Pennine Care Centre

Pennine Care Centre is a residential care home providing accommodation for people who require personal care to up to 64 people. The service is split into 2 units, Pennine and Moorland. Pennine supports older people, including those with dementia. Moorland is a male only unit and supports both older people and younger people, including those with mental health conditions. At the time of our inspection there were 45 people using the service.

People’s experience of using this service and what we found

We have made a recommendation around the reporting and recording of accidents and incidents to ensure consistency in staff practice.

The provider was working to improve the culture of the service to ensure staff were fully supported and understood and promoted their visions and values.

Improvements had been made to the overall cleanliness within the service and people were protected from the risk of infection. Overall, people received their medicines as prescribed, and the provider was working to support staff competency in recording of medicine administration. Plans were in place to improve guidance within care plans to ensure they were person specific. There were enough staff to meet the needs of people using the service safely. People’s long term health conditions were suitably assessed, and staff followed guidance to support people’s clinical needs. People were protected from the risk of abuse and people were supported to understand how to report concerns about safety.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Governance systems were now embedded within the service and allowed the provider to maintain oversight of key risk areas. There was a focus on continuous learning and improvement and action plans were effectively used to improve people’s safety and experience. Feedback was encouraged and used to make changes within the service. Staff worked collaboratively with a range of different professionals.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 1 September 2022) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We received concerns in relation to the quality-of-care people were receiving, management of accidents and incidents and leadership in the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed to good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Pennine Care Centre on our website at www.cqc.org.uk.

Recommendations

We have made a recommendation in relation to accident and incident recording. Please see the safe section of this report for full details.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Pennine Care Centre is a residential care home providing personal care to up to 64 people. The service is split into two units, Pennine and Moorland. Pennine supports older people, including people with dementia. Moorland is a male only unit, supporting older people and some younger people with mental health conditions. At the time of our inspection there were 45 people using the service.

People’s experience of using this service and what we found

Governance systems were not yet fully embedded to ensure effective action was taken to drive improvement. Further improvements were required to support people to achieve good outcomes and promote person centred care. People and their relatives had opportunities to feedback into the service but did not always feel assured their feedback was acted upon.

Some areas of the service were not cleaned to a high standard. Best infection prevention and control (IPC) practice was not always followed.

People and their relatives were not always involved in their care planning. Further improvements were required to ensure people’s personal spaces were homely and people were supported to participate in activities of their choice.

People were cared for by friendly staff. People’s privacy and dignity was respected, and people were supported to make everyday choices, such as what outfit to wear.

There were enough suitably trained staff to meet the needs of people. People’s long-term health risks were assessed and clear guidance for staff was available to support people safely. People received their medicines as prescribed by competent staff. Accidents and incidents were reported and investigated and people were kept safe from the avoidable risk of abuse.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was inadequate (published 27 May 2022). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.

This service has been in Special Measures since 6 April 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

We carried out an unannounced focused inspection of this service on 16 and 23 February 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, staffing, dignity and governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Caring and Well-led which contain those requirements.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from inadequate to requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Pennine Care Centre on our website at www.cqc.org.uk.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to safe care and governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

About the service

Pennine Care Centre is a residential care home providing accommodation and personal care to up to 64 people. At the time of the inspection there were 57 people living there. There are two units, Pennine and Moorland Suite. Pennine is for older people, including people living with dementia. Moorland Suite is a male only unit and supports older and some younger people with mental health conditions.

People’s experience of using this service and what we found

The provider lacked oversight and governance arrangements to ensure improvements were made and quality of care maintained.

Audits were in place, however had not been used to make the required changes or to drive the changes to keep people safe. The morale in the home was poor and this led to people receiving inappropriate care that did not respect them or consider their dignity.

There was not enough staff to undertake effective cleaning of the home or to support people whose behaviours posed a risk. Staff had not received the required training to ensure competency.

Infection, prevention and control was not well managed, and we were not assured staff used personal protective equipment appropriately. Visiting arrangements were not in accordance with the government guidance.

Medicines were not managed safely and risk assessments had not been completed consistently for all health conditions. Behaviours plans were not in place to support staff with the guidance they required.

People were not always protected from the risk of harm and safeguards had not been raised following all incidents which had occurred. When safeguards had been raised, they had been investigated and information shared with professionals.

Staff felt unsupported and reported the home lacked structure and clear guidance. People were not enabled to enjoy daily choices or have activities to occupy their time. People had contributed to the menu planning.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was good (published 28 August 2021).

Why we inspected

The inspection was prompted in part due to concerns received about infection prevention and control and the providers oversight. A decision was made for us to inspect and examine those risks.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to inadequate based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Pennine Care Centre on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to safe care, dignity and governance oversight this inspection.

Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

About the service

Pennine Care Centre is a residential care home providing accommodation and personal care to up to 64 people. At the time of the inspection there were 54 people living there. There are two units, Pennine and Moorland Suite. Pennine is for older people, including people living with dementia. Moorland Suite is a male only unit and supports older and some younger people with mental health conditions.

People’s experience of using this service and what we found

People and their relatives told us people were safe and protected from avoidable harm. There was a proactive approach to risk assessment and management. There were infection prevention and control procedures that met current government guidance for COVID-19. There were enough staff on duty to support people safely. Staff were safely recruited. People received their medicines as prescribed. When accidents and incidents happened there were reviews and investigations to see if these could have been prevented and how to prevent them in the future.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff received induction and training to carry out their role. The premises was designed and decorated in a way that met people’s individual needs and preferences. People told us they enjoyed the food and drink.

People and relatives praised the staff for being kind, caring, patient and forming close bonds with people. There was a range of different activities to appeal to both older people and the younger adults living there. People’s independence was promoted. People were supported to have contact with friends and relatives.

The provider and registered manager had embedded a positive culture that achieved good outcomes for people. There was a governance system in place that identified themes and trends and noted where improvements may be required. There was a constant strive for improvements and new systems, such as electronic care plans and new management structures were implemented, and their effectiveness was reviewed.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This is the first inspection under this provider's registration. The last rating for the service, under the previous provider was Good (published on 15 November 2019).

Why we inspected

This was a planned inspection based on the previous rating.

We found the following examples of good practice.

• There were systems in place to ensure the risk of visitors spreading or catching coronavirus were mitigated.

• The registered manager had implemented increased cleaning schedules and identified ‘high touch’ and ‘high traffic’ areas of the home to be cleaned more frequently.

• People only moved into the home after a negative coronavirus test and the registered manager made sure they understood and were happy to be cared for in their bedrooms for the 14 day isolation period.

• The provider had built an outside aviary. Within the aviary was a decked area with a cabin to be used by people and their visitors when visiting was allowed again. People had researched and chosen the breeds of birds who lived in the aviary.

• The provider had bought a large screen interactive device to enable people to enjoy video calls with relatives whilst the home was closed to visitors.

Further information is in the detailed findings below.