Archived: Peregrine House

Updated 7 September 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 30 June 2016 and was unannounced.

The inspection team included an adult social care inspector and a specialist advisor who was a doctor with experience of all aspects of care in particular care for the elderly and the administration of medicines. There was an also expert-by-experience, a person who has personal experience of using or caring for someone who uses this type of care service.

Prior to the inspection we reviewed the information we held about the service. This included previous inspection reports and notifications we had received. A notification is information about important events which the service is required to send us by law.

During the inspection we spoke with thirteen people using the service and one visitor. We looked at seven people’s care records and medicine administration records and pathway tracked six care records. This means we looked at all the documents associated with people’s care and checked that aspects of these were occurring in practice. We looked at ten people’s money transaction records. We spoke with six members of staff and the administration officer. We also spoke with the registered manager, the deputy manager and the visiting group operations manager and regional manager. We looked at seven staff files. This included staff recruitment documentation in addition to staff training, supervision and appraisals.

Following the inspection we spoke with one relative and the commissioning body.

Updated 7 September 2016

This inspection took place on 30 June 2016 and it was an unannounced inspection.

Peregrine House is a residential care home providing accommodation and care for up to 36 people who are older and people who have mental health and physical disability support needs. Peregrine House is a purpose built home where accommodation provided is divided into four units on two floors. It is part of Gold Care Homes.

There was 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.

At the last inspection on 15 December 2014 the service was found to Require Improvement overall. There were two breaches concerning medicine administration and the guidance given to staff in risk assessments to minimise risks to people and others. We found these breaches had been addressed at this inspection.

During our inspection visit we found three breaches concerning people’s legal rights, maintaining premises and auditing.

The service had applied for Deprivation of Liberty Safeguards (DoLS). These are a legal requirement under the Mental Capacity Act (2005) when people do not have the capacity to agree to their care and treatment. However they had failed to renew the applications when these had expired. This meant the service was not upholding people’s legal rights.

We found that some parts of the premises were not being maintained appropriately for the purpose for which they were used. For example one kitchenette needed work surfaces replacing to maintain good levels food hygiene when preparing food. The hairdressing room and a bathroom had items stored in them and the outside courtyards were not kept in a manner that was inviting for people to use. The signage around the service was poor and did not consider the needs of people with a cognitive impairment.

The service undertook auditing to ensure the quality of the service offered. There had been a change in the way auditing was undertaken in May 2016 but the new system had not had sufficient time to embed. We found that there were some areas such as supervision, Deprivation of Liberty Safeguards and people’s money records that were not being audited in a robust manner.

We found the service had systems in place to enable the staff to recognise and report safeguarding adult concerns. People and the environment were risk assessed to minimise the risk of harm. There was guidance to staff in the risk assessments we looked at.

Medicine administration and storage was undertaken appropriately and staff administering medicines could tell us what medicines were used to treat people. The service had systems in place for the auditing of medicines administration.

Some people told us there was not enough staff, however we saw the service had increased some staffing levels, had changed the rota, and had organised shifts to ensure staff were available at busy times. Bank staff were used to cover staff absence.

Not all staff had received supervision in a timely manner. There was however was an induction period and training to support staff to undertake their role.

People were supported to receive appropriate health care services.

Some people liked the food at Peregrine House but others did not. People were supported to eat and drink enough to remain healthy but we recommended the service consider how they could work with people to improve their satisfaction with the food served.

People had individualised care plans that specified their preferences with regard to their care, however information in the records was sometimes difficult to find due to the format used. The service was in the process of changing to a more accessible format.

The service responded well to complaints by investigating and addressing the concerns. They kept a complaints matrix to enable them to recognise trends in the service.

People, staff and relatives spoke positively about the registered manager. There were regular ‘residents’ meetings and feedback forms.

We found three breaches of the 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.