Archived: Pineapple Place

Updated 2 December 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the nominated individual is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 1 August 2017 and was announced. We gave the service 48 hours’ notice of the inspection because it is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in to meet with us. Unfortunately the manager was not available and we spoke with the senior staff member in their absence. The inspection team consisted of one inspector.

Before the inspection, the provider had completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. This information was received when we requested it.

As part of planning the inspection we checked if the provider had sent us any notifications. These contain details of events and incidents the provider is required to notify us about by law, including unexpected deaths and injuries occurring to people receiving care. We also looked at any information that had been sent to us by the commissioners of the service and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

We examined the information we hold in relation to the provider and the service, and in particular we looked at areas that had been raised with us as safeguarding concerns. We used this information to plan what areas we were going to focus on during our inspection visit.

During our inspection visit we spoke to four people who lived at the home. We spoke with the Nominated Individual on the telephone and the senior staff member. We talked with three members of the staff team. During the inspection we spoke with one health professional. We sampled various records, including people's care records, staffing records, complaints, medication and quality monitoring. After the inspection visit the manager sent us information that we had requested which we reviewed in order to help us reach our judgements.

Updated 2 December 2017

This inspection took place on 1 August 2017 and was announced. Pineapple Place was first registered as a supported living service with CQC in August 2016. This was its first comprehensive inspection. Pineapple Place is registered to deliver personal care to people who live in their own apartments. This service provides care and support to people living in ‘supported living’ setting[s], so that they can live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support. At the time of our inspection 13 people were receiving personal care from the service.

Pineapple Place has not had a registered manager in post since June 2017. 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 and associated Regulations about how the service is run. At the time of our inspection the acting manager was applying to CQC to become the registered manager. Since that time the acting manager has left the employment of the provider and another manager is in the process of applying to become registered with CQC as the Registered Manager.

People told us that they felt safe with the staff who supported them. Staff were aware of the need to keep people safe and understood their responsibilities to report allegations or suspicions of poor practice. Assessments had been undertaken to identify any potential risks to people and guidance was available for staff to follow to minimise those risks. Safe recruitment practices were in place. Medicines had not always been given as prescribed and there were unclear instructions for staff who supported people to use medicated skin creams. The systems in place to ensure medicines were managed safely were not effective.

Staff were provided with training to keep their knowledge and skills current. Staff told us that they had received a planned induction when they commenced working. All the staff demonstrated the need to gain people’s consent to care and support before providing assistance. People were provided with a good choice of food and the majority of people were supported to access relevant healthcare professionals when needed.

People were cared for by staff who knew them well and who they described as kind and compassionate. People expressed how they wanted their care to be delivered. People’s decisions and choices were respected by staff. People told us that they were treated with dignity and had their privacy respected.

People had been involved in the development of their care plans.. People told us they felt their views were taken into consideration and their choices accommodated where possible. People told us that they felt enabled to raise concerns and complaints and were confident that these would be investigated and acted upon.

People described the service as well-led and felt confident with the support they received. However staff did not feel that leadership was clear and did not feel as supported as they would like. Our inspection identified that the leadership was not effective. The systems in place to monitor and improve the quality and safety of the service had not identified issues affecting people’s safety or the impact on the quality of the service. Subsequently they had not driven forward improvements or ensured that risks were mitigated appropriately.

We found that the assessment and the monitoring of the service did not meet the required standards and so the provider is in breach of Regulation 17, of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.