We carried out a review of the data available to us about Penrice House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Penrice House, you can give feedback on this service.
Penrice House is a residential care home providing personal care to up to 29 people. The service provides support to people requiring care and support. Some people were living with dementia. At the time of our inspection there were 24 people using the service
People’s experience of using this service and what we found
The provider had systems in place to protect people from the risk of abuse and people told us they felt safe.
Risk assessments were completed to help identify and minimise risks people faced. Staff had been recruited safely and during the inspection we observed there were enough staff to respond to people's needs. Systems to manage medicines were judged as being safe.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Incidents and accidents were managed safely. The registered manager took necessary action to keep people safe and minimise the risk of reoccurrence. Steps were taken to learn lessons if things went wrong.
The environment was spacious and there was equipment available to support staff in providing safe care and support. Health and safety checks of the environment and equipment were in place. There were certificates in place to support this. Systems were in place to support people in the event of an emergency.
We looked at infection prevention and control and found we were assured that the provider was protecting people, staff and visitors from the risk of infection.
The systems in place to monitor the quality of care within the service were effective. The registered manager promoted a positive person-centred culture and fully understood their responsibilities as a registered manager.
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 good published (6 July 2018).
Why we inspected
This inspection was prompted by a review of the information we held about this service.
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.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Penrice House our website at www.cqc.org.uk.
Notice of inspection
This inspection was announced.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Penrice House is near to St Austell which people visit regularly. Penrice House provides accommodation over two floors. Some bedrooms are on the ground floor where communal areas are also present. The remaining bedrooms are on the first floor which is accessed by lifts. Staff continuously monitor people if they remain in their rooms to ensure people's needs are met at all times. People are able to access the garden area.
There was a registered manager in post who was responsible for the day-to-day running of the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. At the last inspection, in July 2018, the service was rated Good. At this inspection we found the service remained Good.
As part of CQC’s response to the coronavirus pandemic we are looking at the preparedness of care homes in relation to infection prevention and control. This was a targeted inspection looking at the infection control and prevention measures the provider has in place.
This inspection took place on 15 February 2021 and was unannounced.
We found the following examples of good practice.
The registered persons had responded appropriately when the service had cases of Covid 19.
Policies and risk assessment processes were well established, and appropriately reviewed.
Testing routines were robust. For example all visitors were tested, and staff and people who used the service received regular testing, and had received the first dosage of vaccine against the virus.
Suitable visiting arrangements, for people’s friends and relatives were in place.
The service was very clean, additional cleaning routines were in place, and audit systems were in place
Penrice House is near to St Austell which people visit regularly. Penrice House provides accommodation over two floors. Some bedrooms are on the ground floor where communal areas are also present. The remaining bedrooms are on the first floor which is accessed by lifts. Staff continuously monitor people if they remain in their rooms to ensure people’s needs are met at all times. People are able to access the garden area.
There was a registered manager in post who was responsible for the day-to-day running of the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. We carried out this unannounced inspection on 2 June 2018. At the last inspection, in November 2015, the service was rated Good. At this inspection we found the service remained Good.
On the day of the inspection there was a calm, relaxed and friendly atmosphere in the service. We observed that staff interacted with people in a caring and compassionate manner. We spoke with eight people at the service to gain their views of the service. They all told us they were happy with the care they received and believed it was a safe environment. Comments from people included, “It’s the lovely friendly atmosphere that makes me feel safe" and “It doesn't matter what you ask them (staff ) to do, they just do it."
Staff ensured people kept in touch with family and friends. Relatives were positive about the care their family member received. Comments included, "They always make sure my relative has her lipstick on, her earrings and necklace on as they know this is important for her to look nice" and "My relative has only been here a few weeks but the staff have made sure she has settled in well." Relatives told us they were always made welcome and were able to visit at any time.
People were protected from abuse and harm because staff understood their safeguarding responsibilities and were able to assess and mitigate any individual risk to a person’s safety. People said they felt safe at Penrice House, and relatives echoed this view.
The service was warm, comfortable and appeared clean with no unpleasant odours. The service was well maintained. People were pleased with their private bedrooms and had decorated them to reflect their preferences and tastes. People were treated with kindness, compassion and respect.
The service had suitable arrangements for the storage and disposal of medicines. Medicines were administered by staff who had been trained and assessed as competent to manage medicines.
