Inspection on 19/10/06 for Peregrine House

This inspection was carried out on 19th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Peregrine House 29/08/07

Peregrine House 02/12/05

Peregrine House 01/08/05

Peregrine House 04/10/04

Peregrine House 08/04/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Peregrine House 350 Hermitage Road South Tottenham London N15 5RE Lead Inspector Stephen Boyd Key Unannounced Inspection 11:15 19th October 2006 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Peregrine House DS0000010734.V305790.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Peregrine House DS0000010734.V305790.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Peregrine House Address 350 Hermitage Road South Tottenham London N15 5RE Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8809 5484 020 8802 1471 Servite Houses Ms Yvonne Evadney Smythe Care Home 35 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (35), Old age, of places not falling within any other category (35), Physical disability (16), Physical disability over 65 years of age (35) Peregrine House DS0000010734.V305790.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Limited to 35 people of either gender who fall into the category of old age (OP) and who may also have a mental disorder (MD(E)) and who may also have a physical disability (PD(E)). Up to 16 of the 35 places may accommodate people of either gender who are aged between 40 and 65 years of age and have a physical disability (PD) 2nd December 2005 Date of last inspection Brief Description of the Service: Peregrine House is a large care home for up to thirty-five service users, the majority of whom are older people but there is a significant group of younger service users with physical disabilities. The home is run by Servite Homes. The home is located in a residential road in South Tottenham. It is sited close to local shops, public transport and local amenities. The home is organised over two floors, with the ground floor functioning as a specialist unit for up to sixteen younger people with physical disabilities. All bedrooms are for single occupancy and have en-suite facilities. There is a lift and a number of assisted bathrooms. There are patio areas with raised tubs which are accessible to service users. The stated aims of the home are: ‘Peregrine House offers care and support to enable residents to remain as independent and active as possible. Each person is treated as an individual with his or her own likes and dislikes.’ The home provides twenty-four hour care and support and access to a range of residential specialist services geared towards meeting individual service users needs. Fees charged at the home range between £378.88 and £580.68 A copy of this Inspection report can be requested directly from the home or via the CSCI website (web address can be found on page 2 of this report.) Peregrine House DS0000010734.V305790.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place in one day in October 2006. The Manager, Ms Smythe was available throughout the inspection. The inspector spoke with five service users and three staff and also met two relatives during the inspection. A tour of the premises was undertaken and various records and policies were looked at during the inspection. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Peregrine House DS0000010734.V305790.R01.S.doc Version 5.2 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Peregrine House DS0000010734.V305790.R01.S.doc Version 5.2 Page 7 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This Judgement has been made using available evidence including a visit to this service. Prospective service users have their needs comprehensively assessed prior to moving to the home. After admission needs are periodically reassessed. EVIDENCE: The home carries out comprehensive assessments on prospective service users prior to admission and this was evidenced from sampled files of residents admitted since the previous inspection. The Manger, Ms Smythe will visit service users in their own homes or hospital prior to admission to make the assessment. Placing authorities also provide their statutory assessment information. Service users are also encouraged to visit the home for a day prior to making any decision regarding moving to the home. Files of sampled service users showed evidence of periodic reassessment of needs being made. The home does not offer an intermediate care service. Peregrine House DS0000010734.V305790.R01.S.doc Version 5.2 Page 8 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is adequate. This Judgement has been made using available evidence including a visit to this service. Service users have individual plans of care setting out their needs, however the quality of plans was variable. Service users healthcare needs are generally met, though Risk reduction planning was variable in content. Service users are not fully protected by the homes policies and procedures for dealing with medicines. Service users are treated with respect and their privacy rights are recognised. EVIDENCE: Service users sampled were found to have individual plans of care based on the activities of daily living. The plans sampled were found to vary in consistency and quality. For example, one plan did not have any objectives listed on how to meet the service users needs. Other plans had detailed objectives. Some sampled plans had been signed as agreed by the service user whilst others had not. Monthly monitoring of older service users plans was not always achieved. A life history on one sampled plan was seen to have not been completed. Records and discussions with service users indicated that their health needs were generally being met. Records of appointments with health professionals Peregrine House DS0000010734.V305790.R01.S.doc Version 5.2 Page 9 such as G.Ps, Dentists and Opticians were clearly indicated on service users files. Risk reduction plans were not in evidence for all service users sampled. The home operates a monitored dosage system of medication administration. This was viewed during the inspection and found to be working well. There were some issues