CQC report explained · a residential care home
What the CQC found at Peel Moat
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- The lift was not properly checked and had been out of order. Medicines were not always stored, recorded or administered safely, and care records did not always give enough safety information.
- Effective?
- Good
- Staff had training and supported people with food, drink and access to health services. However, some care records did not fully describe measures such as sensor mats or actions taken after weight loss.
- Caring?
- Good
- Staff treated people with dignity and respect, listened to their choices and supported their independence. Care plans did not always show clearly how people and relatives had been involved.
- Responsive?
- Good
- People were supported with activities, relationships and complaints. The lift failure reduced some people's opportunities to join activities, and some care plans lacked detail about personal preferences and end of life wishes.
- Well-led?
- Requires improvement
- Management checks did not identify the lift and medicines problems. Improvements were slow, and the same issues appeared in meeting records over several months.
What inspectors found, March 2024
Rated Requires Improvement; inspectors found kind, respectful care, but serious problems with medicines, lift safety and management checks.
Inspectors visited on 30 November and 13 December 2023. The first visit was unannounced. They reviewed care and medicines records, spoke with staff, people living there and relatives, and checked the home and its systems.
The home was not always safe. The passenger lift had not had the required checks and had been out of order for several weeks. Medicines were not consistently stored, recorded or administered safely. Inspectors also found that checks by managers had missed these problems and that improvements had been slow.
Staff were kind and supported people's independence. The home was clean, staff had training, and activities and visits were supported. The overall rating is Requires Improvement. Effective, caring and responsive care were rated Good, while safe and well-led were rated Requires Improvement.
Kind and respectful staff
Staff spent time with people, listened to their choices and supported them with compassion.
“Staff treated people with dignity and respect. We observed staff taking the time to sit and speak with people.” from the report
Support for independence
Staff encouraged people to move around and complete personal tasks themselves where possible.
“Staff supported people with their independence. Staff supported and encouraged people with their independence by encouraging them to move independently around the home.” from the report
Activities and community links
People were offered group and one-to-one activities, outings and contact with the local community.
“The service had activities coordinators in place who supported people in group activities and a one to one basis.” from the report
Safe recruitment and training
The required checks were completed before new staff started, and staff had training for their roles.
“All necessary pre-employment checks were completed before new staff commenced work at the service.” from the report
Clean environment
Inspectors found a routine cleaning programme, appropriate use of protective equipment and enough supplies.
“There was a routine cleaning programme in place at the home. Visitors told us they thought the service was clean.” from the report
Lift safety
seriousThe passenger lift had not been fully inspected since July 2022 and was out of order during the inspection. Its failure affected meals, medicines and people's ability to use communal areas.
“The provider did not ensure safety of equipment at the service was maintained. This potentially placed people at risk of harm.” from the report
Medicine management
seriousInspectors found missing guidance and records for patches, 'when required' medicines and medicines for people with swallowing difficulties. Three medicine counts were incorrect, so inspectors could not be certain people had received the prescribed dose.
“We found three counts of people's medicines to be incorrect. This meant we could not be certain that the person had received the correct dose of their medicines as prescribed.” from the report
Weak management checks
seriousAudits did not identify the lift and medicines problems. Records showed that improvements were repeated in meetings without clear progress or timescales.
“Systems were not in place to effectively monitor and ensure the safety of the service.” from the report
Incomplete care planning
needs fixingSome records did not contain enough detail about pressure mattress checks, personal care choices, people's involvement or end of life wishes.
“Some plans lacked detail about how people would like to be supported at the end of their lives.” from the report
Impact of the lift failure
needs fixingSome people could not come downstairs to socialise and spend their day, and some activities were reduced. Food was reported to be cold for one person before insulated bags were introduced.
“Due to the lift failure some people's opportunity to engage had been reduced.” from the report
- 01What checks now show that the passenger lift is safe and being inspected every six months?
- 02How are medicines now checked after the move to the electronic recording system?
- 03How do staff record patch application sites and decide when to give 'when required' medicines?
- 04What guidance is available for safely preparing medicines for people with swallowing difficulties?
- 05What changes have been made to care plans so they record people's wishes, involvement and end of life choices?
This was a full inspection covering all five key questions, including the premises and care provided; the previous overall rating was from an inspection published in 2017. This explanation was written from the published report of 23 March 2024 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, April 2021
Inspected but not rated; inspectors found kind, personalised care and good infection control, but some relatives wanted better communication and more activities.
This was an unannounced inspection on 7 April 2021. One inspector spoke with five people, seven relatives, seven staff members and a visiting health and social care professional. The inspector also reviewed three people's care records and other care records.
The inspection followed a historic concern about person-centred care. Inspectors found no evidence that people were at risk of harm from this concern. Care plans reflected people's preferences, staff knew people's needs, and people said they felt safe and were treated well.
Inspectors were assured about infection control during the COVID-19 pandemic. The home was clean, staff had suitable protective equipment, and visiting arrangements included risk assessments, testing and protective equipment.
The home was inspected but not rated at this visit. Safe and Responsive were looked at only in relation to specific concerns, and the other areas were not inspected. The previous overall rating was Good, published on 29 December 2017.
Kind and attentive staff
People said they felt safe and staff treated them well. Inspectors also saw staff showing a good rapport with people.
“People felt safe at Peel Moat and told us staff were kind to them.” from the report
Personalised care
Care plans reflected people's needs and preferences. Staff supported people with personal care, medicines and pressure care.
“During this inspection we found that care plans were person-centred and we saw people being attended to in accordance with their preferences.” from the report
Infection control
The home was clean and hygienic. Staff had protective equipment and COVID-19 training, and visiting arrangements included individual risk assessments and testing.
“Peel Moat was clean and hygienic and there was a designated housekeeping team.” from the report
Family contact during the pandemic
Staff supported people to keep in touch with relatives by phone and video calls. Most relatives told inspectors they were happy with communication during the pandemic.
“Staff supported people to remain in contact with their families by phone and video calls during the pandemic.” from the report
Telephone communication
minorOne relative said it could be difficult to get through by telephone and wanted more proactive reassurance about their relative's welfare.
“One relative told us that it could be difficult to get through on the telephone and would appreciate more proactive reassurance about the welfare of their loved ones.” from the report
- 01How quickly can relatives usually get through to the home by telephone?
- 02How will you give families proactive updates about their relative's welfare?
- 03What activities are currently available, and how often does each person take part?
- 04What changes followed the recruitment of the additional activity coordinator?
- 05How are visiting arrangements, testing and protective equipment managed now?
This was a focused inspection of specific concerns under Safe and Responsive, including infection control; Effective, Caring and Well-led were not inspected and the previous ratings were carried forward. This explanation was written from the published report of 27 April 2021 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 Peel Moat
3 rated inspections over 7 years: the service has held its Requires improvement rating throughout.
- March 2024Requires improvementcurrent ratingSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2021Inspected but not ratedSafe: Inspected but not ratedResponsive: Inspected but not rated
- December 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- July 2014
Registered with the Care Quality Commission on 29 July 2014.
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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