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Inspection Summary


Overall summary & rating

Good

Updated 1 June 2016

The inspection took place on 12 and 13 April 2016 and was unannounced.

Pendruccombe House provides nursing care and accommodation for up to 54 persons. There is a Residential Home and a Nursing Home that are on two distinct sites on the same location; plus a domiciliary care agency which provides a personal care service to people living in their own home which operates from the same location. On the day of the inspection, 49 people were living at the home and 20 people were being supported with their personal care needs in their own homes.

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 and staff were relaxed throughout our inspection. There was a very calm, friendly and homely atmosphere. People told us they enjoyed living in the home . Comments included, “I’m very happy here. There’s good food and lovely staff.”

People and their relatives spoke highly of the care and support that staff gave. Care and support focussed on the person, their individual needs, their likes, dislikes and the routines that were important to them. When people's needs changed staff reacted promptly, and involved social and health care professionals if needed. One person commented, “The staff are very, very good. They’ve got my full recommendation. I’m only too pleased to talk about them.”

People were provided with adequate food and fluids to maintain their nutritional needs. Staff supported people to eat and drink as needed. Where concerns were raised action was taken. People chose the meals they wished to eat and decided where to eat them. Special diets were available for people with particular dietary needs. People who were at risk of choking had their meals prepared in line with their care plan to help reduce the risk.

People told us they felt safe. All staff had undertaken training on safeguarding vulnerable adults from abuse. They demonstrated good knowledge of how to report any concerns and described what action they would take to protect people against harm. Staff told us they felt confident any incidents or allegations would be fully investigated.

People were protected by the service's safe recruitment practices. Staff underwent the necessary checks which determined they were suitable to work with vulnerable adults, before they started their employment.

Medicines were managed, stored and disposed of safely and people told us they received their medicines on time. However, where medicines needed two signatures to confirm they had been administered safely, the person providing the second signature had not always received medicines training. Also, there was no clear direction given to staff on the precise area prescribed creams should be placed and how often; some creams had been recorded as ‘no creams available’ for several days and creams were not all dated when opened, so staff knew when to dispose of them. The registered manager and staff took immediate action regarding these concerns.

People and those who mattered to them knew how to raise concerns and make complaints.

New staff received a comprehensive induction programme. There were sufficient staff to meet people's needs. Staff were appropriately trained and had the correct skills to carry out their roles effectively.

Staff described the management as supportive and approachable. Staff talked positively about their jobs. This helped ensure positive progress was made in the delivery of care and support provided by the service. A member of staff told us, “The managers are really supportive and encourage us to come forward with any ideas.”

The registered manager and staff understood their role with regards to the Mental Capacity Act (2005) and where applicable the associated Deprivation of Liberty Safeguards.

There were effective quality assurance systems in place. Incidents were appropriately recorded and analysed. Learning from incidents and concerns raised was used to help drive improvements and ensure positive progress was made in the delivery of care and support.

Inspection areas

Safe

Good

Updated 1 June 2016

The service was safe. Safe recruitment practices were followed and there were sufficient numbers of skilled and experienced staff to meet people’s needs.

People were supported by staff who had a good understanding of how to recognise and report any signs of abuse.

People were protected by staff who understood and managed risk. People had risk assessments in place so staff knew how to mitigate risks identified.

Where gaps in the safe administration of medicines was highlighted, the registered manager and staff took immediate action to address them.

Effective

Good

Updated 1 June 2016

The service was effective. People were looked after by staff who

were trained to meet their needs.

People were assessed in line with the Mental Capacity Act 2005

as required.

Staff received a comprehensive induction and regular training to ensure the care they provided was based on current best practice.

People's nutritional and hydration needs were met.

Caring

Good

Updated 1 June 2016

The service was caring. People were looked after by staff who

treated them with kindness and respect.

Staff spoke about the people they were looking after with fondness.

People and relatives spoke highly of staff and said they were treated with respect.

Staff were proactive in supporting people’s wellbeing.

Responsive

Good

Updated 1 June 2016

The service was responsive. People had care plans in place to reflect their current needs. Care was centred on the person.

Activities were provided that took into account people's interests and abilities.

People and their relatives knew how to complain and concerns and complaints were used to improve practice.

Well-led

Good

Updated 1 June 2016

The service was well-led. People, relatives and staff said the

service was well-led.

The registered manager had audits in place to help ensure the quality and safety of the service.

People and staff felt the registered manager was approachable and had developed a culture which was open and inclusive.