6 October 2016
During a routine inspection
Accommodation is provided over two floors with a lift that provided level access to all parts of the home. People spoke well of the home and relatives confirmed they felt confident leaving their loved ones in the care of staff at Peterhouse.
There is a registered manager at the home. 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 inspected Peterhouse on 6, 7 and 11 October 2016. This was an unannounced inspection which meant the provider and staff did not know we were coming. There were 34 people living at Peterhouse during the inspection process.
Quality assurance systems were in place but had not identified the shortfalls found in care documentation and record keeping. Whilst people’s medicines were stored safely and in line with legal regulations, people did not always receive their medicines as prescribed. There were also missing signatures for medicines. These had not been followed up to ensure that people had received their prescribed medicines. We also found poor recording and lack of directives of topical creams and ‘as required’ medication for pain relief. There were some inconsistencies in the completion of fluid charts and in diabetic guidance for staff to follow. Emergency procedures were in place in the event of fire and people knew what to do, as did the staff but we asked that advice was sought from the fire service in respect of night evacuation plans.
Staff knew people well, they were kind and caring and treated people with respect. They had a good understanding of their care needs and individual choices.
Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. We found that the manager understood when an application should be made and how to submit one.
Where people lacked the mental capacity to make decisions the home was guided by the principles of the Mental Capacity Act 2005 (MCA) to ensure any decisions were made in the person’s best interests.
Accidents and incidents were recorded appropriately and steps taken by the home to minimise the risk of similar events happening in the future. Risks associated with the environment and equipment had been identified and managed.
Staff had received essential training and there were opportunities for additional training specific to the needs of the service, such as diabetes, catheter care and dementia. Staff had received both one to one and group supervision meetings with their manager, and formal personal development plans, such as annual appraisals were in place.
Staff knew how to safeguard people from the risk of abuse. Risk assessments were in place and staff had a good understanding of the risks associated with the people they cared for. There were enough staff in place, who had been appropriately recruited, to meet the needs of people.
People were encouraged and supported to eat and drink well. One person said, “The food is good, always tasty and looks nice.” There was a varied daily choice of meals and people were able to give feedback and have choice in what they ate and drank. People’s special dietary requirements were met. People’s weight was monitored, with their permission and advice sought as required. Health care was accessible for people and appointments were made for regular check-ups as needed.
People could choose how to spend their day and they took part in activities in the home when they wanted to. People themselves told us they enjoyed the activities, which included singing, puzzles and films. People were encouraged to stay in touch with their families and receive visitors.
People felt well looked after and supported, and were encouraged to be as independent as possible. We observed friendly and genuine relationships had developed between people and staff. One person told us, “They treat you well here.” One person told us the staff supported them with their hair and make-up and it made them feel ‘good’.
People were encouraged to express their views and completed surveys, and feedback received showed people were satisfied overall, and felt staff were friendly and helpful. People also said they felt listened to and any concerns or issues they raised were addressed. One person said, “If there is anything wrong, I tell the staff.”