- Care home
Pine Lodge Care Home
Report from 27 February 2024 assessment
Contents
On this page
- Overview
- Shared direction and culture
- Capable, compassionate and inclusive leaders
- Freedom to speak up
- Workforce equality, diversity and inclusion
- Governance, management and sustainability
- Partnerships and communities
- Learning, improvement and innovation
Well-led
The management of the service has improved and the key question of well led has been assessed as good. The management team within the service had changed since the last inspection. They understood that though improvements had been made there were still further improvements required and had a vision of how to achieve this. The culture within the service had improved and the management team had been open and transparent with staff, relatives and people about the changes needed to the service. There was now a culture of learning and following best practice guidance to drive improvements.
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.
All staff we spoke with told us there was a significant improvement to the culture of the service. The nominated individual told us they had focused on developing the culture of the service and building an effective staff team. They felt the “old fashioned” model of care had gone and staff had been very receptive to new ways of working. They told us they had spent a lot of time at the service and had got to know people and staff. They felt this had been important to share and explain the vision and hear others views. They told us they had been lots of changes at the service and they had tried to maintain continuity for people and staff along with a shared direction. A number of staff had left the service for different reasons and the nominated individual told us this had caused division between long standing and new staff. They told us they had worked to support staff with this and “Get everyone onboard with the changes”. They told us, “As staff are seeing the benefits of the improvements, they are getting more involved”. They told us the staff and leadership teams were now in place and work was being done to support all of them to develop a positive culture at the service. The nominated individual told us working at the service had been easier over the past couple of months as staff confidence had developed and the physical changes to the building had been completed. One staff told us, “Its been tough. To get through the pandemic, then the CQC inspection to now. I can’t believe the improvements which have been made. The staff and everyone are working so much better together. Happy staff – Happy people.” and “We are kept up to date of all the changes that have been made and that are in progress. I can’t tell you how much more valued we feel.”
There were systems in place to keep staff, people and relatives informed about changes in the service. The management team held regular meetings and sent out newsletters to show the changes and activities taking place. The vision for the service following the last inspection had been shared with staff, who were expected to work towards the goals.
Capable, compassionate and inclusive leaders
Following our last inspection there was now a new manager at the service. Though they did not have experience in the role previously, the nominated individual told us, they demonstrated the qualities they required in an effective leader. They had recognised the manager would require support to develop in the role and had put support systems in place. The nominated individual confirmed staff morale had reduced following our last inspection. Staff had felt their opinions were not valued and their suggestions had not been acted on. They told us, “I have tried to give everyone a voice”. They had worked with the longstanding staff team to understand their skills and competence and some staff had been promoted to senior roles. New staff with “fresh energy and experience” had also been employed to develop the staff team as a whole. Positive feedback received from funding authorities and people’s relatives had been shared with staff and had boosted their morale. Feedback on the new manager was wholly positive including, “I absolutely have confidence in the new manager.” And “They (new manager) have embraced everything, I really think the staff respect her.” Staff felt the new manager and the nominated individual were approachable and fair to all.
After the last inspection new systems and processes had been put in place. The nominated individual and operations managers had been on site supporting the manager and were both on site undertaking this when we arrived to complete the inspection. Staff had now received training to make sure they had skills to support people following best practice and guidance, to improve the experience of care for people and for staff to feel valued.
Freedom to speak up
All staff we spoke with were able to tell us what they would do in the event that concerns were not listened to. They knew of the providers policy around raising concerns internally but also where to report concerns, if they felt they were not being taken seriously. Staff we spoke with had the confidence to raise concerns and that they would continue to seek feedback on what had been done about them. “I absolutely would have the confidence to speak up. I think (the new manager) would do something straight away as that’s my impression of them however, if they didn’t, I would come straight to the CQC. No doubt.”
The provider has policies and procedures in place to support staff to speak up about any concerns they have. The processes offer staff protection to whistle blow about any concerns without fear of discrimination.
Workforce equality, diversity and inclusion
The nominated individual confirmed there was a diverse workforce, “Yes, it’s a diverse workforce. We have many staff from different backgrounds and this only adds to the mix of skills. I feel everyone is treated fairly and each get to have our say when needed.” And, “At Ramadan we gave staff extra breaks, we had 4 staff and told them at sun downing ‘do what you need’” Staff told us, “We are really looked after. It’s all going really well and see improvements and there’s more to come.”
The provider has policies and procedures in place to support a diverse workforce including their spiritual, cultural beliefs and protected characteristics.
Governance, management and sustainability
Staff told us about the new structure within the service has had a strong positive impact on them. They were clear of the reporting structure and who supervised them to support them in their role.
There were now systems in place to check the quality of the service. Since the last inspection, an external consultant had completed monthly audits. These audits showed the improvements made in all areas of the service, though there continued to be more improvements required. The checks had not identified there was no system in place to inform the chef when people required a fortified diet. Following the assessment, the nominated individual sent confirmation, there was now a system in place. The management team completed daily walk round audits to check the cleanliness of the service. They also completed regular medicine audits and reviewed the dining experience of people to make sure these were of the standard required.
Partnerships and communities
Relatives told us they were kept informed about their loved ones care. One relative told us, "I am informed about changes; I visited and after I left, I had a phone call to say the GP said (Name) required some medicines and they were hoping to start it that night." Another relative told us, "I am immediately informed of any changes. " They also wanted to add that they couldn’t think of a better place for their loved one to be, they are looked after perfectly by them, it is a brilliant home. Other relatives told us, "I receive newsletters and emails about things happening in the home. Manager requested feedback and suggestions recently, there’s been a remarkable improvement in the home. The whole atmosphere is really uplifting, it has a joyous feel because of all the activities." One relative told us, "Yes, there have been a couple of meetings since the last report. When the report was published I made an appointment with the manager who explained the report and there have been 2 relatives meetings since to discuss this and the changes that would be made."
Staff told us they work with general practitioners, district nurses, dieticians and other healthcare professionals to ensure people have joined up care. Team leaders told us, “I go around with the GP when they visit people, or with the district nurses. Most of the time I know why they are there and I always make sure I can make it as easy as possible for them so I'll do urine testing for example. They follow me as I know people who live here."
We requested feedback from other professionals who support the service but we did not receive a response.
There were now regular meetings for people, staff and relatives to give opinions, make suggestions and keep informed of the changes within the service. The management team have put in place systems to work with health and other professionals. The staff have invited groups from the community to visit the service including spiritual groups.
Learning, improvement and innovation
The provider’s oversight of the service had improved since our last inspection. The nominated individual told us our last inspection had been “a huge wake up call”. They told us when they purchased the service the provider had decided not to make changes to the way it operated and the service had not developed. They told us they had started from scratch with record keeping processes and after looking at a number of different systems had chosen an “all-encompassing programme” which integrated with other areas of the service, such as auditing. They said they had chosen to do this as they understood it was a huge transition for the staff to make. Staff told us, “I think a lot has been learnt since the CQC came before and since the new company purchased the home. We give feedback constantly and also in our monthly meetings. We are listened to and feel valued.”
There are now processes in place to receive feedback. Staff and people were asked for their opinions of the service by completing quality assurance surveys. The results of the surveys had been analysed and an action plan put in place to meet any shortfalls, although most all the responses were positive. The nominated individual had put changes in place to identify shortfalls, take action, learn from these and make improvements.