Inspection on 29/08/07 for Peregrine House

This inspection was carried out on 29th August 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Peregrine House 19/10/06

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 Margaret Flaws Key Unannounced Inspection 09:30 29th August 2007 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.V343052.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.V343052.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.V343052.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) 19th October 2006 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 £444 and £612 per week. 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.V343052.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 during one day. The Manager was available throughout the inspection, along with the Servite Houses Residential Service Manager. I spoke to nine people living in the home and twelve staff during the inspection. I toured the premises and examined the home’s records and policies as part of 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. The summary of this inspection report can be made available in other formats on request. Peregrine House DS0000010734.V343052.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.V343052.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 People using the home experience good outcomes. This judgement has been made using available evidence including a visit to this service. Prospective residents have their needs comprehensively assessed prior to moving to the home. EVIDENCE: Comprehensive assessments are completed for all prospective residents prior to admission. Four files of new residents were sampled and contained full assessments of need, which formed the basis of care plans. The Manager visits the prospective residents in their own homes or in hospital to make each new assessment. Placing authorities also provide statutory assessment information. Pre-admissions visits to the home are actively encouraged. On the day of the inspection, there were four vacancies and two people were in hospital. The main local authorities placing people in the home are the London Boroughs of Haringey, Islington, Camden, Hackney and the City of London. Peregrine House DS0000010734.V343052.R01.S.doc Version 5.2 Page 8 The home does not offer an intermediate care service. Peregrine House DS0000010734.V343052.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 People using the home experience adequate outcomes. This judgement has been made using available evidence including a visit to this service. Each person living the home has a care plan and their healthcare needs are assessed and appointments organised in their interests. Risk reduction planning still needs some improvement to ensure the resident’s safety. Residents are protected by the home’s policies and procedures for dealing with medicines and they are treated with respect, with their privacy valued. EVIDENCE: Ten files for people living in the home were examined. All had individual care plans, which had improved in consistency and quality. Objectives had been discussed with the people living in the home and documented. The individuals or someone acting on their behalf signed the care plans. Most care plans were reviewed regularly, an improvement on the previous inspection. Health needs are reviewed and addressed. Appointments with healthcare professionals such as GPs, dentists, opticians and gynaecologists were clearly indicated on the residents’ files and diarised for action by staff on a daily basis. Peregrine House DS0000010734.V343052.R01.S.doc Version 5.2 Page 10 This support included mental health support for five residents with mental health diagnoses. Two residents were receiving care from district nurses for ulcers and another received twice daily insulin injections. I sat in on the handover process on two units – it was evident from these discussions that staff had an in depth understanding of the residents and their needs and communicated daily issues comprehensively across shifts. I did, however, observe that staff regularly said or noted that “residents refused to take part” in certain activities. While this old fashioned terminology does not reflect actual practice in the home, it is recommended that there is discussion on how outmoded terminology can subtly influence the philosophy of care. Risk reduction plans were patchy – some were good and in other cases, risk were not adequately assessed. A requirement given at the last inspection is repeated. Medication policy and procedures were inspected. The home operates a monitored dosage system of medication administration. This was found to be working well. Several issues have been addressed since the last inspection. The temperature of medication storage areas are now recorded daily and medication overstocking has been eliminated. Self medication is an option and risks in relation to this are assessed. X people living in the home were spoken with during the inspection. They all said that they were generally treated with respect. One said that “I know that there are care homes with bad practice but this is not one of them – I think I’ve fallen on my feet in coming here”. Another said There are private areas in the home for people to meet and socialise. Peregrine House DS0000010734.V343052.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 People using the home experience good outcomes. This judgement has been made using available evidence including a visit to this service. People living in the home benefit from a range of social and other activities, to meet their social needs and expectations. Family involvement is supported and people can exercise, with help if needed, control and choice over their lives. The food on offer at the home is healthy and nutritious. EVIDENCE: There is a weekly programme of activities including bingo, board games and mobile library visits. On the day of inspection, people participated in a bingo game run by the part time activities person, while others followed their own interests. Entertainers and musicians come to the home from time to time and staff also take people out into the local community. One person said she regularly goes out and about and enjoys the freedom the home enables her to have. People living in the home said they could maintain contact with their families and friends as they wished. Faith needs are supported and, for example, a Catholic priests visits regularly. The home has Muslim, Jewish, Christian residents and members of North London’s diverse cultural communities. Peregrine House DS0000010734.V343052.R01.S.doc Version 5.2 Page 12 Celebrations and meeting specific cultural needs are part of the life of the home. There are regular residents’ meetings for people to give their views and determine what happens in the home. Meeting minutes were inspected and showed that vigorous discussions took place. A contracted catering company provides the main meals served in the home. Catering staff were positive about the resources available to produce these meals. The main kitchen inspected was clean, tidy and functional. Fridge and freezer temperatures were recorded daily and food handling was observed to be good. Menus offered a reasonable choices. Meals and preferences are discussed at resident’s meetings. The home has a culturally diverse group of people living there and their dietary needs are addressed in the menus created. People spoken to were generally positive about the quality and quantity of food on offer. There were good stocks of food in kitchen and the lunch was healthy and appeared reasonably appetising. Peregrine House DS0000010734.V343052.