Tara's Retreat Care Home

Tara's Retreat Care Home is registered to provide accommodation and treatment for up to 69 people, some of whom may live with Dementia. Accommodation is spread over three floors.

People were encouraged to wear masks when they attended appointments or outside visits. The environment people lived in was clean and well ventilated. The home was spacious with enough sitting areas to ensure people and staff could socially distance when they were spending time outside their bedroom.

Visitors at the home had been tested and it was required for them to wear appropriate Personal Protective Equipment (PPE) when entering the home. Staff wore their PPE according to current guidance and they were trained in safely putting on, taking off and dispose of these safely.

Staff were allocated to work in the same units as far as possible and regular testing in line with current guidance meant if staff had to move to another area, they could do this following a negative rapid test.

The inspection took place on 23 May 2018 and was unannounced.

Tara's Retreat 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. They are registered to provide accommodation and treatment for up to 46 people, some of whom live with Dementia.

At our last inspection on 31 March 2016, we rated the service Good. At this inspection, we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 told us they felt safe at the service and there were appropriate risk management arrangements in place to help keep people safe. There was a robust recruitment process in place with sufficient deployed to ensure that people’s needs were met when required.

Staff received a comprehensive induction to the service when their employment commenced and they continued to receive regular training and updates as required. This gave staff the skills and information they needed to support people effectively and safely.

People`s medicines were managed safely by staff who had received training and had their competencies checked. Care plans were comprehensive and provided staff with detailed information. People, where they were able and or family were involved in the development and review of people's care plans.

Staff asked people for their consent before they provided support. Where people were unable to consent verbally, staff took time to get their consent through other means such as eye contact or body language. The management and staff worked in line with the Mental Capacity Act (MCA) principles and associated deprivation of liberty safeguards DoLS.

People and their relatives told us staff were kind and caring and we observed staff supported people with compassion and were patient. Staff were aware of people`s likes, dislikes and preferences and delivered care and support in accordance to people`s wishes.

People were provided with opportunities to engage in social activities of interest to them. The environment and the grounds were well maintained and provided people with opportunities to utilise the surrounding garden areas as well as al fresco dining if people wished. The décor was appropriate for people who lived with Dementia with plenty of stimulating objects for people to engage with. Memory boxes and memorabilia were placed in corridors and outside people’s bedrooms to help them recognise their environment.

The Management was open, transparent and inclusive and we observed visible and effective leadership within the service. The service was effectively managed. The registered manager was supported by deputy and assistant manager who effectively as a team.

The management team provided people with a range of opportunities to provide feedback and comment upon the service in order to continually make improvements. There was a comprehensive range of quality monitoring checks completed with an action plan in place to address any shortfalls.

At the time of our inspection, the home was having some building and refurbishment work done. We noted risk assessments were in place. The work was planned to minimise inconvenience to people who used the service.

The service 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 there were systems in place to safeguard them from the possible risk of harm. The service followed safe recruitment procedures and there were sufficient numbers of suitable staff to keep people safe and meet their needs. Medicines were managed safely and people received their medicines regularly, on time and as prescribed.

People received care and support from staff who were competent in their roles. Staff had received relevant training and support from the management team for the work they performed. They understood the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards. They were aware of how to support people who lacked mental capacity. People’s nutritional and health care needs were met. They were supported to maintain their health and wellbeing, and had access to and received support from other healthcare professionals.

The experiences of people who lived at the care home were positive. They were treated with kindness and compassion and they had been involved in the decisions about their care. People were treated with respect and their privacy and dignity was promoted.

People’s care needs were assessed, reviewed and delivered in a way that promoted their wellbeing. They were supported to pursue their leisure activities both outside the home and to join in activities provided at the home. An effective complaints procedure was in place.

There was a caring culture and effective systems in operation to seek the views of people and other stakeholders in order to assess and monitor the quality of service provision. However, the advice and guidance received from the public health department had not been adhered to in order to minimise the risk of the spread of infection.

We found that the people's care was well planned in conjunction with the person or their relatives. We saw that the people's care plans were relevant to the person's needs and that their care was planned to understand the person and how their dementia impacted on their life. Staff strived to ensure that those people who were living with dementia had a good quality of life. People were given choice where possible and throughout the inspection we saw that the people's dignity and independence was promoted.

People were offered stimulation and staff ensured that they engaged with the people in a manner the person understood. We found that staff understood the principles of caring for people living with dementia and understood the need for people to live well with dementia.

Care records were reviewed regularly and were responsive to any changes in people's circumstances. We saw people with dementia were protected from harm because staff were trained and knew the people they cared for well and were able to respond to body language.

Care staff had been trained in the care of people living with dementia and were aware that people should have the opportunity to live a full life, we saw that people were assisted to do this.

The home worked in partnership with health and social care professionals to ensure the person had optimum health and welfare. This included using local health care services to avoid hospital admissions where possible.

The home had good systems in place to review the services to the people. There were systems in place to invite feedback from all stakeholders in the service particularly the people who lived in the home. This ensured the peoples' wishes were at the heart of running their home.

Here are some of the things the people and their relatives told us about living at Tara's Retreat:

'I am well looked after', 'I love living here' and 'I would give them 10 out of 10'. 'The staff are great and that nothing is too much bother for them'. 'When I am sad the staff are lovely to me and try to make things better for me'. 'I can sit in the lounge and watch television for as long as I like in the evening, I get up when I want to, no one minds and I am left alone to suit myself, but the girls are always around and come when I need them'.

People were satisfied that there were plenty of activities and we saw that there was an activities timetable. People had also been on a trip to Southend and/or Woburn Safari Park earlier in the week.

People told us that their privacy and dignity were respected and that staff always closed the doors when they helped with personal care. We observed the home to be visibly clean on the day of our visit and all the people appeared to have their personal care needs met.

The staff we spoke to had a good understanding of people's needs and how to meet them. However, from our review of the care plans, we found that monthly evaluations had been carried out but some changes identified had not been reflected in the careplan.

Staff told us they enjoyed working at the home and felt supported by management.