Penn House Residential Home

Pen House is a residential care home providing personal and nursing care to up to 26 people. The service provides support to older people some of who were living with dementia. At the time of our inspection there were 16 people using the service.

People’s experience of using this service and what we found

Systems were not ensuring medicines administration records were completed accurately; however, medicines had been administered as prescribed. People were kept safe as staff understood how to recognise and report any concerns about potential abuse and could manage known risks to people’s safety. There were enough staff to support people safely, and when incidents occurred there were systems in place to learn from these and prevent things from happening again. The home was kept clean, and staff understood how to protect people from the risk of cross infection.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Systems were in place to check on the care people had received and ensure accurate care records were in place. There were opportunities for feedback about the service to be sought and this was used to support learning and development of the service. There were other professionals involved in people’s care and people received person centred support. The registered manager was approachable and responsive to any concerns raised.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 2 October 2023). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

The inspection was prompted in part due to concerns received about risk management and medicines. A decision was made for us to inspect and examine those risks.

This inspection also followed up on action we told the provider to take at the last inspection.

We carried out an unannounced comprehensive inspection of this service on 25 July 2023. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Penn House Residential Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Penn House is a residential care home providing accommodation in 1 adapted building for persons who require nursing or personal care to up to 26 people. The service provides support to older people some of whom are living with dementia. At the time of our inspection there were 18 people using the service.

People’s experience of using this service and what we found

The governance arrangements at the home were not effective in ensuring people’s care needs were met. Where the provider’s monitoring system identified issues with people’s care delivery there were no actions taken to address the concerns.

People were not consistently receiving their care and support when they needed it as there were insufficient staff available at some points through the day. People did not always feel they were asked about their care and given choices.

People felt safe living at the service and were supported by staff who understood how to protect them from the risk of abuse. Staff were recruited safely and risks to people’s safety were minimised through assessment and planning.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were supported to receive care which considered needs, preferences, and their protected characteristics. People and their families had opportunities to give their feedback on the service. The manager ensured they worked with other agencies and had adopted a learning culture to ensure changes to the service were made following feedback. Staff were supported to access training and have supervisions to discuss their role.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 26 October 2022). This service has been rated requires improvement for the last 3 consecutive inspections. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.

Why we inspected

The inspection was prompted in part due to concerns received about staffing, medicines and how the service was managed. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has remained requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Penn House Residential Home on our website at www.cqc.org.uk.

Enforcement

We have identified a breach in relation to governance arrangements in the home at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Penn House Residential Home is a care home providing personal care for up to 26 older people. People have access to their own bedroom along with communal spaces including lounges and gardens. At the time of our inspection there were 17 people at the home, some who are living with dementia.

People's experience of using this service and what we found

There were not always enough staff to support people during busier times. People therefore had to wait for support. Further Improvements were needed to ensure all risks were reviewed when incidents occurred and to ensure all care plans were in place for people.

Improvements were needed to ensure lessons were consistently learnt when things went wrong. Action plans in place needed to be clearer to reduce the risk of incorrect action being taken. The provider needed to ensure audits covered all key areas.

There were safeguarding procedures in place to ensure people were protected from potential harm. Infection control procedures were in place and implemented throughout the home. Medicines were stored and managed in a safe way.

People were happy living in the home and with the support they received. Staff felt supported to and listened by the management team and had the opportunity to raise concerns. We were notified of significant events that happened in the service.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 11 March 2022) and there were breaches of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found the provider remained in breach of regulations.

Why we inspected

This inspection was a planned inspection, prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.

We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified a breach in relation to Regulation17, Good governance.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Penn House Residential Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Penn House Residential Home is a care home providing personal and nursing care to up to a maximum of 24 people. The service provides support to older people who may have dementia. At the time of our inspection there were 17 people using the service.

People’s experience of using this service and what we found

People had not been kept safe from the risk of fire because the provider had not completed the actions required to keep the home safe following a fire risk assessment.

Improvement was needed to ensure people always got their medicine on time, every time. The security of medicines at the home also needed improvement.

Risks associated with people’s care and support were identified and plans were in place to help staff manage and help reduce the risks. Staff knew how to support people safely and were attentive to their needs. People were supported by sufficient numbers of staff and staff knew how to raise concerns in relation to people's safety or abuse. The provider was following current government guidance in relation to keeping people safe during the COVID-19 pandemic.

People and relatives felt involved in what happened at the home and their feedback was used to help improve outcomes for people. The registered manager was aware of their duty of candour and worked in partnership with other organisations for the benefit of the people who lived at Penn House Residential Home.

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

Rating at last inspection

The last rating for this service was good (published 24/08/2018).

Why we inspected

We completed this inspection because we had identified concerns at the provider’s other two care homes about the quality of care, people's safety and management oversight. We wanted to assure ourselves these concerns were not present at Penn House Residential Home. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively. This included checking the provider was meeting COVID-19 vaccination requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

The provider took action to mitigate the immediate risks we found at this inspection and continues to make improvements.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Penn House Residential Home on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to good governance and safe management of fire risks and the environment at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request a further action plan from the provider to understand what they will do to continue to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Penn House Residential Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Penn House is registered to provide accommodation for up to 24 people. At the time of inspection there were 23 people living at the home. Penn House is arranged over two floors, the second floor was for people who were more independent. Many of the people living at Penn House are living with dementia.

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.’

The provider had audits in place which were used to drive improvement within the home. However, where feedback from people was sought, this information had not been used to identify actions to improve the service for people. We also found that where people had raised verbal issues or concerns, although these were dealt with, there was no evidence of the provider taking any learning for improvements to minimise the chance of things going wrong again in the future.

People told us they felt safe and were happy living at the home. People’s individual risks were assessed and minimised because staff knew people’s needs well. People were safe from the risk of harm because staff knew how to spot signs of abuse and how to report concerns. People received their medication as prescribed and staff were trained to give medication safely. There was enough staff to meet people’s physical needs.

People were supported by staff who had the skills and knowledge to meet their needs. Staff had a good understanding of the Mental Capacity Act 2005 and were aware of the importance of consent. People’s nutritional needs were met and people had access to health professionals when required. The registered manager was aware of their responsibilities to submit and update Deprivation of Liberty Safeguards (DoLS) applications.

People were supported by kind and caring staff. People told us they were encouraged to be as independent as possible. Staff ensured they protected people’s privacy and dignity. There was a homely, relaxed feel to the home and relatives and friends were able to visit freely.

People were involved the assessment and review of their care. People’s care records detailed their individual needs and preferences and staff had a good knowledge of these. People were supported to engage in meaningful personalised activities but staff did not have the time sit and chat to people. However, people and relatives told us staff did not have the time to sit and talk to people.

People and relatives knew how to complain and felt confident doing so. We saw people and relatives approach the registered manager’s office to discuss any concerns or to have a general conversation.

People, relatives and staff spoke positively about the management team and felt able to approach them. The provider had strong links with the local community and professionals.