Background to this inspection
Updated
26 August 2023
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The first day of inspection was carried out by 2 inspectors and a specialist advisor. The specialist advisor had expertise medicines. The second day of inspection was carried out by 2 inspectors and an Expert by Experience. A second Expert by Experience contacted relatives and people in the housing with support complex remotely. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Pennington Court is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. This service also provides care and support to eight people living in specialist 'extra care' housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is rented and is the occupant's own home. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people's personal care and support service.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
This inspection was unannounced. The inspection activity started on 23rd May 2023 and ended on 7th June 2023. We visited the location on 23rd May 2023 and 7th June 2023.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
We spoke with 9 people living at the service and three people over the telephone who lived in the extra care section. We spoke with 5 relatives over the telephone about their experience of the care provided. We spoke with 6 members of staff including the registered manager, care workers, domestic staff and the chef. We observed care in the communal areas to help us understand the experience of people who could not talk with us.
We reviewed a range of records. This included 8 people's care records and multiple medication records. We looked at 3 staff files to check how staff had been recruited into the service. We reviewed a variety of records relating to the management of the service, including policies and procedures. Offsite we continued to see
Updated
26 August 2023
About the service
Pennington Court Nursing Home is a residential care home providing personal and nursing care to 48 people at the time of the inspection. The Registered Provider is registered to accommodate a maximum of 62 service users at Pennington Court Nursing Home. Attached to the building are 8 extra care apartments each comprising of a bedroom with attached lounge, bathroom, and kitchen area.
Pennington Court Nursing Home accommodates people over 2 floors. People who live in Ash require residential care. Willow provides support for people who require nursing care. People living in the extra care flats are provided with personal care support. Not everyone who used the housing with support service received personal care, although the contract provides for two hours support each day. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence, and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.
People’s experience of using this service and what we found
Some care intervention records were incomplete, and some evidenced contradictory information. Quality assurance processes had not highlighted or addressed issues to ensure improvements were made.
Some of the risks to people's safety and wellbeing had not been recorded, to ensure actions were put in place to protect people from harm. Recorded risk reduction measures did not always show the necessary control measures were in place.
Medicines were not always managed safely with gaps in stock checks and MAR charts. Medication was not consistently stored safely including the fridge temperatures being incorrect.
Most people and their relatives told us they were safe at the home and most people we spoke with told us they were happy living there. We observed that people were well groomed and dressed appropriately.
People were not supported to have maximum choice and control of their lives. staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 6th September 2021). The service remains rated requires improvement. At this inspection we found the provider remained in breach of regulations.
Why we inspected
This inspection was prompted by a review of the information we held about this service. We carried out an unannounced focused inspection of this service. Breaches of legal requirements were found. You can see what action we have asked the provider to take at the end of this full report
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Enforcement and Recommendations
We have identified breaches in relation to safe care and treatment, need for consent and good governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.