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Pennington Court Nursing Home Requires improvement

Reports


Inspection carried out on 27 May 2021

During an inspection looking at part of the service

About the service

Pennington Court Nursing Home is a residential care home providing personal and nursing care to 47 people at the time of the inspection. The Registered Provider is registered to accommodate a maximum of 62 service users at Pennington Court Nursing Home. Attached to the building are eight extra care apartments each comprising of a bedroom with attached lounge, bathroom and kitchen area.

Pennington Court Nursing Home accommodates people over two floors. People who live in Ash require residential care. Willow provides support for people who require registered nurses to provide their care and treatment. People living in the extra care flats are provided with personal care support. Not everyone who used the housing with support service received personal care, although the contract provides for two hours support each day. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

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

The quality of care had deteriorated since our last inspection and this service was no longer considered to be providing outstanding care. Some care intervention records were incomplete and contained gaps to evidence care had been provided. Quality assurance processes had not highlighted or addressed issues to ensure improvements were made.

Some of the risks to people’s safety and wellbeing had not been recorded, to ensure actions were put in place to protect people from harm. Recorded risk reduction measures did not always show the necessary control measures were in place. Care plans often contained conflicting information, and information in people's rooms did not contain information about how to manage all of their clinical needs. We were not assured infection control measures were consistently managed in line with current best practice. Some communal areas required de-cluttering and deep cleaning.

Medicines were managed safely. Staff involved in handling medicines had received recent training around medicines and had their competencies assessed. The application of cream records was inconsistently recorded.

Most people and their relatives told us they were safe at the home and people we spoke with told us they were happy living there. People were well groomed, and the hairdresser attended on both days of our inspection. We received positive feedback from the advanced nurse practitioner attached to the GP surgery. They told us the service was very proactive when a person’s needs had changed and obtained the services of the relevant health professionals.

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 Outstanding (Published 10 October 2018).

Why we inspected

The inspection was prompted in part due to concerns received about how the service managed complaints and in relation to end of life care. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of safe, responsive and well-led only. Ratings from previous comprehensive inspections for those key questions not inspected against were used in calculating the overall rating at this inspection.

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.

The overall rating for the service has changed from outstanding to requires improvement. This is based on the findings at this inspection. We have found evidence that the provider needs to make improvement. Please see the safe, responsive and well-led sections of this full report. You can see what action we have asked the prov

Inspection carried out on 7 August 2018

During a routine inspection

This inspection took place on 7 and 13 August 2018 and was unannounced. At the time of our inspection, there were 47 people receiving both nursing care and residential care at the service.

At the last inspection in November 2015, we identified a breach of Regulation 12 of the Health and Social Care Act (Regulated Activities) Regulations 2014 Safe care and treatment. This was because equipment used to support people had not been subject to regular examination to ensure it remained safe to use. We asked the provider to complete an action plan to show what they would do and by when to improve the key question; ‘Is the service safe?’ to a rating of at least good.

At this inspection we saw there had been improvements made in this area and the service was compliant with all relevant health and social care regulations. The breach we identified in November 2015 had been addressed and the rating for the key question; ‘Is there service safe?’ is now good.

Pennington Court Nursing Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission regulates both the premises and the care provided, and both were looked at during this inspection. The service provides residential, nursing and intermediate care services for a maximum of 62 people. Accommodation is arranged over two floors with communal lounges, dining areas and bathing facilities available. All bedrooms are single occupancy and many have ensuite toilet facilities.

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 registered manager was extremely passionate about delivering very high standards of care to people using the service. They had established excellent links within the local community and worked collaboratively with other professionals.

The provider demonstrated a strong commitment to ensuring people received care based on best practice guidance, with the aim of achieving the best possible outcomes. They gave people, their relatives and staff ways of sharing their opinions and ideas for any improvements that could be made. Staff told us they were proud to work at the service. They said the registered manager was very supportive and the provider gave them opportunities for professional development.

The provider had gone to great lengths to ensure people had access to a wide range of meaningful activities. This included trips out to places that people said they wanted to visit. We saw many examples of where the involvement of the local community had enabled people to feel included and maintain the links they previously had. People were also supported by staff to develop new interests which contributed to their overall wellbeing. People told us they looked forward to things and felt excited by activities, visits and events at the service. This demonstrated activities were truly meaningful for people.

