The Pines Residential Care Home

The Pines Residential Care Home provides accommodation and personal care for up to 13 people who have learning disabilities and mental health needs. At the time of the inspection 12 people were living at the home.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 13 people. 12 people were using the service. This is larger than current best practice guidance. However. the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

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

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. People told us they were ”very happy”, felt safe and that staff had a good understanding of their needs and preferences.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible to gain new skills and become more independent.

Risks had been identified and measures put in place to keep people safe from harm. Medicines were managed safely and administered by trained staff.

Staff were well trained and skilled. They worked with people to overcome challenges and promote their independence. The emphasis of support was towards inclusion and enabling people to learn essential life skills.

Staff understood and promoted equality, diversity and human rights.

People, professionals and their families described the staff as being caring, kind and friendly and the atmosphere of the home as relaxed and engaging.

People received pre-admission assessments and effective person-centred support. The service was responsive to people's current and changing needs. Regular reviews took place which ensured people were at the centre of their support.

Leadership was visible and promoted good teamwork. People, professionals and staff spoke highly about the management and staff had a clear understanding of their roles and responsibilities. The registered manager and staff team worked together in a positive way to support people to achieve their own goals and to be safe.

Checks of safety and quality were made to ensure people were protected. Work to continuously improve the service was noted and the registered manager was keen to make changes that would impact positively on people's lives.

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

Rating at last inspection:

The last rating for this service was Good (published 9 November 2016).

Why we inspected:

This inspection was a scheduled inspection based on the 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.

There was no registered manager at the home at the time of the inspection. 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. At the time of the inspection the manager was in the process of registering with the Commission.

Overall, people were being well cared for and supported at the home.

The manager had systems in place to make sure people were looked after safely both in terms of care delivery and maintaining a safe environment. Risk assessments had been completed to ensure care and support was delivered safely with action taken to minimise identified hazards. The premises had also been risk assessed to make sure that the environment was safe for people.

Staff had been trained in safeguarding adults and were knowledgeable about the types of abuse and how to take action if they had concerns.

Accidents and incidents were monitored to look for any trends where action could be taken to reduce chance of their recurrence.

Sufficient staff were employed at the home to meet the needs of people accommodated.

Robust recruitment systems were followed to make sure that suitable, qualified staff were employed at the home.

Medicines were managed safely.

The staff team were both knowledgeable and suitably trained.

Staff were well supported through supervision sessions with a line manager, and had an annual performance review completed.

Staff and the manager were aware of the requirements of the Mental Capacity Act 2005 (MCA) and acted in people’s best interests where people lacked capacity to consent. There was good documentation to reflect compliance with the MCA.

The home was compliant with the Deprivation of Liberty Safeguards, with appropriate referrals being made to the local authority.

People were provided with a good standard of food and were fully involved in planning menus and what they wanted to eat.

Staff treated people compassionately and were knowledgeable about their needs and goals.

People’s care needs had been thoroughly assessed and care plans put in place to inform staff of how to support people. The plans were person centred, covered all areas of people’s needs and were up to date and accurate.

People enjoyed a range of activities that they had chosen and were of interest to them.

There was a complaint system in place and people made aware of how to complain. Complaints had been responded to in line with the company procedures.

Should people need to go into hospital, systems were in place to make sure that important information would be passed on so that people could experience continuity of care.

The home was well led and was taking forward a change programme seeking to promote people’s independence. There was an open culture in the home.

There were systems in place to audit and monitor the quality of service provided to people.

We spoke with the provider, the registered manager and the administrator. We also spoke with the manager, deputy manager, team leader and a support worker for the home care service, and three support staff for the residential care. Staff told us 'The management team is very supportive. We make sure people are safe, but they have fun.' Another said 'The company is very professional". A third said 'They are the best bosses I've ever had.'

We reviewed care records for two people who lived at The Pines and two people receiving care in their own homes. Care and support were planned and delivered so as to ensure the welfare of people using the service and to meet their individual needs.

We found that people were protected from the risks associated with unsafe management of medication because there were effective systems in place.

People using the service benefited from a staff team who were well trained and supported to do their job.

People benefited from safe care and support because the provider monitored the quality of service that people received.

During our inspection we looked at five care plans and spoke with three of the people whose plans were had examined. We spoke with three members of staff and the manager.

People we spoke with gave positive comments concerning their time spent at the home.

People's diversity, values and human rights were respected.

People told us their needs had been assessed before they came to live at the home and they were kept involved in their daily support and care.

People were protected against the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

People were cared for by sufficient numbers of staff to ensure their needs were met.

We found the provider had an effective system in place to regularly assess and monitor the quality of service that people received.