Background to this inspection
Updated
26 May 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
We made an unannounced inspection on 23 and 30 March 2016. The inspection team consisted of one inspector, an expert by experience and a specialist advisor. The specialist adviser was a specialist with nursing care.
We looked at the information we held about the service and the provider. We looked at statutory notifications that the provider had sent us. Statutory notifications are reports that the provider is required to send us by law about important incidents that have happened at the service.
Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.
We spoke with 15 people who lived at the home and seven relatives.
We observed how staff supported people throughout the day. As part of our observations we used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
We spoke with the manager, the unit manager and 12 staff. We looked at five records about people’s care. We also looked at complaint files, minutes for meetings with staff, and people who lived at the home. We looked at quality assurance audits that were completed.
Updated
26 May 2016
The inspection took place on the 23 and 30 March 2016 and was unannounced.
Perrins House is located near to the town of Malvern. This service provides nursing and personal care for up to 43 people. On the day of our inspection there were 32 people living at the home.
There was manager at this home who was not registered with us for this service. The provider was in the process of re-registering the home as part of another service. The manager was registered for the other service and would be applying for registration with this service when re-registration was complete. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered providers and registered managers 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 and their relatives said they were happy with the support that staff provided people that lived at the home. They told us staff were caring and promoted people’s independence. People told us they were able to maintain important relationships with family and friends. Relatives said they were welcome to visit as they wished. We saw people had food and drink they enjoyed and had choices available to them, to maintain a healthy diet. They were included in regular meetings to ensure they had a say in the choices available to them. People told us they had access to health professionals as soon as they were needed. People we spoke with said they had access to interesting things to do.
We found that people had not been protected against the risks associated with medicines because some people had not received their medicines as prescribed. The management team took immediate action and had a plan in place to ensure people received their medicines. Staff were knowledgeable about how to manage people’s individual risks, and were able to respond to people’s needs. However we found that guidance for staff about regimes to ensure people did not have sore skin were not always carried forward to ensure staff had up to date knowledge. The unit manager had ensured this guidance was updated and all staff were aware between our two visits. We saw this was now in place.
Relatives we spoke with said they felt included in planning the support their relative received and were always kept up to date with any concerns. They knew how to raise complaints and felt confident that they would be listened to and action taken to resolve any concerns. The management team ensured people were listened to, we saw that complaints were investigated and action taken to resolve them.
Staff we spoke with were aware of how to recognise signs of abuse, and systems were in place to guide them in reporting these. Staff had up to date knowledge and training to support people. We saw staff treated people with dignity and respect whilst supporting their needs. Staff knew people well, and took people’s preferences into account and respected them. Staff had the knowledge and training to support people they provided care for. Staff ensured people agreed to the support they received.
The management team had identified that applications to the local authority to deprive people of their liberty were needed for some people living at the home. These applications had not been completed to ensure people were not deprived of their liberty unlawfully. There was a plan in place to ensure these were completed.
The manager promoted an inclusive approach to providing care for people living at the home. People, their relatives and staff were encouraged to be involved in regular meetings to share their views. The provider sent out questionnaires to ask for feedback from people, their relatives and professional involved with the service. The management team had an action plan to address the feedback received. For example they had increased how they provided interesting things to do by providing activity staff at the weekend.
The provider and manager had systems in place to monitor how the service was provided. The management team had identified areas of improvement and were providing the resources to complete these actions. The management team reviewed accidents and incidents and took steps to learn from these.
You can see what action we told the provider to take at the back of the report.