Pinewood Residential Home

Updated 31 October 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by one inspector and an Expert by Experience.

An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Pinewood 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.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the Provider Information Return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with 12 people who used the service and three relatives about their experience of the care provided. We spoke with eight members of staff including the provider, registered manager, deputy manager and cook. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included five people’s care records and multiple medicines records. We looked at four staff files in relation to recruitment, training and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We contacted four health and social care professionals and had feedback from two.

Updated 31 October 2019

About the service

Pinewood is a residential care home providing personal and nursing care to 32 people aged 65 and over at the time of the inspection. The home is a large, converted period property with sea views. Accommodation is arranged over four floors and can support up to 35 people.

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

There had been several changes at the service since the last inspection, including a change of registration from a nursing home to a residential home, a change in the management team and a turnover of staff. This, combined with a flu outbreak, had impacted significantly on the running of the service over the previous 12 months. The provider and registered manager told us they had prioritised the care of people at the same time as making improvements to quality and safety. This was still a work in progress

People told us they felt safe living at Pinewood Residential Home. Most risks to people's safety were assessed and managed well, however this was not always the case. Although risks were well understood and managed by staff, there was a potential for error because the information documented on the computerised system, and paper records kept in people’s rooms did not always correspond, and both were in use. A new computerised care planning system was being sourced. In the meantime, the registered manager encouraged staff to refer to the paper care plans, which contained a summary of people’s needs, and had been completed for 90 percent of people at the time of the inspection.

Staff did not always follow best practice guidance when administering medicines. The member of staff administering the medicines was frequently interrupted during the medicines round which meant they were unable to focus fully on the task. The provider took immediate action to address this, ensuring staff understood and followed the processes for administering medicines safely.

The registered manager was in the process of reviewing and updating quality monitoring processes to improve their effectiveness. Policies and procedures were also being reviewed to reflect that the service now provided residential rather than nursing care.

There were systems in place to protect people from abuse and avoidable harm. There were enough staff to support people safely and the provider had robust recruitment processes to help ensure they were suitable for the role.

The registered manager had reviewed and updated the induction and training programme, so that staff received the training they needed to help them do their job effectively. People received the support they needed to maintain their health and wellbeing, including a healthy balanced diet. The provider had considered how the home environment could be adapted to meet people's needs, and was considering further improvements, including pictorial signage to promote the independence of people living with dementia.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff were compassionate and caring and people felt respected and valued as a result. Although the majority of the staff team had started working at the service since the last inspection, they knew people well and had developed positive working relationships with them. Staff enabled people to make choices about their care on a daily basis and the home had a culture that promoted dignity and independence. An equality, diversity and human rights approach was firmly embedded at the service.

People received personalised care that took into account their needs, preferences and backgrounds, including their preferences around end of life care. People enjoyed a dynamic programme of activities, based on their interests and aspirations. This included visiting musicians, arts and crafts and visits from the ‘library ladies’, who brought people books. Community activities incorporated ten pin bowling and cruises on the river. An enabler was employed to support people with activities on a one to one basis. One person told us, “The number one thing about Pinewood is the fact that they make sure all my time is filled with interesting and varied things for me to do.”

The service was able to provide information in a variety of accessible formats, according to people’s individual needs. The registered manager was committed to developing this aspect of the service further.

There was a complaints procedure in place and information about this was displayed in communal areas.

People were involved in the running and development of the service. The service had a person-centred culture that supported people to understand their rights and express their views. Staff were proactive in collecting and acting on people's feedback.

People, relatives and staff felt the provider and registered manager were open and approachable and managed the service well. They commented on the recent improvements at the service. One member of staff said, “It’s a lot better since [managers name] has been here. It’s more organised and there is more structure in the way things are done. It makes it feel a lot more at ease.”.

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

This was a planned inspection based on the previous rating.

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

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.