People received care and support that was responsive to their needs because staff were aware of the needs of people who lived at Penrice House. Staff were prompt at recognising if a person’s health needs had changed and sought appropriate medical advice promptly. One person told us “You can talk with anybody if you have a problem and they sort it out." Relatives told us the service always kept them informed of any changes to people’s health and when healthcare appointments had been made.
Care plans were well organised and contained personalised information about the individual person’s needs and wishes. Care planning was reviewed regularly and whenever people’s needs changed. People’s care plans gave direction and guidance for staff to follow to help ensure people received their care and support in the way they wanted. Risks in relation to people’s care and support were assessed and planned for to minimise the risk of harm.
People told us they were able to take part in a range of group and individual activities at Penrice House and in the local community. Care records showed that people took part in a range of activities. We saw people undertaking individual activities such as reading books, socialising, listening to music and watching TV. Penrice house is situated in large grounds; the service had an electric buggy and regularly took people for a drive around the grounds. People told us how much they enjoyed this.
People told us, “The food is great, with a good choice." Staff supported people to maintain a balanced diet in line with their dietary needs and preferences. Where people needed assistance with eating and drinking staff provided support appropriate to meet each individual person’s assessed needs.
Staff were recruited in a safe way. There were sufficient numbers of suitably qualified staff on duty and staffing levels were adjusted to meet people’s changing needs and wishes.
Staff were supported by a system of induction training, one-to-one supervision and appraisals. The induction and on-going training of staff ensured they were effective in their role. Staff knew how to ensure each person was supported as an individual in a way that did not discriminate against them. People’s legal rights were understood and upheld.
Management and staff had a good understanding of the Mental Capacity Act 2005 (MCA) and the associated Deprivation of Liberty Safeguards (DoLS). They demonstrated their understanding of these principles in the way they cared for people. Staff believed that everyone at the service had the right to make their own decisions and respected them. The manager told us some people they supported had capacity to make decisions about their health and welfare and this was constantly reviewed. The manager knew the process to follow if a person’s level of capacity changed so that the service would act in accordance with legal requirements.
There was a management structure in the service which provided clear lines of responsibility and accountability. Staff had a positive attitude and the management team provided strong leadership and led by example.
People and relatives all described the management of the service as open and approachable. People and their relatives told us if they had any concerns, or comments about the service that they could approach the provider, manager or staff “without hesitation.”
People were asked for their views on the service regularly. There were effective quality assurance systems in place to make sure that any areas for improvement were identified and addressed.
We carried out this unannounced inspection of Penrice House (St Austell) Limited on 23 November 2015. Penrice House (St Austell) Limited is a residential care home, which provides care and dementia support for older people. The care home can accommodate up to a maximum of 29 people. On the day of the inspection there were 27 people using the service. The service was last inspected in March 2014 and was compliant with regulations at that time.
The service is required to have a registered manager and at the time of our inspection a registered manager was 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.
People and their relatives told us they were happy with the care and support provided by staff at Penrice House and believed it was a safe environment. One relative said, “My relative feels safe because the staff have great patience and provide a home in every sense of the word”. A person who lived at the service told us how happy they were living at Penrice House and said, “The staff are like my friends”.
Staff had developed positive relationships with people and understood their needs well. People were encouraged to be individuals and do what they wanted to do to provide them with a fulfilling life. For example, people went out to local community activities and people left the home for trips supported by staff in the service’s mini-bus. There were a range of personalised and appropriate risk assessments in place to help keep people safe.
The safety of the premises was looked after by the registered manager, who employed a maintenance person to ensure regular maintenance of electrical and gas appliances.
Staff demonstrated they understood how to keep people safe including what they should do if a safeguarding issue was raised. Accidents and incidents were recorded appropriately and investigated where necessary.
Support was provided by a consistent staff team who knew people well and understood their needs. staffing levels had recently been adjusted to meet people’s changing needs and wishes.
Medicines management administration procedures were safe. However, we found a number of recording errors in the medicines records which had not been recognised or corrected during medicine auditing procedures.
We found the service was effective. People who lived at Penrice House told us they were confident in the staff, who provided good quality care. Staff demonstrated they were skilled and knowledgeable about their roles. We heard there were opportunities for further training and for obtaining additional qualifications. Staff told us they felt supported by management and received regular individualsupervision and appraisal to review staff work performance over the year.
