The Care Quality Commission
  • Care Home
  • Care home

Archived: Pine Meadows Care Home

Overall: Requires improvement read more about inspection ratings

Park Road, Leek, Staffordshire, ST13 8XP (01538) 392520

Provided and run by:
Four Seasons 2000 Limited

Important: The provider of this service changed. See new profile

All Inspections

30 September 2015

During an inspection looking at part of the service

This inspection took place on the 30 September 2015 and was unannounced. At our last inspection on 1 July 2015 we found that people were not receiving care that was safe and that met their needs this was because the providers quality assurance systems were ineffective. There were insufficient staff deployed to meet the needs of people who used the service and some people were being deprived of their liberty unlawfully. We had asked the provider to make improvements and issued a warning notice in relation to the insufficient staffing levels. At this inspection we found that staffing had been increased and people were no longer being unlawfully restricted of their liberty. We found that there had been some improvements made in all areas of concern since our last inspection, however further improvements were necessary. You can see what action we have told the provider to take at the end of the full version of the report.

Pine Meadows provides accommodation and personal or nursing care to up to 70 people. The service is divided into three living areas. One area called Acorns provides residential care, one area called Chestnut provides nursing care and the other area called Fir Cones cared for people living with dementia.

The service was being managed by an acting manager (for the purpose of this report we will call them ‘the manager’) and there was no 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.

People’s medication was not managed safely. Previous professional advice had not been followed to ensure systems were safe.

People did not always have their health care needs met as staff did not always follow health professional’s advice.

Most people were supported by sufficient numbers of staff, however some people were in the process of having their needs reassessed to ensure that staffing levels were sufficient for them.

When people were at risk, such as falling, assessments were completed and control measures put in place to reduce the risk of the incident occurring again.

People felt safe and protected from abuse. Staff knew what constituted abuse and what to do if they suspected abuse had taken place.

The Mental Capacity Act (MCA) 2005 is designed to protect people who cannot make decisions for themselves or lack the mental capacity to do so. The Deprivation of Liberty Safeguards (DoLS) are part of the MCA. They aim to make sure that people in care homes, hospitals and supported living are looked after in a way that does not inappropriately restrict their freedom. The provider followed the guidelines of the MCA to ensure that people were not being unlawfully restricted of their liberty.

People’s nutritional needs were met, however specialist diets were not always presented in a pleasing manner. People who had been identified as losing weight were referred to their GP or dietician for advice and support.

People were treated with dignity and respect and their privacy was maintained. Relatives and friends were free to visit at any time.

Care was not always delivered in a way that met people’s personal preferences. Staff did not always ensure that people had their belongings which they required.

People were encouraged to engage in hobbies and activities of their choice. New activity coordinators had been employed to support people in their chosen activity.

People were involved in their care. Regular meetings took place for people who used the service and their relatives.

The provider had taken steps to meet the breaches of Regulations following our previous inspections, however further on-going improvements were required. Quality systems had been put in place and were proving effective however the service required a period of stability to embed the systems.

Staff felt supported by the management; however some staff lacked direction due to inconsistent management.

1 July 2015

During a routine inspection

This inspection took place on the 1 July 2015 and was unannounced. At our previous inspections in June 2014 and September 2014 we had concerns that there was insufficient staff to keep people safe. People were not receiving care that was safe and that met their needs this was because the providers quality assurance systems were ineffective. At this inspection we found that there was still insufficient deployed staff to meet the needs of people who used the service and some people were being deprived of their liberty unlawfully. The provider’s quality assurance systems had not been effective in ensuring that the on-going breach in staffing was met and that people were receiving care that was unsafe.

Pine Meadows provides accommodation and personal or nursing care to up to 70 people. The service is divided into three living areas. One area provides residential care, one area called Chestnut provides nursing care and the other area called Fir Cones cared for people living with dementia.

