Background to this inspection
Updated
28 March 2020
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 Care Act 2014.
Inspection team
The inspection team consisted of three inspectors and an assistant inspector on the first day of inspection and three inspectors, an assistant inspector, a medicines inspector and medicines support services on the second day of inspection. An Expert by Experience attended for both days of the inspection.
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
The Peele 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.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided
Notice of inspection
This inspection was unannounced.
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. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
During the inspection, we spoke with the registered manager, the residential manager, the regional manager, the head of nursing, two nurses, four team leaders, 11 care workers and kitchen staff.
We reviewed 10 care plans and associated risk assessments. We looked at the management of medicines and medication administration records. We viewed quality audits and analysis, five recruitment records of newly employed staff and information relating to the health and safety of the home.
We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
After the inspection
After the inspection we spoke with the local authority performance and quality improvement team who had been supporting the home since the last inspection who validated our findings on this inspection.
Updated
28 March 2020
About the service
The Peele is a care home providing personal and nursing care to 62 older and younger people and people living with dementia, at the time of the inspection. The service can support up to 108 people.
The Peele is a large adapted building consisting of nine separate households. At the time of the inspection, three households were closed. Two of the households supported people with nursing needs.
People’s experience of using this service and what we found
People felt safe while living at The Peele. Medicines were safely managed, and people received their medicines as prescribed. Risks were assessed, monitored and reviewed. Staff were recruited safety and oversight of the recruitment processes had been greatly improved. People felt there was enough staff on duty and people were supported by a consistent staff team. The health and safety of the premises was continually reviewed. The home was clean and housekeeping staff worked hard to prevent the spread of infection.
Staff received appropriate induction, training and supervision to enable them to carry out their job role. Staff told us the training was good and they had received robust training to enable them to effectively complete care plans. Assessments of needs were completed to ensure the service could meet people’s needs. People were supported to eat and drink with dignity. Choices around food and drink were captured in care plans. People were complimentary of the food. People’s personal health was regularly monitored and referrals for health interventions were requested promptly.
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.
Staff were caring and kind. People’s and relatives’ comments echoed this. Staff were aware of people’s needs and preferences and had been involved in developing people’s care plans which enabled staff to get to know people better. We saw kind and dignified interactions throughout our inspection.
Care plans captured people’s needs, choices and preferences. Care plans were regularly reviewed. Life histories had been formulated in conjunction with families and staff which had promoted conversations between the staff team and the people they support. Activities had improved and activities were based on people’s preferences and needs. The home had built links with local schools to enable people to interact with the young. Complaints were listened and responded to. People were supported effectively at the end of their life.
The registered manager had been supported by the wider management team to improve the home since the last inspection. Improvements in care planning, medicines and oversight meant the home was now meeting the regulations of the Health and Social Care Act 2008. The staff team were complimentary about the work that had been undertaken to improve the home and consistently told us the registered manager had been at the helm of the improvements and they were well supported. Quality monitoring audits had improved and were regularly completed which gave a greater oversight of the service.
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 Inadequate (published 5 October 2019). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
This service has been in Special Measures since 5 October 2019. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.
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.