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Care Home: Perrins House Nursing Home

  • Moorlands Road Malvern Worcestershire WR14 2TZ
  • Tel: 01684562701
  • Fax: 01684893994

Perrins House is located in extensive grounds on the outskirts of Malvern overlooking the common. It was constructed in 1972. The family home (Davenham) and grounds were bequeathed to The `Friends of the Elderly` by Mrs Perrins in memory of her late husband, Mr Dyson Perrins. The `Friends of the Elderly` are a registered charity. Perrins House has well appointed communal rooms that have views across the mature gardens. The home is registered to accommodate 43 people of either sex. All rooms can be used for nursing care. All bedrooms are for single occupancy and have en-suite facilities. The home is fitted with three shaft lifts to facilitate movement between floors. The email address for the home is: enquiries @fote.org.uk Information regarding the home can be obtained from the Statement of Purpose and the Service User`s Guide, which are available in the home. For up to date information about the fees please contact the home direct, other charges are outlined in the homes terms and conditions.

  • Latitude: 52.119998931885
    Longitude: -2.3259999752045
  • Manager: Mrs Maria Socorro Walker
  • Price p/w: £595
  • UK
  • Total Capacity: 41
  • Type: Care home with nursing
  • Provider: Friends of the Elderly
  • Ownership: Charity
  • Care Home ID: 12272
Residents Needs:
Old age, not falling within any other category, Physical disability

Previous Inspections

This may not be the latest inspection for this service as we are having techinical problems updating from CQC - please check directly on the regulators website for the most recent report; bestcarehome hopes to be back to regular updates shortly.

For extracts, read the latest CQC inspection for Perrins House Nursing Home.

Key inspection report Care homes for older people Name: Address: Perrins House Nursing Home Moorlands Road Malvern Worcestershire WR14 2TZ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Christine Potter     Date: 2 1 0 1 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Perrins House Nursing Home Moorlands Road Malvern Worcestershire WR14 2TZ 01684562701 01684893994 enquiries@fote.org.uk www.fote.org.uk Friends of the Elderly Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Type of registration: Number of places registered: care home 43 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is: 43 The registered person may provide the following category of service only: Care Home with Nursing (Code N); To service users of the following gender: Either; Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) 43 Physical Disability (PD) 43 Date of last inspection Brief description of the care home Perrins House is located in extensive grounds on the outskirts of Malvern overlooking the common. It was constructed in 1972. The family home (Davenham) and grounds were bequeathed to The Friends of the Elderly by Mrs Perrins in memory of her late husband, Mr Dyson Perrins. The Friends of the Elderly are a registered charity. Perrins House has well appointed communal rooms that have views across the mature Care Homes for Older People Page 4 of 29 Over 65 43 0 0 43 Brief description of the care home gardens. The home is registered to accommodate 43 people of either sex. All rooms can be used for nursing care. All bedrooms are for single occupancy and have en-suite facilities. The home is fitted with three shaft lifts to facilitate movement between floors. The email address for the home is: enquiries @fote.org.uk Information regarding the home can be obtained from the Statement of Purpose and the Service Users Guide, which are available in the home. For up to date information about the fees please contact the home direct, other charges are outlined in the homes terms and conditions. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We, the commission, undertook an unannounced inspection of this service, which means that the home did not know we were coming. This was a key inspection where we look at a wide range of areas. The last Key inspection was the 19th of March 2007 and the overall rating for the home was excellent. We have completed two Annual Service Reviews since the last Key inspection, and these did not change our opinion that Perrins House was providing an excellent service. Perrins House returned their Annual Quality Assurance Assessment (AQAA) document when requested earlier in the year. The AQAA is a self-assessment and a dataset that each registered provider has to complete each year and send to us within agreed timescales. The document tells us about how providers of services are meeting outcomes for people who use the service and is an opportunity for them to share with us what aspects of the service they believe they are doing well. Care Homes for Older People Page 6 of 29 Information was gathered from speaking to and observing people who lived at the home. Three people were case tracked. This involved discovering their experiences of living at the home by meeting and observing them, looking at medication and care files. Case tracking helps us understand the experiences of people who use the service. We received surveys from people using the service, staff and professionals involved with the home. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: From discussion and comments received from residents, staff and professionals it is recommended that the home review the new organisation arrangements as staff feel the changes are not working in the best interests of the residents. Care plans need to be reviewed to reflect the health and social care needs for residents, and provide clear guidance for the staff to follow, especially around wound management, diabetic care and clear protocols for administering as required medication. Review activities for people living in the home over the seven days, so people are offered suitable interests every day. Clearer job specifications for the manager and the deputy manager so each know what they are doing. Care Homes for Older People Page 8 of 29 Review all windows and doors above the ground floor level with no restrainer or alarm. To ensure that they are risk assessed to assist in protecting the health and welfare of residents and visitors to the home. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 29 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is sufficient information available for people to decide whether Perrins House is right for them. There are opportunities for people to visit the home before making up their minds. The home carries out assessments of peoples needs before they move in, so that staff can provide the care that is needed. Evidence: The last key inspection in March 2007 rated these standards as good. The home provides written information in the form of a Service User Guide to help people decide whether they wish to live at Perrins House Nursing Home. One resident told us that they had received the information and came on a trial visit prior to moving into the home. We saw copies of the Service Users Guide and Statement of Purpose in the reception area of the home. The home has the ability to have the documents translated and made available in other formats including large print, and audio. Care Homes for Older People Page 11 of 29 Evidence: We looked at the pre admission assessments for three people who had recently moved into the home. The assessments are completed by the manager and deputy manager to decide whether they would be able to meet the persons needs if they chose to move into the home. In addition the home obtain a medical report from the individuals own doctor to provide more information about the persons health care needs. People using the service and relatives confirmed that the manager had visited and assessed their relative prior to them being admitted to the home. The manager told us that they also accept people for short term care where the individuals carer may need a break. The home completes a pre needs assessment prior to people entering the home. We received 20 completed surveys from people using the service who confirmed that they had received enough information about the service. Comments received included: the home is outstanding and I doubt whether one could find a better place to grow old gracefully. The AQAA received from the home gave clear information about how they are meeting these standards and stated that all people admitted to the home are provided with a contract which details their accommodation, fees and any extra fees that may be incurred. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Some improvements have been made to care plans. However there is insufficient written information about the individuals health care needs and how they are monitoring them. People are treated with dignity and respect but the service is not personalised to peoples individual preferences and health care needs. Evidence: The last key inspection, March 2007, rated these standards as good. It told us that even though there was weaknesses with the individuals care records, this was not affecting the care being provided. This inspection found that each person had a written plan of care in place. We looked at three peoples care plans in detail. The care plans had been developed from the pre admission assessment. The plans provided basic information about the individual, and why they had been admitted to the home. Information regarding religious needs, social activities and dietary preferences were clearly documented. For example, enjoys coffee with one sugar. The care records were lacking information about the Care Homes for Older People Page 13 of 29 Evidence: individuals health care needs. An example of this on one persons care plan shows skin damage recorded on a body map. However, there was no explanation for how the damage occurred and no plan of how they were caring for the damage. Another care plan for a diabetic person provided insufficient information on how they were managing their condition. The care plan stated monitor blood sugar / urinalysis frequently. The nurse confirmed that they were just monitoring the persons blood sugar daily. For people with acute illnesses, a care plan had not always been developed. For example, a person with a chest infection. All staff spoken to demonstrated a clear understanding of individuals needs. The nurses told us that they just do not have the time to keep the care plans up to date. Comments from people using the service and professionals were excellent in respect of the care provision and included: provide excellent patient centred care and a holistic approach. Staff are always well informed and liaise well with the patients families, and on the whole, the home is very good at everything and has very high standards. Some risk assessments were in place for identified potential risks, but there was an inconsistent approach to reviewing these. Some assessments were being reviewed and updated monthly, whilst others stated review monthly and were dated 31/08/09. Not all individuals had a nutritional risk assessment in place, whilst those in place, the guidance was not being followed and developed into a care plan. The home has regular physiotherapy input for the residents, and