Archived: The Pines Nursing Home

They helped us answer our five questions; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

Is the service safe?

People who used this service had been cared for in a clean, safe and hygienic environment. There was enough staff on duty to meet the needs of the people who lived at The Pines.

Staff personnel records contained all of the information and checks required. This meant that the provider could demonstrate that the staff employed at the home were suitable and had the skills and experience to support the people who used the service.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to homes. Whilst no applications had needed to be submitted the information recorded about one of the people who used this service was not clear. We asked the manager to discuss this with social workers for clarification. We had confirmation from the local social services department to confirm that the home manager had made these checks.

Is the service effective?

People told us that they were happy with the care they received and felt that their needs had been met. It was clear from what we saw and from speaking with staff that they understood people's care and support needs. The care staff we spoke to told us of their working arrangements. They told us that they attended the handover meetings at the start of their shift. One of the staff said, 'This way of working helps us to get to know everyone's needs.' We were told by a relative, 'Staff are amazing, I cannot fault them. I don't have to ask how my relative is, they tell me.'

We found that staff had been supported in their work by regular supervision and appropriate training.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers were patient and gave encouragement when supporting people. There was a calm and friendly atmosphere in the home at the time of our inspection. We observed and people told us, that they were able to do things at their own pace and that they were not 'rushed."

One person told us, 'I have had a bath this morning. The carer did it very nicely. She also took time to do my hair as the hairdresser in town had cancelled my usual appointment.'

Is the service responsive?

We found that people had received an assessment of their needs prior to them moving into the home. Records had been reviewed and contained up to date and relevant information about the care and support needs of people who used this service. We noted that where needs had changed, care plans had been reviewed and updated accordingly.

Records also showed that people had access to health care professionals such as the doctor, dentist, physiotherapist and speech and language therapists. People had access to activities and had been supported to maintain relationships with their friends and families.

Is the service well led?

We saw evidence that quality assurance processes were in place and in use at the home. People had been asked for feedback on the service they received. We noted that the provider had attended staff meetings to discuss the outcomes of previous CQC inspections and of the actions they intended to take.

We found that the provider had implemented action plans that had been developed to improve the services provided by the home.

Staff told us that they felt the service was 'better organised now', although one person did comment that things were 'not always' explained as well as they might be.

During this visit we looked at the recruitment records of three staff that had commenced employment since our last visit. For all three we found that some of the information required in respect of people seeking to work at the home had not been obtained before commencing employment.

We found that care plans were not always kept up to date and that the audit processes had not highlighted any concerns about the maintenance of accurate records. The registered manager told us she did not always have the time to make the audit checks. We were told that the manager found it difficult to complete her managerial responsibilities on a regular basis.

We looked at the care plans for a person living at The Pines who had supplementary feeding requirements and saw that extra fluids were required on a daily basis. The records for food and fluids showed that this amount of extra fluid was either not given or not recorded as being given. This meant that there was no accurate record of fluids being given.

The records for the recruitment of staff did not include all of the appropriate checks to ensure that staff were of good character for the work they were employed to do.

Staff spoken with said they were well supported within the home. All of the staff that we spoke with said that the manager was supportive and available to talk about issues relating to the home.

People were asked by the service about their care and treatment in a recent survey (March 2013). The majority of the results were very positive. The service users who completed the survey said they felt listened to and involved in their care.

The records we looked at in people's rooms were not up to date nor did they reflect what was occurring in the practical care being delivered. This meant that people using the service were at risk of not being protected and kept safe due to inaccurate and inappropriate records.

We found that people were asked for their consent and the provider acted in accordance with their wishes and that people experienced care, treatment and support that met their needs. People who used the service were protected from the risk of abuse and the provider had an effective system to regularly assess and monitor the quality of service that people receive. People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.