that needed to be addressed in order to enhance the safety of the overall medication system. The temperature of the main storage room and a fridge within that room was not always recorded on a daily basis. Also, there was evidence of some overstocking of boxes and bottles of medication. Items should generally only be required to be kept in supplies equivalent to a twenty eight day period, some prescriptions seen had three times this level. Service users spoken with during the inspection felt that they were generally treated with respect. Their privacy was seen to be upheld in a number of ways during the inspection, for example by staff knocking on bedroom doors. Visitors were seen to meet with service users in private and there were areas in the home set aside to facilitate this. Peregrine House DS0000010734.V305790.R01.S.doc Version 5.2 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is good. This Judgement has been made using available evidence including a visit to this service. Service users benefit from a range of social and other activities which meet their needs and expectations. Service users have contact with family, friends and representatives in accordance with their wishes. Service users can exercise, with help if needed, control and choice over their lives. Service users largely enjoy the range of food provision on offer at the home. EVIDENCE: Some service users attend day services outside the home. There was a weekly programme of activities displayed in the home incorporating activities such as bingo, board games and mobile library. The home has it’s own shop where service users can purchase items such as sweets and toiletries. On the day of inspection service users were seen to be involved in individual activities such as reading, chatting or watching television. Entertainers come to the home from time to time and staff also take service users out within the local community. One service user spoken with goes out by bus to a local church. One service user expressed the desire that a Karaoke machine is purchased to increase entertainment opportunities. Service users spoken with said they could maintain contact with their families and friends as they wished. Two relatives of a service user were spoken with during the inspection and they confirmed they could visit the home at any Peregrine House DS0000010734.V305790.R01.S.doc Version 5.2 Page 11 time. They said they were always welcomed and kept informed of issues relating to their relatives care. Service users have regular meetings at which they can give their views across on the operation of the home. At an individual level, for example, they are able to decide how to spend their time, whether to join in activities, when to go to bed and get up in the morning. They are able to wear clothes of their own choice and eat a range of meals that are provided. A service user spoken with stated, “all in all I think this home is pretty good” An outside contracted catering company provides the main meals served at the home. Catering staff were spoken with during the inspection and the main kitchen inspected which was found to be clean and tidy with suitable working equipment. Fridge and freezer temperatures were recorded and meat temperatures were also checked. Menus which offer a good level of choice were seen and these were subject to service user input via service user meetings. Cultural requirements were seen to be reflected in the menus. Service users were generally positive in their remarks about the quality and quantity of food on offer at the home. One service user said they would like more roast dinners. One requirement from the previous inspection to ensure bottles of ketchup were kept refrigerated had not been fully complied with as observed during the inspection. Stocks of food were seen to be ample and the lunchtime meals were well presented. Peregrine House DS0000010734.V305790.R01.S.doc Version 5.2 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This Judgement has been made using available evidence including a visit to this service. Service users and others can be confident that their complaints would be dealt with in an appropriate manner. The home has appropriate policies and procedures in place to protect service users from abuse. EVIDENCE: The home has an appropriate complaints policy and procedure which is made available to service users and others. Since the previous inspection there had been twelve documented complaints which had been dealt with in an appropriate manner and in a timely fashion. No service users spoken with during the inspection raised any issues of concern. The home also has policies and procedures for the protection of vulnerable adults from abuse. The manager is a member of the borough POVA committee. Staff have received training in what constitutes abuse and how to recognise and deal with any abuse situations. Peregrine House DS0000010734.V305790.R01.S.doc Version 5.2 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is adequate. This Judgement has been made using available evidence including a visit to this service. Service users generally live in a safe and well-maintained environment, though some improvements are necessary. The home was clean, pleasant and hygienic. EVIDENCE: The home is purpose built and service users live in four semi self-contained units which have their own kitchen and dining areas. The home was generally comfortable and well- maintained. Service users bedrooms had evidence of personalisation with pictures, photographs and ornaments. The home was found to be clean, tidy and odour free during the inspection. There were some areas of the home that needed attention in order to enhance the living environment and ensure safety is fully maintained. These were: 1. A new cistern top was required for the toilet in the “blue” unit bathroom. 2. There was a hole in the roof in the “blue” unit hallway caused by water damage. 3. Flowers or pictures/prints would enhance the bathrooms which tend to look uninviting. 4. A new table would benefit the large communal lounge on the ground floor. 5. In room 27, there was cable showing where a Peregrine House DS0000010734.V305790.R01.S.doc Version 5.2 Page 14 light switch had been removed. 