Without exception, people and their relatives gave consistent, positive feedback about the service. This included the approach of staff, the food, the range of meaningful activities that were on offer to them and the accommodation.

People and their relatives gave very positive feedback about the food at the service. People said they looked forward to their meals and relatives told us they were happy to see their loved ones with an appetite and putting weight on. The provider had a number of mechanisms in place to monitor the quality of the catering and we saw people's feedback was used to make improvements.

People told us they felt safe at the service and were well supported by staff who were caring and friendly. Staff told us they were

Inspection carried out on 24 November 2015

During a routine inspection

We inspected Pennington Court Nursing Home on the 24 November 2015 and the visit was unannounced. At the last inspection in August 2013, we found the provider was meeting the regulations we inspected.

Pennington Court nursing home provides residential, nursing and intermediate care services for a maximum of 62 people. Accommodation is arranged over two floors with communal lounges, dining areas and bathing facilities available. All bedrooms are single occupancy and a few have en-suite facilities.

At the time of the inspection, the service had a manager registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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.

People told us they felt safe. Staff had a good understanding of safeguarding vulnerable adults and knew what to do to keep people safe. People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines safely.

We found there were systems in place to protect people from risk of harm and appropriate recruitment procedures were in place. There were policies and procedures in place in relation to the Mental Capacity Act 2005. Staff were trained in the principles of the Mental Capacity Act (2005) and could describe how people were supported to make decisions. Where people did not have the capacity; decisions were made in their best interests.

We found two slings whereby the Velcro had been compromised by debris within the fabric. Debris within Velcro compromises the ‘sticking’ and as such the Safe Working Load may not be achieved. Therefore putting people at risk of falls.

There were enough staff to keep people safe. Staff training and support provided staff with the knowledge and skills to support people safely.

People told us they received the support they needed with meals and healthcare. Health, care and support needs were effectively assessed. People had regular contact with healthcare professionals, this helped ensure their needs were met.

People were supported by staff who treated them with kindness and were respectful of their privacy and dignity. People participated in a range of activities and were able to choose where they spent their time.

The service had good management and leadership. People had opportunity to comment on the quality of service and influence service delivery. Effective systems were in place which ensured people received safe and quality care. Complaints were investigated and responded to appropriately.

We found the home was in breach of Regulation 12(2)(e) (Safe care and treatment) of Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

You can see what action we told the provider to take at the back of the full version of the report.

Inspection carried out on 29 August 2013

During a routine inspection

We used a number of different methods to help us understand the experiences of people who used the service including speaking with people who used the service and their relatives, observing the care being delivered, talking with staff and looking at records in the home.

During our visit, we saw staff interacting with people in a positive, respectful and caring manner. Everyone we spoke with were very complimentary about the staff who provided care to them. One person said, �I�m getting on champion. They look after us very well here, they couldn�t do any better. They always tell you what is going on � Another person told us, �The staff are beautiful and that�s the main thing, I love them all, they really listen to me and help me whenever I need.�

We spoke with two relative. Both spoke highly of the staff and care which they provided to people. One relative said, �I can�t fault the staff here. I would recommend it here to anyone.�

The home was very clean and had systems in place to reduce the risk of infection.

We saw evidence which showed that appropriate checks were undertaken before staff began work to make sure they had the relevant experience and skills for the role.

The home had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who used the service.

Inspection carried out on 19 September 2012

During a routine inspection

During our visit we spoke with four people who were living in or staying at Pennington Court and two visiting relatives to gain their views of the service. People were complimentary about the standard of care provided by the staff in the home with comments such as: �I am very happy with the care in this home;� and: �I can highly recommend this place.�

One person told us how staff in the home supported her in regaining her mobility following an accident and a stay in hospital, to enable her return to her own home in the near future. People told us about how they were able to express their views and were involved in making decisions about their care and treatment.

People spoken with said they were happy living in the home and we saw people appeared happy and comfortable with staff in their interactions with them. We spoke with five members of staff who told us they enjoyed working at the home. One member of staff commented: �I really enjoy working here very much� and another said: �All the staff here are very supportive and we work well as a team.�

People spoken with said they had no concerns or complaints about the home at this time. People told us they felt able to speak out if they needed anything and believed the staff or the manager would act on their concerns without the fear they would be discriminated against for making a complaint.

Reports under our old system of regulation (including those from before CQC was created)