Archived: Petersfield

Petersfield is a residential care home providing accommodation and personal care to up to 36 people. At the time of our inspection there were 25 people using the service.

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

People were being supported with agency staff due to the service having a number of support worker vacancies. The registered manager confirmed staffing levels were monitored and they adapted these to people’s individual needs. Some people told us they had experienced staff speaking to them briskly although all were happy with the care and support they were receiving at the time of our inspection.

The provider had quality assurance systems in place that identified issues relating to the recording of topical creams. The nominated individual following our inspection confirmed they were in the process of implementing a new system following a pilot they had undertaken elsewhere.

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.

Staff felt supported by the registered manager and that it was a nice place to work. Staff had recruitment checks completed prior to working in the service. The registered manager monitored incidents and accidents and records confirmed actions taken. Referrals and discussions were held with health and social care professionals when required.

Communal areas such as bedrooms, bathrooms, corridors and the dining area were clean and tidy during our inspection. However, we found the two staircases which were predominantly used by staff to be dusty and dirty.

People’s care plans contained important information relating to their individual support needs although two people required a risk assessment. The registered manager took action to address this following our inspection.

People felt safe and staff had a good understanding of abuse and who to raise concerns with. During our inspection, we observed staff and the registered manager take time to speak to people asking them how they were.

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 is Good (published 8 August 2019). The service remains rated as Good.

Why we inspected

We undertook this focussed inspection to look at the safe and well-led key questions due to concerns we had received.

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.

Follow up

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

Petersfield is a residential care home providing accommodation and personal care for up to 36 people. At the time of our inspection 29 people were receiving care, five of whom were receiving respite care.

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

Overall people were positive about the care they received and this was reflected in their feedback to us. Our observations highlighted positive and respectful relationships between people and staff. The service continued to face challenges in relation to recruitment of staff and there was a high usage of agency staff to cover shifts. However, the registered manager was working hard to appoint suitable staff and was using regular agency staff to minimise the impact on people. We also identified some safety concerns within the environment of the home. However these had already been identified by the provider and we were shown plans to address them.

The service was effective and helped ensure people received support with their health needs from the relevant professional. Staff received good training and support to help them in their roles. Supervision and appraisal took place to monitor staff performance and development.

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.

Activities took place in the home for people to take part in as they wished. Resident meetings also took place as a means of enabling people to give their views and opinions.

The home was well led with a person-centred culture established. The registered manager was supported in their role by team leaders and senior care staff. There were systems in place to monitor the quality and safety of the service and this included gathering feedback from people who used 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 The service was rated requires improvement at our last inspection published in August 2018.

Why we inspected

This was a planned inspection based on the previous rating.

Petersfield care home provides accommodation for up to 36 people who require personal care. The service is a residential care home for older people. At the time of our inspection there were 27 people living at the home.

Petersfield has 36 rooms set over two floors and has communal lounges and sitting rooms, staff room, training room, laundry room, hairdressing room, offices, a dining area, kitchen and gardens including outdoor seating area.

The service had 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.

People were supported to receive their medicines safely and when required although some records relating to medicines were not always accurately completed.

Staff did not have access to suitable handwashing facilities to minimise the risk of cross infection after helping people with personal care.

People felt the use of agency staff at times meant they were supported by staff who were not always familiar with their individual needs. Staff felt at times there was a lack of staff. However we found that enough staff were available to meet people’s needs.

People were supported by staff who had suitable checks in place prior to being employed by the service. Staff received supervision and training and the registered manager was planning any outstanding appraisals. However, staff were not always able to demonstrate who to raise safeguarding concerns with or how to support people’s individual diverse needs.

People had care and support plans that confirmed how they wished to be supported. People who had dietary requirements had a detailed information in place. People received food and drink to meet their needs, however there were limited options for people who were diabetic.

Not all people had risk assessments that identified their individual risks and how these were being managed.

The staff respected the rights of people who lacked capacity to make certain decisions in line with the Mental Capacity Act 2005.

People had access to a range of healthcare professionals to ensure their health needs were met, these included the GP, dentist, district nurse and the falls team.

People were supported by staff who were kind and caring and who encouraged people to be independent. Staff offered people choices. People received support by health care professionals when required.

