We carried out a review of the data available to us about Pebble Mill 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 Pebble Mill Care Home, you can give feedback on this service.
Pebble Mill Care Home is a care home providing personal and nursing care to up to 62 people. The service provides support to younger and older adults and people with physical disability. At the time of our inspection there were 29 people using the service.
Pebble Mill Care Home accommodates people across 2 floors of the purpose-built building. People had en suite facilities in their own rooms and access to lounges and dining areas as well as an enclosed shared garden.
Staff used systems to monitor and maintain health and safety and manage risks effectively. People were supported by adequate numbers of trained staff. People were supported to take their medicines safely. People lived in a clean and well-maintained home. They told us they felt safe.
Care records were accurate and up to date and guided staff as to how people wanted to be supported. Staff received inductions tailored to their experience and ongoing training to keep them updated. Adaptions were made to take account of people’s individual needs. People had plenty of food to eat and could have snacks and drinks when they wanted them.
Staff treated people with respect and dignity. People were encouraged to do what they could for themselves to retain independence. People’s equality and diversity were respected, and care was offered in line with their cultural and religious needs.
Some people and their relatives felt there was not enough for them to do. People described a range of events and activities they had participated in previously. Two full time activity coordinators were recruited to support the existing part time activity coordinator during our inspection. People were supported by staff who knew about their individual needs and preferences.
The was no registered manager in place at the time of our inspection. A home manager was recruited during the inspection. Regional managers had supported the service during the absence of a registered manager. Staff told us although they had not received appraisals they felt well supported by the regional manager.
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 requires improvement (published 11 January 2020) The service was found to be in breach of regulations. 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.
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.
The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.
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 relatives and friends who were important to them through video and telephone calls.
¿ Visitors to the home had their temperatures checked and completed a Covid-19 screening questionnaire prior to entering the home.
¿ Staff changed their clothing upon starting and finishing their shifts, to reduce the risk of cross infection.
¿ People who had tested positive for Covid-19 self-isolated in line with current guidance. Clinical waste and laundry were handled in line with government guidance.
¿ Staff break times were staggered to ensure only two staff members were in the staff kitchen area at any one time.
¿ The provider had dedicated Covid-19 leads who staff could approach for advice or support if needed.
¿ The provider put staff wellbeing high on their agenda and introduced 'thank you' schemes to maintain morale and boost wellbeing.
Further information is in the detailed findings below.
Pebble Mill is a care home that provides nursing and personal care for older people, most of whom are living with dementia. At the time of the inspection, 36 people lived at the service. The accommodation is organised into three floors, each with its own communal areas.
People’s experience of using this service:
People did not always receive safe and effective care that was personalised to their needs. Some people had not received their medication as it was not in stock and staff did not always follow care plans to ensure people’s safety when helping people to move. Staff did not respond in a timely way when people used their call bells to request assistance.
Senior staff did not keep an oversight of day to day practice which meant that issues that were identified at this inspection had not been addressed. The service did not notify us of Deprivation of Liberty Safeguards applications that had been granted as required.
There were enough staff on duty to keep people safe and the provider carried out checks on new staff to make sure they were suitable to work in the home.
The home was spacious, well-decorated and clean and people had the opportunity to spend time alone or with visitors in privacy. People were generally happy with the food and individual preferences were catered for. People did not always have the opportunity to have a drink when they wanted one.
Staff showed compassion and were patient with people when they were upset or distressed but did not always take the opportunity to spend time talking and interacting with people. People did not always have the opportunity to express how they wanted their care delivered which meant they did not always receive care that was personalised.
The provider responded promptly to any concerns and complaints that were received and worked well with other agencies to promote people’s health and ensured people were well supported at the end of their life.
Some audits and checks were effective in highlighting gaps in record keeping and practice and where gaps had been identified, action had been taken to improve the quality of care and support. The provider and registered manager were open and honest throughout the inspection and were committed to address the issues highlighted at this inspection.
More information is in the detailed findings below.
Rating at last inspection:
This was our first inspection of this service since their registration in March 2018.
Why we inspected:
This was a planned inspection.
Enforcement:
Please see the ‘action we have told the provider to take’ section towards the end of the report.
Follow up:
We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk