Pine Lodge

Updated 29 July 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Pine Lodge is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Pine Lodge is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service. We also sought feedback from Healthwatch, Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We reviewed a range of records. This included two care records and associated risk assessments, staff training, supervision and two recruitment files. A variety of other records relating to the management of the service, including the providers policies and procedures were reviewed. We spoke with three relatives about their experience of using the service. During the site visit we spoke with two care staff, the registered manager and the service manager.

After the inspection

We used electronic file sharing to review the providers health and safety audits and management quality monitoring audits and received written feedback from two care staff on their experience of working for the service.

Updated 29 July 2022

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Pine Lodge is a residential care home providing personal care for up to 12 younger adults with a learning disability and autism. At the time of the inspection four people were using the service.

Pine Lodge provides short-term residential care including support for two younger adults with a learning disability, in self-contained apartments, to develop independent living skills and plan for transition towards independent living.

Right support

People were not always supported to have maximum choice and control over their lives. The Mental Capacity Act (MCA) principles were not always followed when assessing mental capacity and in making best interests’ decisions.

People had not always received high quality person-centred care, that was stimulating, followed people’s preferences, enabled people to develop, flourish and pursue their own interests.

People received support with their medicines safely and in the way they preferred.

Staff enabled people to access and follow up specialist health and social care support in a timely manner.

Right care

People’s care and support plans had not always been updated when people’s needs had changed, to ensure people received the right care that was responsive to their changing needs.

Risks associated with people’s care and choices were not always set out in their care records and regularly reviewed.

People were protected from abuse and avoidable harm.

People were supported to communicate in the way they preferred. Staff were provided with the training to support people in this area.

People received care that strived to support their needs and aspirations, focused on their quality of life, and followed best practice.

The staff team provided kind, compassionate and effective care and support.

Right culture

Difficulties with staff retention and recruitment, placed the companies’ ethos, values, attitudes and behaviours at risk of not always being able to support people to be empowered and to lead fulfilled lives.

People received, support and treatment from staff that were sufficiently trained and supported in their roles.

People and those important to them were involved in planning and reviewing their care.

The registered manager promoted an open and welcoming culture. People using the service, relatives and staff felt valued and supported.

Rating at last inspection

Pine Lodge was registered with us on 01 April 2021 and this is the first inspection. The last rating for this service under the previous provider was Good, published on 31 August 2018.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Why we inspected

This was a planned inspection based on the provider's registration date and to assess that the service is applying the principles of Right support right care right culture.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified a breach in relation to the need for consent and good governance. Please see the action we have told the provider to take at the end of this report.

We have made a recommendation about creating therapeutic environments for people with a learning disability and autism.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.