Background to this inspection
Updated
22 July 2022
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
As part of this inspection we looked at the infection control and prevention measures in place. This included checking the provider was meeting COVID-19 vaccination requirements. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
This inspection was carried out by two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Pine Tree court is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Pine Tree Court is a care home providing nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
At the time of our inspection there was not a registered manager in post. The provider was looking to recruit a manager for Pine Tree Court.
Notice of inspection
This inspection was unannounced
What we did before the inspection
The provider had completed a Provider Information Return (PIR) prior to this inspection in December 2021. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with six people living at Pine Tree Court. We also spoke with five people’s relatives and one person’s friend. 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 talk with us.
We reviewed a range of records. This included four people’s care records and medication records. We looked at four staff personnel files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
We spoke with two representatives of the provider, the clinical lead, a nurse, four care staff (one who also works in the kitchen) and a housekeeping staff.
Updated
22 July 2022
About the service
Pine Tree Court is a residential care home providing personal and nursing care to 18 older people living with dementia at the time of this inspection. The service can support up to 40 people.
People’s experience of using this service and what we found
People’s needs had been assessed. However, people were at risk of not always being protected from harm or inappropriate care as their care plans did not always provide current or clear guidance for staff to follow on how to mitigate their risks. Care plans had not always been updated where people’s needs had changed or when lessons had been learnt from incidents or accidents.
The service was not always following all aspects of the governments COVID-19 guidance. Management took immediate action to ensure they were following current guidance.
Safe recruitment practices had not always been followed and pre-employment checks had not always been undertaken to gather assurances about staff’s previous employment and conduct.
People and their relatives felt the service was safe and that there were enough staff to meet people’s needs.
Staff, people and relatives spoke positively about the management and the support they received. While monitoring systems were in place to manage the services, the service records did not always show how risks were being mitigated while action was being undertaken.
People's medicines were managed and administered well. Management and staff worked with people’s representatives and healthcare professionals to ensure people’s needs were reviewed and care was carried out in their best interest.
Care staff used personal protective equipment (PPE) and supported people to reduce the risk of infection.
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 18 May 2019)
Why we inspected
This inspection was prompted by a review of the information we held about this service. This included information about staffing and fire safety processes in the service.
As a result, we undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Pine Tree Court on our website at www.cqc.org.uk.
Enforcement and Recommendations
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We made a recommendation to support the provider’s oversight of the quality monitoring systems.
We have identified breaches in relation to safe care and treatment and safe recruitment practices at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.