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, and to provide a rating for the service under the Care Act 2014 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.
Pinehaven is a care home for up to nine people with learning disabilities. At the time of the inspection nine people were living at the home.
This was an unannounced inspection. On the day of the inspection we spoke with three people who lived at Pinehaven. We also spoke with the manager, team leader and two support workers. Following the inspection we spoke with four people’s relatives.
The manager told us that they had been managing the home for two months and had made an application to the Care Quality Commission (CQC) to become the registered manager of the service. This application was being considered by CQC at the time of inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider
People’s medicines were securely stored and controlled drugs were safely managed. The provider had a policy to guide staff regarding the safe management of medicines. Staff were aware of the actions to take in the event of an error when giving medicines. However, the provider did not have safe arrangements in place for managing two people's ‘when required’ pain relief.
CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. No-one living at the service was subject to a DoLS authorisation. The manager told us that they planned to review whether any applications needed to be made following a change in the law. We spoke with three staff who were not familiar with DoLS or when an application should be made. The manager told us that DoLS training was not mandatory for staff working at the home.
Staff were aware of what constituted abuse and the actions to take if they suspected someone was being abused. The provider had a policy regarding safeguarding and the manager told us that they had recently made an alert to the local authority safeguarding team regarding an incident of alleged abuse. However, the provider had not made a statutory notification to CQC regarding this incident as they are required. At our previous inspection of the service in April 2013 we found that the provider had not made all of the statutory notifications to CQC as they are required. We noted this in the inspection report for the provider’s information. This was a breach of Regulation 18 Care Quality Commission (Registration) Regulations 2009.
People’s support records and found that they did not always contain consistent or accurate information. The manager and the team leader acknowledged that records were not all up to date and had started work to rectify this. This was a breach of Regulation 20 Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.
The provider had not consistently analysed incidents and accidents to identify trends. We found the provider had undertaken regular visits to the home to monitor the quality. However, actions required following these visits were not always specific which made it difficult to establish whether or not the actions had been completed.
The people using the service, staff and relatives we spoke with, considered that there were sufficient numbers of staff. Appropriate checks were carried out before staff were employed, such as references and employment history. The provider’s disciplinary policy did not provide guidance to staff regarding the circumstances whereby a referral to the Disclosure and Baring Service (DBS) should be made. However, the manager was aware of the types of situations when referrals to the DBS may be required.
The staff we spoke with were aware of people’s risks and needs and how they should be supported. The staff we spoke with considered that they had were effectively trained and supported to carry out their roles. However, staff had not received training in the Deprivation of Liberty Safeguards.
The people and the relatives we spoke with told us that they had sufficient to eat and drink. We saw that people were offered a choice of food and drink and that fruit was available in the home for people to help themselves to.
The people and relatives we spoke with told us that the staff were kind and compassionate. We saw that people were involved in making decisions about their care and the staff we spoke with were aware of people’s preferences. People accessed a variety of activities and work to meet their needs.
The people, relatives and staff we spoke with told us that they were comfortable raising concerns about the service if they had any. There were forms available in the home in an ‘easy read’ format for people to use. There was a complaints procedure which staff were aware of and regular meetings which sought people’s views of the service were held. However, there was no analysis or action plan developed in light of a recent survey of people’s views.