Archived: Petteril House

Updated 11 September 2018

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 11 and 17 July 2018 and was unannounced.

The inspection team consisted of one adult social care inspector and a specialist advisor whose area of expertise was nutrition.

Before we visited the service, we checked the information we held about this service and the service provider, for example, inspection history, complaints and statutory notifications. A notification is record about important events which the service is required to send to us by law. We contacted health and social care professionals involved in caring for people who used the service, including community nurses, commissioners and safeguarding staff. Information provided by these professionals was used to inform the inspection. We also contacted Healthwatch, but they did not hold any information about Petteril House.

During our inspection, we spoke with four people who used the service and three family members. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not speak with us.

We also spoke with the registered manager, operations manager, two supervisors, four care assistants, the cook and two of the domestic staff. We observed staff practices, looked at the care records of six people who used the service, staff recruitment, training and supervision files and records associated with the management of the service.

We did not ask the provider to complete a Provider Information Return (PIR) at this inspection. This is information we usually require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make

Following the inspection, we asked the provider to send us information about their staffing levels and how these were calculated to meet the needs of people using the service. We also asked the provider to send us various policies and procedures in relation to the running of the service. The provider sent us this information as requested.

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 kind manner. People were supported with respect and dignity and staff ensured support was carried out in private. We received positive comments about the way in which staff cared for and supported the people who lived at this home.

People had access to health and social care professionals when they needed them. The service provided opportunities for people, their friends and relatives to be involved with, and comment on the operation of the home.

We found five breaches of the Regulations. These related to obtaining lawful consent, nutrition, staffing levels, notifications and governance of the service.

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