We used a number of different methods to help us understand the experiences of people who were using the service, because they had complex needs which meant that not everyone was able to tell us their experiences. We spoke with people's keyworkers (members of staff allocated to be the key contact for the person) and we observed the support that people were given to see what their experiences were. Whilst some people were not able to tell us their views of the service they were able to indicate to us, either verbally or through gestures, what activities they had been doing and what things were important to them. We were then able to make checks that these things had happened for them. We saw that the staff employed permanently at The Pines understood people's needs and knew how to communicate with them. There were some temporary staff on duty from an agency and from the Avenues 'bank' and we saw that, where they did not work regularly in the service, they did not always understand what people were trying to communicate or recognise their needs. Whilst the permanent staff spent time engaging people in daily tasks, such as helping to prepare drinks and meals, the agency/bank staff were not always supporting people in this way. There was one occasion where staff from the bank and agency did not recognise a person's need to be helped to the bathroom, which resulted in them being left in an uncomfortable and undignified state for five minutes. This had to be pointed out by the inspector.
We saw that generally people were treated with respect and were encouraged to make choices about things. People generally appeared relaxed and comfortable with the staff supporting them.
We saw people being supported to go out for social activities and to undertake tasks such as shopping. One person told us they were going out on a bus later that day. Another person told us, with staff support, that they were looking forward to a visit from their mum.