6. One shower room needed a new padded arm on the toilet surround. 7. The laundry room should always be locked when not in use by staff or dangerous chemicals should be locked in a cabinet facility. Peregrine House DS0000010734.V305790.R01.S.doc Version 5.2 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is good. This Judgement has been made using available evidence including a visit to this service. Service users needs are met by adequate numbers of staff, who have been recruited in an appropriate manner and have the necessary skills and training for the needs of service users. EVIDENCE: Staffing levels at the home allow for six carers per shift with one staff member allocated for each unit and two “floating” staff between units. There are separate cooking, housekeeping and laundry staff. The manager or a duty officer is always on duty to manage the home. Three night carers cover the home overnight. Staff levels remain as at the previous inspection and staff spoken with during the inspection felt these were generally enough to meet service users needs, although some pressure on their time was noted at lunchtime due to some service users needing 1-1 assistance. Over fifty percent of the current care staff have National Vocational Qualifications at level two or above. Since the last inspection a requirement for staff to have training in mental health issues had been met. Training records on staff files indicated a range of training had been pursued relevant to the needs of service users such as medication, protection of vulnerable adults and safety courses. Staff spoken with confirmed that training opportunities were available. The manager was in the process of indexing all staff files to make retrieval of information on recruitment and training easier. Sampled files showed that staff Peregrine House DS0000010734.V305790.R01.S.doc Version 5.2 Page 16 had been recruited in an appropriate manner. Application forms were completed, interviews held, references taken up, Criminal Records Bureau checks undertaken and photo identity obtained. Staff spoken with during the inspection confirmed these processes and said they received a good induction into the home. Peregrine House DS0000010734.V305790.R01.S.doc Version 5.2 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Quality in this outcome area is good. This Judgement has been made using available evidence including a visit to this service. The registered manager is professional in approach and manner. The home is run in service users best interests. The financial interests of service users are safeguarded. The health, safety and welfare of service users and staff are given good priority. EVIDENCE: The registered manager, Ms Smythe has been in that post for over five years. She has achieved the Registered Manager Award and presented as very caring and professional in her approach. Staff spoken with said they felt well supported by her and service users also felt confident in her capabilities. Service users are involved in the running of the home through service user and relative meetings. Minutes were seen of these and they confirmed a range of topics were discussed such as menus and activities. Service user satisfaction surveys are carried out to ensure their viewpoints are obtained to inform the running of the home. Peregrine House DS0000010734.V305790.R01.S.doc Version 5.2 Page 18 The home holds a small amount of monies for a number of service users. These were randomly sampled and checked and found to be in order. It was recommended that to facilitate easier auditing of these sums that receipts for items purchased are numbered and correspond with the same number in record sheets. The health, safety and welfare of service users and staff was promoted and protected in a number of ways in accordance with specified regulations. Certificates of safety were seen to have been obtained in respect of Electrical installation and portable appliances. There was a contract for hazardous and chemical waste in place. Workplace risk assessments had been carried out. Audits of water quality and safety were undertaken. Certificates of safety in respect of fire equipment were seen and fire alarm tests were carried out regularly. Accident records were completed. Infection control policies and procedures had been put in place. Peregrine House DS0000010734.V305790.R01.S.doc Version 5.2 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Peregrine House DS0000010734.V305790.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 Requirement The registered provider must ensure that care plans are recorded in a consistent and thorough manner. The registered provider must ensure that risk reduction plans are available for all service users. The registered provider must ensure that medication held for service users does not become overstocked. Thereby creating a potential risk. The registered provider must ensure that the temperature of the main medication storage room and fridge is monitored and recorded on a regular basis. This requirement is amended and restated. Original timescale of 1/2/06 not met. The registered providers must ensure that any ketchup bottles or jams that require refrigeration are kept in fridges. This requirement is restated. Original timescale of 1/2/06 not met. The registered provider must ensure the homes environment DS0000010734.V305790.R01.S.doc Timescale for action 31/12/06 2. OP8 13(4) 31/12/06 3 OP9 13(2) 31/12/06 4. OP9 13(2) 30/11/06 5. OP15 13(4) c 30/11/06 6. OP19 23 31/01/07 Peregrine House Version 5.2 Page 21 is free from safety hazards and kept well maintained. (See standard 19 for detail). RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP35 Good Practice Recommendations It is recommended that numbered receipts are kept in relation to service users financial transactions for ease of auditing. Peregrine House DS0000010734.V305790.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Peregrine House DS0000010734.V305790.R01.S.doc Version 5.2 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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