• Care Home
  • Care home

Penhayes

Overall: Good read more about inspection ratings

Kenton, Exeter, Devon, EX6 8JB (01626) 899159

Provided and run by:
Modus Care Limited

All Inspections

23 January 2019

During a routine inspection

This unannounced inspection took place on 23 January 2019. Penhayes is registered to provide care for up to five people who may have an Autistic Spectrum Disorder (ASD) and/or learning disability and complex needs. Some of the complex needs may include mental health issues. The service supported people who at times may challenge the service. The service worked in partnership with commissioners and other health and social care professionals.

People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

There was a registered manager in post. They were also responsible for a four bed service in the same grounds as Penhayes called Penhayes House. 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.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The values that underpin Registering the Right Support and other best practice guidance were seen in practice at this service. There was evidence that the core values of choice, promotion of independence and community inclusion; were at the centre of people's day to day support. Staff were person centred in their approach in supporting people.

At our last inspection in 2016 we rated the service good. At this inspection we found the evidence

continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why the service is rated Good.

People remained safe at the service. Staff understood safeguarding procedures and said they

would not hesitate to report any concerns. Risk's to people safety and well-being were managed without imposing unnecessary restrictions on people. Medicines were managed safely ensuring people received their medicines as prescribed.

Staff were safely recruited and employed in sufficient numbers to meet people's needs. The staff team were well trained and supported. There was an action plan to ensure all staff received regular supervision. All staff said they felt they were supported in their role.

Staff protected people's rights by following the principles of the Mental Capacity Act 2005 (MCA). People were supported to have choice and control of their lives.

People were provided with nutritious food and drink, which met their dietary preferences and requirements. People were supported to eat a healthy diet of their choice.

People's care plans had been developed to identify what support they required and how they would like this to be provided. People had opportunities to take part in activities and had a core group of staff supporting them. These had been kept under review to ensure they were still relevant based on each person’s wishes.

All complaints had been acknowledged, recorded and investigated in accordance with the provider's policy, to the satisfaction of the complainant. People’s views were sought through regular care reviews. People were supported to keep in contact with their family. Relatives were able to visit Penhayes and participate in regular care reviews.

The service was well managed. There were effective quality assurance arrangements in place to monitor care and plan ongoing improvements. People's views about the running of the service were sought regularly and changes and improvements took account of people's suggestions.

9 August 2016

During a routine inspection

This unannounced inspection took place on 9 August 2016. We returned on 10 and 24 August 2016 to complete the inspection. This was Penhayes first inspection since registering as an adult social care service. Previously the service was registered as an independent mental health hospital for adults, some of whom required treatment or assessment under the Mental Health Act 1983. Under that registration an inspection was carried out in October 2015 and found incident records on the use of restraint and or seclusion practices were not clear. For example, the majority of incidents, recorded as seclusion and restraint, were not actually seclusion or restraint. This confused the overall figures when analysed because there appeared to be more incidents than there had been; there were issues with the maintenance of the premises; and most staff had not received supervision and appraisal. This inspection found that positive changes had been made to the service since its inspection as a hospital.

Penhayes is registered to provide care for up to five people who may have an Autistic Spectrum Disorder (ASD) and/or learning disability and complex needs. Some of the complex needs may include mental health issues.

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.

People were safe and staff demonstrated a good understanding of what constituted abuse and how to report if concerns were raised. Measures to manage risk were as least restrictive as possible to protect people’s freedom. People’s rights were protected because the service followed the appropriate legal processes. Medicines were safely managed on people’s behalf.

Care files were personalised to reflect people’s personal preferences. People were supported to maintain a balanced diet, which they enjoyed. Health and social care professionals were regularly involved in people’s care to ensure they received the care and treatment which was right for them.

Staff relationships with people were caring and supportive. Staff were motivated and inspired to offer care that was kind and compassionate. For example, when a person was feeling anxious.

There were effective staff recruitment and selection processes in place. Staffing arrangements were flexible in order to meet people’s individual needs. Staff received a range of training and regular support to keep their skills up to date in order to support people appropriately.

Staff spoke positively about communication and how the registered manager worked well with them and encouraged their professional development. The registered manager recognised the importance of investing in staff through additional training opportunities in order for them to feel empowered.

A number of effective methods were used to assess the quality and safety of the service people received and make continuous improvements.

