Archived: Pine View Care Home

Pine View is a 15 bed residential home providing personal care to 11 older people, some with mental health needs and others with dementia. The care home supports people in an adapted residential property.

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

Risks had been assessed prior to people moving into the home. Medicines were stored and administered safely, people were supported with their medicines in a safe way. Recruitment checks had been carried out to ensure staff were suitable to work with people. Staffing levels were adequate to provide individual support and good overall levels of care.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Training for staff was linked to people’s individual support needs. The staff team felt involved in the running of the home and felt supported by the provider, registered manager, nursing and senior staff. Staff received supervisions to ensure they met people’s needs. Staff responded to and supported people’s health and care needs.

People were provided with a varied diet which met their individual cultural needs. Healthcare was supported by the staff and people were provided with treatment following consultations.

People were involved in making decisions about their care and their consent was obtained prior to offering care. People were supported by a staff team who were kind and caring and treated them in a considerate and respectful manner. Staff promoted people’s privacy and dignity.

Staff were knowledgeable about people’s individual needs informed by detailed care and support plans. There was a complaints process in place which was managed effectively. Staff had considered people’s end of life choices and made reference to this in care plans.

There were systems in place to monitor the quality and safety of the service being provided. People’s views of the service were sought through regular meetings and surveys. The registered manager understood their roles and responsibilities as a registered person. They worked in partnership with other agencies to ensure people received care and support that was consistent with their assessed needs.

We have made recommendations in the report around medicines and checking the environment for any changes to infection controls.

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

Why we inspected

This was a planned inspection based on our previous rating.

Follow up

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.

Pine View Care Home is a care home that provides residential care for up to 15 people. The home specialises in caring for older people. At the time of our inspection there were 12 people in residence.

Pine View care home had 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.

Staff were subject to a recruitment procedure that ensured staff were qualified and suitable to work at the home, however some staff files did not have a reference from their last employer. They received induction and on-going training for their specific job role, and were able to explain how they kept people safe from abuse. Staff were aware of whistleblowing and what external assistance there was to follow up and report suspected abuse. There were sufficient staff available to meet people’s personal care needs and we saw staff worked well in meeting people's needs.

The compliance and care managers’ undertook quality monitoring in the home, which then informed the board of directors on the progress of the home. However this had not picked up the shortfalls in care plans, risk assessments or staff files.

People felt staff were kind and caring, and their privacy and dignity was respected in the delivery of care and their choice of lifestyle. Care plans and risk assessments were in place but these could have been improved. People were involved in the review of their care plan, and when appropriate were happy for their relatives to be involved. We observed staff offered people everyday choices and respected their decisions. Staff had access to people’s care plans and received regular updates about people’s care needs.

People were provided with a choice of meals that met their dietary needs. The catering staff were provided with up to date information about people’s dietary needs, and staff sought the opinions of people to tailor their individual meal choices. Medicines were ordered, stored and administered safely and staff were trained to provide the medicines people required. Care plans included the changes to peoples care and treatment, and people attended routine health checks.

Staff provided planned activities for people over all seven days of the week. Staff had a good understanding of people’s care needs. People were able to maintain contact with family and friends as visitors were welcome without undue restrictions. Staff sought medical advice and support from health care professionals.

Staff told us they had access to information about people’s care and support needs and what was important to people. Staff knew they could make comments or raise concerns with the management team about the way the service was run.

The provider had a clear management structure within the home, which meant that the staff were aware who to contact out of hours. The provider had developed opportunities for people to express their views about the service. These included the views and suggestions from people using the service, their relatives and health and social care professionals. We received positive feedback from visiting professionals with regard to the care offered to people and professionalism of nursing staff. Staff were aware of the reporting procedure for faults and repairs and had access to the maintenance to manage any emergency repairs.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People told us they felt safe. The home had proper policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards although no applications had needed to be submitted. Relevant staff had been trained to understand when an application should be made, and in how to submit an application.

Care plans reflected people's needs and staff understood how to support people in line with their care plans. They were written in an individual way ensuring people received personalised care from staff and staff were able to tell us how they met people's individual's needs. There were arrangements in place to deal with foreseeable emergencies such as individual evacuation plans in case of a serious event such as a fire. We noted that work was required to ensure care plans and other confidential material was held securely, as these were open to public view.

From our inspection of 19 September 2013 we found that there were some infection control issues. The provider had made some improvements.

Equipment in the home was well maintained and serviced regularly. We found medicines were managed, held and distributed to people safely, though the record system in use for controlled medicines could be made more secure. We also found out of date medication which was removed from the building whist our visit was on-going.

Is the service effective?

People's health and care needs were assessed, and they and their representatives were involved in the agreement of their plans of care. We saw that people were treated with respect and dignity by staff. One person said to us, "We looked at many [care] homes and chose this one as it's more like a home, and was not so clinical as others." There were shortfalls with a number of the quality assurance processes.

Is the service caring?

The service worked well with other agencies and services to make sure people received care appropriate to their needs. We saw where people were supported by visiting doctors, specialists and district nurses on a regular basis.

Is the service responsive?

We noted that a fire escape ramp needed to be replaced, and this was rectified during the inspection. We found that the periodic monitoring of the fire and evacuation system was inadequate and required to be re-evaluated as this issue had not been picked up by the periodic monitoring process.

Is the service well-led?

Quality assurance systems were in place to make sure that managers and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. People using the service and their relatives, were invited to complete an annual satisfaction survey. Where shortfalls or concerns were raised these were addressed.

We found that people were able to make informed decisions about their care and support. One person told us 'the staff are absolutely first class. They always explain things to me and seek my permission.' One relative told us 'you can't ask for a better place than this. Everything is perfect; the staff and everything.'

We found people experienced care and support that met their needs and protected their rights. One person told us 'the staff are nice and look after me. I have no complaints at all. The care here is very good.' Care and support was delivered in a way that met people's needs and ensured their safety and welfare.

Whilst we found the provider had systems in place to reduce the risk and spread of infection, we found these systems were not always effective. There were a number of issues relating to the cleanliness of Pine View Care Home.

We found staff were supported in their work and were confident that they were able to provide the care people using the service required.

We found the provider had a complaints policy in place. People using the service, and their relatives, we spoke with told us they were aware of the provider's complaints policy and how to make a complaint.

We observed people living at the home taking part in the day to day running of the home. One person was seen to be cleaning the window sills of the conservatory whilst another person cleaned the dining tables after the lunchtime meal before they vacuumed the dinning room.

We spoke with two members of care staff, who had a good understanding of the needs of the people they cared for. We observed their interactions with people and found care staff to respond to their needs and provide support and guidance reflective of people's care plans. Records we looked at were up to date and had been regularly reviewed and showed people using the service were supported to access health care professionals.