Archived: Pine Lodge Care

Updated 24 November 2020

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC’s response to care homes with outbreaks of coronavirus, we are conducting reviews to ensure that the Infection Prevention and Control (IPC) practice was safe and the service was compliant with IPC measures. This was a targeted inspection looking at the IPC practices the provider has in place.

This inspection took place on 5 November 2020 and was unannounced.

Updated 24 November 2020

The inspection took place on 21 July 2017 and was unannounced.

Pine Lodge Care is a large detached building with support split between two units which are linked by a corridor. It provides care and support for up to 59 older people some of whom are living with dementia. There were 50 people living at the service when we visited. The service had some double rooms and some of these were shared by couples. People could choose if they preferred a shared room or a single one.

The service was run by a registered manager who was supported by an assistant manager, a head of care and a team leader in each unit. 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 the previous inspection in May 2016 we found breaches of regulations. At this inspection improvements had been made and was compliant with regulations.

At the last inspection there had been a breach in regulation related to people’s nutritional needs not being met, advice from health care professionals not being recorded in people’s care plans and people’s weight not being recorded on a regular basis. At this inspection we found that all care plans included advice given by health professionals about how to support people to maintain a healthy weight. People’s weights were taken on a regular basis and any weight loss was reviewed. If required referrals were made to health professionals. A monthly review of people’s weights and any actions taken was completed by the registered manager.

At the previous inspection there had been a breach in regulation related to effective systems to monitor and improve the service and records not being completed fully or updated when required. At this inspection improvements had been made. Regular audits of the service, including care planning had been completed by the registered manager, assistant manager and an external assessor. Where shortfalls were identified these had been addressed and actions were recorded when completed.

At the last inspection we made recommendations about medicines and about pre-employment checks for staff. At this inspection we found action had been taken. Audits of medicines now included the review of PRN protocols and these were up to date and gave the information needed for staff to administer PRN medicines safely. The registered manager had carried out the necessary checks prior to staff starting work.

People and their relatives told us staff kept them safe. Staff understood different types of abuse they may encounter and were able to tell us what they would do if they were concerned. There were enough staff to keep people safe and staffing was adjusted by the registered manager based on the needs of people. Staff told us they had the support and training they required to meet the needs of the people they supported. People and their relatives told us, and we observed that the staff were competent and confident in their roles. Risks to people and the environment were assessed and plans were put in place to minimise the risks in a way which least restricted people. People’s medicines were managed safely and in the way they preferred.

The registered manager and staff understood how the Mental Capacity Act (MCA) 2005 was applied to ensure decisions made for people without capacity were only made in their best interests. The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS). The registered manager had applied for DoLS authorisations in line with the legislation. People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way. People’s care plans gave staff information about the best way to offer each person a choice, for example. ‘Only offer me a choice between two items as more may overwhelm me.’ Staff took time to give people choices and respected their decisions.

People told us they enjoyed the food, they were offered regular drinks and snacks throughout the day. People had a say in the menu via surveys and residents meetings. Requests had included a cooked breakfast and more green vegetables which had both been added to the menu. People’s food and fluid records were comprehensive and completed regularly. When people needed support with their health referrals were made to health professionals quickly. The service worked closely with community health teams such as the community matrons to improve people’s health and also to take part in trials of new systems aimed at meeting people’s health needs more quickly and efficiently.

People and staff had built positive and caring relationships. Throughout the day there was genuine affection between people and staff, with hugs and lots of laughter. Staff encouraged people to do as much for themselves as possible and offered reassurance if people were upset or anxious. People and their loved ones were involved in planning their care and regular updates. Staff treated people with dignity and respect at all times. Visitors were welcomed at the service and regular church services were held for people to attend if they wished.

The service used an online care planning system. People’s care plans were detailed and contained details of people’s lives before coming to the service along with what was important to them. Including details such as, ‘I like to have three pillows,’ and ‘I can only sleep if my room is completely dark.’ People who were living with dementia had a section in their care plan which detailed how staff should support them to live well with dementia. There was also clear guidance for staff around communication for each person. People had access to regular activities both in and out of the service. The registered manager was working with the activity co-ordinator to find new activities including new technology for people. People had access to sensory based activities such as ‘twiddle blankets’ which they found calming.

People and their relatives told us they knew how to make a complaint. Complaints were logged and all had been resolved to the complainant’s satisfaction. People and staff told us the management team were approachable and supportive. The management team including the registered manager often worked alongside staff providing role modelling and support. Everyone we spoke to knew that the visions and the values of the service were that the people they support are the priority. The registered manager sought out opportunities to work with other professionals to increase her knowledge and understanding of good practice. This information was used along with the results of any audits to improve the service and provide people with high quality care.