What the CQC found at Peter House

Staff understood people's communication, needs and signs of distress. They usually adapted their support and helped people remain as independent as possible.

“However, care staff and managers were all able to tell us about people's individual risks in detail and how they supported people.” from the report

Inspectors saw staff speaking with people in a caring way. Staff respected privacy, dignity and preferences for male or female care workers.

“Staff knew people well and we observed them talking to people in a caring and engaging manner.” from the report

People were supported to access health checks and treatment. Staff communicated with relatives and health professionals and advocated for people's needs.

“Staff strongly advocated for people to get the healthcare they needed and there was good communication with professionals and peoples loved ones about how to support people.” from the report

The home had enough staff, including for commissioned one-to-one support. More staff could drive the home's vehicles, improving access to outings.

“At this inspection we saw that had improved.” from the report

The well-led rating improved from Inadequate at the previous inspection to Requires Improvement. A new deputy manager and activity staff member were supporting planned changes.

“At this inspection the provider had changed and whilst the service continues to require improvement, it was improving under new management.” from the report

The garden was overgrown and patio slabs were uneven. This issue had been raised at the previous two inspections but had still not been addressed.

“At this inspection the outside space remained unchanged and would not be fully accessible for all.” from the report

Some care plans and risk assessments had not been reviewed for many months. This meant the home could not consistently show that support reflected people's current needs.

“Peoples care plans although person centred, were significantly out of date.” from the report

People who needed support with activities spent much of the day in the dining room on one inspection day. Daily records did not show how people had spent their time.

“People who needed staff to help engage with meaningful activities were observed doing limited daily activities during the first day of inspection.” from the report

A noisy fire door had not been repaired ten days after it was first seen. A water temperature above the acceptable range had no recorded immediate action.

“Systems in place did not always identify risks to people and where risks were identified they were not always acted on in timely way.” from the report

Audits did not always identify problems or lead to timely action. The provider had not dealt with all concerns from earlier inspections.

“Audits in place were not always robust and did not always lead to timely action to manage risks.” from the report

The manager spoke with people individually instead of holding resident meetings, but these conversations were not documented and there was no evidence that they led to changes.

“These discussions had not been documented and there was no evidence of the conversations leading to changes and adaptions at the service.” from the report