• Care Home
  • Care home

The Pines

Overall: Good read more about inspection ratings

Culford Road, Fornham St Mary, Suffolk, IP28 6TN (01284) 705062

Provided and run by:
Consensus Support Services Limited

All Inspections

During an assessment under our new approach

We visited the service on 4, 5 and 16 June 2025. An adult social care inspector undertook the visits on 4 and 16 June 2025, and a medicine inspector on 5 June 2025. We gave the service 2 hours’ notice of the inspection, as the service was small we needed to know people and staff would be in the service.

The service is a residential care home service providing support for up to 12 adults of all ages with learning disabilities and/or autistic people. During our inspection there were 11 people using the service.

We assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted.

The provider had a learning culture and people could raise concerns, which would be listened to, addressed and used to drive improvement. Incidents and accidents were monitored. Risks were assessed and mitigated and systems were in place to reduce abuse and avoidable harm. The facilities and equipment met people’s needs, were clean, well-maintained and risks mitigated. Since our last inspection, the environment had been redecorated and refurbished, this was ongoing. There were enough staff with the right skills, qualifications and experience. Staff received training and appraisals to support them to meet people’s needs. Staff managed medicines well and safely.

People were central to the care they received and were involved in assessments of their needs. Staff reviewed assessments taking account of people’s communication, personal and health needs. Care was based on latest evidence and good practice. People had enough to eat and drink and were supported to make decisions to stay healthy. Staff worked with health and social care professionals involved in people’s care for the best outcomes and smooth transitions when moving services. People had access to health professionals when needed and their health was monitored by staff. Staff listened to people’s choices and systems were in place to make sure people understood their care and support so they could give informed consent.

People were treated with kindness and compassion. Staff promoted and protected people’s privacy and dignity. People were treated as individuals and their preferences were respected. People were supported to maintain relationships with family and friends. Staff responded to people’s requests for assistance in a timely way. The provider supported staff wellbeing.

People were involved in decisions about their care. The service was accessible, including the environment and the ways information was provided to people in formats which they could understand. People with protected characteristics were supported. People received fair and equal care and treatment. People had access to the community and were encouraged to play an active part in the community they lived in.

Leaders and staff had a shared vision and culture based on listening, learning and trust. Staff told us they felt supported to give feedback and were treated equally, free from bullying or harassment. Staff understood their roles and responsibilities. There was a culture of continuous improvement with staff given time and resources to try new ideas.

Prior to our assessment we received feedback from a commissioner of the service. During our inspection we spoke with the manager and two regional directors. The provider’s head of quality attended the inspection feedback via video call. We also spoke with the nominated individual on the telephone. We gained feedback from five staff members remotely electronically and by telephone. We reviewed the care records for four people who used the service and reviewed the medicine records for 11 people. We looked at staff training and recruitment records and records relating to governance and monitoring, including policies and procedures, audits, and incident records.

20 January 2022

During an inspection looking at part of the service

The Pines is a service that provides personal care and accommodation for up to 12 people who have a learning disability and who may autistic. On the day of the inspection, there were 12 people living at the service. This inspection took place on 20 January 2022 and was announced. We gave the provider 24 hours' notice as the service is small and we needed to be sure someone would be at home.

We found the following examples of good practice.

The service had policies and procedures to assist the registered manager and staff to manage any risks associated with the COVID-19 pandemic.

There was sufficient supply of Personal Protective Equipment (PPE) for staff and any visitors to use. Hand sanitiser was readily available. Staff had received updated training on the use of PPE, and we observed staff wearing it correctly during our visit.

A programme of regular COVID-19 testing for both people living at the service, their visitors and staff was in place. All visitors, including healthcare professionals were subject to a range of screening procedures, including a temperature check, screening questionnaire, showing evidence of vaccination and a negative lateral flow test before entry into the service was permitted.

People living in the service and their relatives were supported to maintain contact, with visiting available at all times.

Daily cleaning schedules were in place and tasks were completed by staff including two hourly cleaning of frequently touched areas. Within one of the kitchen’s the worksurfaces were worn . There was also an area of broken flooring in another kitchen. This meant cleaning may not have always been effective. The registered manager told us works to address these had already been agreed by the provider and dates were being scheduled to commence.

20 September 2017

During a routine inspection

This inspection took place on 19 September 2017 and was announced. We gave the provider 24 hours’ notice as the service is small and we needed to be sure someone would be at home. The Pines is a service that provides personal care and accommodation for up to 12 people who have a learning disability and who may be living with autism. On the day of the inspection, there were 11 people living at the service.

There was a registered manager in post at the time of our inspection however they were away from work and not available to meet with us. 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.

At our last inspection in June 2016 we rated The Pines ‘Requires Improvement’ in caring and responsive and as a result ‘Requires Improvement’ overall. This was because we were concerned that staff practices were not consistently good and staff did not always act in a way which fully promoted people's independence and rights. We were also concerned at our last inspection that the range of activities for people was limited by a number of factors including staffing levels, transportation and the range of different needs people had which was not conducive to individualised care. We found at this inspection that improvements had been made to these areas however we concerned about the environment. There was damaged paintwork, stained carpets and the lighting needed enhancing.