There was a registered manager in post, they were not available on the day of the inspection. We were supported by the area and peripatetic 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 Mental Capacity Act (MCA) 2005 is designed to protect people who cannot make decisions for themselves or lack the mental capacity to do so. The Deprivation of Liberty Safeguards are part of the MCA. They aim to make sure that people in care homes, hospitals and supported living are looked after in a way that does not inappropriately restrict their freedom. The provider did not ensure that people were not being unlawfully restricted of their liberty.

People’s needs were not always met in a timely and safe way due to there being insufficient staff deployed throughout the service. Some staff did not like or feel confident working in some areas of the service. People’s medicines were not always managed safely.

Risks to people’s health and wellbeing were not consistently managed and reviewed. People were at risk of not receiving the care they required through poor record keeping.

Some people were not treated with dignity and respect. Staff practice was not managed to ensure that people were not being abused and that they were treated with kindness and compassion.

People told us there was not enough to do. Some people sat for long periods of time with little or no social stimulation. Limited opportunities were available to people to be able to engage in a hobby or activity of their choice.

Systems to monitor the quality of the service were not effective. The provider used a dependency tool to ascertain staffing levels, however we saw that this was not effective as there were not enough staff to meet people’s needs.

People’s were supported to attend health appointments supported by staff. The staff responded when they recognised a change in people’s health care needs and sought support from other agencies.

We found three breaches of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the provider to take at the back of the full version of the report.

24 September 2014

During an inspection looking at part of the service

We visited Pine Meadows Care Home on an unannounced follow up inspection to assess if they had made improvements to the areas of non-compliance found at the last inspection carried out on the 11 June 2014.

Is the service safe?

During our last inspection on 11 June 2014 we found the service was non-compliant in relation to the number of staff available to meet people's needs safely.

We found that there had been no improvements to the way that the provider deployed staff within the nursing unit to ensure that there were sufficient skilled staff to meet people's needs safely.

We saw that staff did not always follow advice in the care plans to ensure that people received their care safely. People were put at risk because incorrect equipment was used to transfer people safely.

Is the service responsive?

We found that people were not always able to alert staff to their care needs because call bells were not made available to people. This meant that staff were unable to respond to peoples' needs in a timely manner.

Is the service well led?

We found that there were systems in place to assess the required numbers of staff against people's needs but the provider had not taken into consideration the geographical layout of the nursing unit. This meant that the dependency tool had not been used effectively and people who used the service were at risk of receiving unsafe care.

11 June 2014

During an inspection in response to concerns

We visited Pine Meadow Care Home on a planned, responsive, unannounced inspection. We had received information of concern which meant that this inspection had been brought forward.

Below is a summary of our finding based on our observations, speaking to people who used the service, the staff supporting them and from looking at records. If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

There were insufficient staffing levels to meet people's needs safely.

The service followed the correct procedures when they suspected abuse.

Is the service effective?

Everyone had a care plan which informed staff how to meet people's needs.

Assessments included people's needs for specialist equipment, mobility aids and dietary requirements.

Is the service caring?

People who used the service generally told us that they felt well cared for. One person told us: "They (staff) are generally ok, some are nicer than others".

On the day of our inspection staff treated people with dignity and respect.

Is the service responsive?

People had their care needs regularly reviewed.

If people became unwell staff responded appropriately to ensure their needs were met.

Is the service well led?

The service had systems in place to monitor the quality of the service provided, although there was no system to determine the required amount of staffing to meet individual needs.

The manager followed the relevant legislation and consulted with the appropriate professionals at the required time.

Staff told us they felt supported to fulfil their role.

30 October 2013

During a routine inspection

During the inspection we spoke with six members of staff and the registered manager. We spoke with people who used the service and their relatives. We did this to obtain the views and experiences of people who used the service and their representatives.

People who used the service told us that they were involved in the planning of their care and treatment. We saw that people were treated with dignity and respect. One person told us, 'The nurses are particularly good and treat you with respect'. Another person told us, 'I like it here the staff are really good to me'.

We found that care was assessed and planned to meet the individual needs of people who used the service. During the inspection we found that individual needs and preferences of people were not always considered. In relation to dementia care some improvements were needed to ensure that staff were able to meet people's needs safely.

