This inspection took place on 12 and 13 July 2018, and was unannounced. Peaker Park Care Village 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.

Peaker Park Care Village is a large residential and nursing home comprising of three separate buildings on one site. These are called Melody, Mulroy and Fiddlers Corner. Melody is the largest building and this is divided into four separate units. The four separate units are called Gumley, Bowden, Albany and Clipston. The home houses a maximum of 137 people, with between 20-30 people living in each unit.

People who live in the Gormley site are more independent. Fiddlers Corner mainly supported people with re-ablement from hospital, although this contract had recently ended. People who lived in the different units in Melody had more physical nursing needs and/or dementia care needs. At the time of our visit, the home had 110 people living there.

The home had 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.

The home had staffing vacancies which they were actively recruiting to. Sometimes there were not staff available to meet people’s needs at the time they wanted them met, especially at night time. Staff deployment meant there were times when people were not safely supported by staff.

People were safeguarded from harm. The registered manager and staff knew, and adhered to safeguarding procedures.

The risks related to people’s health and well-being had been identified, and actions to reduce the risks from becoming a reality had been taken by staff. Medicines were managed safely.

People’s healthcare needs were met by the nurses on duty; and by access to other healthcare professionals when requested or needed.

Good liaison between different health and social care professionals supported people to receive effective care.

The equipment people used was adequately maintained and clean; and the premises kept in safe and good repair. The home was clean and staff had a good knowledge of infection control measures.

Staff received training from the provider’s in-house training department, and this provided them with the skills and knowledge to meet people’s needs. They received support from their line managers to help them do their jobs well.

People received a choice of meals and regular fluids to keep them hydrated. There were mixed opinions about the quality of meals and the choice of food. The meal time experience of some people with higher dependency needs was rushed and task focused.

People were supported 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.

Staff were caring and kind to people. They supported people’s dignity and privacy. Staff provided to support to people at the end of their lives.

There was a range of activities available to people, although some people who lived with dementia did not have their interests or needs provided for as well as others. Some people had not been supported to undertake activities they had previously enjoyed.

The registered manager responded to complaints as they arose, but some people were not satisfied that enough changes had been made in response to their concerns.

Visitors were welcomed into the home.

The registered manager was respected by their staff team. They were open to learning from mistakes and passionate about providing good quality care to people who lived at the home.

The provider undertook regula

Our inspection took place on 25 and 26 April 2015. The first day of the inspection was unannounced, we informed the registered manager we would return the following day to complete the inspection.

Peaker Park Care Village is registered to provide care for up to 137 people who require personal or nursing care. The service consists of five self-contained units comprising of accommodation, dining areas, lounges and other communal areas. Facilities include a cinema, games rooms and hairdressing salons. People have access to landscaped gardens. At the time of our inspection 108 people were using the service.

The service had 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 because staff knew how to recognise and report signs of abuse. People were supported to be as independent as possible. The registered manager and team leaders of the five units calculated staffing levels based on the needs and dependencies of the people using the service.

Equipment was used safely and was regularly maintained.

The provider had robust recruitment procedures that ensured as far as possible that only staff suited to work at Peaker Park Care Village were employed there.

People received their medicines on time. The provider had effective procedures for the safe management of medicines. Medicines were safely stored and there were effective arrangements for the disposal of medicines that were no longer required.

People using the service told us they felt staff were knowledgeable about their needs. Staff received relevant training and support to be able to meet the needs of people using the service. Training was delivered by the provider’s own trainers and by externally sourced trainers. Relatives of people using the service consistently told us they felt staff were well trained.

The registered manager and senior staff had a good working knowledge of the relevance of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Other staff had an awareness of the legislation. All staff understood that no forms of restraint were permissible without authorisation by the local authority.

People’s nutritional needs were met. People had a choice of foods and drinks and were satisfied with the quality of the meals that were provided. Staff were attentive to people’s health needs and supported people to access health services when they needed them.

Staff were caring. We saw lots of examples of staff showing kindness and compassion. Staff often made extra special efforts on their days off to bring happiness into people’s lives. People using the service and their relatives had opportunities to be involved in decisions about their care and support. Relatives of staff working at the service or for the provider organisation used the service. This showed the service passed it’s `mum’s test’ that staff were happy for the loved ones to use the service. People were treated with dignity and staff respected people’s privacy.

People received care and support that was centred on their needs. They had access to social activities. An activities coordinator had developed activities that supported people to follow their interests and hobbies. People had opportunities to make suggestions and raise concerns. They told us they were confident about raising concerns and that they would be listened to. The provider had acted upon people’s comments and feedback, for example in relation to social activities and meals.

