Peacemills Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safety risks to people were not always managed well. Risks were not always documented accurately, and staff did not always follow best practice guidance. People were not always equipped with the tools to call for support. Areas of the home required attention to ensure they were safe. An action plan was in place to ensure improvements to the safety of the environment were made. There were enough staff on duty to support people safely however the deployment of staff meant there were periods of time where people with a cognitive impairment who could not anticipate risks, or their needs were left alone. Staff received support through supervision and appraisal to support their continuous learning and improve their working practice. Managers made sure recruitment checks were undertaken on all staff to ensure only those individuals that were deemed suitable and fit, would be employed to support people at the service. Staff understood their duty to protect people from abuse and knew how and when to report any concerns they had to managers. When concerns had been raised, managers reported these promptly to the relevant agencies and worked proactively with them, to make sure timely action was taken to safeguard people from further risk. The home was clean and tidy, and staff were confident in infection and prevention control systems in place.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People told us they felt safe living at Peacemills. A person we spoke with told us, “I feel safe and know I can ask for help.” A relative we spoke with echoed this feedback, “My [relative] is very well looked after. I can’t fault the place.” We found feedback was acted on. For example, issues surrounding food had been raised, menus and food choices were discussed at residents’ meetings to ensure people were happy with the food on offer, changes had been made to menus as a result of people’s feedback.

Staff told us they were able to raise concerns with the management team if needed. We found staff to be relaxed and confident in the presence of the management team. Regular supervisions and team meetings provided staff with an opportunity to discuss and learn from any incidents at the service. The management team told us, “We have a lovely team and do our best to support them, we get some lovely feedback and make sure staff hear the good feedback as well as anything we need to work on.”

Staff completed training to support them to carry out their duties safely. The management team ensured staff completed refresher training as needed. Training for staff to enable them to support autistic people and people with a learning disability had been completed. A monthly review of accidents and incidents was carried out to review trends and themes. This ensured lessons were learnt and the risk of reoccurrence reduced. For example, a trend of a person falling was identified and whilst risk reduction measures were already in place such as specialist equipment, staff identified a possible medication issue might have been contributing to the frequent falls. The person was promptly referred to their GP for support and their instructions implemented. Lessons learnt were shared with staff during staff meetings. There was a complaints policy in place which was accessible to people, staff, and visitors. A log of complaints was kept ensuring these were used as learning opportunities.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

Staff understood how to respond to allegations of abuse. Staff told us that they had no concerns, but if they did, they were confident the management team would act appropriately. We spoke with or received feedback from 11 members of staff during our inspection all of whom had a good understanding of their role in ensuring people were protected from abuse and neglect. The registered manager told us, “We discuss safeguarding at meetings and during handover, so staff are confident to spot any signs and report them if needed.” Staff recognised unlawful restrictions as a safeguarding concern and ensured people were protected from this type of abuse. For example, staff told us, “I ensure I seek people’s opinions in whatever I do or offer to them, I don't force or impose anything against their wishes.” Staff knew where to find the safeguarding policy. Staff understood what they needed to report and how they should report any concerns of abuse.

Safeguarding concerns were reported in a timely manner to the relevant authority. Reflective practice was in place to ensure immediate action was taken whilst waiting for the safeguarding authority to conclude their investigations. Lessons learnt were shared with the staff team to reduce the risk of recurrence. If an allegation of abuse was made, there were appropriate policies in place to guide staff. Records showed incidents were investigated and referred to the local authority safeguarding team and CQC if needed. Staff completed training in safeguarding. Safeguarding information and contact details were clearly displayed for staff, people and visitors. This meant people had accurate information to contact the safeguarding authority if needed.

People told us the support they received from staff made them feel safe. One person said, “It’s the staff that make us feel safe, the carers are second to none” and another person told us, “I feel confident in staff to keep me safe, and they always do their best, the [staff group] are so devoted.” There were no unlawful restrictions imposed on people. People were free to complete their own routines and live their lives as they wished. Some people would be at risk if they did not have continuous supervision and control, where this was the case, we saw staff had applied the suitable Deprivation of Liberty Safeguards. These safeguards ensure people who cannot consent to their care arrangements in a care home or hospital are protected if those arrangements deprive them of their liberty.

