We carried out a review of the data available to us about Peterlee Care Home 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 Peterlee Care Home, you can give feedback on this service.
Peterlee Care Home is a residential care home providing personal and nursing care for up to 44 people. At the time of our inspection there were 42 people using the service.
People’s experience of using this service and what we found
People and their relatives were very positive about the care provided. People told us they felt safe and staff had the skills to support them. Relatives provided positive examples of how staff had helped improve people’s lives since moving to the home.
Staff were safely recruited and received an induction followed by on-going training from the provider. Training was monitored and staff were supported with regular meetings and supervisions. Staffing levels were appropriate and met people’s needs.
People and relatives were involved in every stage of care planning. People had personalised care plans and staff were delivering person-centred care.
The manager had an effective quality assurance system which included regular audits and checks. These were used to identify any areas for improvement.
Staff ensured people living at the home were happy. Staff found ways to promote people’s independence, their passions and personal interests. People, relatives, staff and professionals were offered opportunities to provide feedback about the care provided at the home.
The service was following infection prevention and control procedures to keep people safe.
Medicines were managed safely. Risks to people were assessed and action was taken to reduce the chances of them re-occurring. The manager acted on feedback immediately. People were safeguarded from abuse.
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.
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 2 February 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.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
We found the following examples of good practice.
People were supported to maintain contact with those who were important to them. In line with government guidance, visitors were supported to access the home safely. Some family members we spoke with were unclear about visiting arrangements. This has been fedback to the manager who has agreed to ensure communication around visiting is addressed.
There were enough staff to meet people’s needs. People’s requests for support were responded to in a timely manner. The manager said they had recently completed a recruitment drive which ensured there were sufficient staff to cover staff absences.
Staff were observed to be wearing appropriate PPE at all times and had received training in infection prevention and control. The manager had produced a competency checklist which they were implementing to ensure staff continued to follow the correct donning and doffing (putting on and taking off) of PPE.
The service had access to regular testing for staff and people. Staff knew what to do should they suspect someone had Covid-19 to reduce the risk of spreading the infection.
The home was clean, tidy and odour free. Cleaning schedules were in place to include the additional cleaning of frequent touch points within the home.
Peterlee Care Home was last inspected by the Care Quality Commission (CQC) on 20 and 21 July 2016 and was rated Requires Improvement overall and in two areas, Safe and Responsive. We informed the provider they were in breach of regulation 12 regarding the safe management of medicines and the management of risk assessments and regulation 9 regarding not having person centre activities which met people's individual needs.
Whilst completing this visit we reviewed the action the provider had taken to address the above breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We found that the provider had ensured improvements were made in these areas and this had led the home to meeting the above regulations.
Peterlee Care Home 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. Peterlee care home provides nursing and personal care for up to 44 people. At the time of our inspection there were 41 people living at the home, some of whom were living with dementia.
There was a registered manager in place. 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.
At the last inspection we found that the service didn’t have appropriate arrangements in place for the safe handling of medicines. This was in regard to topical medicines that were found to be not dated on opening and no guidance in place for staff to administer them correctly. As Topical medicines such as creams or ointments have a short shelf life such as 28 days once opened. At this inspection we found that improvements had been made to the storage and management of topical medicines and improved directions and recording were in place.
At the last inspection we found the service didn’t offer a varied range of activities for people that were individualised to their needs, wishes and preferences. At this inspection we saw that this had been improved and a wider range of activities were provided that were more meaningful and we saw people taking part and feedback was positive.
At the last inspection we found risk assessments were not managed appropriately. At this inspection we found that risks to people were assessed and improved. These risk assessments were up to date individualised. These were in place to ensure people could take risks as part of everyday life and minimise any potential harm by mitigating risks.
Accidents and incidents were monitored by the registered manager to highlight any trends and to ensure appropriate referrals to other healthcare professionals were made if needed.
