CQC report explained · a residential care home
What the CQC found at Penmeneth House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People told inspectors they felt safe. Staffing, recruitment, medicines and risk management had improved, although staff were not wearing masks when inspectors arrived because updated guidance had been misunderstood.
- Effective?
- Requires improvement
- Care, food, staff training and healthcare support were generally effective. However, the home did not have an effective system for recording all DoLS applications.
- Caring?
- Good
- The report did not give a separate Caring rating. People and relatives described staff as kind, friendly and attentive, and inspectors saw staff spending time with people.
- Responsive?
- Good
- Care plans were regularly updated and daily care records were accurate. People were supported with activities, visitors, relationships, communication and end of life care, although digital records contained limited information about some people's backgrounds and interests.
- Well-led?
- Good
- Leadership and quality monitoring had improved. The new manager was supported by the provider, although there was not a registered manager in post at the time of inspection.
What inspectors found, August 2022
Penmeneth House is rated Good overall; people were safe and cared for kindly, but the Effective rating was Requires Improvement because DoLS applications were not fully recorded.
This was an unannounced inspection on 21 June 2022. One inspector spoke with 10 people, three relatives, staff, managers and a visiting healthcare professional. They also checked care records, medicines records, recruitment files and management records.
People said they felt safe and were happy with their care. Inspectors found enough staff, safer recruitment, improved medicines management and good support from healthcare professionals. Staff spent time talking and doing activities with people, and relatives described the home as well run.
The home was not always effective. It did not have a reliable system for recording all applications under the Deprivation of Liberty Safeguards. Staff were also not wearing masks when inspectors arrived because recent infection control guidance had been misunderstood. This was corrected straight away, but the inspector made recommendations for improvement.
The overall rating improved from Requires Improvement at the previous inspection in December 2019 to Good. Safe, Responsive and Well-led were rated Good. Effective was rated Requires Improvement. The report did not give a separate Caring rating.
Kind and attentive care
People felt safe and were happy with their care. Staff supported people at a relaxed pace and spent time talking and playing games with them.
“People told us they felt safe and were happy with the care they received at Penmeneth House.” from the report
Enough staff
Inspectors found enough staff to meet people's needs. People said staff responded quickly when they asked for help.
“There were enough staff available to meet people's support needs.” from the report
Medicines were managed safely
Medicines records, storage temperatures and controlled medicines were checked and had improved since the previous inspection.
“Medicines administration records (MARs) had been accurately completed and there were no missing records in the charts reviewed during this inspection.” from the report
Improved leadership
The provider had addressed earlier problems with recruitment and medicines. Managers and directors were involved in monitoring the home and supporting staff.
“Issues identified at the last inspection had been addressed and resolved.” from the report
Infection control guidance
needs fixingStaff were not wearing masks when inspectors arrived because recent national guidance had been misunderstood. Mask wearing was restarted immediately, but inspectors recommended better checks when guidance changes.
“Staff were not wearing masks on our arrival. We raised this issue with the provider and the use of masks was immediately reintroduced.” from the report
DoLS records
needs fixingThe home had not kept effective records of all DoLS applications. Inspectors recommended getting expert guidance to improve monitoring.
“However, the service did not have effective systems in place to record details of all DoLS applications submitted.” from the report
Limited personal history in digital records
minorDigital care records contained limited information about people's backgrounds, history and interests. This could make it harder for new or agency staff to understand people's preferences.
“The provider's digital care records contained limited information about people's backgrounds, history and interests.” from the report
- 01How do you now record and monitor every DoLS application and its outcome?
- 02How do you make sure staff understand and follow changes to infection control guidance?
- 03How are people's backgrounds, interests and conversation preferences recorded for new or agency staff?
- 04Who is currently responsible for managing the home, and what is the progress of the manager's application to register with CQC?
- 05What activities are available on days when the activities coordinator is not working?
This was an unannounced inspection that examined the overall service, including infection prevention and control; the report gives ratings for Safe, Effective, Responsive and Well-led but not a separate Caring rating. This explanation was written from the published report of 31 August 2022 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, December 2019
Rated Requires Improvement; inspectors found kind, personalised care but unsafe medicines systems and weak checks on quality.
This was an unannounced comprehensive inspection by two inspectors on 04 November 2019. They spoke with people, relatives and staff, and checked care records, medicines, recruitment records, incidents, training and quality checks.
The home was rated Good for Effective, Caring and Responsive. People were treated kindly, received personalised care, enjoyed the food and activities, and were supported to access healthcare. Staffing levels were considered sufficient, and people said staff responded promptly.
The overall rating was Requires Improvement because medicines were not managed safely, recruitment checks were incomplete and quality checks had failed to identify these problems. This was worse than the previous overall rating of Good, published on 27 February 2017, although the provider and registered manager had changed since then.
Prompt support
People said staff responded quickly when they needed help. Inspectors also observed prompt support and found staffing levels sufficient.
“People told us staff responded promptly when they called for assistance.” from the report
Kind, respectful care
Inspectors saw caring interactions and found that staff knew people well. People said they felt respected and well cared for.
“We observed many kind and caring interactions between people and staff.” from the report
Personalised care plans
Care plans recorded people's needs, preferences and routines. They were reviewed and updated when people's needs changed.
“Care plans described people's individual needs, preferences and routines.” from the report
Training and support
New staff received induction and shadowing, and existing staff had updated training and meetings with managers.
“Records showed training was regularly updated to ensure staff had the skills necessary to meet people's support needs.” from the report
Medicines safety
seriousSome medicines records did not match the stock held. Cold storage was not monitored, handwritten records were not checked by two staff and people were not always observed taking medicines.
“Medicines which required cold storage were stored in a fridge. However, the fridge temperature had not been recorded since the 24 August 2019.” from the report
Recruitment checks
seriousEmployment gaps had not always been investigated and references were not always obtained from previous care employers. Disclosure and Barring checks had been completed for all staff.
“There were gaps in employment histories with no evidence the registered provider had investigated to identify the reasons for the gaps.” from the report
Weak quality checks
seriousThe home's audits had not found the medicines and recruitment problems. This meant managers did not have reliable checks showing that care and safety systems were working.
“These concerns have failed to be identified by the provider's quality and monitoring systems.” from the report
Limited bathing facilities
minorThe home had only one bathroom. People said this could affect when they chose to have a bath, and inspectors recommended reviewing the facilities and their impact.
“The provider was aware of the impact for people and stated the lack of bathing facilities would be reviewed.” from the report
- 01What changes have been made to medicines records, controlled medicines records and the checking of handwritten entries?
- 02How are fridge temperatures for medicines now recorded and checked?
- 03How do you make sure staff observe people taking all medicines, including as-required medicines?
- 04How are employment gaps and references from previous care employers now checked before staff start work?
- 05What new audits or management checks are in place to identify safety and quality problems?
This was an unannounced comprehensive inspection covering all five CQC questions, including the premises and care provided. This explanation was written from the published report of 6 December 2019 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 Penmeneth House
2 rated inspections over 3 years: the service has improved, from Requires improvement to Good.
- August 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- December 2019Requires improvementSafe: Requires improvementEffective: GoodResponsive: GoodWell-led: Requires improvement
- November 2018
Registered with the Care Quality Commission on 14 November 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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