CQC report explained · a nursing home
What the CQC found at Pinewood Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Staff administered medicines safely, stored them correctly and ordered them in good time. Inspectors also found enough staff, safe recruitment, thorough risk assessments and a clean, well-maintained home.
- Effective?
- Good
- People's needs were assessed and care plans were updated. Staff were trained, people received support with food and drink, and healthcare professionals were involved when needed.
- Caring?
- Good
- Staff treated people with kindness, dignity and respect. People and relatives were involved in care decisions, and people were supported to remain as independent as possible.
- Responsive?
- Good
- Care plans were personalised and reviewed monthly. People could follow their interests, take part in activities, maintain relationships and raise concerns.
- Well-led?
- Good
- The provider and senior staff used audits, meetings and feedback to monitor the home. Staff understood their roles and the home had improved its systems after the previous inspection.
What inspectors found, April 2020
Rated Good; inspectors found safe, kind and personalised care, with improvements since earlier medicines and management problems.
This was an unannounced inspection on 18 February 2020 by two inspectors. They spoke with four people, four relatives and eight staff. They also reviewed care records, medicines records, staff files, training information and management audits.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found trained staff gave medicines safely, there were enough staff, the home was clean and safe, and people received personalised care and support.
People were treated kindly and involved in decisions about their care. They could choose how to spend their time, take part in activities, keep in touch with family and have their communication needs supported.
The previous rating was Requires Improvement, with multiple breaches of regulation. The home had made improvements to medicines procedures, staff training and quality checks. Inspectors found the home was no longer in breach of regulations.
Safer medicines systems
Inspectors found that medicines were given safely and at the correct times. Staff training, ordering arrangements and regular audits had improved since the previous inspection.
“Trained staff administered medicines safely.” from the report
Kind and respectful care
Staff spoke politely and gently, respected people's choices and protected their privacy. People could choose whether to join activities or spend time in their rooms.
“People at the home were treated with kindness and their views were respected.” from the report
Personalised support
Care plans recorded people's routines, preferences and communication needs. Staff knew people well and changed care plans when needs changed.
“Care plans were person centred throughout and included a personalised profile of the person in their folder.” from the report
Activities and relationships
People were supported to keep in touch with relatives and take part in activities. The home also helped people achieve personal wishes and interests.
“People were able to fulfil long held dreams or new wishes via a 'wish' scheme.” from the report
Improved leadership
The home had strengthened its audits, training and management checks after the earlier inspection. Senior staff were able to manage the home while the registered manager was away.
“Enough improvement had been made at this inspection and the provider was no longer in breach of regulation 17.” from the report
Inspectors raised no specific concerns in this report.
- 01How do you check that the improved medicines procedures are still being followed and that people do not run out of medicines?
- 02How often are each person's care plans and risk assessments reviewed, and how are families involved when needs change?
- 03How do you make sure there are enough staff to spend time with people as well as provide personal and nursing care?
- 04What activities and support are available for someone who prefers quiet time, has communication difficulties or cannot leave the home easily?
- 05Who manages the home when the registered manager is away, and how are important decisions and concerns handled?
This was an unannounced inspection of the care, premises and management of the home, covering all five CQC questions; the previous Requires Improvement rating and breaches had been followed up. This explanation was written from the published report of 2 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, February 2019
Rated Requires Improvement; inspectors found kind, personalised care, but repeated medicines errors put people at risk.
CQC carried out an unannounced comprehensive inspection over two days. Inspectors spoke with people, relatives, visitors and staff, observed care, looked around the home and checked care, medicines and quality records.
The main problem was medicines. Six errors had occurred in the 12 days before the inspection. Some people missed medicines, including pain relief, while other medicines were signed for but not given. Earlier audits had also found repeated errors, and previous action had not fixed the problem.
The home was rated Good for Effective, Caring and Responsive. Inspectors found kind staff, personalised care, suitable activities, good support with health needs and a clean environment. Safe and Well-led were rated Requires Improvement because medicines were not managed safely and quality checks had not led to lasting improvement.
Kind and respectful care
Inspectors saw staff treating people warmly and with patience. Staff knew people well and had built strong relationships with them.
“People were supported by staff who were both kind and caring and we observed staff treated people with patience, kindness and understanding.” from the report
Personalised support
Care plans included people's preferences, history, communication methods and cultural, religious and spiritual needs. Staff used this information in daily care.
“People's care plans were personalised to each individual, contained information to assist staff to provide care in a manner that respected people's wishes.” from the report
Good staff preparation
Staff completed induction, training and competency checks. Recruitment checks were carried out before staff started work.
“People were protected by safe recruitment procedures. Required checks had been conducted prior to staff starting work at the home.” from the report
Activities and choices
People could take part in activities linked to their interests and had choices about food and how they spent their time.
“People took part in a variety of activities. Outside entertainers were brought into the service.” from the report
Repeated medicines errors
seriousMedicines were not always supplied, given or recorded correctly. This included two people not receiving pain relief and other medicines being signed for when they had not been given.
“These included two people having not received their pain relief medicines, other medicines signed for but not given and medicines not signed for when they had been given.” from the report
Improvements had not lasted
seriousMedicines audits had found errors over several months. Retraining and other actions had not stopped the errors from continuing.
“However, these had not been successful and medicines errors were found to have continued.” from the report
- 01What specific changes have been made to prevent medicines being missed, given without a signature or signed for when not given?
- 02How are medicines audits now checked to prove that errors have stopped and that improvements are lasting?
- 03How will the home make sure people receive pain relief medicines at the right time?
- 04Who reviews medication administration records, and how quickly are any errors investigated and corrected?
- 05What evidence can you show that the additional medicines training has improved staff practice?
This was an unannounced comprehensive inspection covering the home, nursing and personal care, and all five CQC questions. This explanation was written from the published report of 21 February 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 Pinewood Nursing Home
3 rated inspections over 4 years: the service has held its Good rating throughout.
- April 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2019Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2014
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 20 January 2011.
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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