What life is like for people using this service:

People told us they liked living at Pinehurst. They said they felt safe and they had a good relationship with staff. The relative we spoke with described the staff as “superb” and “excellent”. Staff knew people well and described to us people’s likes, dislikes and preferences. Our observations showed people were treated with kindness and respect. There was a relaxed atmosphere between people and staff, with friendly conversation.

Staff understood their roles to protect people from harm and to promote their independence. Records showed action was taken to reduce risks to people’s safety and welfare. However, risk assessments and management plans did not include this information for staff about what actions to take to protect people. Care records also required improvements to fully describe people’s abilities and needs. This meant people’s care needs might not be fully known and understood by the staff, particularly those new to the home.

Recruitment practices were not always safe; some staff had not had pre-employment checks carried out or references obtained from previous employers.

Staff had received the training they required to undertake their role. This included training in health and safety topics as well as those relating to people's mental health needs.

Medicines were being managed safely and people were supported to attend healthcare appointments. Specialist support was provided by the community mental health team.

People’s rights, privacy and dignity were protected. Where it was necessary to make decisions on people’s behalf, this was done after appropriate capacity assessments had been undertaken.

At the time of the inspection, the home did not have effective systems in place to assess, monitor and improve the safety and quality of the service. Immediately following the inspection, management processes were reviewed and quality assurance systems developed.

We identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and one breach of the Care Quality Commission (Registration) Regulations 2009. We made one recommendation for improvement.

More information is in the detailed findings below.

Rating at last inspection: Good (last report published 9 July 2016)

About the service: Pinehurst Residential Home is a residential care home registered to provide accommodation and personal care for up to 20 people of all ages who may have mental health issues. The home is a large end of terrace property with access to a private park. Pinehurst is situated within easy reach of the town centre of Dawlish.

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

Enforcement: We have issued three requirement notices which can be found at the end of this report.

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

Pinehurst is a residential home in the seaside town of Dawlish. It is registered to provide accommodation and care for up to 20 people of all ages who may have mental health needs. This inspection took place on 24 and 26 May 2016 and was unannounced. At the time of the inspection, 17 people were living at the home. People were all physically independent and able to engage in conversation. People living at the service were all over 40 years old.

The service had a registered manager. 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 expressed a high level of confidence in home. They told us they felt safe and happy living at Pinehurst. The atmosphere of the home was calm and relaxed throughout our inspection. There was laughter and appropriate banter between staff and people living at the service, as well as opportunities for quiet conversation.

People were supported by staff that knew them well. Staff were kind and caring and people spoke very highly of the care they received. One person said “The atmosphere is lovely, staff are nice, [name of registered manager] is great and you’re treated like you are one of the family”. There were enough staff available to meet people’s care needs safely. Staff worked in a calm, unhurried way and had time for talking and supporting people with activities of their choice. People were encouraged to maintain their independence and to be part of the local community.

Staff ensured people's privacy and dignity was respected at all times. They worked closely with people to ensure they understood their needs and preferences. People were involved in planning and reviewing their care and felt listened to by staff. Staff demonstrated a shared commitment to the wellbeing and care of the people they supported and respected people’s right to individuality and difference.

People were able to follow their interests and hobbies. There was also a range of activities available within the home which people enjoyed. Many people went out every day, either independently or supported by a member of staff. Staff had time to spend individually chatting with people. There were two holidays organised by the registered manager each year, where a group of people went away for a few days, supported by staff. These were greatly enjoyed.

Staff had received training in safeguarding adults and knew how to raise concerns if they were worried about anybody being harmed or neglected. They felt confident that if they had any concerns they could raise them with the registered manager and they would be acted upon quickly and effectively. One person said “If I was feeling nervous or unsafe I could go to anyone here, I feel perfectly safe”.

We observed medicines being administered and this was done safely and unhurriedly. Medicines were stored safely and all stock entering and leaving the home was accounted for. Staff received regular training in medicines management and medicines audits were completed to ensure consistent safe practice.

There were robust recruitment processes in place to ensure that suitable staff were employed. Staff were well supported by the registered manager through supervision and appraisal. High standards of care were encouraged through staff training and development. Staff participated in a wide range of training courses in topics relating to people’s care needs including medicines management, mental health, health and safety and safeguarding.

Staff had received training in, and understood the principles of the Mental Capacity Act 2005 (MCA) and the assumption that wherever possible people should make their own decisions about their care and treatment. We found that the registered manager had not ful

At our previous visit on 22 October 2013 we found that improvements were needed to the way medication was managed. This visit in March 2014 was to check to see if the improvements had been made.

One inspector visited the home and looked to answer the question, is the service safe?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with staff and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Was the service safe?

Systems were in place to make sure that medication was managed effectively.

There were 15 people living at Pinehurst at the time of our inspection. We spoke with nine people who lived at the home, two care workers, a senior care worker, the manager and two visiting community health care professionals.

People who lived at the home told us they were well looked after and were happy. One person said "I like it here, wouldn’t improve anything.”

We saw that care workers respected people's wishes and people told us they felt respected. People's privacy was protected by care workers. For example we saw care workers knocked or doors and waited to be invited in before entering people’s rooms.

People had not been protected against the risks associated with medicines because the provider did not have appropriate arrangements in place to manage medicines.

People were cared for by suitably qualified, skilled and experienced staff. One care worker told us "I love this job, I absolutely love it".

The provider had an effective system to regularly assess and monitor the quality of service that people received.

People who lived at the home were aware of how to make a complaint if they were unhappy.. We asked one person whether they would feel comfortable making a complaint. They told us that they would and added “Not made one yet, don’t think I ever will”.

The home was last visited by the Commission for Social Care Inspection (the predecessor organisation of the Care Quality Commission) in October 2007.

One person told us "I like it here – it's a good place – it's my home".

People expressed their views and were involved in making decisions about their care and treatment. People’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. There were enough qualified, skilled and experienced staff to meet people’s needs.

People who used the service, their representatives and staff were asked for their views about their care and treatment and they were acted on.