The Care Quality Commission
  • Care Home
  • Care home

Archived: Trelana

Poughill, Bude, Cornwall, EX23 9EL (01288) 354613

Provided and run by:
Embrace (South) Limited

Important: The provider of this service changed. See new profile

All Inspections

1 October 2013

During an inspection looking at part of the service

We met several people who used the service but most were unable to tell us their experience of living at Trelana due to their physical and mental health conditions. However, one person told us, "It's alright. I love it. The staff are very good" and another said, "Friendly."

We looked closely at the care of two people using the service, spoke to 11 staff, the registered manager and a GP with good knowledge of the home.

We saw that staff were attentive to people's needs, kind and respectful. They knew about people's needs and how to care for them in a safe way. Care records described people's needs, plans of care, risks and showed that care was monitored. This meant that people's health and wellbeing were promoted.

Staff knew how to safeguard people from abuse. They had received training and additional information to support that training.

Staff training was well organised, with clear indication as to what training was required, when it was due and when it must be repeated. A GP said staff were knowledgeable about people's needs. He said he could see definite improvements at the home. Staff told us of much increased training, closer supervision of their work and better communication. They said they felt well supported.

There were regular checks and audits at the home to test the quality of the service and ensure people's safety. Areas identified for further improvement were the format of care planning and upgrades to the environment.

3 July 2013

During an inspection in response to concerns

We had received information which could indicate poor or abusive practices were being used at the home. We used a number of different methods to help us understand the experiences of people using the service because some people had complex needs which meant they were not all able to tell us their experiences.

We observed some skilled and respectful care and five of the six staff talked with enthusiasm about their work. We saw examples of individual needs being met, one being a birthday cake with a "tipple" and a (baby) doll handed tenderly to the person who received it with a look of joy. However, some staff were unable to tell us about some people's needs, such as one person's high risk of pressure damage.

Two people told us their experiences. Their comments included, "Some things are first class. Some things are not" and "Some staff are nice but not all of them." One talked of 'wetting herself' when waiting for staff to attend. We saw many positive comments in the home's feedback questionnaires but also comments of concern - "Some staff are good and helpful but many are not" and ",,,I do have concerns about the way (mum) is spoken to." These comments had not led to further investigation. Neither did staff have a formal opportunity to express any concerns. Most did not know how to alert concerns outside of the home if this was felt necessary to protect people. This despite having received training in the safeguarding of vulnerable adults.

4, 9 April 2013

During a routine inspection

During our visit we spoke with five people who were living in the home, either in their private room or in the lounges or dining rooms. We were able to observe 12 others who were not able to speak with us. We spoke with fourteen staff on duty as well as the registered manager. We looked at care records, staff training records and other records necessary to the running of the home.

We saw staff treating people with respect throughout our visit, and making good efforts to relate well with them.

We saw that families had been involved in reviewing the way the home provided care for people. We saw that people's nutritional needs had been assessed and that care was taken to provide good food and drinks that were suitable for each person.

There were sufficient staff on duty at the time of our visit. We saw from the rota that the service had not always been able to cover for absence at short notice and recruitment was continuing. Training had been provided to enable staff to provide care in a safe way. Further training was needed to develop staff competence in the particular needs of people who lived in the home.

Care needs had been recorded carefully with guidance for staff in the way that each person liked their care to be delivered. Records needed to ensure consistent safe care were accurate and up to date. Audits had been carried out to ensure safe running of systems including fire safety and record keeping.

14 August 2012

During an inspection in response to concerns

On the first day two inspectors visited the home. We made a partial tour of the premises, observed how people were being cared for, looked at care records, spoke with staff and looked at staff records and provider information.

The home did not have a manager in post. Management support was provided by the company but not consistently enough to check on staff's performance and provide a safe and satisfactory service.

We saw that staff were working well to provide good care for people. The care plans gave good information about how this care should be provided, but the records kept in people's rooms did not show that the care was being delivered consistently in the way that it had been planned.

We found that not enough trained nurses were employed to provide consistent nursing care. There had been a recruitment drive and five posts had been offered but most nurses had not taken up the offer of employment at Trelana. This resulted in reliance on agency trained nurses to a level that did not give sufficient stability to the team.

The second visit to the home was carried out by an inspector and a compliance manager to give feedback to the nominated individual for the company and the Regional Manager who accepted that prompt action was needed to address this combination of problems.

28 June 2012

During an inspection looking at part of the service

We carried out an unannounced inspection on 28 June 2012. On the day of our visit there were 39 people living at Trelana. The inspection team was led by a CQC inspector and was joined by an "expert by experience"; this is somebody who had experience of using services and who would provide that perspective.

We spoke with or observed fifteen people who live in the home and four regular visitors. We spoke with the company representative, the clinical lead nurse and six other staff.

We made a partial tour of the premises. We saw that on the lower ground floor there were displays that people could touch with furry and sequinned pictures, also objects of interest at intervals along the corridor. There were plenty of pictures and mementos of the recent jubilee celebrations. These were there to stimulate people's interest and help them find their way around the home.

There were several display boards with photos showing people who live in the home and their relatives engaging in recent activities in the home.

People were well dressed, clean, and comfortable in their surroundings. Staff told us they were able to be flexible about the time they helped people to get up and dressed in the mornings.

We saw lunch being served. One person told us they had complained because 'pasta bake had been served every day for tea', and now they get something different.

People were anxious because some staff had recently left and they knew that some more staff were due to leave soon. Regular visitors to the home told us they thought that staff who worked regularly in the home were 'Brilliant' but they were not so happy with agency staff who did not know people well.

We looked at care records and found that they were maintained to a safe standard but there was insufficient evidence of consultation and personal preferences.

There were significant gaps in training provided, so staff lacked updates in vital areas, and lacked specialist training in dementia care. This may mean that people with dementia may not have the specialist support they need.

We looked at staff rotas. We found that a safe level of staffing was maintained by the use of agency staff. An arrangement had been made with an agency so that the same staff would be provided consistently, to become familiar with people living in the home and their care needs. Recruitment was on-going at the time of this visit, with new care and nursing staff due to commence employment. There was no manager in post and the recruitment process had started. Some staff said they felt low morale because of the lack of stability in the team, and some said they felt undervalued by the company. European Care were responsible for management support. Though there was a business services manager who often worked at Trelana, three different regional managers had supported the home over the months of May to July 2012. This did not contribute to stable management.

16 June 2011

During an inspection in response to concerns

People told us that staff are 'very attentive' and 'always pop in when passing the door'.

Relatives told us that they have been to residents meetings (with their relative) and feel like they can make suggestions.

We were told that people know who to go to if they wish to make a complaint or raise concerns.

Lunch was underway when we started our visit. There were a lot of people in the dining room, there was little conversation. We were told that the meals are 'good'.