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Archived: Petteril House Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 11 September 2018

The inspection took place on 11 and 17 July 2018 and was unannounced.

At our last inspection of this service, the provider was meeting the legal requirements and the last rating was Good.

Petteril 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.

Petteril House is registered to accommodate up to 37 people across three separate units, each of which have separate adapted facilities. One of the units specialises in providing care to people living with dementia. Accommodation is provided over two floors. At the time of our inspection there were 24 people living at the home.

The service had a registered manager. 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 service had ineffective systems in place to ensure there were sufficient numbers of staff on duty at the home. This was of particular concern at night when, at times only two members of staff were on duty for the whole of the home.

People were not supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible; the policies and systems in the service did not support this practice.

The service did not effectively monitor and manage the risks associated with poor nutrition and hydration. Support with eating and drinking was inconsistently provided and records relating to nutrition and hydration were poorly maintained.

The service had systems in place to help monitor the quality and safety of the service. The systems were not always effective in identifying where improvements should be made.

These are breaches of the Regulations.

The care records that we reviewed did not always reflect the most up to date and accurate information about people’s care and support needs. There were protocols in place to help ensure people were supported appropriately at the end of their life.

Medicines were not always managed safely. Gaps in records meant that people either did not receive their medicines as their doctor had intended or that staff had not recorded the administration of some medicines correctly.

Written information about other support services that people and their relatives could access was available. However, these formats would not meet the communication needs of some of the people using this service.

We have made a recommendation about involving people in decisions about their care.

There was little information recorded about people’s hobbies and interests. Staff organised activities such as bingo and quizzes on a day to day basis, if they had the time. Care and support planning did not take account of the social needs of people using this service.

We have made a recommendation about supporting people to follow their interests and participate in relevant social activities.

The provider had systems in place to help ensure people were protected from the risks of abuse. Staff were recruited safely and provided with training to help them understand the actions they should take if they suspected someone was being abused.

Staff employed at the service had access to, and attended training programmes to help keep their skills and knowledge up to date. Staff attended team meetings and supervisions, which provided a platform for them to discuss their work and performance.

Staff followed good infection control practices. The service ensured that safety checks at the home and maintenance of equipment had been regularly carried out.

Staff attended to people’s needs in a friendly and kin

Inspection areas

Safe

Requires improvement

Updated 11 September 2018

The home did not always have enough staff on duty to meet the needs of people living at the home.

Individual care records were not always accurately maintained.

Medicines were mostly managed safely. There were gaps in information and record keeping about �when required� medicines and topical ointments and creams.

The provider had systems in place to help ensure people were protected from the risks of abuse.

Effective

Requires improvement

Updated 11 September 2018

The service was not always effective.

People were not always effectively supported with their nutritional needs. This placed them at risk of receiving inadequate food and drink, which potentially impacted on their health and wellbeing.

The service did not consistently follow the principles of the Mental Capacity Act 2005.

Staff at the service were provided with training and supervision to help them understand and fulfil their roles and responsibilities.

People who used the service had access to health and social care professionals when requested or needed.

Caring

Requires improvement

Updated 11 September 2018

The service was not always caring.

Staff treated people with kindness and respect. They were mindful of the need for privacy and dignity.

Staff were usually sensitive to people�s needs and recognised when support was needed.

Information was not easily accessible to some of the people who lived at the service.

We were not assured that people consistently received a high quality compassionate service.

Responsive

Requires improvement

Updated 11 September 2018

The service was not always responsive.

Care plans, assessments and reviews had not been kept up to date so that they reflected people's personal needs, choices, leisure and social interests.

There were limited opportunities at the home for people to actively engage in meaningful leisure and social events.

The provider had a complaints process in place that people were able to access.

Well-led

Requires improvement

Updated 11 September 2018

The service was not always well led.

The service had policies, procedures and auditing systems to help monitor the quality and safety of the service.

The governance systems were not always effectively applied and failed to identify areas where improvements should be made.

People living at the home were provided with opportunities to comment on the quality and operation of the home. Their comments had not always been acted upon, particularly in relation to activities.