Peacehaven

We identified prior to the inspection that no people living in the service had tested positive for COVID-19 in the last 5 days.

Alternative forms of maintaining social contact were used for friends and relatives; for example: keeping in touch using video calls, portal, or through meeting at a closed window.

Appropriate testing is in place for all staff and service users in order to detect Covid-19 s soon as possible.

Staff were observed to put on/take off Personal Protective Equipment such as aprons, gloves, masks and eye protection (PPE) as per guidelines. Staff spoken with had a clear understanding as to when and how to use PPE appropriately

The service had made the decision that until none of the people living in the service were testing negative for coronavirus no new admissions would be undertaken. The service supported people and their relatives to understand the isolation processes and how the service could help to alleviate them feeling lonely, such as calls with friends and loved ones and dedicated support time from staff members.

Maintaining the mental health of people and staff was a priority with proactive sup-port from the service to encourage peoples well being

Where the provider is responsible for cleaning, there are clear schedules in place, which include the frequency of cleaning of high touch areas. Records show compliance with the cleaning schedule.

Provider understood and was meeting COVID-19 staff vaccination requirement.

Staff understood their roles and responsibilities and were observed to maintain good standards of Infection and Prevention Control (IPC) during the inspection. Staff had maintained good standards of person-centred care despite the restrictions of COVID-19.

Staff wear PPE in line with guidance where appropriate social distancing cannot be maintained or achieved.

Routine testing for all staff and people who receive support has been implemented.

Peacehaven is a residential care home providing personal and nursing care to people aged 65 and over. At the time of the inspection 53 people were living at the home.

Peacehaven accommodates 54 people in one adapted building.

People’s experience of using this service and what we found

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.

Activities were organised around the wishes and aspirations of people living at Peacehaven. All staff worked outstandingly well together to gather the views or people they supported. Activities took place each day. Volunteers worked with staff to enable as many people as possible to join in outings and trips.

The service was highly effective at promoting people's independence. The service used technology to make sure that people lived with as few restrictions as possible. People had been offered ‘lifeline’ pendants to be able to request staff assistance in an emergency, when they were not in close contact with a call bell device.

People had end of life care plans in place, which helped to provide information to staff about how they wanted to be cared for. The home provided facilities to enable relatives to stay overnight with their family member. Family members were highly complementary about the care their relatives received.

Staff knew how to keep people safe from harm. Staff were recruited safely, and sufficient numbers were employed to ensure people's care and social needs were met.

People’s preferred method of communication was recorded. Staff had created mood boards, emotion cards, yes and no cards, and printed sentences for pointing to help people who had difficulty communication verbally.

People were supported to eat a varied and nutritious diet based on their individual preferences. People were involved in making changes to the menu.

The leadership of the service promoted a positive culture that was person-centred and inclusive. We received positive feedback about the quality of care and support people received and the overall management of the service from people and their relatives. The registered manager and the staff team showed a desire to improve on the service provided and in turn the quality of life experiences for the people living at Peacehaven.

Staff were committed to delivering care in a person-centred way based on people's preferences and wishes. There was a stable staff team who were knowledgeable about the people living at the service and had built trusting and meaningful relationships with them.

Staff treated people with kindness and compassion. There was a very caring and friendly atmosphere in the home between staff and people using the service. People described staff as “caring and respectful”.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 3 February 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Located near Southport town centre, Peacehaven Care Home provides accommodation and personal care for up to 55 people. Shared areas include two dining rooms, three lounges and a conservatory on the ground floor. A lift is available for access to the upper floors. There is an enclosed extensive garden to the rear of the building and parking to the front. A call system operates throughout the home. There were 54 people living in the home on the day of our inspection.

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.

Medicines were managed safely in the home.

Risk assessments had been undertaken to support people safely and in accordance with their individual needs.

The staff we spoke with described how they would recognise abuse and the action they would take to ensure actual or potential harm was reported.

Safety checks of the environment and equipment were completed regularly.

There were enough staff on duty to provide care and support to people living in the home.

The provider had robust recruitment procedures in place to ensure staff were suitable to work with vulnerable adults.

Staff worked in partnership with health and social care professionals to make sure people received the care and support they needed.

Staff were trained to ensure that they had the appropriate skills and knowledge to meet people’s needs. They were well supported by the registered manager.

Staff sought the consent of people before providing care and support. The home followed the principles of the Mental Capacity Act (2005) for people who lacked mental capacity to make their own decisions.

People told us they liked the food and were able to choose what they wanted to eat.

People told us the staff had a good understanding of their care needs and people’s individual needs and preferences were respected by staff.

Care plans provided information to inform staff about people's support needs, routines and preferences.

