We carried out a review of the data available to us about Pemdale on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Pemdale, you can give feedback on this service.
We found the following examples of good practice.
¿ The home was clean. Cleaning schedules showed key areas were cleaned regularly and on a daily basis.
¿ Staff, professionals, and when necessary maintance persons were supervised to enter the home in a safe way. Staff promoted good social distancing practices.
¿ There were plans in place to manage an outbreak or if a person developed COVID-19 symptoms to isolate people and cohort staff.
¿ We observed staff wearing personal protective equipment (PPE) and washing their hands correctly. Staff received training and refresher training in relation to PPE. People had been supported (where possible) to understand the importance of staff wearing this equipment.
¿ The manager was monitoring key aspects of infection protection control (IPC) such as PPE stock levels to promote people’s safety.
Pemdale is a residential care home. The service can accommodate up to six people in one adapted single storey building, which is accessible for people who may have a physical disability. At the time of this inspection four adults were using the service who had a range of care needs including learning disabilities, autistic spectrum disorders and physical disabilities.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence.
People’s experience of using this service:
People’s privacy and dignity was respected and promoted. Staff knew how to protect people and keep them safe. They had the right skills and training to meet people’s needs, including making sure they had their medicines when they needed them.
Improvements had been made to the building, so it was safe, clean and comfortable for people to use. The building provided people with enough accessible individual and communal space, including a garden.
Staff supported people to stay healthy. They helped people to access healthcare services when they needed to and ensured they had enough to eat and drink.
The service acted in line with legislation and guidance regarding seeking people’s consent. People were enabled to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The outcomes for people using the service reflected the principles and values of Registering the Right Support by having opportunities to gain new skills and become more independent. This meant that people using the service received planned and co-ordinated person-centred support that was appropriate and inclusive for them.
People were given opportunities to participate in activities, both in and out of the service. People could go on holiday too if they wanted to.
Systems were in place for people to raise any concerns or complaints they might have about the service. The service responded in an open and transparent way when things went wrong, so lessons could be learnt, and improvements made.
There was strong leadership at the service which promoted a positive culture that was person centred and open. Since the last inspection a new manager had come into post. Everyone spoke very highly of them.
For more details of this inspection, 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 22 May 2018) and there were multiple 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 in all areas and the provider was no longer in breach of regulations.
Why we inspected:
This was a planned inspection based on the previous rating.
Follow up:
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
We inspected this service in January 2016 and rated the home as Good overall. When we inspected the service on 14 March 2018 we rated the home as Requires Improvement overall. This is the first time Pemdale has been rated as Requires Improvement. This inspection was announced the day before we visited. This was to ensure a member of staff would be present to let us into the home.
Pemdale is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Pemdale provides personal care and accommodation for people who have a range of learning disabilities and physical disabilities. Pemdale can provide care for up to 6 adults. At the time of the inspection 5 people were living at the home. Pemdale comprises of accommodation over one floor.
The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.” Registering the Right Support CQC policy
There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
We found some issues with the upkeep and maintenance of the home. The landlord was not maintaining the home to a reasonable standard. The landlord was separate from the provider. But the provider was responsible under their registration to provide accommodation to people living at Pemdale. We found walls were chipped and marked; bathroom furniture was chipped and rusty in places. This had the potential to trap dirt which could increase the spread of infection.
The service was not testing for the virus Legionella and there was a build of lime scale in parts of the home which could support the growth of this virus. This had the potential to make people unwell.
The home looked tired and uncared for. The land lord had not invested in the up keep of the building. The provider had not resolved this investment issue. This was a historical matter and had not been resolved for some time. The provider had not taken any timely action to resolve this issue and improve the day-to-day quality of lives of the people at the home. As a result of this the registered manager had to rely on charity funding to repaint people’s bedrooms and the communal parts of the home. This lack of investment connects with how the provider values the people living at Pemdale and how they promoted people’s rights.
People were also not given the opportunities to go on trips, attend events or go on holiday.
Staff training had been cancelled by the provider and some staff’s training was out of date. Staff competency checks were not robust and did not evidence how a member of staff was competent in their work. We identified some shortfalls in staff practice and knowledge which had not been identified before. There were no on going staff checks to ensure staff were competent in their work and that they had the knowledge to do their job well. There was no system to check the training had been effective.
