Inspection on 08/12/06 for Peregrine House

This inspection was carried out on 8th December 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 23/02/06

Peregrine House 15/12/05

Peregrine House 26/01/05

Peregrine House 22/09/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Peregrine House 48/52 Upgang Lane Whitby North Yorkshire YO21 3HZ Lead Inspector Gill Sample Key Unannounced Inspection 8th December 2006 09:30 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 DS0000007665.V323555.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 DS0000007665.V323555.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Peregrine House Address 48/52 Upgang Lane Whitby North Yorkshire YO21 3HZ 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) 01947 603886 01947 606663 peregrinehouse@yahoo.co.uk www.peregrinehouse.co.uk Aikmo Medical Limited Mrs Alison Jane Bedford Care Home 27 Category(ies) of Dementia (3), Dementia - over 65 years of age registration, with number (10), Old age, not falling within any other of places category (27) Peregrine House DS0000007665.V323555.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The category (DE) refers to service users over the age of 60. Service users in the category (DE) only if the predominant care need is due to a mild or moderate dementia in accordance with the homes` statement of purpose. 23rd February 2006 Date of last inspection Brief Description of the Service: Peregrine House provides long-term accommodation and personal care for a maximum of twenty-seven older people. The home provides a specialist service to people with dementia who are cared for alongside other residents. If capacity permits people may be admitted on a short-term or respite care basis. The home is in a residential area of Whitby and is conveniently located for all main community facilities. It does not have its own parking facilities but ample on-road parking is readily available. It is a traditional building constructed during the late Victorian period. It was originally three properties that have been converted into one. Peregrine House is built on three floors with service users’ accommodation on each floor. The main communal areas, such as the dining room, are located on the ground floor. Peregrine House has a number of small lounge areas situated on the upper floors thereby giving the service users a choice of communal space. The home has twenty-three single and two shared or double bedrooms, all of which have en suite facilities consisting of a toilet and a wash hand basin. There is a passenger lift to all floors suitable for a wheelchair user and their helper. The home has large lawned gardens that have areas of seating for service users. Several ‘windbreaks’ have been built in the garden so that people can sit in comfort and privacy. Ramps with handrails lead to all the main entrance doors. Information is given to new and existing service users to the home detailing the accommodation, facilities and services provided. The weekly fee is quoted by the registered manager as between £427.00 and £550.00 per week in October 2006. Additional charges not covered by the fee are hairdressing at between £4.50 and £23.00, private chiropody £10.00, newspapers at cost price, and bus outings at £4.00. Peregrine House DS0000007665.V323555.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report gives the findings of a key inspection of the service including a site visit that was made on 8th December 2006. The inspection focussed on certain key standards and those recommendations made at the last inspection. A total of six hours and forty five minutes was spent at the home. There were twenty four residents living at the home. As part of this unannounced inspection the quality of information given to people about the care home was looked at. People who use services were also spoken to, to see if they could understand this information and how it helped them to make choices. The information included the service user’s guide (sometimes called a brochure or prospectus), statement of terms and conditions (also known as contracts of care) and the complaints procedure. These findings will be used as part of a wider study that CSCI are carrying out about the information that people get about care homes for older people. This report will be published in May 2007. Further information on this can be found on our website www.csci.org.uk Prior to the visit, the registered manager had provided written information about the service to the Commission and the background history of the home was analysed using records held at the Commissions York office. At the visit, general areas of the premises were seen and a number of bedrooms, bathrooms and living areas. Some written records were also examined and practice was observed during the visit. Individual discussions were held with residents, the registered manager Alison Bedford, the deputy manager and staff on duty at the time. Written comment cards were distributed to service users at the visit some of which were returned to the Commission’s office in York. What the service does well: The service manages the care of a range of service users and their needs. This is supported by the care planning system in place which enables any temporary or permanent change to the care of individual service users to be noted and staff to be aware of these. This means that each service user can be confident that staff are vigilant about their health and wellbeing and will take action if there is concern. Service users spoken with said that they were happy with their care “staff are very, very kind”, “the ones I see are very nice”. Service users said, “food is good” and that they can choose where and with whom they eat, either in their own room or in the dining room with others “I can do either.” Peregrine House DS0000007665.V323555.R01.S.doc Version 5.2 Page 6 The service is receptive and responsive to service users’ suggestions about what and how service is provided at the home and service users have been able to positively influence the service in a number of ways. Service users said “we are free to make requests any time and especially at our Residents’ Meetings. “ Every effort is made to meet the needs and wishes of us all” and “this is an excellently run home. We are cared for by very caring staff – and all they do is done so very cheerfully.” 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 DS0000007665.V323555.R01.S.doc Version 5.2 Page 7 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 DS0000007665.V323555.R01.S.doc Version 5.2 Page 8 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): 2 and 3. Standard 6 does not apply. Quality in this outcome area is good. Prospective service users can be assured that they will have chance to experience the service, their individual needs will be assessed and recorded prior to entering the home and they will be protected by having a contract for their care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care records examined showed that information had been gathered about prospective service users and an assessment made of their needs. Where information had been supplied by a purchasing local authority, this information was used as a basis to make a detailed assessment and develop a plan of care to ensure individual’s needs would be met. In all files examined, the initial assessment had been more fully developed within days of the service user moving into the home. Individual preferences were recorded, for example, Peregrine House DS0000007665.V323555.R01.S.doc Version 5.2 Page 9 whether service users had any preference for a male or female carer. A service user confirmed that they had had chance to visit the service and talk with other service users prior to deciding to come into the home. “I knew in my mind that I was going to need more care and when I made a decision to leave Scarborough, I came here to be nearer my sister”. Service users had a copy of the home’s service user guide in their room to refer to if they wished. While the standard relating to the service user guide to the home was not part of this inspection, it was noted that this document needed updating. Peregrine House DS0000007665.V323555.R01.S.doc Version 5.2 Page 10 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 and 10 Quality in this outcome area is excellent. Service users can be assured that their health care will be properly monitored and dealt with and that their physical, social, psychological and emotional needs will be recognised and met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care records examined showed that the personal care and health care needs of service users were being properly recognised and addressed. Recording was made when medical attention had been sought following minor injuries and issues noticed by care staff such as unusual skin conditions. Where mental health issues needed to be addressed, notes of referral to psychiatric services were seen. One care record noted the continuing attendance at day hospital to assist the service user to regain physical ability. All care records seen had had monthly summaries made by each service users’ key worker, daily recording reflected service users’ individual wellbeing and gave care staff comprehensive Peregrine House DS0000007665.V323555.R01.S.doc Version 5.2 Page 11 information on how to care for service users. A handover meeting was observed at the visit at which any pertinent issue about the care of service users was shared with staff coming on duty. Care records showed the medication service users were taking on admission. Assistance with medication was observed while talking with a service user. The service has put into practice safe assistance with medication by giving each tablet individually to service users. Medication is assisted using a monitored dosage system supplied by a qualified pharmacist and each service user has a locked cupboard in their own room which staff access on each occasion when medication is needed. Recording seen was up to date and signed by the staff member assisting. All care records seen were up to date and well maintained and provided a sound basis for care staff to follow, refer to, and to give care. A staff member said that care records were “excellent, really easy to follow”. Care staff showed awareness of the need to respect the privacy and dignity of service users “you need to be as discreet as you can in case of accidents”. She also reflected that service users needed to feel safe in their own environment, which included privacy. Peregrine House DS0000007665.V323555.R01.S.doc Version 5.2 Page 12 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 and 15 Quality in this outcome area is excellent. Daily life and social activities offer service users opportunities to live their preferred lifestyle, contribute to their own and others lives within the home, and retain relationships in the wider community. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A programme of activities was seen for the month of December, which detailed an organised activity for each day, some based on a Christmas theme and others on visiting entertainment. On the day of the visit to the service, a large group of local schoolchildren were giving a Christmas concert and the previous day a falconry expert had brought a number of different owls into the home where service users were given the opportunity to touch and handle the birds. A service user said that following the death of one of the residents, she had made the suggestion of holding a small memorial service at the home at the same time as the main funeral was being held. This suggestion had been taken up and the registered manager said that this was likely to become part Peregrine House DS0000007665.V323555.R01.S.doc Version 5.2 Page 13 of the way respects are paid to deceased residents, as some residents would be unable to attend a funeral service outside the home. Relatives were seen visiting residents at the home. One service user spoken with said that she had kept in contact with members of the church she attended in Scarborough and corresponded with a number of people. Service users said that they enjoyed meals served at the home. Meals are served in the home’s dining room, which provides a pleasant place in which to eat a meal, and service users can choose with whom they sit. Some service users prefer to eat their meals in their own rooms. The menu was seen which provided a variety of food and a number of alternative choices were available. Service users had chances to make suggestions for meals served at the home, and the cook said that she had cooked Toad in the Hole as a direct result of residents’ suggestions. Peregrine House DS0000007665.V323555.R01.S.doc Version 5.2 Page 14 