The premises and people’s rooms were clean and tidy and throughout the inspection we saw staff cleaning communal areas. Staff had access to plenty of personal protective equipment.
People who used the service were supported by sufficient numbers of staff to meet their individual needs and wishes.
Staff understood safeguarding issues and procedures were in place to minimise the risk of abuse occurring. Where concerns had been raised we saw they had been referred to the relevant safeguarding department for investigation. Robust recruitment processes were in place.
Staff were supported to maintain and develop their skills through training and development opportunities.
Staff had regular supervisions and appraisals with the registered manager, where they had the opportunity to discuss their care practice and identify further training needs
People’s health was monitored and referrals were made to other health care professionals where necessary, for example, their GP.
People were treated with equality, dignity and respect.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible, the policies and systems in the service supported this practice.
Where people lacked the mental capacity to make decisions about aspects of their care, staff were guided by the principles of the Mental Capacity Act to make decisions in the person’s best interest. For those people that did not always have capacity, mental capacity assessments and best interest decisions had been completed for them. Records of best interest decisions showed involvement from people’s family and staff.
Consent to care and treatment records were signed by people where they were able.
People were supported to maintain a healthy diet, and where needed records to support this were detailed.
People enjoyed their dining experience and we received positive feedback regarding the food and the choices on offer.
Throughout the day we saw that people who used the service, relatives and staff were comfortable, relaxed and had a positive rapport with the registered manager and also with each other.
The service supported people to access advocacy services. Procedures were in place to provide people with appropriate end of life care.
People’s needs were assessed before they moved into the service. Care plans were then developed to meet people’s daily needs on the basis of their assessed preferences. Plans were improved and included more person centred details regarding people’s preferences and were updated regularly.
An experienced registered manager was in place and understood the importance of monitoring the quality of the service and reviewing systems to identify any lessons learnt. The service regularly consulted with people, relatives and staff to capture their views about the service.
Peterlee Care Home is a detached, two storey building in its own grounds. The home has 44 single bedrooms with en-suite facilities. The home also provides separate lounges and dining rooms both upstairs and downstairs and communal bath and shower rooms. There was also an enclosed rear garden with a patio area.
At the last inspection on 15 and 17 April 2015, we asked the registered provider to take action to make improvements to ensure their care documentation was accurate and up to date, and this action had been completed. We also asked them to improve their auditing of the home and found there were regular audit processes in place to monitor the quality of the service.
The home had a registered manager in place. 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.
Checks had been carried out on staff before they were able to start work in the home. This meant the registered provider ensured only suitable staff worked with people who used the service.
The home had in place a number of safety checks which were carried out on a regular basis these included fire checks, health and safety checks and portable appliance testing (PAT) to keep people safe in the home.
We found people’s care plans described their individual needs and gave staff guidance on how to care for people. The care plans were regularly reviewed to check if there had been any changes to people’s needs. The registered manager had in place a dependency tool which they used to measure people’s needs to determine the staffing levels. We found the registered manager had a staff rota in place to reflect the pre-determined staffing levels.
We observed people were given their medicines with patience. Medicine records were up to date. People’s medicines were stored safely. We found systems were not in place to manage people’s topical medicines and could not be assured people received their topical medicines as prescribed.
The service adhered to the principles of the Mental Health Act and had made appropriate applications to the authority to deprive people of their liberty. This meant people could be kept safe.
We saw there were arrangements in place to inform kitchen staff about people’s dietary requirements. Kitchen staff were aware of people’s dietary needs. People were offered a choice of menu. The service had work in progress to give people a choice of menu using pictures.
Staff were provided with support through supervision, appraisal and training. Staff confirmed to us they felt supported.
People who used the service and their relatives told us staff were caring. We noted staff spoke with people in kindly tones and we found people were treated with respect by the staff.
Relatives were involved in people’s care planning. We found staff had listened to people who used the service and their relatives and had responded to their wishes.
People had in place hospital passports. Hospital passports are documents which give information about people to medical staff if they need to go to hospital. We found the passports accurately recorded people’s needs.