13, 14 June 2013

During a routine inspection

Penhayes was last visited by the Care Quality Commission in November 2012. At that visit, we (the Care Quality Commission) found that Penhayes was not meeting one or more essential standard and that improvements were needed. During this inspection we looked to see if these improvements had been made. We saw that the format of care plans had been changed, but not all care plans were fully completed.

Four of the five people who lived at the service were detained under the Mental Health Act 1984. This meant that they may have more restrictions placed on their choices and ability to consent to care and treatment.

We saw that staff acted in accordance with people's wishes and provided care that was delivered with their consent. For example, we saw some evidence that people had been involved in completing their care plans.

One person who lived at the service told us they were "very happy" living there. One professional told us that they "were really pleased with the way things were going" for the person they represented.

We observed some very good interaction between staff and people who lived at the service.

We saw the medication systems in use meant people had their medicines at the time they needed them and in a safe way.

We looked at three staff files which showed us there were effective recruitment procedures in place.

We saw the provider had moved to a computer based system that collated a series of audits that highlighted any concerns.

16 November and 3 December 2012

During a routine inspection

Penhayes was last visited by the Care Quality Commission in December 2011. At that visit, we (the Care Quality Commission) found that Penhayes was not meeting one or more essential standard and that improvements were needed. During this inspection we looked to see if these improvements had been made. We saw that although there had been some progress the format of the care plans had not changed. The provider and manager told us that when they had started to change the format they realised that it was going to be a greater task than they had anticipated.

Since our last visit the hospital had been subject to safeguarding procedures which related to the care of one person who no longer lived at the hospital. The process had been closed and the hospital was working through an action plan with health and social care professionals.

We saw evidence in some people's care plans that they had been involved when their care plans had been reviewed. When we looked in people's care records, we saw that incidents were well recorded and incident forms had been completed.

Staff that we spoke with were able to describe people's needs and how they liked their needs to be met. During our visit we heard staff speaking with people in a respectful and caring way. People looked at ease with the staff members and initiated conversation with them. There was no sign from people's body language of any fear or anxiety in their interactions with staff.

20, 21 October 2011

During a themed inspection looking at Learning Disability Services

Members of the team made the following observations about Penhayes whilst on site:

'The gardens were beautiful and there was a nice communal courtyard with a table tennis table and place for people to leave their bicycles'

'People seemed to be relaxed with the staff that were supporting them'

'There was a relaxed and calm atmosphere'

'Some of the communal areas were sparsely decorated and lacked a homely feel'

Other comments made to us included:

One person told us that they had met staff before they had moved in and had been able to talk to them about the support they would need.

People talked to us about their care plans. One person said they didn't have a copy of their plan, and didn't know why not. They said they did think they could see it at any time and have a copy if they asked.

One person said they enjoyed visits from their family and had gone out for a trip with them the previous week. The same person said they have a key so that they can use facilities around the home and gardens.

People talked to us about some of the goals they were working towards or had achieved. One person said that the staff had helped them to cope with difficult situations and develop their independence.

We were told by one person that the service uses a reward system to help them think about and improve their behaviour. We were also told that some restrictions have been put in place regarding some people's diet and the use of mobile phones. The people we spoke to about these arrangements said that although they did not always agree with the restrictions the reasons had been fully explained to them by the staff and that they understood why they were in place.

One person said that they usually speak to an independent advocate on a weekly basis and can raise any concerns about their care.

Family members spoke to us about their experiences when their relative first moved into the home. They said that the staff gathered lots of information and visited the family in their own home prior to the move.

One relative said that they are kept well informed, and that staff contact them every week to share information. Another relative we spoke to said that the staff listen to their views and treat them with respect.

We spoke to an independent advocate who said that the service has always encouraged and supported patients to use independent advocacy services.

Mental Health Act Commissioner reports

Each year, we visit all NHS trusts and independent providers who care for people whose rights are restricted under the Mental Health Act to monitor the care they provide and check that patients' rights are met. Immediate concerns raised by patients on those visits are discussed, if appropriate, with hospital staff.

Our Mental Health Act Commissioners may carry out a number of visits to each provider over a 12-month period, during which they talk to detained patients, staff and managers about how services are provided. In the past, we summarised themes from the visits and published an annual statement followed by the provider's response where applicable. We are looking at different ways to indicate the outcomes of our monitoring in the future.