CQC report explained · a nursing home
What the CQC found at Pebble Mill Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People received their medicines safely and staff understood their needs. The home had enough care staff, but it was relying on regular agency nurses and one medicines patch did not have recorded daily checks.
- Effective?
- Good
- Care records were personalised and up to date. Staff received training, people had access to food and drinks, and health and social care professionals were involved when needed.
- Caring?
- Good
- Staff treated people with kindness, dignity and respect. People were offered choices and encouraged to remain as independent as possible.
- Responsive?
- Good
- Staff knew people's preferences and communication needs, and visiting was unrestricted. However, some people and relatives said there were not enough activities and that planned activities did not always happen.
- Well-led?
- Requires improvement
- Leadership had improved, but the home did not have a registered manager during the inspection. Some relatives were not involved in care reviews, communication about management changes could have been better, and not all staff had received appraisals.
What inspectors found, March 2023
Rated Good overall, but inspectors found leadership and activity planning still needed improvement.
Inspectors made an unannounced visit on 13 February 2023. They spoke with people living in the home, relatives, staff and other professionals. They also reviewed care records, medicines records, staff files and management records.
The home was rated Good for safety, effectiveness, care and responsiveness. People were generally safe, treated with respect, supported to make choices and given suitable food, drinks and healthcare. Care records were accurate and staff understood people's needs.
The home was rated Requires Improvement for being well-led. There was no registered manager during the inspection. Inspectors also found that advertised activities were not always provided, some staff had not received appraisals and some relatives had not been involved in care reviews.
The overall rating improved from Requires Improvement at the previous inspection in January 2020. The report says the home had made enough progress to no longer be in breach of the regulations that had previously been breached.
Safe care
People told inspectors they felt safe. Staff understood risks, medicines were given when needed and the home was clean and well maintained.
“People received support to take their medicines safely. People received their medicines when needed and staff understood how people needed to be supported with their medicines.” from the report
Kind and respectful staff
Staff spent time talking with people and supported their choices, privacy and independence.
“People received kind and compassionate care from staff who used positive, respectful language which people understood and responded to well.” from the report
Personalised records and support
Care records gave staff clear information about people's needs, preferences and communication styles.
“People's care records contained personalised holistic information about how they wanted to receive support.” from the report
Food and drink
People could have food, drinks and snacks when they wanted them. The home supported cultural and dietary preferences.
“At this inspection we found this was no longer a concern. We saw people could have a drink or snack at any time.” from the report
Activities were not always delivered
needs fixingSome people and relatives said there was not enough to do. The weekly newsletter listed two activities each day, but inspectors were told these did not always take place.
“Some people told us they didn't see these being offered in practice.” from the report
Leadership was not yet settled
needs fixingThere was no registered manager in post during the inspection. A new manager had been recruited, but was still undertaking induction and the registration process.
“At the time of our inspection there was no registered manager in post.” from the report
Relatives were not always involved
needs fixingSome relatives had not been included in reviews of their loved one's care. Plans were being made to arrange meetings and provide access to electronic care records where appropriate.
“Relatives told us they had not been involved in reviews of the care of their loved ones.” from the report
Some staff processes were incomplete
minorNot all staff had received an annual appraisal. Inspectors also found that checks of one person's pain relief patch were not recorded, although nursing staff said visual checks took place.
“The regional manager told us staff had not all received an annual appraisal in line with the policy and practice of the provider.” from the report
- 01Has the newly recruited home manager completed the registration process, and who is responsible for the home until then?
- 02How do you check that the activities listed in the weekly newsletter actually take place?
- 03How will relatives be invited to care reviews and, where appropriate, given access to electronic care records?
- 04Have all staff now received their annual appraisal and regular supervision?
- 05How are daily checks of medicines patches recorded and audited?
This was an unannounced inspection covering all five key questions and included infection prevention and control checks; the report also compares the findings with the previous inspection. This explanation was written from the published report of 24 March 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, November 2020
Inspected but not rated; inspectors were assured the home had safe infection prevention and control measures.
This was an announced, targeted inspection on 12 November 2020. It looked only at infection prevention and control because of the home's response to coronavirus outbreaks.
Inspectors were assured that the home used personal protective equipment safely, followed shielding and social distancing rules, supported testing, and kept its infection control policy up to date.
The home supported people to keep in touch with relatives by telephone and video calls. Visitors had temperature checks and completed a coronavirus screening questionnaire before entering.
The home was inspected but not rated. This means the inspection did not give an overall quality rating or assess all five areas of care.
Contact with relatives
People were supported to keep in touch with important relatives and friends using telephone and video calls.
“People were supported to maintain contact with relatives and friends who were important to them through video and telephone calls.” from the report
Visitor checks
Visitors had their temperatures checked and completed a coronavirus screening questionnaire before entering the home.
“Visitors to the home had their temperatures checked and completed a Covid-19 screening questionnaire prior to entering the home.” from the report
Infection control
Inspectors were assured that the home used PPE safely, supported testing and followed measures to prevent or manage outbreaks.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Staff support
The provider had dedicated coronavirus leads and introduced thank-you schemes to support staff morale and wellbeing.
“The provider had dedicated Covid-19 leads who staff could approach for advice or support if needed.” from the report
Inspectors raised no specific concerns in this report.
- 01How do you currently screen visitors before they enter the home?
- 02How do you support residents who test positive for Covid-19 to self-isolate?
- 03How do you make sure staff use PPE safely and have access to testing?
- 04Who are the home's current infection prevention and control leads, and how can families contact them?
- 05How do you support residents to keep in touch with relatives and friends?
This was a targeted inspection of infection prevention and control practices only; the service was inspected but not rated and the other areas were not assessed. This explanation was written from the published report of 27 November 2020 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Pebble Mill Care Home
2 rated inspections over 3 years: the service has improved, from Requires improvement to Good.
- March 2023Goodcurrent ratingSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2020Inspected but not ratedSafe: Inspected but not rated
- January 2020Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- March 2018
Registered with the Care Quality Commission on 12 March 2018.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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