CQC report explained · a residential care home
What the CQC found at Penrice House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found effective safeguarding, detailed risk assessments, safe medicines arrangements, suitable infection control and enough staff on duty to meet people's assessed needs.
- Effective?
- Good
- No rating was given for this question in this report.
- Caring?
- Good
- No rating was given for this question in this report. Inspectors did observe positive and caring relationships between staff and residents.
- Responsive?
- Good
- No rating was given for this question in this report. Inspectors said staff understood people's individual care, communication needs and daily choices.
- Well-led?
- Good
- Inspectors found clear responsibilities, effective audits and quality checks, open management and a positive culture focused on person-centred care.
What inspectors found, February 2023
Penrice House is rated Good; inspectors found people were safe, supported by kind staff and a well-run management team.
The inspection visit took place on 14 January 2023. It was announced, and one inspector visited the home. They spoke with residents, visitors, staff, the manager and trustees, and checked care, medicines, recruitment and management records.
The home was rated Good overall. Inspectors rated Safe and Well-led as Good. They found effective safeguarding, up-to-date risk assessments, safe medicines systems, enough staff on duty during the visit and suitable infection control arrangements.
Inspectors also found a positive, person-centred culture. Staff understood people's individual needs and choices. The management team used audits, meetings and feedback to monitor the service and make improvements. The previous overall rating was also Good, published on 6 July 2018.
People felt safe
People told inspectors they felt safe. Staff knew how to report safeguarding concerns and the manager understood their responsibilities.
“People told us they felt safe living at Penrice House.” from the report
Safe medicines and risk management
Risk assessments were detailed and up to date. Medicines were ordered, stored, administered and disposed of safely.
“People received their medicines in a safe way, as prescribed for them.” from the report
Person-centred support
Staff understood people's care and communication needs and supported their individual routines and choices.
“Staff understood people's individual care and communication needs and this helped to ensure people received care and support that promoted their well-being.” from the report
Strong management oversight
The management team and trustees used regular audits, meetings and feedback to monitor quality and identify improvements.
“There were effective quality assurance and auditing systems in place designed to drive improvements in the service's performance.” from the report
Positive relationships
Inspectors found a positive culture, with caring relationships between staff and residents. Relatives said they felt welcome and confident in the management.
“Management and staff were committed to their roles and had built positive and caring relationships with people.” from the report
Possible staffing gaps
minorStaff said there could be times when the home was short-staffed, although gaps were filled by other staff and inspectors saw enough staff available during the visit.
“Staff told us there could be times when they were short of staff but that any gaps were filled in by other members of the staff team.” from the report
- 01How do you make sure there are enough staff when there are unexpected absences or vacancies?
- 02How are medicines that need extra security or cold storage checked and recorded?
- 03What activities and community opportunities are currently available, now that community engagement is being rebuilt?
- 04How will the planned woodland trails and gardening opportunities be developed, and when will residents be able to use them?
- 05How can relatives raise concerns, and how will the home keep them updated about changes in a person's needs?
This inspection rated Safe and Well-led only; the report does not give current ratings for Effective, Caring or Responsive. This explanation was written from the published report of 17 February 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, May 2021
Inspected but not rated; inspectors found strong infection control arrangements, with one visitor-check procedure not followed on arrival.
This was an unannounced, targeted inspection on 15 February 2021. It focused on how well the home was prepared to prevent and control coronavirus infections.
Inspectors found that the home had suitable visiting arrangements, regular testing, effective use of protective equipment, and up-to-date infection control policies. They also found the home was very clean and had extra cleaning and audit arrangements.
There was one shortfall. When the inspector arrived, staff did not complete all the checks required by the home's policy. The manager said staff would be given further guidance.
The home was inspected but not rated at this visit. The report says it remained Good from the previous inspection in July 2018, but this inspection did not reassess all five areas of care.
Covid response
The home had responded appropriately when it had coronavirus cases, with established policies and risk assessments.
“The registered persons had responded appropriately when the service had cases of Covid 19.” from the report
Testing and vaccination
Visitors, staff and residents were tested regularly. The report also says staff and residents had received a first vaccine dose.
“Testing routines were robust. For example all visitors were tested, and staff and people who used the service received regular testing” from the report
Clean environment
Inspectors found the home very clean, with extra cleaning routines and audits in place.
“The service was very clean, additional cleaning routines were in place, and audit systems were in place” from the report
Visiting arrangements
Arrangements were in place to support visits from residents' friends and relatives.
“Suitable visiting arrangements, for people's friends and relatives were in place.” from the report
Arrival checks
needs fixingStaff did not complete the relevant checks required by the home's policy when the inspector arrived. The manager said staff would receive guidance so this would not happen again.
“However when the inspector arrived staff members did not complete relevant checks, in line with the service's policy.” from the report
- 01What changes were made after staff did not complete the required arrival checks?
- 02How do you now check that staff follow the infection prevention and control policy?
- 03What testing arrangements are currently in place for visitors, residents and staff?
- 04What visiting arrangements are currently available for friends and relatives?
- 05When was the service last fully inspected across all five areas of care?
This was an unannounced targeted inspection of infection prevention and control during the coronavirus pandemic; the other areas were not reassessed and the service was inspected but not rated. This explanation was written from the published report of 26 May 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 Penrice House
3 rated inspections over 7 years: the service has held its Good rating throughout.
- February 2023Goodcurrent ratingSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2021Inspected but not ratedSafe: Inspected but not rated
- July 2018Goodstayed GoodSafe: GoodWell-led: Good
- March 2016GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2014
Report published without a new overall rating.
- March 2014
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 19 January 2011.
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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