People told us staff were kind, polite and maintained their privacy and dignity. We observed positive interaction between the staff and people they supported.

A programme of activities was available for people living at the home to participate in.

A process for managing complaints was in place. People we spoke with knew how to raise a concern or make a complaint.

Feedback we received from people, relatives and staff was complimentary regarding the registered manager’s leadership and management of the home.

Staff told us there was an open and transparent culture in the home. Relatives said the home had a ‘family atmosphere’ to it.

People living in the home and relatives told us they were able to share their views and were able to provide feedback about the service.

Systems and processes were in place to assess, monitor and improve the safety and quality of the service.

After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach. We undertook a focused inspection on the 12 February 2016 to check that they had followed their plan and to confirm that they now met legal requirements.

This report only covers our findings in relation to these topics. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Peacehaven’ on our website at www.cqc.org.uk’

Located near Southport town centre, Peacehaven provides accommodation and personal care for up to 55 people. Shared areas include two dining rooms, three lounges, and a conservatory on the ground floor. A lift is available for access to the upper floors. There is an enclosed garden to the rear of the building and parking to the front. A call system operates throughout the home.

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.

During our last inspection in August 2015 we found there was lack of individual assessment around the risk of falls. During this inspection we looked at individual falls risk assessments for people who lived at the home, and found the management of the risk relating to this was much improved and people were better protected against these risks

We found that the risks associated with the administration of medications was improved.

Staff recruitment procedures were robust and all relevant recruitment checks had been undertaken before staff started work.

We saw that staff were up to date with mandatory training.

We saw that people received support from other medical professionals when needed, and had their care provided in way which was meaningful to them.

There were audits in place to monitor the concerns identified at our last inspection, and we saw during this inspection the provider had made significant improvements to their auditing systems.

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well led?

This is a summary of what we found-

Is the service safe?

People who lived in the care home were cared for in an environment that was safe,clean and hygienic. Equipment at the home had been well maintained and serviced regularly. This meant people were kept safe and their welfare protected.

All staff members had undergone the appropriate checks before starting work at Peacehaven Care Home. We checked the staff training matrix and noted all staff had completed safeguarding training. We spoke to several staff who told us they would report any issues related to safeguarding to the manager without delay.

Deprivation of Liberty Safeguards (DoLS) become important when a person is judged to lack the capacity to make an informed decision related to their care and treatment. The Care Quality Commission (CQC) monitors the use of DoLS. The provider had submitted an application for a DoLS recently and was awaiting confirmation. When completed we were told, "I will inform CQC immediately."

Is the service effective?

People who lived at the care home told us they were happy with the care and support they received. This meant their needs were being met. We observed staff members in communal areas and it was clear they had a good understanding of individual people`s needs.

One person told us, "We are well looked after here - my family are happy I am here." Another person told us, "It`s beautiful here - the food is marvellous." People`s needs were taken into account with signage and the layout of the care home.

Is the service caring?

We spent time in communal areas during our inspection. We observed staff members who were very patient with people who lived in the care home. Staff took time to listen and understand people`s different communication styles, particularly those with limited verbal communication.

People`s needs and choices had been recorded in care plans and their support was provided in accordance with people`s wishes. People and their families were involved in annual satisfaction surveys and any issues were addressed without delay.

Is the service responsive?

All people living at Peacehaven care home had their individual needs assessed before moving into the care home. One person told us, "I go to the meetings every three months and if we have any problems we discuss them and tell the manager."

People had access to activities that were important to them which included their cultural needs. Church services were held weekly at the care home. People living in the care home were also encouraged and supported to maintain relationships with friends and family if they so wished.

Is the service well-led?

Peacehaven care home had a quality assurance system in place, which included both internal and external audits. There were also regular surveys conducted for people who lived in the home and staff members. This meant the quality of care provided continued to improve.

Staff members told us they were clear about their roles and responsibilities. One staff member told us, "We always manage here - there are never any problems." The provider told us, "We always have residents on the panel when we are interviewing for new staff." This meant the people who lived in the home had an input into who was employed at the care home and who provided their care and support.

People who were living at the home told us staff were respectful of their choices. One person said, 'They [staff] don't tell us when to get up or go to bed. I go can to bed at whatever time I want.' The people we spent time with were aware of their care needs and said staff discussed their care with them, particularly if there were any changes. We heard one person say, 'They [staff] can't do enough for me and they tell me what is happening.'

Care records informed us that assessments and care plans had been developed for each person and these were reviewed consistently each month.

Arrangements were established for ensuring the environment was clean, safe and well maintained. We found that effective staff recruitment processes were in place.