records of their visits are kept with the care records. The physiotherapist gave a positive response about the standards of care in the home. We looked at the medication for three people. The system was well managed and staff had signed or included the appropriate code where medication had not been given. This was usually for pain tablets not being required. Some people are risk assessed to administer their own medication and the medication is stored in a small locked cabinet in the individuals bedroom. The nurses told us that they find the medication rounds take a long time, and sometimes when they have an emergency, the medication rounds can run into another. It is recommended that this is reviewed to ensure that people have their correct dose of medication at the prescribed times. The doctor visits the home weekly and is available to see people who are registered with them. At other times the doctor is called in as required. Staff spoken to told us they enjoyed working at the home, but feel that with changes to the staffing levels they are no longer able to provide that extra something for the residents which they missed. Examples included spending time talking with the Care Homes for Older People Page 14 of 29 Evidence: residents, some of whom have no family. Not being able to do extra baths for people if they feel like one. With only one nurse on shift they are finding difficulties administering the medication, dressings for people, supervision of carers and keeping the care plans up to date. The doctor responded in the survey Provide excellent patient centred care and a holistic approach. Staff are always well informed and liaise well with the patients families and for an improved service reduction in secretarial staff has caused noticeable increase in the workload and stress of the clinical staff The nursing cover appears to have been reduced leaving patients potentially vulnerable when there is a medical problem eg. With only one nurse when a person is sick requiring hospital admission the others have to wait for their care and medication People using the service also commented about the staffing levels being reduced and as a result were in some cases having to wait 20 minutes for care. All this information was shared with the manager at the inspection, and recommended that a review of peoples dependency levels and organisation of the home. The AQAA received from the home told us how they felt they were meeting these standards and plans for the next 12 months which included providing dementia training for all staff. Care Homes for Older People Page 15 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service have the opportunities to be involved and stimulated by a wide range of interesting activities and access the gardens. The dietary needs of the residents are well catered for with a balanced diet and a varied selection of foods. Evidence: The last key inspection rated these standards as good and made no requirements or recommendations. We spoke to the activities organiser who told us they work 24 hours over four days. She is very enthusiastic about her role and clearly committed to the residents who live at Perrins House. Planned acivities include regular church services and people can receive Holy Communion if they choose to. This means that people can continue to follow in their chosen religion. The hairdresser visits the home twice a week and the people told us that they were pleased with the service. Other activities provided include sewing, puzzles, occasional outings and exercise classes. Comments from people using the service about activities included more creative activities tailored to individuals capabilities, crafts. There are activities I would like to do such as outings which are difficult because of sensory problems, staff are not always able to take me. During the inspection people were observed sitting in quiet areas reading, a Church service was well attended, some residents had gone out for Care Homes for Older People Page 16 of 29 Evidence: the day with families, and one resident was observed arranging the flowers around the home. Records are maintained of peoples participation in social events. A contracted company provide the catering provision for Perrins House and the sister home Davenham. The catering manager told us that, generally, they prepare 100 meals a day and can provide meals for staff and visitors on request. They pride themselves on providing fresh ingredients and all home cooked food. The last environmental health officer gave the Kitchen a five star rating which is excellent. The home provides a varied four week rolling menu offering hot choices for lunch and tea. In addition the home provides a choice of fish or chicken every day for peoples preferences. The home is able to cater for diets for medical or cultural reasons. We observed the lunchtime meal in the dining room being served. The food looked appetising and serving dishes were on the tables for people to serve themselves. The dining room was attractively presented with fresh fruit and flowers on display. The catering manager told us they have a comments book for people to give opinions about the food quality and in addition, food is always discussed at the residents meetings. Comments from people about the quality of food included generally the food is excellent the food always looks nice and improve the menu choice. There is an open visiting policy, which means that people can see their visitors as they choose and maintain relationships that are important to them. We saw visitors coming and going throughout the day. There is provision for them to make drinks whilst visiting the