Archived: Pensby Hall Residential Home

Updated 1 April 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 9 February 2016. The inspection was unannounced and carried out by an adult social care inspection manager and an inspector. Prior to our visit we looked at any information we had received about the home to enable us to plan for our visit.

During our visit, we spoke with five people who lived at the home, a relative, three staff members and the manager.   We looked at the communal areas that people shared in the home and visited a selection of individual bedrooms. We looked at a range of records including six care records, medication records, five staff personnel files and documentation relating to the quality and safety checks undertaken by the manager or provider.

Updated 1 April 2016

This was an unannounced inspection carried out on 9th February 2016. Pensby Hall Residential Home provides personal care and accommodation for up to 30 older people. Nursing care is not provided. On the day of our visit, there were 24 people who lived at the home.

We carried out an unannounced comprehensive inspection of this service on 17 and 18 August 2015. During this visit multiple breaches of legal requirements were found. We found breaches in relation to Regulations 9, 10, 11, 12, 13, 15, 17, 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider was rated as inadequate and placed in special measures. Services that are placed in special measures are inspected again within six months to ensure that significant improvements have been made to meet the legal requirements.

During this visit we followed up the breaches identified at the August 2015 inspection.

Pensby Hall Residential Home is a detached house situated within walking distance of local shops and public transport. Accommodation consists of 30 single bedrooms. A passenger lift enables access to all floors for people with mobility problems. On the ground floor, there is a communal lounge and dining room for people to use and a conservatory. Specialised bathing facilities are also available.

On the day of our visit, there was no registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.’ We found however that a new manager had been appointed. They told us they had submitted an application to The Care Quality Commission to become the registered manager. We saw evidence to confirm this. This application was still in progress at the time of our visit.

During this visit, we found that although some improvements had been made to the service, there were still a number of significant issues that caused us considerable concern. We found continued breaches of Regulations 10, 17, 18 and a new breach of Regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

For example, we looked at five staff recruitment files and saw that staff were not always recruited safely, inducted into their job role appropriately or trained sufficiently. This meant the provider could not be assured that these staff members were safe and suitable to work with vulnerable people. This caused us considerable concern as staff may not have had the skills, knowledge, experience or attitude to work with vulnerable people safely and effectively.

We found staffing levels and deployment still required further review to ensure they were safe and people’s needs were met. During our visit, we observed significant periods of time when people were left sat on their own in communal areas with no independent means of calling for help and no staff in the vicinity to support them. This was a concern raised at our last inspection and we found no evidence that any significant improvements in how the staffing levels were determined and deployed had been made.

People we spoke with were happy with the care they received and told us staff looked after them well. From our observations, we saw that staff supported people in a kind and unhurried way but sometimes failed to ensure that the person’s right to dignity and privacy were respected and their care preferences adhered to. We found that some people were woken and got up early despite their preference to stay in bed, some people were left sat for long period of time without any social interaction and some people’s personal care needs were not supported in a dignified manner. This again was an issue we raised at the last inspection with the provider and we spoke to the manager again about our concerns. They assured us they would investigate these issues.

These examples indicate that further improvements were still required at the time of our visit in respect the management of the service. We did not consider the service therefore to be consistently well led.

We did find that the new manager in post had made some improvements to the way the service was provided. For example, we found improvements in the way some people’s care was planned, risk assessed and managed. Some care plans were now person centred and it was clear that people had been involved in discussing their support needs and preferences. We saw that where advice had been given on how to manage people’s needs and risks, this advice had been followed by staff to ensure people received the care they required. This new system of assessing and planning people’s care however was still in its infancy and not all of the people who lived at the home had had their care and risks reviewed in this way. We spoke to the manager about this and they agreed to complete this work without further delay.

The manager had started to assess people’s capacity to make informed decisions where their ability to do so was in question. It was obvious from this information that people had been an active participant in this assessment process. This was an area of improvement from our last inspection and showed the beginnings of good practice in relation to the implementation of the mental capacity act and deprivation of liberty safeguard legislation at the home. Further work was still needed however to ensure this legislation were fully understood.

The décor of the home had been refreshed and some of the carpets at the home had been replaced following our last visit. The home was clean throughout and there were no malodorous smells which had been an issue raised at our last inspection. The specialised bathing equipment which had been out of use at our last inspection was now accessible and we saw evidence to demonstrate that people were now in receipt of regular baths and showers. The provider has also replaced the home’s gas boiler and had a valid certificate of inspection to show it was safe.

Fire safety arrangements had been reviewed and there were a range of new audits in place to identify and manage any potential risks to people’s health, welfare and safety.

People’s views about the quality of the service had been sought and the results were openly displayed in the entrance area of the home for all to see. A copy of the provider’s complaints procedure was also displayed. Records showed that any complaints received were responded to appropriately by the manager.

People told us they felt safe at the home. Safeguarding incidents were now appropriately documented and reported and we saw that staff had received training in how to recognise and respond to allegations of abuse. Record keeping overall had improved at the home but we found that further improvements were still required.

We spoke to the manager about the progress the service had made since our last inspection and where further improvements were required. The manager acknowledged that further work was still required. The service will remain in special measures as the overall rating for the service is still inadequate.