We found there was a lack of stimulating activities in the home which met people’s individual needs and preferences.
Surveys had been carried out by the manager to measure people’s views of the service. We found the surveys which had been returned to the service showed professionals were positive about the service.
The registered provider had not met the requirement to display their latest CQC rating on their website.
The service worked with community based professionals to meet people’s needs. These included opticians, dentists, chiropodists, community based nurses and occupational therapists.
During our inspection we found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.
This inspection took place on 15 and 17 April 2015 and was unannounced. This meant the staff and the provider did not know we would be visiting. On the 7 May 2014 the Care Quality Commission (CQC) completed an inspection and we informed the provider they were in breach of the following regulations:
Whilst completing the visit we reviewed the action the provider had taken to address the above breaches of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. We found that the provider had ensured improvements were made in these areas and these had led the home to meeting the above regulations
The home had a registered manager in place. A registered manager is a person who has registered with CQC 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.
Peterlee Care Home provides nursing care and accommodation for up to 44 people. During our visit the service provided care to younger people with learning disabilities and people with older age conditions. On the day of our inspection there were 36 people using the service. The home was undergoing a planned programme of building work and refurbishment during our visit.
People who used the service and their relatives had conflicting views about the standard of care at Peterlee Care Home. All the care records we looked at showed people’s needs were assessed before they moved into the home.
Care plans and risk assessments were in place when required but were not always person-centred and reflective of people’s needs. Staff used a range of assessment tools however these were not always well completed or up to date. This was a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.
The layout of the building provided adequate space for people with walking aids or wheelchairs to mobilise safely around the home but could be more suitably designed for people with dementia type conditions.
The provider had procedures in place for managing the maintenance of the premises and there were appropriate security measures in place to ensure the safety of the people who used the service.
The provider had an effective recruitment and selection procedure in place and carried out relevant checks when they employed staff. There were sufficient numbers of staff on duty in order to meet the needs of people using the service. Training records were up to date and staff received supervisions and appraisals.
CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The Deprivation of Liberty Safeguards (DoLS) are part of the Mental Capacity Act (MCA) 2005. They aim to make sure that people in care homes, hospitals and supported living are looked after in a way that does not inappropriately restrict their freedom. We discussed DoLS with the registered manager and looked at records.
We saw mental capacity assessments had been completed for people and best interest decisions made for their care and treatment. We also saw staff had completed training in the MCA and DoLS.
People were protected against the risks associated with the unsafe use and management of medicines.
We saw staff supporting and helping to maintain people’s independence. People were encouraged to care for themselves where possible. Staff treated people with dignity and respect.
People had access to food and drink throughout the day and we saw staff supporting people in the dining room at lunch time when required.
The home had a programme of activities in place for people who used the service.
We saw people who used the service had access to healthcare services and received ongoing healthcare support. Care records contained evidence of visits from external specialists.
The provider consulted people who used the service, their relatives and visitors and stakeholders about the quality of the service provided.
You can see what action we told the provider to take at the back of the full version of the report.
We looked at the information provided to us and looked at the information we held about the service. As part of our inspection we spoke with 7 people who used the service, looked at 11 people's care records and spoke with 8 members of staff including the provider and the Quality Assurance Manager.
People who used the service told us "staff and social workers have stopped us doing what we want", "I've been here a long time it's ok, but it's not home" and "the staff are ok, they help the best they can".
We found people did not receive care which was dignified or effectively planned and delivered. We found instances where people were spoken to like children, were left watching TV programmes where staff did not know if they enjoyed them or not.
We found people's care needs had not been appropriately assessed, for example people identified as being at risk of choking did not have robust assessments completed, where people had lost weight there were no assessments or care plans in place to ensure people received effective care. We also found where people had complex behaviours the service had not implemented the advice and guidance of professionals to ensure care plans contained sufficient strategies and interventions to ensure people's safety.