home. Care Homes for Older People Page 17 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to express their concerns, and have access to a robust. Effective complaints procedure, and they are protected from abuse, and have their rights protected. Evidence: The last key inspection March 2007 rated these standards as good. People using the service and relatives told us they were aware of the complaints procedure, including how to complain to the Care Quality Commission by way of information provided by the home. Information is available in the Service Users Guide and notices displayed in the homes reception area. The home has received no complaints since 2008. Records demonstrated complaints are investigated by the manager, discussed with the owner and responded to within given timescales. The home reported a nurse working for them from an agency for making a medication error. At the time of the inspection the manager was not aware of the outcome of the investigation. Review of the current accident book showed no occurrences, or trends, in the nature and type of reported accidents, which caused us concern. The homes thorough approach to the prevention and management of incidents, such as falls, was evident through crosschecking with the individual documentation. The home operates an open door policy to allow residents and visitors to voice their concerns at any time. Residents and relatives confirmed to us they would have no hesitation in raising Care Homes for Older People Page 18 of 29 Evidence: concerns they might have. Policies and Procedures on whistle blowing and advocacy information is available on display for everyone, and all staff receive abuse training during their induction. We had discussions with eight staff, all of whom were able to describe the action they should take if they were in receipt of a complaint, or observed abuse of a resident. Training records confirmed they had all received relevant adult protection training. In the last 12 months the home have referred one incident to the safeguarding team in respect of a person being discharged from hospital. Comments from people using the service included:Meeting their individual needs always and if a service user or member of staff has any issues or problems, you are listened to and any problems are sorted to the best that they can be. Care Homes for Older People Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical design and layout of the home enables residents to live in a safe, well maintained and comfortable environment. Evidence: Perrins House is a large purpose built home that shares the spacious grounds of its sister home Davenham. It is located at the foot of the Malvern Hills with wonderful views. Perrins House is registered for nursing and residential care. The grounds have paved areas for people to use and seated areas when the weather permits. Perrins House provides accommodation for 43 people in a variety of bedrooms, depending on the individuals degree of Independence and health care needs. All bedrooms and suites were personalised to reflect the individuals personal preferences and provide a more homely appearance. Communal areas are pleasant with attractive fittings and furnishings. There are several small kitchenettes around the home for residents and visitors to make drinks. A room is equipped for people that may wish to do their own ironing. All areas of the home are in good decorative order. There is a passenger lift to assist people with mobility problems to access all areas of the home. The builders are currently creating a laundry and relocating the staff room. This is being completed with minimal disruption to the people living in the home. When this is completed the home is looking to upgrade some of the carpets which are looking worn Care Homes for Older People Page 20 of 29 Evidence: in some areas. All areas of the home were clean and tidy, and no odours were evident in any part of the home. The home employ gardening and maintenance staff who keep the home and the grounds in good condition. It was discussed with the manager of the need to review and risk assess all windows on the first floor and the door leading from the sun lounge on to the balcony, which could provide easy access for people either entering or leaving the home. Care Homes for Older People Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. By failing to provide sufficient staff over the 24 hour period may result in peoples health and social care needs not being fully met. Recruitment and employment practices are consistent with safeguarding them from abuse. Evidence: The last key inspection in March 2007 rated these standards as good. Prior to the inspection we received several comments in the completed surveys from residents, staff and other professionals indicating that there were insufficient staff on duty over the 24 hour period to safely meet the health and social care needs of the residents. Comments included: the nursing cover appears to have been reduced leaving patients potentially vulnerable when there is a medical problem eg. With only one nurse when a person is sick requiring hospital admission the others have to wait for their care and medication, staff are all rushed off their feet and feel that not all the residents needs are met due to lack of staff and Be allowed more staff or better organisation, even when fully staffed we can wait for twenty minutes plus for attention. We looked at the staff rotas from December 2009 to the end of January 2010. These showed that generally the home planned for the manager and deputy manager to cover Monday to Friday office hours and were working non clinical duties. On the day