Background to this inspection
Updated
8 December 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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 1 November 2017 and was unannounced. The inspection was carried out by three inspectors and an expert by experience with experience of services for older people. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Before the inspection we reviewed the information we held about the home. This included looking at information we had received about the service and statutory notifications we had received from the home. We also contacted the local authority commissioning and safeguarding teams and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We also sought the views of two healthcare professionals and one professional responded.
We asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. The provider returned the PIR and we took this into account when we made judgements in this report.
We observed how care and support was provided to people. We spoke with six people who were using the service, six relatives, two team leaders, two care staff, the chef, the activity co-ordinator, the physical therapist, the registered manager and the operations manager.
We looked at six people’s care records in detail, six staff files, medicine records and the training matrix as well as records relating to the management of the service. We looked round the building and saw people’s bedrooms and communal areas.
Updated
8 December 2017
This inspection took place on 1 November 2017 and was unannounced.
At our last inspection on 29 March 2017 we rated the service as ‘Requires Improvement’ and identified three breaches which related to safe care and treatment, person-centred care and good governance. The service remained in 'special measures' as the well-led domain was rated 'Inadequate' which it had been at our previous inspection in October 2016. If any key question is rated ‘Inadequate’ over two consecutive comprehensive inspections the service is placed in special measures. We have now rated these key questions and the service overall as ‘Good’.
Pennine Lodge 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. Pennine Lodge provides personal care for up to 40 older people living with dementia. The home is split into three separate units each with their own communal areas. Harrison unit has 14 places, Ryland and Williams units each have 13 places. There were 39 people using the service when we visited.
The home has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
We found the provider, registered manager and staff had worked hard to sustain and build on the improvements we had found at the last inspection. The increase in staffing levels had been maintained and was kept under review. The registered manager recognised additional staff were required at mealtimes and recruitment was on-going. We saw staff team worked well together as a team in meeting people’s needs.
Staff understood safeguarding procedures and knew how to report any concerns. Safeguarding incidents had been identified and referred to the local safeguarding team and reported to the CQC. Risks to people were assessed and managed to ensure people’s safety and well-being.
Medicines were managed safely. Robust recruitment procedures were in place which helped ensure staff were suitable to work in the care service. Staff received the training and support they required to carry out their roles and meet people’s needs.
The home was clean, bright and well maintained. Many areas had been redecorated and refurbished and this was on-going. People had been involved in these discussions for example choosing their own bed linen and murals to go round their bedroom doors.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People’s care plans were more personalised and the home was implementing an electronic care record system. People had access to healthcare services such as GPs, district nurse, dentist and chiropodist.
The mealtime experience for people had improved. Lunchtime was a pleasant, sociable occasion and we saw people were offered choices and given the support they required from staff. People's weights were monitored to ensure they received enough to eat and drink.
People told us they liked the staff and described them as kind and caring. People told us they were treated with respect and this was confirmed in our observations. People looked clean, comfortable and well groomed. We saw people enjoyed a wide range of activities both in the home and out in the wider community.
People and relatives knew how to make a complaint. Records showed complaints received had been dealt with appropriately and the outcome communicated to the complainant.
People, relatives and staff praised the improvements that had been made since the last inspection. Everyone spoke highly of the registered manager who they described as someone who listened and was approachable and supportive. Effective quality assurance systems were in place and we saw actions had been taken when issues had been identified.