Penrose Care Limited

Updated 3 March 2022

The inspection

We carried out this performance review and assessment under Section 46 of the Health and Social Care Act 2008 (the Act). We checked whether the provider was meeting the legal requirements of the regulations associated with the Act and looked at the quality of the service to provide a rating.

Unlike our standard approach to assessing performance, we did not physically visit the office of the location. This is a new approach we have introduced to reviewing and assessing performance of some care at home providers. Instead of visiting the office location we use technology such as electronic file sharing and video or phone calls to engage with people using the service and staff.

Inspection team

This inspection was carried out by one ASC inspector and one Expert by Experience. An Expert by Experience (EXE) is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Penrose Care Ltd is a domiciliary care service. It provides personal care to people living in their own houses and flats in the community.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. The registered manager was also the owner of the service

Notice of inspection

We gave the service 48 hours' notice of the inspection visit because we wanted to make sure the registered manager and staff were available on the day of our inspection

What we did before the inspection

We reviewed the completed PIR and previous inspection report. We reviewed other information we had about the provider, including notifications of any safeguarding concerns or other incidents affecting the safety and wellbeing of people. Prior to our visit our Expert-by-Experience carried out telephone interviews with three people who used the service and five relatives who gave us their feedback on the service provided. Additionally, prior to the inspection we emailed care staff employed by the service and external health social care professionals to ask for their feedback about care provided. . We received feedback from five staff and two health and social care professionals. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with the registered manager. We reviewed four people's care records, which included care plans, risk assessments and daily care notes and medicines administration records (MARs). We also looked at four staff files, complaints and quality monitoring and audit information.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

Updated 3 March 2022

About the service

Penrose Care Ltd is a domiciliary care service that provides personal care and support to older people in their own homes in and around North London. People receiving a service included those with physical disabilities, and health issues relating to the progression of age. At the time of this inspection the service was providing a service to 12 people out of which seven people received the regulated activity of personal care.

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

Penrose Care was a small service embedded in the community in North London. The service had a well-defined ethos to remain small and provide holistic and highly personalised care. The most characteristic of the service was that the support they offered met people's specific needs and enabled them to live their lives as comfortable as possible despite the need for care and support. The service's commitment to improving people's lives led to their families being overjoyed with the care. This was because the highly effective and responsive care led to improvements in people's wellbeing in ways families wanted but never expected.

The services strong ethical stand exceeded toward their staff. The service provided the staff team that was suitably paid, well trained, supported and motivated to do their best. The "No Problem" approach meant that the service was very adaptable and dealt with arising issues efficiently and easily. The service empowered staff to sort things out and go the extra mile to ensure people receive their needed care.

Stakeholders, including people using the service, their relatives, local community members, and external health and social care professionals, gave consistently positive feedback about this service. They described the service as very well run, passionate about supporting people, and highly responsive to people's needs. They described staff as intelligent, well trained and having an exceptional level of commitment to facilitating people's improvement. They gave us numerous examples of how staff commitment to providing a high standard of care and readiness to go the extra mile contributed to the wellbeing of their relatives improving.

Staff had an in-depth knowledge of people's needs which they achieved through extended induction every time they started supporting a new person. The same small group of care staff supported each person. This helped to develop a trusting and friendly relationship between people and staff. People's care plans were comprehensive and provided staff with detailed information on risks, needs and preferences related to people’s care.

Staff proactively sought continuous professional development to ensure they knew how to best support people. The staff promptly sought support and liaised with other health and social care professionals when needed. As a result, staff safely and effectively met people's needs.

The provider regularly consulted people about their views of the service. People and family members confirmed that they were fully involved in planning people's care and that staff promptly acted on any changes to the support needs. They told us that this readiness to respond to emerging needs gave people and relatives additional comfort and reassurance that the service could meet people's needs.

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.

The provider was passionate about ensuring that they suitably rewarded staff employed at the service for their continuous contribution to improving people's wellbeing. They provided staff with the necessary and additional benefits, not common in similar services, such as, medical insurance, safe transport home to and from work and full-time employment contracts. Staff confirmed this had contributed to their wellbeing and work satisfaction. They described the managers at Penrose as always exceptionally supporting and caring.

The provider's contribution to the quality of life of people using the service and the local community was outstanding. They initiated, funded, and carried out a range of initiatives within the local community to ensure the quality of life for people's families and other local community members improved. This was especially observable during the Covid-19 pandemic. For example, the service started an alfresco dining initiative called “Streatery” and delivered PPE resources to other health services at the start of the pandemic.

The registered manager monitored the quality of people's care and support provided by Penrose Care. They have stayed in regular contact with all people who used the service and their families and staff to ensure people were happy with the service received and that staff had everything they needed to provide a high standard of care.

The service had effective processes and procedures in place, which helped ensure the service met all the Health and Social Care Regulations.

Staff received appropriate training and induction to ensure they safeguarded people from harm and that the care they provided was effective. The recruitment procedures were safe, and the provider ensured that only suitable staff supported people. We were assured that the service followed current guidelines on infection control and Covid-19 risk reduction measures. The provider had a range of effective quality monitoring systems that helped to ensure the continuous provision of ethical and high-quality care. Any shortfalls in the care provision were quickly spotted and addressed.

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

Rating at last inspection

Outstanding (last report published on 08 April 2019)

Why we inspected

This was a planned inspection as part of our quality assurance process checking a range of Good and Outstanding services.

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