Penhurst Gardens Care Home

Updated 14 December 2017

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 and to look at the overall quality of the service.

This inspection took place on 10th October 2017 and was unannounced. The inspection team consisted of two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. Additionally two newly recruited inspectors attended to observe the inspection for their learning and development.

Before the inspection, we reviewed the information we held about the service. This included the notifications we had received from the provider. Notifications are changes, events or incidents the provider is legally required to tell us about. We did not ask the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

Throughout our inspection we spent time observing care at the service. We spoke to seven people and eight relatives. We also spoke with the registered manager, the nurse deputy manager, two senior care assistants, one care assistant, the maintenance man, the home trainer, the lifestyle co-ordinator, one member of housekeeping team and the chef.

We looked at records, which included five people's care records and sixteen people's medication administration records (MAR). We checked recruitment, training and supervision records for four staff. We also looked at a range of records about how the service was managed. Following the inspection we contacted a number of external health and social care professionals and commissioners to obtain their views about the service.

Updated 14 December 2017

We inspected this service on 10th October 2017. Penhurst Gardens Care Home is a new service that opened in December 2016. It is registered to provide personal or nursing care and accommodation for up to 58 people. On the day of our inspection 16 people were living at the service. Two more people were being admitted on the day of our inspection and further admissions were planned for the upcoming weeks. People only occupied the ground floor with a view for the first floor to become operational when more people moved in. This was our first inspection at this service.

There was a 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.

There was a positive culture within the service that reflected the provider's stated aim of providing support 'created with you in mind'. The registered manager and the team had a clear vision about how they wished the service to be provided to people. Staff talked about 'personalised support' and they aimed to improve people's lives and enable them to live the lives the way they wanted. People were supported by skilled, knowledgeable staff that provided people with effective care. Staff effectively supported people in a way that recognised them as individuals and enhanced their well-being.

People had exceptional opportunities to enhance their social inclusion and participate in various activities that met their needs and took account of their preferences. Feedback from people reflected that activities provision enhanced their well-being and sense of purpose.

People's care plans were current and gave clear guidance to staff on how people wished to be supported. Staff knew people's needs well and used this knowledge to provide people with personalised care that put their well-being at the centre of the service delivery.

Staff benefited from training and support that was focused on motivating them and recognizing individual strengths. The provider ensured staff were supported to develop their work practices as well as assisted them with personal growth. Staff spoke positively about the support they received from the management. Staff supervisions and meetings were carried out regularly. Staff told us the management was very approachable and supportive and that there was good communication between the departments.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and report on what we find. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The records surrounding processes of assessing people's capacity were detailed and reflected staff involved people as much as possible. Staff had excellent understanding of MCA and people's rights to make their own decisions were respected.

People were complimentary about the quality of food at the service. The registered manager ensured procedures were in place so people had balanced diet and received their correct meals that met their dietary needs and preferences. The meal service we observed was an example of a very positive, social experience enjoyed by people. This included people who chose to remain in their bedrooms.

People complimented the caring nature of staff. People's dignity, privacy and confidentiality were respected. People's end of life wishes had been recorded and people were supported to have a pain free and dignified death.

People told us they were safe at the service and did not need to wait for the support. There were sufficient numbers of staff deployed to keep people safe. Appropriate checks were carried out before staff started to work to make sure they were suitable to work with people. The provider had safeguarding procedures in place and staff knew how to escalate any concerns.

People's views were sought and acted on as required. People and their relatives knew how to complain and we saw complaints were managed well and in line with the provider's policy.

There were arrangements in place to manage risks to people's safety. Risks surrounding people's pressure areas, nutrition or mobility were in place and gave clear guidance how to manage these risks. People received their medicines safely and as prescribed. Medicines were stored and administered as per manufacturer's guidance. People were supported to have their health needs met. Robust communication ensured important information was shared with staff. Prompt referrals were made when required and advice followed up.

People spoke positively about the way the service was run. People's relatives complimented good communication, staff commented on good team working and effective working relationships between the departments.

The provider had effective quality assurance systems in place to monitor the service and to drive continuous improvements. The provider worked well with other professionals including local health professionals to ensure people were safe and well cared for. The registered manager met their legal statutory requirements to inform the relevant authorities of notifiable incidents.