This was an unannounced inspection, carried out on 31 August 2017. The service was last inspected in August 2015 when it was rated as 'Good'. At this inspection we found the service remained 'Good'.The Pines provides accommodation for up to three people with complex needs. There were three people living at the service at the time of our inspection.
We saw that people were relaxed, engaged in their own choice of activities and appeared to be happy and well supported by the service. One person told us they were happy and felt safe living at The Pines. Comments included; “I like living here” and “I’m happy.” Relatives of people who lived at The Pines told us, “My thoughts regarding the care my [relative] is that they are receiving very good care and I am entirely positive about the Pines. I believe staff are well trained and they have a competent team. My [relative has thrived since moving to The Pines. I have no concerns with this placement at all.”
We walked around the service and saw it was comfortable and personalised to reflect people’s individual tastes. People were treated with kindness, compassion and respect. Staff demonstrated they had an excellent knowledge of the people they supported and were able to appropriately support people without limiting their independence. Staff consistently spent time speaking with the people they were supporting. We saw many positive interactions and people enjoyed talking to and interacting with staff. One staff member said, “I love my job. I’ve come to this work from an entirely different sector and I get so much pleasure from working here. I get a great sense of achievement by supporting the people who live here to live happy lives.”
People had regular routine access to visiting health and social care professionals where necessary. People attended an annual health check with a GP and had access to specialist medical services to ensure their health needs were met. Professionals told us there was appropriate communication between the service and medical services. Comments included, “Communication was always good and staff were happy to listen and respond to any suggestions. I rate this service as excellent” and “I always found staff to be really helpful and skilled.”
We saw clear guidance for staff about how they were to meet people’s needs so that they worked in collaboration. Staff responded to people’s changing health needs and sought the appropriate guidance and care from healthcare professionals when required.
Medicines were managed safely to ensure people received them in accordance with their health needs and the prescriber’s instructions.
Staff were well supported through a system of induction and training. Staff told us the training was thorough and gave them confidence to carry out their role effectively. The staff team were supportive of each other and worked together to support people. Staffing levels met the present care needs of the people that lived at the service.
The service was meeting the requirements of the Mental Capacity Act 2005 (MCA) and associated Deprivation of Liberty Safeguards (DoLS). People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People had a choice of how they spent their time and the activities they undertook. Meals, snacks and drinks were chosen by people, which we saw they enjoyed. People had been included in planning their own menus and their feedback about the meals in the service had been listened to and acted on. Some people were actively involved in meal preparation.
Visitors told us they were always made welcome and were able to visit at any time. People were able to see their visitors privately if they wanted to. Relatives of people who used the service commented, “I have nothing but praise for the service. My [relative] is very happy living there and I am made very welcome when I visit and receive regular and very full updates on what is going on for [Person’s name].”
The service had clear complaint systems and people had regular opportunities to discuss how they felt about the service. Each person had a key-worker who checked regularly if people were happy or wanted to raise any concerns. One relative told us, “If I have any conerns at all I am comfortable raising them with any of the staff or management at The Pines. I feel it is better not to let things fester and in my experience they are open and quick to fix any issues that arise.”
People had individual support plans, detailing the support they needed and how they wanted this to be provided. Staff reviewed plans at least monthly with input from the person who was supported. Relatives told us they were kept informed of changes to their relatives support plans and were regularly invited to review meetings. A professional commented, “I have been kept up to date with any changes to the care or intervention re the person I work with. I have been asked to comment on any changes to risk assessments. I have also been kept up to date with any changes to the management team at The Pines. I have been very satisfied with what I have seen and with the service provided.”
Staff demonstrated they knew the people they were supporting, the choices they had made about their support and how they wished to live their lives. For example, staff understood the previous life experiences of people before they came to The Pines and this understanding of people’s social histories helped staff develop positive relationships with people.
The service had comprehensive quality assurance processes which were regularly undertaken to ensure the service was aware of people’s views of the service and could monitor auditing processes at the service. This ensured an open service culture that is both open to challenge and is learning from any issues affecting the quality of the service as they arise.