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 Quality in this outcome area is good. Service users are able to make a complaint using information provided by the home and are protected by the awareness of staff of potential abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a complaints policy and procedure that is detailed in the service user guide to the home available to all service users in their own rooms. One complaint had been dealt with by the service, which had been investigated, and the outcome given to the complainant within a timescale of 28 days. A service user said that they had not liked the room that they had originally occupied and had spoken to Mrs O’Sullivan about this. Mrs O’Sullivan “took steps straight away” for her to move rooms and said, “she kept her promise, she always has done”. The home has a policy on how the service will protect vulnerable adults and a copy of the local authority’s procedure is available to the manager and staff. Staff training records showed that the majority of staff have been trained in the protection of vulnerable adults. Peregrine House DS0000007665.V323555.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 Quality in this outcome area is good. Service users can be assured that the home is a clean and pleasant place in which to live that is being properly maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All floors of the home were seen including some bedrooms, bathroom and toilet facilities, the sitting and dining areas and the kitchen and laundry facilities. All areas seen were clean and free from unpleasant odours. There was evidence that the home was being properly maintained inside and outside. Staff said that there were plans for the laundry to be re-located to provide more space to deal with washing and that the work was likely to start in the new year. Pre inspection information provided detailed the visits made by local fire and environmental health authorities after which no action was needed. Peregrine House DS0000007665.V323555.R01.S.doc Version 5.2 Page 16 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 and 30 Quality in this outcome area is good. Recruitment processes ensure that potential staff are properly checked as being suitable to work with vulnerable adults. Service users are given help by staff who are properly trained and have their practice monitored. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staffing rotas supplied prior to the key inspection and observation at the visit showed that there are sufficient staff to provide for the needs of service users. Additional staff have been employed since the last inspection to provide additional care in the mornings and evenings. Of the thirty care staff employed at the home, twelve have qualified to NVQ level 2 in care and three care staff have an NVQ level 3 qualification. Recruitment and selection processes were checked by examining three files, which showed that all proper checks had been made prior to the appointment of new staff including written application, obtaining criminal records disclosures, two written references and face to face interviews using equal opportunities principles. One record showed that a discussion had taken place Peregrine House DS0000007665.V323555.R01.S.doc Version 5.2 Page 17 about a candidates previous employment but did not recorded the detail of the discussion. Staff training records seen on file and pre inspection information showed that staff are trained in mandatory health and safety topics and in topics pertinent to their work, such as care of people with dementia. Records showed that staff had received induction and foundation training. Peregrine House DS0000007665.V323555.R01.S.doc Version 5.2 Page 18 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 Quality in this outcome area is good. Service users can be assured that their views will be sought and acted upon and that the service will be managed in their best interests. Systems in place at the home ensure that the health and safety of service users is being properly addressed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Mrs Alison Bedford is the registered manager of the home and has now obtained the Registered Manager’s Award including an NVQ Level 4 in management and care. She has several years’ experience in managing the Peregrine House DS0000007665.V323555.R01.S.doc Version 5.2 Page 19 home and is supported in this role by a deputy manager who also has experience managing the home. A quality assurance system is in place based on the views of service users, their relatives, the staff and health care professionals. Service users commented that Mrs O’Sullivan who jointly owns the company, which operates the home, is attentive to their views and visits the home so that they are able to speak directly to her about the service. Systems are in place so that service users’ money and valuables are handled in a proper way. Pre inspection information confirmed that a number of service users have help with their financial affairs from relatives or legal representatives and some service users have either an appointed Power of Attorney or are subject to Guardianship. Where money is held on behalf of service users, separate records are maintained. Service users have a lockable space in which to keep money or anything valuable. Pre inspection information supplied showed that records are maintained as required by legislation. A range of records were seen including staff fire training records, hot water checks and accident records. Accident records showed notification under RIDDOR using the Internet and to the Commission’s York office. Peregrine House DS0000007665.V323555.R01.S.doc Version 5.2 Page 20 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 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 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 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 DS0000007665.V323555.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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 OP29 Good Practice Recommendations Any discussion about previous employment which is pertinent to appointment should be recorded. Peregrine House DS0000007665.V323555.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 DS0000007665.V323555.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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