood oxygen level and temperature. We do that as well.”
 

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Systems were in place to ensure people’s fluid targets were monitored and measured. The provider also told us they created new systems such as graphs, to monitor people’s high-risk conditions including epilepsy
 

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

The provider had processes in place to gain consent to aspects of people’s care such as personal care. We saw the provider completed monthly reviews for this. However, it was not always clear what information and decisions were being reviewed. We fed this back to the provider during the assessment. The provider had processes in place for ensuring that Deprivation of Liberty Safeguard [DoLS] had been applied for appropriately and were monitored and reviewed.