Archived: Pinewood Manor

Updated 27 April 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the registered persons continued to meet the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service and to provide a rating for the service under the Care Act 2014.

We used information the registered persons sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We also examined other information we held about the service. This included notifications of incidents that the registered persons had sent us since our last inspection. These are events that happened in the service that the registered persons are required to tell us about. We also invited feedback from the commissioning bodies who contributed to purchasing some of the care provided in the service. We did this so that they could tell us their views about how well the service was meeting people’s needs and wishes.

We visited the service on 6 March 2018 and the inspection was unannounced. The inspection team consisted of a single inspector and an expert by experience. An expert by experience is a person who has personal experience of using this type of service.

During the inspection we spoke with 11 people who lived in the service and with three relatives. We also spoke with four members of a care staff, a nurse and the chef. In addition, we met with the clinical lead who supervised the delivery of nursing care and with the registered manager. We also observed care that was provided in communal areas and looked at the care records for five people who lived in the service. We also looked at records that related to how the service was managed including staffing, training and quality assurance.

In addition, 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 speak with us.

After the inspection visit we spoke by telephone with a further two relatives.

Updated 27 April 2018

We inspected the service on 6 March 2018. The inspection was unannounced. Pinewood Manor is a ‘care home’. People in care homes receive accommodation, nursing and/or personal care as a single package under one contractual agreement. The Care Quality Commission regulates both the premises and the care provided, and both were looked at during this inspection.

Pinewood Manor is registered to provide accommodation, nursing and personal care for 31 older people, people who live with dementia and people who have sensory adaptive needs. There were 29 people living in the service at the time of our inspection visit.

The service was run by a company who was the registered provider. There was 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. In this report when we speak about both the company and the registered manager we refer to them as being, ‘the registered persons’.

At the last inspection on 9 September 2016 the service was rated, ‘Requires Improvement’. We found that there was one breach of the regulations. This was because the registered persons had not deployed enough care staff to ensure that people promptly received all of the care they needed. We asked the registered persons to take action to make improvements to staffing levels and at the present inspection we found that this action had been completed.

Also, at the last inspection we identified that another improvement was needed to ensure that people reliably benefited from receiving safe care. This was because there was a shortfall in the level of fire safety protection provided in the service. Furthermore, we noted that the way in which people’s consent to receive care needed to be strengthened in order to ensure that it was effective in meeting their expectations. We also found that there were shortfalls in the arrangements that had been made to ensure that the service was well led. In particular, quality checks had not always been completed in the right way and this had resulted in the persistence of the concerns we had noted.

At the present inspection the service was, ‘Good’. We found that most of the individual concerns we had previously raised had been addressed. We noted that enhanced provision had been made to protect people from the risk of fire and quality checks were being completed. Although further improvements were needed to the way in which the obtaining of consent was recorded, in practice suitable provision had been made to ensure that decisions were taken in people’s best interests.

Our other findings were as follows. There were systems, processes and practices to safeguard people from situations in which they may experience abuse including financial mistreatment. Risks to people’s safety had been assessed, monitored and managed so they were supported to stay safe while their freedom was respected. This included occasions when people became distressed and needed support in order to keep themselves and others around them safe. Also, medicines were managed safely. Background checks had been completed before new nurses and care staff had been appointed. The accommodation was clean and there were robust arrangements to prevent and control infection. In addition, lessons had been learnt when things had gone wrong.

Nurses and care staff had been supported to deliver care in line with current best practice guidance. As part of this, people had been helped to eat and drink enough to maintain a balanced diet. Also, suitable steps had been taken to ensure that people received coordinated and person-centred care when they used or moved between different services. People had been supported to live healthier lives by having suitable access to healthcare services so that they received on-going healthcare support. Although some parts of the accommodation were not well decorated, in general it was adapted and designed in a way that met people’s needs and expectations.

People were treated with kindness, respect and compassion and they were given emotional support when needed. They had also been supported to express their views and be actively involved in making decisions about their care as far as possible. This included them having access to lay advocates if necessary. Furthermore, confidential information was kept private.

Although people received personalised care that was responsive to their needs information was not always presented to them in an accessible manner. However, people had been offered opportunities to pursue their hobbies and interests. Also, the registered manager recognised the importance of promoting equality and diversity. This included but was not limited to supporting people if they chose gay, lesbian, bisexual and transgender lifestyles. People’s concerns and complaints were listened and responded to in order to improve the quality of care. Suitable provision had been made to support people at the end of their life to have a comfortable, dignified and pain-free death.

There was a registered manager who promoted a positive culture in the service that was focused upon achieving good outcomes for people. They had also taken steps to enable the service to meet regulatory requirements. Nurses and care staff had been helped to understand their responsibilities to develop good team work and to speak out if they had any concerns. Furthermore, people, their relatives and members of staff had been consulted about making improvements to the service and their suggestions had been put into action. The registered persons had made a number of arrangements that were designed to enable the service to learn, innovate and ensure its sustainability. In addition, the registered persons were actively working in partnership with other agencies to support the development of joined-up care.