Peregrine House

Peregrine House is a residential care home providing accommodation and personal care support to 35 people who have dementia, mental health, physical disability or sensory impairment and older people at the time of the inspection. The service can support up to 36 people.

Peregrine House is a purpose built home divided into four units on two floors. Each unit has people's bedrooms with toilet and sink facilities, and communal areas including a sitting area, a dining room, a kitchenette and bathrooms.

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

People’s needs were met safely by staff who were appropriately recruited and knew how to provide safe care. People were safeguarded against risk of abuse. People received safe medicines support. People were protected from the risk of infection. Incidents were analysed, and lessons learnt when things went wrong.

People's needs were assessed before they moved to the home. People and relatives told us staff provided effective care. People’s dietary needs were identified and met. People were supported by staff who were appropriately trained and supervised. People received consistent support to access ongoing healthcare services to live healthier lives.

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.

People and relatives told us staff respected them and they were caring and helpful. People received person-centred support from staff who provided care without discrimination. People were involved in the care planning process. People’s independence was promoted and encouraged.

People’s care plans were personalised. People were offered a range of group and individual activities. People were supported to engage with other people and in the community. People were satisfied with the complaint process. People’s end of life care wishes was explored, recorded, and me by trained staff.

People told us they were happy with the service. Relatives found the management approachable. Staff felt supported by the registered manager. People, relatives and staff feedback was sought, and their views considered to drive improvement. The service worked well with other agencies to improve people’s physical health and emotional wellbeing.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 19 October 2018) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

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 registered to provide accommodation and personal care support to 36 people who have dementia, mental health, physical disability or sensory impairment support needs and older people. Peregrine House is a purpose built home divided into four units on two floors. Each unit has people’s bedrooms with toilet and sink facilities, a sitting area, a dining room and a kitchenette. At the time of inspection, 34 people were living at the home.

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 provider did not always follow appropriate infection control practices. Some communal rooms and people’s bedrooms were not appropriately cleaned. Staff knew safeguarding and whistleblowing procedures, and how to identify and report abuse. However, the management did not always follow appropriate safeguarding procedures. The provider had failed to notify us of a safeguarding concern as required by law.

People told us they felt safe living at the service. Risks to people were identified and assessed and measures put in place to mitigate those risks. Staff knew risks to people and how to provide safe care. There were suitable and sufficient staffing in place to meet people’s needs safely. People were provided with safe medicines management support. Accidents and incidents records were accurately kept with processes in place to learn lessons from them to prevent future occurrences.

People’s needs were assessed before they started living at the service and people told us staff met their needs. Staff told us they received regular supervision and training to provide effective care. People were generally happy with the food and the nutrition and hydration support. Staff supported people to access ongoing healthcare services to maintain healthier lives. Staff followed healthcare professionals’ recommendations to ensure people’s needs were met effectively. The provider was making progress with their premises refurbishment plans whilst causing least disruption to people living at the service. People told us staff gave them choices and asked permission before supporting them.

People told us staff were caring and kind. Staff were trained in dignity in care and respected people’s privacy. People’s cultural and religious needs were identified and recorded in their care plans. Staff supported and encouraged people to remain as independent as they could.

People were at the centre of the care planning process and relatives were involved where requested. People’s care plans were personalised and regularly reviewed. The provider promoted and encouraged lesbian, gay, bisexual and transgender people to use the service. Staff encouraged people to raise concerns and people were satisfied with the complaints process. The provider had systems in place to support people’s end of life care needs.

There were monitoring and auditing systems in place to check the safety and quality of the service. However, they did not always accurately and consistently recognise gaps and errors that had been identified during our inspection. People, relatives and staff told us the service was well-led and the management was approachable. Feedback was sought from people their relatives and staff and was considered to improve the service.

We found two breaches of regulations during the inspection. These were in relation to good governance and notifications of incidents. We have made recommendations in relation to safeguarding infection control procedures.

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

Peregrine House is a care home providing accommodation and personal care for up to 36 people who have dementia, mental health, physical disability or sensory impairment support needs and older people. Peregrine House is a purpose built home divided into four units on two floors. At the time of inspection, 36 people were living at the home.

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 and their relatives told us the service was safe and staff reliable. Risks associated to people’s health and care were identified and assessed, and instructions provided to staff on how to mitigate those risks. However, not all risk assessments had the most up-to-date information. Staff understood their role in safeguarding people against harm and abuse, and knew how to identify and report abuse.

People were supported safely with their medicines management and we did not find any gaps in medicines administration records. There were sufficient staffing levels and people’s needs were met. However, staff did not always work as a team and some staff felt stretched. The service followed appropriate recruitment procedures to ensure people were supported by staff who were suitably vetted before starting work.

The service did not meet appropriate infection control standards. There were some maintenance and repair issues that had not been fixed and posed safety concerns. The service was clean and did not have any malodour.

Staff received regular support and training to do their jobs effectively. Staff were aware of people’s needs and abilities and met those needs. The service operated within the legal framework of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS).

People’s nutrition and hydration needs were met and they liked the food. However, information on people’s nutrition and hydration intake was not always recorded and the assessments did not always correspond with the care plans. The service promptly involved health care professionals to improve people’s health and well-being.

People told us staff were caring and friendly and treated them with dignity and respect. Their cultural and spiritual needs were acknowledged and supported when required.

Staff recorded people’s likes and dislikes in their care plans and supported them to remain as independent as they could. People’s relatives were regularly informed about their family member’s health and updated on any changes. The provider responded appropriately to people and their relatives’ complaints. There were regular residents’ and relatives’ meetings where they could discuss their concerns and views.

The service did not always update people’s care plans to reflect changes in their needs. The service’s audits and monitoring checks did not always identify gaps and areas of improvement to ensure the quality and safety of the service delivery.

We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014. These breaches were in relation to safe care and treatment, premises and equipment, and governance.

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