People’s care plans contained important information relating to their life histories and people felt able to choose the care that was important to them.

People could participate in a variety of activities and were able to spend their time how they wanted within the home and within the community.

The service had quality assurance systems in place that identified shortfalls and there was a clear action plan for areas to improve upon.

People, staff and relatives all had their views sought so that feedback could improve the care provided.

Petersfield care home provides accommodation for up to 36 people who require personal care. The service is a residential care home for older people. At the time of our visit there were 36 people living at the home. Petersfield has 36 rooms; it is set over two floors and has four communal lounges, a smoking room, staff room, training room, laundry room, hairdressing room, management office, dining area, kitchen, garden and patio area.

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.

People lived in a clean home although water checks needed improving due to inconsistent water temperatures and checks not being undertaken in line with the home’s guidelines. People felt the environment was not always promoting their independence. For example, at times people relied on staff to turn taps and the toilet layout could be improved.

People had mixed views about their meals and choices. Meals were not always provided in line with people’s specific dietary requirements relating to their diabetes and risks of choking. People felt supported by staff who were kind and caring and staff demonstrated a caring approach.

People’s care plans were detailed and personalised and contained informative risk assessments. However people who had diabetes and modified diets had no support plans in place which gave staff clear guidelines to follow. People were supported to maintain relationships with friends and family. Staff gave people choice and control in their care and support.

People felt safe in the home and received support from staff who had appropriate checks in place prior to commencing their employment. People’s care plans confirmed if people were unable to make decisions relating to their care and treatment and the principles of The Mental Capacity Act 2005 were being followed. People were happy with the medicines they received although records were not always accurately completed relating to prescribed creams.

People were supported by adequate staffing levels and staff supported people in a kind and caring manner. Staff received regular supervision and training to ensure they were skilled to meet people’s individual care needs. Staff felt happy and supported by the management of the home.

People were supported by staff who gave people choice and control in their care and support. People had access to activities and social events that were important to them. Activities available included quizzes, cards, coffee mornings, reading newspapers and exercises to music.

People told us they felt able to make a complaint to the registered manager should they need to do so. People and relatives were involved in planning their care. Peoples’ views were sought so that improvements could be identified, feedback received was overall positive about the care provided and received.

The provider had quality assurance systems in place that identified most areas for improvement. However we found during the inspection some areas that had not been identified prior to our inspection. For example, shortfalls in recording medicines, water temperatures and people’s feedback relating to difficulty with using the taps and toilets. The registered daily walk around had also failed to identify where one person was receiving a diet that was not in line with their health care professionals advice.

We examined the care records for people living in the home and observed how staff interacted and supported people in communal areas. We crossed referenced peoples care plans with the observations that we made. We found that people were being supported in line with their assessed needs.

Overall people's comments were positive about the service they received. Comments included: 'I have no grumbles here other than sometimes it's a bit quiet'; 'We do have choice here and that is respected. I like my own company and spend time in my room'; and 'the staff are lovely really they are'.

Staff told us 'it's a good home. We provide a high standard of care here' and 'We are well supported by the management. I am very happy here'. Another member of staff said 'at the end of the day we are a busy team. But we do have time to meet people's needs'.

The provider had effective systems in place to monitor the effectiveness of the service that was provided and to gain the views of people that used the service.

People who used the service were more involved in planning and agreeing to the care that they received. The care records included better information about people's individual needs and the support that they required from staff.

The people we spoke with commented favourably about the care and support they received. One person, for example, told us 'if you are ill you are well attended'; somebody else said there was 'never a problem with getting the doctor out'.

People also spoke positively about the staff team; one person, for example, commented 'you can't fault any of them and the night staff are just as nice'. Action was being taken to ensure that people were cared for by staff who were well supported and had received the training that they needed.

People had been asked for their views about the home; as a result, changes had been made to the meal arrangements. A programme of audits had continued as a means of identifying any improvements in standards that may be needed.

When we returned to the home on 24 October 2012, we found that changes had been made. We saw for example that people's needs had been reviewed and new care plans had been written with the people who used the service. Overall we found that this aspect of record keeping had improved significantly since our last inspection.