CQC report explained · a residential care home
What the CQC found at Pinehurst Care Centre
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Medicines were handled safely and risk assessments were kept up to date. Staff files were mostly complete, but some employment history checks had gaps and one previous conduct check was missing at the time of inspection.
- Effective?
- Good
- Staff training was up to date or had plans for renewal. Care plans reflected people's needs and choices, and people received support with food, health care and decision-making.
- Caring?
- Good
- People and relatives described staff as kind, respectful and caring. Inspectors saw staff protecting privacy, dignity and independence and involving people in decisions about their care.
- Responsive?
- Good
- Care was tailored to people's preferences and changing needs. People had access to activities, could maintain relationships, and knew how to raise concerns.
- Well-led?
- Good
- The home had introduced effective audits and an action plan after the previous inspection. Staff, people and relatives described managers as approachable, and the provider was meeting its legal responsibilities.
What inspectors found, April 2020
Pinehurst Care Centre was rated Good; inspectors found kind, personalised care and improvements since the previous Requires Improvement rating.
This was an unannounced inspection on 10 and 11 March 2020. The inspection team spoke with people living at the home, relatives, staff and other professionals. They reviewed care plans, medicines records, staff files and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that medicines were handled safely, risks were reviewed, staffing was suitable, and staff had the training and skills needed.
People were treated with kindness, dignity and respect. Care was personalised, activities reflected people's interests, and people were supported to make choices. The home had improved since the last inspection and was no longer in breach of regulations.
Safer medicines
The home introduced checks after the previous inspection. Inspectors found robust processes for ordering, storing, giving and recording medicines.
“There were robust processes in place and followed by staff, for ordering, storing, administrating and disposing of medicines including controlled drugs.” from the report
Personalised care
Care plans were based on assessments and included people's preferences and choices. Staff knew people well and adapted support when needs changed.
“People received support that was individualised to their personal needs.” from the report
Kind and respectful staff
People and relatives reported that staff were caring and respectful. Inspectors observed staff supporting privacy, dignity and independence.
“People were treated with care and kindness. They were consulted about their care and support and could change how things were done if they wanted to.” from the report
Activities and relationships
The home provided activities based on people's interests and supported contact with relatives and the wider community. One-to-one activities were available for people unable to join group activities.
“People had access to activities that took into account their individual interests and links with different communities.” from the report
Improved management
Management introduced audits and worked through an action plan. The report says these changes helped the home meet legal and quality requirements.
“An audit system had been introduced and operated effectively so that the registered manager was able to ensure the fundamental standards were being met.” from the report
Recruitment records
minorSome staff files did not contain all the required recruitment information. Gaps in employment histories had not been explained, and one previous conduct check was missing at the time of inspection, although the information was obtained promptly afterwards.
“Staff files included most, but not all, of the required recruitment information.” from the report
- 01How do you now check that every new staff file contains a complete employment history and all required conduct checks before the person starts work?
- 02How are medicines audits carried out now, and what happens if an error or missed dose is found?
- 03How often are people's falls, nutrition and skin-risk assessments reviewed when their needs change?
- 04What dementia-friendly changes were completed in the unit where people were living with dementia?
- 05How are relatives involved in reviewing care plans and choosing activities?
This was a planned, unannounced inspection covering all five key questions; the previous inspection had rated the service Requires Improvement overall, with Caring and Responsive already rated Good. This explanation was written from the published report of 8 April 2020 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, April 2019
Rated Requires Improvement; inspectors found kind and responsive care, but medicines, falls records, staff training and oversight were not reliable enough.
This was an unannounced inspection over two days. Inspectors spoke with people living in the home, relatives, staff and health professionals. They observed care and checked medicines, care records, accidents, complaints, recruitment, training and quality checks.
The home was rated Good for caring and responsive care. People were treated kindly and with dignity. Staff knew people's backgrounds and preferences. There was a choice of food and drink, and people could take part in activities suited to their interests.
The home was rated Requires Improvement for safe, effective and well-led care. Inspectors found missed medicines signatures, gaps in medicines guidance, out-of-date risk assessments and incomplete accident records. Some staff training was overdue, and quality checks did not always identify problems.
The overall rating fell from Outstanding at the previous inspection, published on 28 September 2016. The home breached Regulation 17 on good governance. CQC said it would check that action was taken and carry out another comprehensive inspection within one year.
Kind and respectful care
People and relatives described staff as caring. Inspectors found that people were treated with dignity and respect.
“People were treated with care and kindness.” from the report
Personalised support
Staff knew people's backgrounds, preferences and interests. Care planning involved families where appropriate.
“People's diverse needs, their personalities and what was important to them were well known by staff.” from the report
Choice of food and drink
People were offered a variety of meals and drinks, including alcohol, as well as fruit and hot and cold drinks throughout the day.
“There was a choice and variety of meals and drinks offered to people, including alcohol.” from the report
Activities and community links
The home provided activities linked to people's interests and worked with local groups and organisations.
“The provider worked in partnership with a local school, beaver and brownie groups, preschool and toddler groups and exotic wildlife agency.” from the report
Staff felt supported
Staff said management was approachable and that they could raise concerns. Inspectors said this had a positive effect on people's wellbeing.
“Staff felt the management was supportive and approachable.” from the report
Medicines records and guidance
seriousStaff had not always signed medicines records. Guidance for some as-required medicines was missing or unclear, and stock records did not match the medicines held.
“Medicines procedures were not always handled safely.” from the report
Falls and accident follow-up
seriousFalls risk assessments and daily notes were not always updated after incidents. Records did not always show that people had been monitored or that steps had been taken to reduce further risk.
“There was no clear action plan available following an incident.” from the report
Overdue staff training
needs fixingTraining in record keeping, moving and handling, first aid, safeguarding, and mental capacity and liberty safeguards was overdue for some staff. Not all staff could explain dementia well.
“The provider did not have an effective system to ensure that staff received appropriate training.” from the report
Weak quality checks
seriousAudits did not always identify problems, and some audit sections had not been completed regularly. This meant managers did not have reliable oversight of safety and care records.
“Systems were not always in place to ensure the service was consistently monitored and quality assurance maintained.” from the report
Support during meals
needs fixingInspectors saw staff talking among themselves during a meal. One person with dementia began eating with their hands before staff provided help.
“People in Pine House were not always supported during meal times.” from the report
- 01What has changed in the medicines system since inspectors found missed MAR signatures, unclear as-required medicines guidance and inaccurate stock records?
- 02How are falls now investigated, recorded and followed up, and how are risk assessments updated after an incident?
- 03Which staff had overdue training at the inspection, and has refresher training in dementia, record keeping, first aid, safeguarding and moving and handling now been completed?
- 04How does management check that care records, medicines audits and quality audits are complete and accurate?
- 05How do staff make sure people who need help to eat receive timely, attentive support at every meal?
This was a planned, unannounced inspection covering all five CQC questions and the overall quality and safety of the home. This explanation was written from the published report of 19 April 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Pinehurst Care Centre
3 rated inspections over 4 years: the service has slipped, from Outstanding to Good.
- April 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2019Requires improvementdown from OutstandingSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2016OutstandingSafe: GoodEffective: GoodCaring: OutstandingResponsive: OutstandingWell-led: Good
- September 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 7 December 2010.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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