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Peregrine House Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 2 November 2018

Peregrine House 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.

Peregrine House is situation in Whitby. The home accommodates up to 40 older people or people living with dementia in one adapted building. They do not provide nursing care.

Inspection site visits took place on 24 and 25 July and 8 August 2018. At the time of this inspection, the service was providing support to 39 people.

At the last comprehensive inspection in October 2015 we found the service was meeting requirements and awarded a rating of outstanding. At this inspection we found the registered manager and staff team had continued to develop the service but some areas required improvements to be made. We have awarded a rating of requires improvement.

There was a manager in post who had registered with the Care Quality Commission. They assisted throughout the inspection process. 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.

We found some quality assurance systems were in place but these had not always been effective in identifying shortfalls in relation to medicine management and care planning. We also found shortfalls in relation to the recordings on re-positioning charts, weight management and call bell checks. We found no evidence that these areas were monitored by management to highlight where improvements were required.

The principles of the Mental Capacity Act 2005 had not always been followed. Best interest decisions had not been recorded and consent forms had been signed by relatives that did not have legal authority to do so.

Risk assessments were in place but they did not always identify current risks and how these should be managed.

Medicine had been stored safely. We found that staff had not always accurately recorded when medicines had been administered, offered or refused.

Safe recruitment procedures had been followed. These procedures had been further developed to ensure people were fully included in recruitment decision. Staff had a thorough understanding of safeguarding and how to report any concerns. Servicing certificates were in place where required and regular maintenance checks were in carried out to ensure the service was safe. We did find that call bells and bed safety rails were not always included in these checks.

There was enough staff on duty to ensure people received the support they required. The registered manager and provider had a flexible approach to staffing to ensure people’s needs were met at all times.

A through induction process was in place to ensure new staff were familiar and followed the services core values. Staff were supported through a regular system of supervision and appraisal which focused on performance and personal development. Training had been delivered at regular intervals to ensure all staff had the appropriate skills and knowledge.

Staff were familiar with people who required specialist diets. We found people had not always been weighed in accordance with the directions within their care plans. Professionals we spoke with were confident staff would raise any concerns with them. The service had excellent relationships with health professionals who visited the service on a regular basis.

People and relatives spoke positively about the meals on offer and we observed the dining experience to be calm, relaxed and enjoyable. Food was presented beautifully and people were able to eat where they preferred.

Respect for privacy and dignity was at the heart of the service’s culture and values. Life history book had

Inspection areas

Safe

Requires improvement

Updated 2 November 2018

The service was not always safe.

Risk assessments were in place but did not always contain sufficient information.

Medicine had been stored safely. However, staff had not always accurately recorded when medicines had been administered, offered or refused.

Robust recruitment procedures were in place. The provider had a flexible approach to staffing levels to ensure people received the support they required.

Effective

Requires improvement

Updated 2 November 2018

The service was not always effective.

The service did not always comply with the Mental Capacity Act 2005.

People’s weights had not always been consistently recorded and advise from professionals had not always been followed.

Staff received consistent support from management and were encouraged to continuously develop their skills. Extensive training had been provided.

Caring

Good

Updated 2 November 2018

The service was caring.

Respect for privacy and dignity was at the heart of the service’s culture and values.

Staff were highly motivated and offered care and support that was exceptionally compassionate and kind.

Staff took time to listen to people and respond in a respectful way with compassion. Personal relationships were encouraged.

Responsive

Good

Updated 2 November 2018

The service was responsive.

There was a wide variety of activities on offer which were tailored to meet people’s needs and interests.

Complaints and concerns had been managed promptly and efficiently.

Staff were familiar with people and their needs which enabled them to provide person-centred support.

Well-led

Requires improvement

Updated 2 November 2018

The service was not always well-led.

Effective quality assurance systems were not in place. Recording shortfalls had not been identified by management.

People, relatives, professionals and staff praised the management team and the support, opportunities and encouragement they were given.

Regular staff meetings took place to allow staff to keep up to date with best practice and any changes within the service.