We observed staff to be cheerful and kind in their interactions with people. As a result, people appeared relaxed in staff’s company. Staff acted appropriately when a person started becoming distressed using redirection and distraction techniques to divert a possible safeguarding incident involving two people living at the service. Staff approached the incident with calmness and recognised the need to keep people safe from possible abuse.

Staff told us they were able to keep people safe from harm. Staff were aware of how to access care plans and told us they had time to update them when changes were needed. All of the staff we spoke with told us people were fully involved in all decisions about the care and support they received and were supported to express their views. The registered manager told us that incidents were reviewed and analysed in a timely manner to ensure risk reduction measures were implemented.

People told us they were supported safely by staff who knew their individual needs and any associated risks. People were involved in decision making and were knowledgeable of the risk reduction measures they had in place. A person we spoke with said, “I have a mat by my bed which lets staff know if I try and stand up by myself. They support me gently when helping me out of bed.”

People had care plans in place, however these were not always detailed enough to ensure staff had accurate information in order for staff to support them safely. For example, a person who we observed to become distressed did not have a risk assessment to direct staff in how to support them safely, however, we observed the staff who knew the person well to support them safely. The use of agency staff who may not know the person well increases the risk of potential harm. We also found many people did not have corded call bells in their bedrooms to call for support if needed and there were no risk assessments in place to support why this decision had been made. We discussed this with the registered manager and home manager who was not aware of this and told us they would rectify this immediately. Other risks were assessed and documented within care plans. For example, falls risk assessments were completed and we observed risk reduction measures such as sensor mats and crash mats in people’s living spaces.

Risks were not always well managed. We observed some staff did not follow best practice guidance to manage some risks. For example, we observed two members of staff to assist two people at risk of skin damage to reposition themselves out of the chair. They stated they were providing pressure relief for the people by hoisting them for approximately 30 seconds and leaving them suspended in the air, they did not provide any continence support or complete any skin checks, they then lowered both people down into the same position. This is not in line with any pressure-relieving guidance, the providers own policy or people’s assessed need. Failure to ensure people were supported in line with their assessed need placed them at an increased risk of skin damage. We did observe some other risks were well managed, for example where a person became distressed staff supported them safely.

During the assessment we found some areas of the home and equipment in it, required attention. We observed a damaged radiator cover in the lounge and a damaged crash mat in a person’s bedroom. We fed this back during our visit to the management team who told us they would rectify this immediately. Many of the observations we found had been identified by the management team at Peacemills and was included in their maintenance action plan. We observed the maintenance team to be completing work around the building and observed quotes for further works to be completed by external professionals. We observed staff to keep people safe in their environment by utilising specialist moving and handling equipment such as a hoist and stand aid.

The management team recognised some areas of the home needed work to ensure the environment remained safe for people living at the service. The registered manager told us they had a maintenance action plan in place with many areas listed for improvement. Staff also recognised some areas of the service needed improvement, a staff member we spoke with said, “The only thing which needs improving is some areas of the home need an upgrade due to the age of the building.” The registered manager told us they were working hard with the provider and maintenance team to improve the environment.

People told us whilst they felt safe living at the home, we received mixed feedback about the environment. We received several comments around call bells and these not being easily accessible which made some people feel unsafe in certain environments within the home. For example, one person we spoke with said, “I can’t always reach the button on my wall” and another person said, “I need to get up out of my chair to press the button on my wall which can be hard for me.” Another person we spoke with told us they could no longer lock their bedroom door which made them feel unsafe, this was due to other people who were living with dementia entering their bedrooms uninvited. Other people we spoke with gave us positive feedback about the environment and told us the home was tidy which made them feel safe.

Processes in place ensured people were kept safe in their environment. Essential safety checks were completed monthly. For example, testing of water temperatures were completed to ensure people were not at risk of scalds and burns. The provider ensured legionella and fire risk assessments were completed by a competent professional to keep people safe from harm. Monthly checks of people’s bedrooms were completed to ensure any environmental issues were identified in a timely manner. A maintenance action plan was in place to ensure any environmental safety concerns were being addressed.

