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Pinewood Residential Home Good

Reports


Inspection carried out on 6 August 2019

During a routine inspection

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 broug

Inspection carried out on 18 January 2017

During a routine inspection

We carried out an unannounced comprehensive inspection on 18 and 30 January 2017. Pinewood Nursing Home provides accommodation for up to 33 people who need support with their personal care. The home provides support for older people requiring nursing care and for some people who are living with dementia. The home is a large, converted period property with sea views. Accommodation is arranged over four floors and there is a talking passenger lift to assist people to get to all floors. The home has 31 single bedrooms, with two which can be used as double rooms if two people choose to share. There were 28 people living at the home at the time of our inspection, two of these people were residential and had their nursing needs met by the community nurse team.

We had previously carried out a comprehensive inspection of this service in November 2014. A breach of a legal requirement had been found at that inspection. The breach was because there were not accurate records in relation to the care and treatment people were receiving. At this inspection we found action had been taken regarding these concerns and the requirement had been met.

The registered manager had left the service in December 2015 and has submitted their application to deregistered with the Care Quality Commission (CQC). 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. A new manager was in post who had undertaken an induction period with the registered manager before they left. The manager had started the process to registered with the CQC to become the registered manager at the service. Staff were very positive about the new manager saying they were approachable and always available if they wanted to talk with them.

There were adequate staffing levels to meet people’s needs. The manager had made changes to the deployment of staff which staff said meant they could meet people’s needs more effectively. There were also two registered nurses on duty each morning which enabled improved record keeping. People felt there were adequate numbers of staff on duty and that staff responded to bells promptly.

People were supported by staff who had the required recruitment checks in place. Staff received an induction and were knowledgeable about the signs of abuse and how to report concerns. Staff had received training and developed skills and knowledge to meet people’s needs. Staff relationships with people were caring and supportive. They delivered care that was kind and compassionate.

Individual risks to people’s safety had been assessed and plans written to show how these were being addressed. The home had a contingency plan and had also developed individual personal evacuation plans to support each person.

Medicines were safely managed and procedures were in place to ensure people received their medicines as prescribed. Improvements were made during the inspection to ensure staff were clearly guided regarding the prescribed administration of topical creams.

Care plans were personalised and recognised people’s health and social needs. We raised concerns with the registered manager that care plans did not always cover people’s emotional and psychological needs. During the inspection the registered manager and deputy manager put in place care plans where needed to ensure all people’s emotional and psychological health needs were covered.

People’s views and suggestions were taken into account to improve the service. Health and social care professionals were regularly involved in people’s care to ensure they received the care and treatment which was right for them.

Staff demonstrated an understanding of their responsibilities in relation to the Mental Capacity Act (MCA) 2005. Where people lacked capacity, h

Inspection carried out on 26 and 27 November 2014

During a routine inspection

We undertook an unannounced inspection of Pinewood Nursing Home on 26th and 27th November 2014.

We last inspected Pinewood Nursing Home in December 2013. At that inspection we found the service was meeting all the essential standards that we assessed.

Pinewood Nursing Home provides accommodation for up to 33 people who need support with their personal care. The home provides support for older people requiring nursing care and for some people who are living with dementia. The home is a large, converted period property with sea views. Accommodation is arranged over four floors and there is a talking passenger lift to assist people to get to all floors. The home has 31 single bedrooms, with two which can be used as double rooms if two people choose to share. There were 31 people living at the home at the time of our inspection.

We observed care and support in communal areas, spoke to people in private, and looked at care and management records.

The service has a registered manager. 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 was accessible and approachable. People who used the service said they felt able to speak with the registered manager and said they were an active part of the team. Staff said they felt well supported by the registered manager and the provider.

People’s needs and risks were assessed before admission to the home and these were reviewed on a regular basis. People and their families had discussed their care needs when they were admitted to the home. However care plans were not personalised to their individual needs. The care plans were pre-populated with standard information, and had very little, and in some cases, no additional person-centred information. However staff had a good understanding of how people wanted to be supported because long standing experienced staff had shared this information. Care plans were reviewed by the nurses at the home and people and their families were not asked their views.

People’s health care needs were well met. People were supported to receive treatment and health care advice and support.

People had access to activities at the home, however there was not an effective system to ensure all people had access to activities. This meant some people were at risk of not being included and becoming socially isolated.

People using the service said they felt safe. One person said “Safe and well looked after.” Staff understood how to protect people from abuse and the home had acted to protect people where they believed abuse or harm might have occurred. Examples included staff reporting bad practice and the registered provider reporting concerns to the relevant external agencies. Each person had risks to their wellbeing assessed and steps were taken to mitigate any known risk, such as falls or skin damage from pressure.

People received their medicines in a safe way because they were administered appropriately by suitably qualified staff and there were effective monitoring systems in place. The home had put into place a more robust system to ensure people had their prescribed creams administered safely and appropriately.

Staffing levels were set according to the needs of the people who used the service. Staff were caring and experienced and held relevant qualifications in health and social care.

Staff liaised with external healthcare professionals to get specialist advice and arrange the care and treatment they needed.

People could choose from a menu which was regularly reviewed and updated and took into account people’s choices and preferences.

Staff were polite and respectful when supporting people who used the service. Staff patiently helped people to eat their meals at their own pace. Staff supported people to maintain their dignity and were respectful of their privacy. People’s relatives and friends were able to visit without being unnecessarily restricted.

People knew how to raise concerns and make complaints. People told us concerns raised had been dealt with promptly and satisfactorily. Any complaints made were thoroughly investigated and recorded. Learning from incidents had occurred and been used to drive improvements.

The provider had an effective quality assurance system in place to monitor the effectiveness of the service.

Inspection carried out on 12 December 2013

During a routine inspection

When we visited Pinewood Nursing Home we spoke with five people who use the service, three relatives, the provider, the matron and three care staff. Comments about the service were positive.

Staff were observed to support people in a calm and respectful manner explaining to people what they were doing. Clear information was given to people by staff. People were appropriately assisted with mobility needs.

Staff confirmed that before people received any care or treatment they were asked for their consent. They said that their wishes were always respected. People we spoke with all agreed that they were consulted about their care and treatment daily.

We looked at peoples individual care plans and saw that the information recorded enabled staff to plan and deliver the required level of care and support on an individual basis.

Appropriate arrangements were in place in relation to obtaining, storage, administering and disposal of medicine.

We looked at the training plan for the service. We saw that the majority of staff had up to date training in all mandatory training including safeguarding, manual handling, infection control, first aid and fire safety. Staff told us that they had received regular training and that they felt that they were supported to carry out their roles and meet the needs of people who used the service.

People were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.

Inspection carried out on 4 March 2013

During a routine inspection

People received good quality support. People were encouraged to express their views and live as they wished. We saw that people had full and varied social lives.

People we spoke with told us that they were happy with their care and felt included in their plans. One person told us they �really like it here� and �I can't fault it�. One person told us they �like the view from my room� and �I get on with all the lovely staff�.

People and their families were encouraged in developing their care plans. We saw that care plans were person centred and reflected each person�s needs and preferences. People told us they were happy with the staff support they received.

Staff were knowledgeable about people�s support needs and treated people respectfully. They were supportive and patient. They explained and reassured people where necessary. Complaints and concerns were listened to and acted upon immediately.

Reports under our old system of regulation (including those from before CQC was created)