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People using the home experience good outcomes. This judgement has been made using available evidence including a visit to this service. People living in the home can be confident that their complaints would be dealt with appropriately. The home has sound adult protection policies and procedures in place to protect the residents. Small improvements are needed to the adult protection procedures. EVIDENCE: The home has an appropriate complaints policy and procedure made available to residents and their families and friends. Complaints records show that complaints received are investigated and addressed appropriately. One adult protection investigation was taking place at the time of the inspection. The home has policies and procedures to safeguard and protect the residents. However, several elements need updating. The public sign with the contact details of the CSCI and the local authority needs to be accurate. The policy must reflect the safeguarding approach to adult protection and the terminology, for example, referring to victims, needs to be changed. A requirement is given. The Registered Manager is a member of the local authority safeguarding adults committee. Most staff have received training in safeguarding adults and in how to recognise and deal with any potentially unsafe situations. However, other staff need their training in this area updated. A requirement is given under Peregrine House DS0000010734.V343052.R01.S.doc Version 5.2 Page 14 Standard Thirty. Those spoken to gave very sound responses about how they would recognise and address potential abuse. Peregrine House DS0000010734.V343052.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People using the home experience good outcomes. This judgement has been made using available evidence including a visit to this service. Residents generally live in a safe and well-maintained environment. Small improvements have been made recently. The home was clean, pleasant and hygienic. EVIDENCE: The home is purpose built and people live in four semi self-contained units which have their own kitchen and dining areas. The home is comfortable and well-maintained. Peoples’ bedrooms are personalised with pictures, photographs and ornaments. The home was clean, tidy and odour free during the inspection. The Registered Manager said that ten additional hours per week had been added for laundry staffing to improve laundry for the residents. Domestic staff said that they have had training in handling dangerous chemicals, infection control, health and safety, dementia and appropriate language to use in the home. Peregrine House DS0000010734.V343052.R01.S.doc Version 5.2 Page 16 The following repairs and maintenance has been done since the last inspection, meeting a requirement: a cistern top has been replaced for the toilet in the “blue” unit bathroom; bathroom decoration improved; a new table purchased; an plug repaired in one bedroom and a new toilet seat purchased. Chemicals were safely locked away. The cause of leak in the roof in the “blue” unit hallway is still under investigation. Peregrine House DS0000010734.V343052.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 People using the home experience good outcomes. This judgement has been made using available evidence including a visit to this service. Residents’ needs are met by adequate numbers of appropriately recruited and trained staff. EVIDENCE: The home has a relatively low staff turnover and many staff have worked in the home for a long time. Staff are recruited in an appropriate manner. Application forms are 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. Rotas accurately reflected the staffing on the day. Staffing levels at the home are comprise 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. The home continues to make good progress in staff to achieve National Vocational Qualifications (NVQ). Training records were inspected and demonstrated that a range of training had taken place. Staff spoken with confirmed that training opportunities were always available. However, some Peregrine House DS0000010734.V343052.R01.S.doc Version 5.2 Page 18 staff required training updated in safeguarding adults. A requirement is made. Staff also participate in the organisation’s staff forum. Staff said that they were happy working in the home; that it was a well run place and that they were supported to do their jobs. Peregrine House DS0000010734.V343052.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 People using the home experience good outcomes. This judgement has been made using available evidence including a visit to this service. The Registered Manager is professional in approach and manner to run the home in resident’s best interests. The financial interests of service users are safeguarded. The health, safety and welfare of people living in the home and staff are given good priority. EVIDENCE: The Registered Manager 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 residents also felt confident in her capabilities. Peregrine House DS0000010734.V343052.R01.S.doc Version 5.2 Page 20 Residents are involved in running of the home through resident’s meetings and informal consultation. Satisfaction surveys are carried out to ensure their viewpoints are obtained. The home holds a small amount of money for a number of service users. These were randomly sampled and checked and found to be in order. The process, which appeared fair and safe, was observed in the morning where residents obtained money for their daily tasks. All health and safety certificates were up to date and in order. Infection control policies and procedures are in place. Workplace risk assessments had been carried out. Incident and accident records are completed and actions taken as required. The home sends detailed Regulation Thirty Seven reports very regularly to the CSCI. Fire protection systems are good. There is a fire risk assessment; regular maintenance of fire equipment; emergency evacuation and fire drills are done regularly. Staff training is ongoing and innovative, with quizzes to check knowledge and specific tests for night staff. Peregrine House DS0000010734.V343052.R01.S.doc Version 5.2 Page 21 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 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 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.V343052.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? 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. 2. Standard OP18 OP30 Regulation 12(1) 18(1) Requirement The Registered Persons must ensure that safeguarding adults contact information is updated The Registered Persons must ensure that all staff receive regular training in safeguarding adults. The Registered Persons must ensure that risk reduction plans are available for all service users. Previous timescale of 31/12/06 not met. Timescale for action 30/11/07 30/11/07 4. OP8 13(4) 30/11/07 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 OP10 Good Practice Recommendations It is recommended that the home review its use of outdated and philosophically inappropriate terminology. Peregrine House DS0000010734.V343052.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Harrow Area Office 4th Floor, Aspect Gate 166 College Road Harrow London HA1 1BH National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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.V343052.R01.S.doc Version 5.2 Page 24 - 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. 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