We found that the provider regularly involved other professionals, which ensured that people who used the service benefitted from co-ordinated care and treatment that met their needs.

The provider had systems in place to protect people from the risks associated with the unsafe management of medicines.

Staff told us that they felt supported by the registered manager and they were given opportunities to develop their skills and knowledge.

During a check to make sure that the improvements required had been made

At our last inspection we found that there were not enough qualified, skilled and experienced staff to meet people's needs. At this inspection we found that the provider had made improvements to the ensure that people's needs were met by an appropriate number of qualified and skilled staff.

15 March 2013

During an inspection looking at part of the service

Pine Meadows care home had three distinct units. Fir Cones, which cares for people with dementia. A nursing Unit, which cares for people with more demanding needs, and a residential Unit, which assists people who are more able. We inspected all three units.

At our last inspection on 21 September 2012, we found that the service was non compliant with a number of the regulations we inspect against and improvements were needed to ensure good outcomes for people who used the service.

During this inspection we spoke with eight staff and seven people who used the service. We also spoke with the registered manager. We carried out observations and reviewed care records.

People who used the service were involved in their care and were given choices. We observed some people being treated with dignity and respect during our inspection.

We saw that there had been some improvements in the care records, which contained an individualised plan of the care required.

The provider had not taken steps to ensure that there were sufficient numbers of staff on the nursing unit to meet the needs of people who used the service.

In this report the name of a registered manager, Ms. Sheena Matthews appears, who was not in post at this location at the time of the inspection. Their name appears because they were still a registered manager on our register at the time.

21 September 2012

During an inspection looking at part of the service

We completed this inspection to follow up and to assess if the provider had made improvements to how it provides care and support to people, since our last inspection visit of 11 May 2012. At our last inspection, we found that the service was non compliant with a number of the regulations we inspect against and improvements were needed to ensure good outcomes for people who used the service.

We completed this inspection on 21 September 2012. We focussed on the outcomes that were assessed as non compliant at the last inspection. The details are in the main body of this report.

We inspected Fir Cones, a unit for up to 20 people who had dementia care needs and Chestnut, a nursing care unit for up to 31 people requiring nursing care. During this inspection, we spoke with five people who used the service and with staff.

We found that improvements had been made in a number of areas and there was evidence that the service was now compliant with some of the regulations we inspect against, but further improvements were needed. There was evidence that people using the service were not always provided with access to the nurse call system and that people's quality of life was compromised by the 'task orientated' routines in the home. There was no significant improvement in people's opportunities for social or recreational interactions or activities.

11 May 2012

During a routine inspection

We carried out this inspection to check on the care and welfare of people using this service. The visit was unannounced which meant the provider and the staff did not know we were coming. We carried out this visit as part of our planned inspection and because we had received information of concern.

We visited all three of the units in the home. Chestnut unit is a nursing care unit for up to 31 people who are physically frail. Acorns is the unit where up to 18 residential people reside and Fir Cones is a dedicated dementia care unit for up to 20 people.

Most people we spoke with said they were happy with the support they received. Some people who used the service had dementia care needs and were not able to communicate well. Where people were not able to express their views to us we observed interaction between people and staff. We also used our SOFI (Short Observational Framework for Inspection) tool to help us see what people's experiences where during the day. The SOFI tool allows us to spend time watching what is happening in a service and helps us to record how people spend their time and whether they have positive experiences. This included looking at the support that was given by the staff.

We saw that people spent long periods of time without interaction or any engagement with staff. The staff met people's physical care needs but there was little opportunity to provide social or recreational activities. People told us, "We don't do a lot really, everyday is the same."

Staff we spoke with knew about the people they were allocated to work with and when they did speak to people, were kind and pleasant.

We talked to staff about training and how they were supported. We saw that many staff had not attended relevant training sessions and that staff supervision and meetings had not taken place regularly.

We spoke to people about the staff that supported them, they told us, "Staff are lovely, nothing is too much trouble."