12 April 2016
During a routine inspection
The inspection took place on 12 April 2016 and was unannounced. The service had recently been registered with the Care Quality Commission (CQC) and had not been inspected before.
Triscott House is an extra care housing service that provides personal care for up to 33 older people. There were 29 people living at the service at the time of our inspection. Each person had their own tenancy with a housing association which also owned the building.
The service is required to have a registered manager and there was a registered manager in post at the time of our inspection. They had recently been promoted to area manager, and another manager working at the service had made an application to become the new 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 received their medicines as prescribed and in a safe way and there were records to show these had been administered. However, medicines records did not include information about how many medicines were received from the pharmacy and there were no recorded audits or tablet counts. Therefore there was a risk that the staff would not identify if there was an error with medicine administration, when stock was running low or another type of medicine error. There was no evidence of impact of these issues and the provider put them right as soon as we raised them.
Staff had received training in safeguarding of adults and this was updated regularly. There was a safeguarding policy and procedure in place. The registered manager worked with the local authority’s safeguarding team to investigate any safeguarding concerns raised.
Staff had undertaken basic awareness training in the Mental Capacity Act (MCA) 2005 and were aware of their responsibilities in relation to the Deprivation of Liberty Safeguards (DoLS). We were told and saw that people were given choices and the opportunities to make decisions, and records showed that consent was obtained.
People told us they felt safe and we saw that there were systems and processes in place to protect people from the risk of harm whilst giving them the chance to take positive risks. There were enough staff on duty to meet people’s needs and there were contingency plans in the event of staff absence to ensure people’s safety.
People’s nutritional needs were being met. Staff supported people to shop for their food and cook meals in their own flats where they were able to, and supported those who chose to come downstairs to use the restaurant.
Staff received effective training, supervision and appraisal. The registered manager sought guidance and support from other healthcare professionals and kept themselves informed of important developments within the social care sector in order to cascade information to staff, thus ensuring that the staff team was well informed and trained to deliver effective support to people.
Staff were caring and treated people with dignity and respect and in a way that took account of their diversity, values and human rights. Care plans were in place and people had their needs assessed. Care records contained detailed information and reflected the needs and wishes of the individual so staff had the information they required to meet people’s needs.
A range of activities were provided in house and people were given the opportunity to take part in projects such as gardening club and running a shop. The provider had taken steps to develop the environment to meet the needs of people living with dementia and those with sensory impairments.
People, relatives, staff and stakeholders told us the registered manager, management team and staff were supportive and professional. The management team told us they encouraged an open and transparent culture within the service. The service supported people to raise concerns and used feedback to make improvements where needed.
The provider had effective systems in place to monitor the quality of the service and ensured that areas for improvements were identified and addressed.
There were regular meetings for staff, managers and people using the service which encouraged openness and the sharing of information.