The inspection took place on the 1, 2 and 5 of February 2016 and was unannounced to the care home and announced to the domiciliary care part of the service. At the last inspection in May 2013 the provider was found to be meeting all of the standards inspected.
Pine Lodge care home provides care and accommodation for up to 22 people. On the days of the inspection 21 people were living at the home. The home is on two floors, with access to the upper floor via two stairs cases or two stair lifts. Some bedrooms have en-suite facilities. There are shared bathrooms, shower facilities and toilets. Communal areas include two lounges, one conservatory, two dining areas (one with tea and coffee making facilities), a front and back garden with patio areas.
The service also provides domiciliary care services to adults within the Milton and Weston Super Mare area. On the day of our inspection thirty three people were using the service. The domiciliary care service provides support to people with physical disabilities, sensory impairments and mental health needs, including people living with dementia.
The service had a registered manager. There was a registered manager in post for the care home and the domiciliary care service. 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. Both the registered managers were available for the days their services were inspected.
People had risk assessments in place to help staff minimise risks associated with people’s care. People had personal evacuation plans in place although these did not always include all the details required in an emergency. The environment was regularly assessed and monitored to ensure it was safe at all times. People were supported by staff who had pre-employment checks undertaken prior to starting their employment.
People felt safe although referrals were not always being made to the relevant authorities when concerns for people’s safety were identified. People’s consent to care and treatment was obtained, and staff asked people for their consent prior to supporting them although care plans did not always detail if people had capacity to make their own decisions. People were involved in their care planning and referrals were made to health care professionals when required.
People received their medicines at the right time from staff who had received training. Systems were in place to monitor the management of medicines. Staff meetings were used for learning opportunities to prevent issues from reoccurring. People who were at risk of developing pressure sores had care plans in place to ensure their position was regularly changed and staff and records confirmed they received this care.
People had access to activities and these were provided at times when people could fully participate in them. People received support by staff and the registered managers to have new experiences and the service went ‘the extra mile’ to ensure people had their individual care and welfare needs met.
People were supported by staff who received regular supervision and training although some areas of staff knowledge were poor especially in relation to safeguarding, whistleblowing and equality and diversity. Staff felt well supported and demonstrated a kind and caring approach to people they cared for.
People told us they enjoyed the meals, and people were supported to eat and drink enough to maintain a balanced diet. People who were at risk of losing weight were not always effectively monitored so that any weight loss could be responded to quickly although they were receiving regular visits from the district nursing team.
People, relatives and staff views were sought. People and relatives felt happy to complain and were aware of the provider’s complaints policy. Quality assurance systems monitored the quality and safety of the service and identified areas for improvement. The registered manager was keen to develop and provide high quality care and had signed to pledge their commitment to provide people with high quality services. The registered manager had recently implemented a staff recognition scheme were staff could be recognised for their input and commitment.