The Pines

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 requires improvement. At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

Improvements had been made in the environment and an ongoing programme of refurbishment and redecoration was in place.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People’s needs were being assessed and they were supported to access other services, such as health care services, where required. People were supported to maintain healthy lives and their dietary and hydration needs were being assessed.

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.

People’s needs were assessed, and these assessments helped to form care plans and risk assessments. People had contributed to the planning of their care and their choices and preferences were documented. People told us they chose what they wanted to do and felt the staff listened to them. Care plans and risk assessments were kept under review with people and they were amended to show any changes in care needs or preferences.

People’s care records included how they communicated and any specific support they required with their communication need. We saw staff communicating with people in line with their communication needs and care plan. This included using physical touch, where a person used staff’s hands to guide them in what they wanted, and writing down a question for a person, when they had said they preferred staff to communicate with them this way. A person’s relative told us how their family member communicated their distress and that the staff recognised this, “They are on it and it doesn’t happen often.”

Since our last assessment, improvements had been made in the environment, people were involved in decisions about the redecoration and refurbishment of the service. Included in the refurbishment, was ensuring equipment and furniture met people’s needs and abilities, including a toilet with a higher seat.

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.

People were supported to maintain contact with family and friends, and where they had relatives who lived away from the area, they were supported to, for example, to have telephone contact. We observed people had visits and received telephone calls from their relatives during our inspection. A person told us about their family and how they saw them regularly.

The provider kept up to date with changes in legislation and good practice, and these were incorporated into policies and procedures and training.

During our inspection, we saw there was plenty of food, including fresh fruit and vegetables available. People told us they got enough to eat and drink, including what their favourite foods and drinks were. We observed mealtimes and people chose what and the amount they wanted to eat. People’s needs and risks were assessed in relation to nutrition and hydration. People were supported to maintain a healthy weight, this included encouragement in healthy eating. The manager told us whilst they were encouraging people to maintain a healthy weight, their decisions were being respected. People’s specific needs and preferences were documented and met. For example, a person chose to have a specific diet, they showed us their food and told us how their diet was respected, including how they chose the food purchased and how it was cooked.

People’s fluid intake was recorded daily, and care plans identified how people were supported to drink. However, the records lacked guidance for staff when low fluid intake became a risk and when staff were to contact health professionals. The management team assured us they were reviewed and any concerns would be identified. We saw people had access to their choice of drinks throughout each visit.

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.

Staff had access to information about how to meet people’s specific and diverse needs and received training in how to meet them. This included people’s plans for the future and how they were going to achieve their goals. Staff meetings were held monthly where staff could discuss how they worked with people.

The provider worked with other professionals involved in people’s care, where treatment or guidance had been received, this was incorporated into care plans to ensure consistency and joined up care. Information was shared across teams involved in people’s care which also maintained consistency, such as if a person required hospital admission.

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.

People were consulted about the care provided, including their health needs and how they were met. People told us they had access to health professionals when needed, such as the GP. Records and discussions with the manager demonstrated people had access to a range of service, including chiropody, Speech and Language Therapy (SALT), opticians and occupational therapy.

Where required, staff sought guidance and support from emergency services. Staff knew people well and they were vigilant to any changes in their physical or emotional wellbeing. Where staff had concerns about people’s wellbeing, referrals were made to other professionals and guidance and treatment was documented into the care plans. Where people refused treatment, this was respected. However, the staff provided support to people to make informed choice and reduce their distress.

Some people were attending a local swimming group to help them to keep active in an enjoyable setting. A person told us about how much they enjoyed going swimming.

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.

People’s care was routinely monitored and assessed, with consultation with people and their representatives, where appropriate. People’s care plans identified their specific and diverse needs and how they were to be met. These were reviewed and amended when changes in people’s needs and preferences happened.

Concerns about people’s wellbeing were identified and referrals made, where required, to other professionals, including health care professionals. Where staff had identified a person was distressed when receiving support, they were working with other professionals to encourage acceptance to achieve the best outcomes for them. Discussions with the manager and records showed treatment was not being forced and actions were being taken to encourage the person by introducing step by step support to gain the person’s confidence and trust to accept the treatment to achieve the best outcomes for them.

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

We found the service was working within the principles of the Mental Capacity Act (2005) and if needed, appropriate legal authorisations were in place to deprive a person of their liberty. These were kept under review and monitored. People’s capacity and the Deprivation of Liberty Safeguards (DoLS) in place were included in people’s care plans, including what the DoLS meant when supporting people. Where people required support to make decisions this was documented, including how decisions were made in people’s best interests.

People told us they chose what they wanted to do in their lives. We saw staff using various methods of communication to support people to make choices, this included verbal, written and using objects for people to point to. This showed staff were aware of people’s specific forms of communicating their decisions. Care plans identified how people were supported to make choices, including their body language and gestures to show staff what they wanted and what they did not want.