Staff were recruited safely and received an induction when they first started working at the service. People were supported by sufficient staff who knew them well. Senior staff were requesting to review the number of support hours with the local authority.

Care records contained individual risk assessments and risk management plans to protect people from identified risks and to help keep them safe. They provided information to staff about action to be taken to minimise any risks whilst allowing people to be as independent as possible.

All medicines were administered by staff who were trained to do so. We identified some issue with record keeping around medicines however were assured by additional records in place that people were having their medicines has the prescribed intended.

Staff had received training and supervision and were able to describe how they worked with people to meet their needs.

Support files were personalised to reflect people's personal preferences. Their views and suggestions were taken into account to improve the service. People were supported to maintain a balanced diet, which they enjoyed. Health and social care professionals were regularly involved in people's care to ensure they received the care and treatment which was right for them.

People received a service that was caring. Staff knew people's needs well and were responsive and supportive. Staff treated people with dignity and respect. People were offered a range of activities both at the service and in the local community. Staff sought to gain people's views.

Staff understood the need to support people to remain as independent as possible. Some people were able to go out unaccompanied by staff. Support plans showed that this had been risk assessed and systems had been put in place to enable them to contact the service if needed.

Good leadership was in place that provided staff with the necessary support and training to make sure people received good quality care. The management team assessed and monitored the quality of the service. A number of audits that had taken place. This ensured the service continued to be monitored and improvements were made when they were identified.

12 February 2016

During a routine inspection

The inspection took place over two different dates the 10th and 12 February 2016 to meet with as many people as possible using the service. The first day was unannounced but the second day was agreed with the registered manager.

The service provided accommodation for up to twelve people and was divided into three separate living quarters to give people further independence according to their needs. Adults had a diagnosis of learning disability, mental health needs or both and were supported in accordance with their needs.

There was a registered manager in post who had been in post in excess of three years.

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 service provided accommodation which was designed to accommodate differing needs including those who were more able and those who needed more assistance. Each part of the accommodation was self- sufficient other than the laundry which was shared. Despite this set up it was not clear how staff were always meeting people’s needs effectively around their individualised needs and according to their wishes and abilities.

Medication administration was carried out by staff who were sufficiently supported to ensure they had the right competencies and skills.

Risks to people’s safety were documented and as far as possible effectively managed.

Staff recruitment was robust and there was good support in place for staff. Their training was up to date but limited access to more specialist in-depth training around mental health and learning disability training meant we could not be assured that staff had the necessary skills and sufficient understanding of individuals.

Staff had a good understanding of legislation relating to the Mental Capacity Act 2005 and the Deprivation of Liberties. The MCA ensures that, where people have been assessed as lacking capacity to make decisions for themselves, decisions are made in their best interests according to a structured process. DoLS ensure that people are not unlawfully deprived of their liberty and where restrictions are required to protect people and keep them safe, this is done in line with legislation.

People were supported to eat and drink sufficient to their needs and staff worked hard to ensure people received the health care they needed and staff monitored people’s health and acted accordingly.

Staff interactions with people were not always as positive as they could be and staff were not seen to promote people’s independence as fully as they might. Some people did not seem to have sufficient interaction or opportunity to participate in a fuller life as possible. Other people who could be more independent were not given the fullest opportunity.

People were consulted about their care and support. Regular reviews and an effective complaints procedure meant gaps in service provision could be identified and rectified.

Support plans were sufficiently detailed but did not always give specific guidance for staff to follow. Support plans were kept under review.

The service was well led with robust audits and quality assurance systems. Staff felt well supported and records were up to date. However the experiences of people using the service could be improved upon.

25 November 2013

During a routine inspection

During our inspection a number of people were at home and were being supported by staff with daily living skills and craft work. Other people were out at the cinema club and work placements. People had a range of regular activities they attended and some people were able to access them independently. We spoke with four people using the service and observed the interactions between them and staff throughout the day. We met with one relative and spoke with two staff. We looked at records relating to the management of the service, care records and records relating to the administration of medication. We found this to be a well-planned and well managed service. Accommodation was appropriate to people's needs and facilitated people's independence. People were encouraged to do as much for themselves as possible and received help from staff when required.

One person told us 'The staff are nice, I like living here.' They told us what they did during the day and evening and what support was provided to them. Another person told us how staff supported them with their health care needs and how their diet was monitored to ensure it was appropriate. One person showed us their jewellery making and what charts they completed which were in place to monitor how their needs were being met. This meant people's needs were being met

7 January 2013

During an inspection in response to concerns

During this inspection our pharmacist inspector looked at the safety of medicine management at the service. We conducted an audit of medicines and found people living at the service were protected by the arrangements in place.

26 October 2012

During a routine inspection

We spoke with four people who said they liked living in the service. Two people told us they were very happy with their room. One person said, 'I chose the colours for my room.' Another person said, 'I choose my own meals and go shopping for food.'

We saw that staff encouraged people to take part in self care, in activities, and to undertake tasks that they were able to manage.

There was good awareness of safeguarding vulnerable adults from abuse. Posters were displayed with information for staff and people living in the service on how to deal with suspected abuse. One person told us, 'I feel safe here.'

We saw that staff were trained to provide care appropriate to the needs of people living at the service. There were systems to monitor safety and the quality of service.