Archived: Pear Tree Lane

There was a registered manager in post. 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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People told us they felt safe living at the home. Staff knew what they would do to protect a person from the risk of harm and how to respond to any concerns. Staff were aware of risks to people’s health and well- being and these were appropriately managed. There were enough staff to meet and respond to people’s needs. Recruitment processes were in place which ensured staff had the appropriate checks and skills before they began working in the home.

People received their medicines as prescribed and these were managed safely. People had access to healthcare professionals as required to maintain their health. People were asked for their consent in ways they understood. People’s care and support was planned in a way that did not restrict their rights and freedom. People were supported to have enough food and drink and were offered meals that were suitable for their individual nutritional needs.

People were cared for by staff who knew them well. Staff were attentive and caring towards people. Staff used people’s preferred communication to ensure their individual choices were respected. Staff respected people’s dignity and privacy at all times. People were supported to follow their own interests and hobbies. Relatives felt comfortable in raising any concerns and felt confident these would be addressed appropriately. Staff were aware how they could support people to communicate their feeling if they were unhappy about something.

People and staff spoke positively about the approachable nature of the registered manager. The registered manager was aware of their responsibilities and had developed systems to monitor the quality of the service people received. There was evidence from learning from incidents and changes put in place. There were audits to monitor the quality of the home which included regular checks of people’s medicines and care plans.

Pear Tree Lane is home to 13 people with learning disabilities who live in three separate buildings on one site. There were nine people at home on the day of our inspection. We observed people during the day. People had very limited verbal communication and expressed their wishes with gestures and behaviours. We talked with the manager and the deputy manager. We looked in detail at the care records of three people. We visited on a weekday and we spoke with two professionals, one senior manager and two relatives. We spoke three members of staff and looked at three staff files.

Below is a summary of what we found. The summary describes the records we looked at and what relatives and staff told us.

If you want to see the evidence that supports our summary, please read the full report.

Is the service safe?

The staff and manager had a good understanding of safeguarding and whistle blowing policies. Staff understood their role in safeguarding the people they supported. We saw people were cared for in an environment that was safe and clean. There were enough staff on duty to meet the needs of people who lived at the home. There were procedures in place to safeguard people from abuse.

The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. We saw that proper policies and procedures were in place. The manager had an understanding of these safeguards which ensured people's rights and choices were protected.

Risk assessments and health and safety measures were in place to keep people safe. A member of staff told us, 'It's second to none. You won't get anything better. Everything is done for the customers. Any issues and concerns are dealt with immediately by the managers.'

Is the service effective?

Care plans specified people's individual needs, for example, a person's mobility, or food requirements. One member of staff told us, 'The manager is very professional and supportive on both a professional and personal front.' The service worked well with other agencies and services to make sure people received their care safely and effectively. A health professional told us, 'Things are dealt with there. They chase me if I haven't done something.'

We saw that people were treated with dignity and care. Since our last inspection the home had acquired a new activities room and relaxation area with a vibrating water bed. There was a ceiling track hoist making it accessible to everyone to improve their comfort and personal enjoyment.

Is the service caring?

We saw the staff and manager were patient and gave encouragement when they supported people. All staff were aware of peoples choices, preferences and support needs. We found the care and support was delivered with respect. A relative told us, 'They are brilliant, they do lots of activities and some staff really care about her, they are lovely with her.'

Records we looked at showed that a great deal of effort had been made by the manager to understand what was important to the person and what made them happy. A member of staff told us, 'The managers really care about people.'

Is the service responsive?

We saw clear and detailed recording that ensured the manager could make timely and informed decisions about a person's care and support. Records showed that other professionals had been involved in peoples care and support when needed. We saw that information from health professionals was acted upon and integrated into care plans. One member of staff told us, 'The managers listen and they deal with things immediately. We get the information we need.'

Is the service well-led?

The manager was aware of their responsibilities in meeting the essential standards of quality and safety. There were systems in place to ensure the quality of the service was regularly assessed and monitored. There was a clear structure of supervision responsibilities within the staff team. Staff had regular training and learning opportunities.

Staff we spoke with told us they thought the manager was approachable and provided good support. We saw that the manager was responding to recent changes in relation to the law and the possibility of depriving a person of their liberty. The operational manager told us the home has, 'A constant wanting to encourage the independence of people. It flows through everything they do here.'

People's consent was sought before staff provided care and support. Records showed that appropriate action was taken when people lacked capacity to make decisions. One relative told us, 'They ask me for my consent for everything. That is way above board.'

People received care that met their needs. Records showed that people had access to see other healthcare professionals when needed.

Medicines were not always managed appropriately to ensure that people received their medicines as prescribed.

We found that selection and recruitment processes were suitable to ensure that people were looked after by appropriate staff. Relatives we spoke with were complimentary about the staff.

Systems were in place to monitor the quality of the service. Complaints were dealt with in a timely manner and taken seriously. One relative said, 'If there is a problem they deal with it. It is never left.'

We found that people's care records were not always fit for purpose and detailed.

We saw that people were well presented and wore clothes that reflected their own preferences, style, and gender. We found that staff involved people's relatives in the planning and delivery of care. One relative told us, 'They always keep me updated, I get a phone call straight away.'

We found that people's care records provided detailed information about their needs and preferences. We saw positive interactions between staff and people living at the home. This meant that people received care that met their needs.

We found that arrangements were in place to ensure that people were safeguarded from abuse.

We found that staff were supported through supervision, appraisals, training and meetings. One staff said, 'I find this useful as we go through everything and talk about my strengths and weaknesses.'

We found a system in place to record complaints. We spoke with three relatives who told us that complaints were resolved promptly.

We found that records had improved since our previous inspection. We found that there were no gaps in people's care records. This meant that the risk of inconsistency in care was minimised.