About the service: Pinetops is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. Pinetops provides accommodation, care and support for up to six people with a learning disability.

People’s experience of using this service:

¿ People’s relatives were positive about Pinetops. Comments included, ”I am very impressed. [Person] is getting good care and is very happy,” and, “I am quite happy with the care that [person] receives.”

¿ People were protected from avoidable harm and abuse.

¿ Risk assessments were in place to ensure people and the environment they lived in was safe.

¿ People received their medicines when they needed them.

¿ Staff were recruited safely and staffing levels were sufficient to meet people’s needs.

¿ Staff were knowledgeable and were kind, caring and patient.

¿ The service had been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion.

¿ People's health was well managed and there were links with other services to ensure that their individual health needs were met.

¿ People were treated with dignity and respect.

¿ Staff knew people well and had developed meaningful relationships with them. Support was provided in a person-centred way based on people’s preferences.

¿ People were supported to have choice in their daily lives, however people were not always supported in the least restrictive way.

¿ People could take part in a range of activities which promoted their wellbeing.

¿ Quality assurance processes were in place and actions were taken to address any issues identified.

¿ The service was run well by a registered manager who was held in high regard by people, their relatives and staff.

¿ The registered manager had good oversight of the service.

Rating at last inspection: Good (report published 19 September 2016)

Why we inspected: This was a planned inspection based on the previous rating.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

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

The inspection took place on the 10 August 2016 and was announced.

Pinetops provided care for up to six people. The home supported people who had a range of learning disabilities.

There is another home next door called Greenacres. This is owned by the same provider and has the same registered manager. As a result there are similarities with both homes in terms of the management and the administration of the services. We inspected these services during the same week.

There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. Throughout this report the registered manager will be referred to as the manager.

People benefited from being supported by staff who were safely recruited, well trained and who felt supported in their work by their colleagues and by the manager. There was consistently enough staff to safely meet people’s individual needs.

Staff understood how to protect people from the risk of abuse and knew the procedure for reporting any concerns. Medicines were administered safely and adherence to best practice was consistently applied. People received their medicines on time, safely and in the manner the prescriber intended. The service regularly audited the administration of medicines. Medicines were stored securely.

Staff knew and understood the needs of people living at Pinetops.

Staff received yearly appraisals. Staff also had regular supervisions. The manager and team leader observed practice and were involved in the daily running of the service.

Staff told us they were happy working at Pinetops. They assisted people with kindness and compassion. People’s dignity and privacy was maintained and respected. People were treated as individuals.

The Care Quality Commission (CQC) is required to monitor the Mental Capacity Act (MCA) 2005 Deprivation of Liberty Safeguards (DoLS) and report on what we find. The service was depriving some people of their liberty in order to provide necessary care and to keep them safe. The service had made applications for authorisation to the local authority DoLS team. The service was working within the principles of the MCA.

The manager’s understanding about mental capacity and the staff’s understanding about DoLS was variable. When we raised this with the manager, they put a plan in place to address this.

People’s care plans contained important, relevant and detailed information to assist staff in meeting people’s individual needs. People had been involved in making decisions around the care they received. People’s needs had been reviewed. People’s care was person centred.

People were supported to maintain good health and wellbeing. The service reacted proactively to changes in people’s health and social care needs.

The service had links with the local community and the manager planned to develop this further.

The service encouraged people to maintain relationships with people who were important to them. There were planned activities on a daily basis to support people to maintain their interests and fulfil their goals.

There was a positive, open culture and a welcoming and friendly atmosphere at Pinetops. There were systems in place to monitor the quality of the service. Although there appeared to be delays at the provider level (New Boundaries) for some of the improvements to the garden, the manager and staff wanted to make.

Most people using the service were unable to tell us verbally what they thought. We observed and listened to interactions between staff and people living in the home. This showed that people were treated respectfully, given choices and that staff explained what was going on. One person told us that they felt the staff were "...lovely..." and supported them well.

We noted that some people were not able to make more complex decisions about their care. Where this was the case there were clear indications that decisions were taken in a way that represented their best interests. The new manager had plans to improve how care plans were developed and increase opportunities for people to communicate if they were unable to do this verbally.

People's needs were assessed and care was delivered in a way that met their needs safely. People had access to other professionals to help keep them well. Staff were able to give us detailed information about people's health and welfare and showed they understood how to meet people's needs. This included how they supported people to have enough fluids and to eat well.

Medicines were managed and administered safely so that people were protected, as far as possible, from risks associated with these.

Most people would need assistance to make complaints. However, there was a system for dealing with these. Our discussions with staff showed that they were aware of the importance of responding to and resolving informal complaints promptly. We observed that people living at Pinetops interacted freely with staff and showed no signs of being ill at ease. One person said they had no concerns but were confident staff would "...sort it out..." if they did.

Observations during our inspection, showed people to be comfortable, relaxed and dressed appropriately. We observed regular interactions with staff and saw that people were included in conversations and friendly banter and were treated with dignity and respect.

At the time of our inspection two people had gone out with their cooking club for a Christmas meal. We were told that both people often liked to spend time cooking in the home's kitchen.

One person's care records showed that they regularly undertook activities, which they said they enjoyed such as bowling, going to the cinema and going out for a coffee and a walk.

We saw that people's individual rooms had been decorated and furnished in accordance with their choices and that people were able to have their personal possessions around them.

We met and spoke with one person while they were relaxing and watching a film in their room. This person told us they were happy and liked their room. When asked, they also told us they liked having their personal collections of DVDs and other items, which they said the staff helped them to dust and clean.

At the time of our inspection, we saw that there were enough members of staff on duty to keep people safe and meet their care and welfare needs.

There were a number of systems in place to assess and monitor the quality of service provided.