During our assessment we observed several times where people were left alone in communal areas such as the lounge, this was a risk as some people living at Peacemills could not anticipate risks for themselves. We observed this to be a deployment and communication issue rather than the number of staff on duty. We fed this back to the management team who advised they would address this with staff. For example, we observed a person who needed support sat in the lounge, we went to alert staff but had to walk down a corridor to go and find a member of staff. The staff member was not aware the previous member of staff had left the lounge area, staff immediately supported the person when alerted. During lunch we observed staff did not always respond to people appropriately. We observed a person struggling to use utensils, but staff did not recognise this and whilst they did encourage the person to eat, they did not address the problem with the utensils. A staff member did eventually intervene after several minutes. Other people who required physical support with their nutritional needs were supported safely in a kind manner.

Processes in place ensured there were enough suitably trained staff on duty. There was a dependency tool in place taking into account people’s individual needs. This determined how many staff were required each day in order to support people safely. Staff were recruited safely. Processes ensured necessary checks were completed prior to staff starting at Peacemills. This included reference checks, proof of identity as well as Disclosure and Barring Service (DBS) checks. A DBS check is a way for employers to check an employee criminal record, to help decide whether they are a suitable person to work for them. This protected people from receiving support from unsuitable staff.

People told us they were supported by kind and caring staff who knew them well. All of the people we spoke with gave positive feedback about staff and told us they did not wait long for support, this made people feel safe as a result. A person we spoke with said, “I feel confident in staff, and they always do their best, even when it is very busy.” Another person we spoke with said, “I’m well cared for and don’t wait long for help.” A relative raised some concerns about the use of agency staff but they recognised during times of need this could not be avoided. They felt confident in the Peacemills staff to keep their loved one safe from harm.

We spoke with 10 staff members during our assessment of Peacemills. All of the staff told us there were enough staff on duty to ensure people’s needs were met. Staff told us in times of need such as staff sickness the management team were reactive to addressing any shortfalls. Staff told us there was good morale and a strong sense of teamwork which made it enjoyable to work at Peacemills. For example, a staff member said, “One of the best things about working here is the teamwork, how we all work together to make it a happy place.” The management team spoke passionately about the staff team at Peacemills and praised their work ethic and commitment to people living at the service.

People and their relatives told us the home was clean and tidy. A person we spoke with said, “It’s kept very clean” and another person told us, “We have brilliant cleaning staff.” A relative we spoke with echoed this feedback and told us, “It’s one of the cleanest places I’ve been in. It’s spotless.” People told us they were happy with the infection and prevention control arrangements at the home. They told us staff supported them to maintain their hygiene needs to reduce the risk of infections. A person we spoke with said, “My clothes are all named, and laundry staff are good. Staff help me to have a shower, to help make sure I am clean.”

The home was clean and had no malodours present. However, some areas of the home required maintenance to ensure they could be cleaned effectively. This had been identified prior to our assessment and work was underway. We also observed some staff not to work in line with guidance and the provider’s own policy. For example, we found a bowl of vomit had been left on the dining room table with people walking around the dining room. Staff had not disposed of it in a timely manner and left it in the communal area. We alerted staff who moved it immediately. We also found some equipment to be unhygienic and stored poorly. For example, we found a stained crash mat to be stored on a person’s toilet floor. We fed this back to the registered manager who addressed this. We observed staff to wear personal protective equipment appropriately and practice safe hand hygiene. We observed pressure-relieving equipment such as mattresses and cushions to be clean and fit for purpose. This protected people from the risk of harm.

There were clear processes and policies to ensure the environment was kept clean and hygienic. An audit was completed to ensure any issues were identified and actioned. A recent audit completed by the specialist infection control nursing team had identified many improvements had been made and their guidance implemented. This protected people from the spread of infection. Audits covering mattresses and pressure cushions were in place to ensure these remained clean and hygienic. This protected people from the risk of harm. Staff had received training in infection control to ensure people were protected from the spread of infection.

Staff knew what personal protective equipment they should wear and when. Staff knew how to put on and remove this equipment, in a safe way. This protected people from the spread of infection. Staff told us the home was clean and tidy and recognised the importance of good infection prevention control measures. Staff said, “I have completed training, and the home is clean and tidy, it’s home it is lived in but is clean and tidy.” Another staff member said, “The home is really clean and tidy, and we have just had another audit from IPC staff, and we did very well.”

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.