There was a lack of robust quality monitoring checks. The quality monitoring checks completed by the provider had not identified the issues which we found during this inspection.
The registered manager was not fully aware of all the important events that they must notify us about by law. A person had sustained a serious injury and we had not been informed about it.
These issues constituted a breach in the legal requirements of the law. There was a breach of Regulation 12, 17, 18, of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. There was also a breach of the Registration Regulations (18). You can see what action we asked the provider to take at the back of the full version of the report.
People received their medicines as the prescriber had intended. The management of the home had taken recent advice about how to improve the administration of people’s medicines. However we found that some medications were not stored safely.
People had robust assessments in place which outlined the risks which they faced. Guidance was given to staff about how to reduce the risks to people. There were safety checks taking place to ensure the service was safe.
We found that people had sufficient to eat and drink. But people were not fully involved with their food choices on a daily basis. One person had complex needs with eating and drinking. Not all the staff were following the recommended guidance, in order to support this person to eat and drink in a safe way.
People had access to health services when they needed this support. Professional’s advice was sought to meet people’s needs. However, information relating to this advice and guidance from health professional was not always fully recorded in people’s care documents.
People were being supported by staff who were kind and caring towards them. People and their relatives spoke positively about the staff at the home.
We saw evidenced that people went out locally for lunch and went shopping or on errands with staff. The management of the home made efforts to meet people’s daily social needs.
People had person centred care assessments and care plans in place. People, their representatives, and staff had been involved in planning people’s care needs. People also had detailed and thoughtful end of life plans in place.
The registered manager showed a commitment for the service to improve. They told us about the changes which had taken place as a result of their input.
This inspection took place on 01 September 2015 and was unannounced. When we last inspected the home in December 2013 we found that the provider was meeting their legal requirements in the areas that we looked at.
Pemdale provides accommodation and support for up to six people who have a learning disability or physical disability. At the time of this inspection there were six people living at the home.
The home has a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People were safe and the provider had effective systems in place to safeguard people. Their medicines were administered safely and they were supported to access other healthcare professionals to maintain their health and well-being. They were given a choice of nutritious food and drink throughout the day and were supported to maintain their interests and hobbies. They were aware of the provider’s complaints system and information about this was available in an easy read format. They were encouraged to contribute to the development of the service. People had access to an advocacy service.
There were sufficient, skilled staff to support people at all times and there were robust recruitment processes in place. Staff were well trained and used their training effectively to support people. The staff understood and complied with the requirements of the Mental Capacity Act 2005 (MCA) and the associated Deprivation of Liberty Safeguards. They were caring and respected people’s privacy and dignity. Staff were encouraged to contribute to the development of the service and understood the provider’s visions and values.
There was an effective quality assurance system in place.
We found that care plans were well documented to promote continuity of care. Staff we spoke with were clear about the needs of the people they were caring for, and accurately reflected the care described in their care plans. We saw evidence that people's nutritional requirements were assessed and managed in line with their needs, and these were reviewed on a regular basis.
We found that people living in the home received their prescribed medication when they needed it and in a way that suited them. The premises were well maintained to ensure the home remained safe for people using the service, staff and visitors. Suitable arrangements were in place to address people's comments and complaints, and this ensured they were listened to.
When we arrived, two people were getting ready to go out. They went in the home's minibus to a local woodland area where they had a good walk, arriving home in time for lunch. One person was very happily singing and dancing to Elvis music in the lounge, with staff joining in. Another person was attending their day service. The fifth person who lives at this home told us he had been pottering around in his greenhouse and watering the garden.
There was a happy, homely atmosphere, with staff and people who live at the home sharing laughter and having fun, clearly enjoying each other's company.
One person told us they were looking forward to going on holiday to Spain and were happy that staff would be supporting them to do this.
We observed that, in their different ways, people showed that they were content living at this home and that they had good relationships with the staff. They showed that they felt safe, and were satisfied with the service being provided. There was a lot of laughter and friendly banter between staff and people living there during our inspection.