The management team were clearly visible and available to people using the service. The management team had clearly defined aims and objectives about what they wanted to achieve for each of the five units and the ser

Our inspection took place on 21 and 30 April 2015. The inspection was unannounced.

Peaker Park Care Village is registered to provide care for up to 137 people who require personal or nursing care. The service consists of five self-contained units comprising of accommodation, dining areas, lounges and other communal areas. Facilities include a cinema, games rooms and hairdressing salons. People have access to landscaped gardens. At the time of our inspection 97 people were using the service.

The service had 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 because staff knew how to recognise and report signs of abuse. People were supported to be as independent as possible. Enough suitably skilled and experienced staff were available to meet people’s needs, though on occasion cover for all unexpected absences had not been arranged.

Equipment was used safely and was regularly maintained.

The provider had robust recruitment procedures.

People received their medicines on time. The provider had effective procedures for the safe management of medicines but these were not always followed by staff. We saw omissions and inaccuracies in medicines records, though this had no impact on people using the service.

People using the service told us they felt staff were knowledgeable about their needs Staff received relevant training and support to be able to meet the needs of people using the service..

The registered manager and senior staff had a good working knowledge of the relevance of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Other staff had an awareness of the legislation. All staff understood that no forms of restraint were permissible without authorisation by the local authority.

People’s nutritional needs were met. People had a choice of foods and drinks and spoke in complimentary terms about the meals that were provided. Staff were attentive to people’s health needs and supported people to access health services when they needed them.

Staff were caring. We saw lots of examples of staff showing kindness and compassion. People using the service and their relatives had opportunities to be involved in decisions about their care and support. People were treated with dignity and staff respected people’s privacy.

People received care and support that was centred on their needs. They had access to social activities and staff supported people to follow their interests and hobbies. The registered manager had begun a review to ensure that all people with hobbies were supported to be able to follow them.

People had opportunities to make suggestions and raise concerns. They told us they were confident about raising concerns and that they would be listened to. The provider had acted upon people’s comments and feedback, for example in relation to social activities.

The management team were clearly visible and available to people using the service. The management team had clearly defined aims and objectives about what they wanted to achieve for the service. Staff felt well led. The provider had effective procedures for monitoring and assessing the service.

When we visited Peaker Park Care Village in October 2012 we found that care records contained basic information about how staff should care for people. During our visit 23 January 2013 we looked at care records for nine people. We found they contained a good level of detail about people’s needs and preferences and appropriate information to enable staff to provide care for people. Most of the staff we spoke with had a good knowledge of people’s care needs. We saw that staff treated people with respect and kindness.

We saw that people were being offered fortified milkshakes where these had been recommended by a dietician and food and fluid charts showed people were able to have snacks and drinks between meals.

We found that since our inspection in October 2012 an additional member of care staff had been allocated to one of the units within the home and an additional member of nursing staff was working across the home each day. We also found that the number of people living in the home had decreased from 86 to 79. This meant that there were more staff available to care for fewer people.

Since our last visit a new manager had started working at the home. She started just over a week prior to our visit 23 January 2013. At the time of our visit she had not gone through our registration process to be the registered manager for Peaker Park.

We received mixed feedback from people living in the home and their relatives. We spoke with six people about the service they received. They were happy with their support. One person told us “staff are very good, but there are not enough of them.” One relative told us “Dad is really looked after here, they are so kind to him.” Two other relatives told us they were not happy with the care of their family member.

As part of our inspection we used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

We spoke with five people who lived at Peaker Park during our visit who all spoke highly of the home although most of the feedback we were given did not relate directly to the areas we were looking at during this visit.

We found that improvements had been made since our last visit to the service in August 2013.

We found that soap and paper towels were available in each of the en suite bathrooms and laundry trolleys had been purchased and were in use to transport dirty laundry with proper regard to hygiene.

We were accompanied on the inspection by an expert in infection control. The provider may find it useful to note that the expert discussed with the hotel services manager and the infection control lead a number of other area where improvements could be made.

We found that quality assurance systems were being used effectively to ensure that the service was meeting the appropriate standards of quality and safety. This included detailed care records audits. We saw that the manager carried out weekly and monthly medication audits. These included reviewing the medication records and counting the tablets that were not dispensed in blister packs. This ensured that medicines were appropriately accounted for. We saw that staff administering medicine had undertaken competency assessments which were completed six monthly.