The service’s premises were properly maintained and were clean, bright and inviting. People could bring their own furniture into the service. All communal areas were clean and well looked after. Outside there were large gardens and these were also kept to a high standard.
People were supported to maintain good health and to access healthcare services. Staff supported people to eat and drink enough and maintain a balanced diet.
Care records had been rewritten and were up to date. Records were regularly reviewed, and accurately reflected people’s care and support needs. Details of how people wished to be supported were personalised to the individual and provided clear information to enable staff to provide appropriate and effective support. Any risks in relation to people’s care and support were identified and appropriately managed.
Care records showed that people had given their consent to their current support arrangements. We observed throughout the inspection that staff asked for people’s consent before assisting them with any care or support. People were involved in making choices about how they wanted to live their life and spend their time. Where people did not have the capacity to make certain decisions the service acted in line with legal requirements under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards.
People and their families were given information about how to complain. There was a management structure in the service which provided clear lines of responsibility and accountability. There was a positive culture in the service, the management team provided strong leadership and led by example.
There were quality assurance systems in place to make sure that areas for improvement were identified and addressed. However, audits about people’s medicines did not show the recording issues we found.
Management were visible in the service and regularly checked if people were happy and safe living at Penrice House.
We previously inspected this service in May 2013. The Commission issued a compliance action as the service had been found to be non-complaint with the Essential Standards of Quality and Safety relating to records. We found peoples care records did not accurately reflect the care and support people received.
In December 2013, the Commission identified further breaches of the Essential Standards of Quality and Safety relating to records, Regulation 21 of the Health and Social Care Act 2008 and issued a warning notice regarding the breach. A warning notice is a written notice that the Commission can give to a registered person, i.e. either a service provider or a service manager, where it appears to the Commission that that person has failed to comply with any relevant requirements. The Commission also issued a further three compliance actions relating to the care and welfare of people who use services, safeguarding people who use services from abuse and assessing and monitoring the quality of service provision.
As part of our inspection we spoke with the registered manager, care staff, housekeeping staff, visiting relatives, and a visiting health professional.
We spoke with people who lived at Penrice House. People we spoke with were complementary of the staff and support they received. Comments included, 'I can't fault it in any way', 'they're so kind and helpful', 'it's a lovely place' and 'it's a great place'.
At our last inspection some people who lived at Penrice House were concerned about staff leaving and told us they sometimes had to wait for support as staff were busy with other people. We were concerned as some people had appeared upset and became tearful when we spoke with them. At our most recent inspection we were told, 'They're trying', and 'matron came to see me'. One person told us there was now an additional member of staff in the morning; they told us 'they've an extra one on because they are so busy'.
We found care and treatment was planned and delivered in a way that ensured people's safety and welfare.
People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.
The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who use the service and others.
People were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.
We spoke with a random selection of staff as part of the inspection process, some staff told us they enjoyed working at Penrice House, however, the majority of people told us they felt unsupported and fearful to raise concerns because of the possible repercussion to their job.
We found care and treatment was not planned and delivered in a way to ensure people's safety and welfare.
People who used the service were not protected from the risk of abuse, because the provider had not taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.
The provider did not have an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who use the service and others.
People were not protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were not maintained.
Overall people we spoke with who lived at Penrice were complementary about the care and support provided. People told us, 'the carers are very good, they work very hard', 'I am happy here, look at the view', 'very nice' and 'if you want anything you just have to ask'.
Relative comments included, 'it's absolutely wonderful', 'I would book myself in' and 'you won't beat this one'.
Our inspection found, before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.
People's care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.
People were cared for in a clean, hygienic environment and appropriate checks were undertaken before staff began work.
However, we found people were not protected from the risks of unsafe or inappropriate care and treatment, because accurate and appropriate records were not maintained.
We found, people experienced care, treatment and support that met their needs and protected their rights.
People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.
We found, people were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines and we observed that there were enough qualified, skilled and experienced staff to meet people's needs.
We found the provider had an effective system to regularly assess and monitor the quality of service that people received and there was an effective complaints system available. Comments and complaints made by people were responded to appropriately.
However, people were not protected from the risks of unsafe or inappropriate care and treatment, because accurate and appropriate records were not maintained.