shift, one nurse and six to seven carers were allocated. Late shift, one nurse and five to six carers and on nights, one nurse with three to four carers. It is Care Homes for Older People Page 22 of 29 Evidence: recommended that the home review the staffing levels using a needs dependency for the residents and take into consideration the size and lay out of the home. We looked at the staff files for three members of staff who had been recruited. These showed that the home had followed their recruitment policy. All the checks and references had been completed as required by the Care Homes Regulations being completed, and evidence retained on file. Staff told us that they had been recruited properly and provided with good induction training. The AQAA received from the home told us that all new staff complete a 12 week induction program in line with common induction standards. The home is committed to staff training and have just introduced a new E Learning training system for which staff were giving mixed responses as to the advantages of this. All staff confirmed that they felt they had appropriate skills to meet the needs of the people living at Perrins House. The AQAA told us the homes plans for improvements over the next 12 months include to recruit registered nurses and healthcare assistants for bank staff to avoid using agency staff. Care Homes for Older People Page 23 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and organisation of the home needs some improvement to ensure it is run in the best interests of the people who use the service. Evidence: The last key inspection in March 2007 rated these standards as excellent. Since the last inspection a new manager Maria Walker has been appointed. Maria has been in post since July 2009, and was complimentary about the standards of care at the home, and how supportive all the staff had been to her. Generally, staff felt that the manager had settled in well and was approachable for advice. Some staff were adjusting to different management styles, which they said would take time. The staff told us that there had been recent organisational changes and this has resulted in less staff. We were told how this has affected the morale of some staff, many of whom have worked at the home for several years and pride themselves on their good local reputation. Many of the changes are included in healthcare and Care Homes for Older People Page 24 of 29 Evidence: staffing sections, but in the summary include: problems with only one nurse on duty, not having time to keep the care files up to date, long medication rounds, less time with the residents, unable to supervise staff clinically and no system in place for emergencies. With the reduction in administration hours staff are having to answer telephone calls and the manager and deputy do more administration work. It is recommended that the organisation review their systems to ensure that they are making the most out of their resources. One possibility to differentiate the nursing and residential people to allow the nurses more time to concentrate on the nursing residents. Records of servicing, tests and maintenance in respect of health and safety for utilities, appliances and equipment such as electricity, fire, emergency lighting and hoists are well maintained and this should ensure they are safe to use. Staff receive fire training and complete fire drills to ensure they have the knowledge to act appropriately to safeguard people in the event of a fire. This information was available and up to date. Accident and incidents were recorded and body maps completed in the individuals care record to show any injury. However this had not been developed in to a care plan to monitor the injury and advise if a risk assessment had been completed or updated to prevent a recurrence. All staff attend regular meetings, and have regular supervision records of these were available. The home has a quality assurance program in place, which includes a number of audits. Copies of the audits and last questionnaire results had been collated and were available in the home. The monthly audits included medication, wound care, infection control and accidents. This gives the home an insight into how the home is performing and assists in monitoring that the staff are following correct procedures. The AQAA received from Perrins House provided brief information about their progress and plans for improvement over the next 12 months. Care Homes for Older People Page 25 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 reg 15(1) (2) Care plans must be in place and sufficiently detailed and care needs reviewed as peoples needs change. To ensure people can be confident their needs will be met. 03/05/2010 2 25 13 Reg 13 (4) (a) 04/03/2010 Provide risk assessments for any window or door not alarmed above ground level. To protect the people living in the home. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 9 The service develop a protacol for administering medication prescribed as required and the triggers for giving the medication so there is a consistent approach. Recommend that the provision of activities are available Page 27 of 29 2 12 Care Homes for Older People Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations over the seven days and assessed on individuals choice and their capabilities. 3 27 Review the staffing levels and skill mix for the dependency needs for the people living at Perrins House. Taking into consideration the size and layout of the home to ensure peoples health and social care needs are met. Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!

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