Pine View Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question required improvement. At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

The provider was previously in breach of the legal regulation in relation to consent. Improvements were found at this assessment, and the provider was no longer in breach of this regulation.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

At our last inspection people’s care plans were not detailed enough to ensure people always received person-centred care, and staff did not always know how to support people when they became distressed.

At this inspection all care plans and risk assessments had been re-written and improved. This meant staff had clear guidance on how to support people effectively and knew what to do if a person became distressed. We observed people receiving person-centred care when they needed it from staff who understood their needs and how best to meet them.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Care plans had been improved to ensure people’s nutritional and hydration needs were met in line with current standards and evidence-based guidance. People were supported to manage their dietary needs and associated risks. This included where people have complex needs, from the risk of poor nutrition, dehydration, swallowing problems and other medical conditions that affected them. If people needed specialist support with their nutrition and hydration staff referred them to SALT (speech and language therapy) team and followed SALT advice regarding dysphagia (swallowing difficulties) and other eating and drinking challenges.

The service’s training programme helped to ensure staff understood current legislation, national standards and evidence-based good practice guidance relevant to the service and applied these effectively. Staff completed the service’s induction which met Care Certificate Standards (which ensure care staff have the foundational skills, knowledge, and behaviours they need to provide compassionate and safe care), followed by more in depth online and face-to-face training.

The service provided care and support for people with sensory impairment, however staff had not had formal training in this. We discussed this with the provider who agreed to ensure staff had the necessary training in this area. When we returned for the 2nd day of our inspection staff had completed this training.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

At our last inspection care records did not always reflect the current needs of people using the service. As a result, there was a risk that health and social care professionals involved in people’s care would not have access to up-to- date information.

At this inspection improvements to care and plans and risk assessments ensured that information was effectively shared between teams and services where they worked together to deliver people’s care. This meant all relevant staff understood people’s needs, how they would be met, and by who, for example when clinical tasks were delegated or when people were referred between services.

Records showed staff were proactive in working with other professionals and contacted them as needed to refer people, obtain advice and support, and report any changes to people’s health and wellbeing. Relatives said people had access to health care professionals including GPs, district nurses, chiropodists, and dentists. A relative told us, “[Person] had the GP out for [medical issue] - I can’t fault them on their care. We’ve just been out to the dentist and the chiropodist visits fairly often and does [person’s] feet.”

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

At our last inspection there were little or no stimulating activities for people and although staff were kind and polite and attentive to people’s needs there was no other conversations and general chatting. This had a potential negative effect on people’s wellbeing.

At this inspection more activities and interactions were available to people. The provider had employed an activities co-ordinator who worked at the service 3 days per week. We observed a lively group activity in progress which people were enjoying and engaging with. At other times people mainly watched TV or stayed in their rooms. We discussed this with the provider who agreed to discuss activities with people to see if there was anything more they would like to do.

People were encouraged and supported to understand and make healthier choices including their diet, lifestyle, physical activity, personal and oral hygiene. For example, one person was encouraged to elevate their legs, when possible, to address a healthcare issue. The person had a footstool next to their chair and staff encouraged them to use it which they did intermittently with staff support. Staff supported another person to walk around the premises and gardens as the wished to remain active.

Referrals were made to appropriate health services when people needed specialist support with their healthcare. People were visited by health and social care professionals including GPs, district nurses and the SALT team, and staff at the service acted on their recommendations to ensure people’s needs were met.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

At our last inspection we identified concerns around care and support of a person experiencing emotional distress. At this inspection improvements had been made. Staff had had further training in dementia care, managing distressed behaviour, and positive behaviour support. We observed staff were effective in supporting a person when they became distressed.

Staff had liaised with mental health services and followed their guidance to ensure a person had the care and support they needed. They worked with a person on a 1-2-1 basis and were skilled at ensuring they remained active and could make choices about their daily life. A visiting social care professional told us staff interacted effectively with the person, distracted them when necessary, and supported them to walk safely. This was a good outcome for them.

The service had a robust approach to monitoring the effectiveness of people’s care, treatment and support and action was taken to continuously improve it. The management team reviewed people’s care plans and risk assessment regularly to ensure people’s needs were being consistently met with changes made where necessary.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

Improvements had been made to the way peoples’ rights and decisions around consent were understood and respected by staff and the service. Since our last inspection staff had had further training in MCA and DoLS and understood the importance obtaining consent before they provided people with care and support. We observed staff asking people for consent before assisting them with meals, activities and personal care. A person told us, “Staff ask me first before helping - they don’t just come and do it ad lib.”

People’s care records contained sufficient information about the type of decisions they were able to make and how best to support them to make these decisions including any support they might need with communication. Where people lacked capacity, the principles of the MCA were followed. Mental capacity assessments were completed and where people lacked capacity, best interest decisions were in place for relevant areas. For example, if sensor mats were in place to alert staff when a person mobilised there was a record of consent or a capacity assessment and best interest decision for the use of this equipment.

The provider ensured effective oversight of all relevant authorities, including those made under the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS) systems were in place to ensure authorisations were appropriately monitored, reviewed, and renewed in a timely manner.