We carried out a review of the data available to us about Tile House 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 Tile House, you can give feedback on this service.
Accommodation was arranged over three floors which could be accessed by stair lifts and a staircase. People had their own private rooms and there were two communal lounge areas, a dining room and a quiet area so people could socialise or spend time alone.
The inspection was conducted on 16 January 2019 and was unannounced.
At the last inspection we rated the service ‘Good.’ At this inspection, 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.
A registered manager was in post. 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 felt safe living at Tile House. Staff knew how to identify, prevent and report abuse. Safeguarding investigations were thorough and identified learning to help prevent a reoccurrence.
Individual and environmental risks to people were managed effectively. Risk assessments identified risks to people and provided clear guidance to staff on how risks should be managed and mitigated.
There were enough staff to meet people’s needs in a timely way and staff were able to support people in a relaxed and unhurried way. Appropriate recruitment procedures were in place to help ensure only suitable staff were employed.
Arrangements were in place for the safe management of medicines. People received their medicines as prescribed. The home was clean and staff followed best practice guidance to control the risk and spread of infection.
People’s needs were met by staff who were competent, trained and supported appropriately in their role. Staff acted in the best interests of people and followed legislation designed to protect people’s rights and freedom.
People had access to health professionals and other specialists if they needed them.
Procedures were in place to help ensure that people received consistent support when they moved between services.
People were cared for with dignity and respect and were treated in a kind and caring way by staff. Staff knew people well, encouraged people to remain as independent as possible and involved them in decisions about their care.
Staff protected people’s privacy and dignity and responded promptly when people’s needs or preferences changed.
The service worked well and in collaboration with all relevant agencies; including health and social care professionals to help ensure there was joined-up care provision. Staff worked in partnership with healthcare professionals to support people at the end of their lives to have a comfortable, dignified and pain-free death.
People had access to a range of activities. They knew how to make a complaint and felt any concerns would be listened to and addressed effectively.
People, their family members and external professionals were positive about the running of the service and were confident in the management team.
There were robust auditing processes in place. The quality of the service was monitored and appropriate actions were taken when required.
People, their families and staff had the opportunity to become involved in developing the service.
The inspection was unannounced and was carried out on 23 May 2016.
There was a registered manager in place at the home. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run.
People and their families told us they felt the home was safe. Staff and the registered manager had received safeguarding training and were able to demonstrate an understanding of the provider’s safeguarding policy and explain the action they would take if they identified any concerns.
The risks relating to people’s health and welfare were assessed and these were recorded along with actions identified to reduce those risks in the least restrictive way. They were personalised and provided sufficient information to allow staff to protect people whilst promoting their independence.
People were supported by staff who had received an induction into the home and appropriate training, professional development and supervision to enable them to meet people’s individual needs. There were enough staff to meet people’s needs and to enable them to engage with people in a relaxed and unhurried manner.
There were suitable systems in place to ensure the safe storage and administration of medicines. Medicines were administered by staff who had received appropriate training and assessments. Healthcare professionals, such as chiropodists, opticians, GPs and dentists were involved in people’s care when necessary.
Staff followed legislation designed to protect people’s rights and ensure decisions were the least restrictive and made in their best interests.
Staff developed caring and positive relationships with people and were sensitive to their individual choices and treated them with dignity and respect. People were encouraged to maintain relationships that were important to them.
People were supported to have enough to eat and drink. Mealtimes were a social event and staff supported people, when necessary in a patient and friendly manner.
Staff were responsive to people’s communication styles and gave people information and choices in ways that they could understand. They were patient when engaging with people who could not communicate verbally and who used a variety of signs, noises and body language to express themselves. Staff were able to understand people and respond to what was being said.
People and when appropriate their families were involved in discussions about their care planning, which reflected their assessed needs.
There was an opportunity for families to become involved in developing the service and they were encouraged to provide feedback on the service provided both informally and through an annual questionnaire. They were also supported to raise complaints should they wish to.
People’s families told us they felt the home was well-led and were positive about the registered manager who understood the responsibilities of their role. Staff were aware of the provider’s vision and values, how they related to their work and spoke positively about the culture and management of the home.
There were systems in place to monitor quality and safety of the home provided. Accidents and incidents were monitored, analysed and remedial actions identified to reduce the risk of reoccurrence.
People were cared for in a clean environment. We saw the home was in a good state of repair and well decorated. This reduced the risk of infection.
We looked at the provider's policies and procedures covering different aspects of infection control. These included risk assessments, which were appropriate for this type of service. A new uniform policy had been introduced, which provided guidance to staff about the wearing of jewellery and the need to keep fingernails short. We saw staff were complying with this policy.
There were effective systems in place to reduce the risk and spread of infection.
The laundry room had been divided in two to ensure clean laundry did not become contaminated by dirty laundry and the facilities for maintaining good hand hygiene had been improved.
Training records showed all staff had received refresher training in infection control since our last inspection. We spoke with four members of staff who explained the circumstances in which they wore personal protective equipment. We saw this was readily available in key places throughout the home and was being used.
We found before people received care or treatment they were asked for their consent. We saw examples of where people's decisions to refuse care had been respected. Where people lacked capacity to consent, best interest decisions had been made in accordance with legislation.
We looked at three care plans and saw each contained an assessment of people's needs. One person we spoke with said, 'I'm quite happy here, everyone looks after you'. A family member told us, 'The staff are wonderful. If you mention anything it gets sorted straight away'. People's needs were known and met.
People were cared for in a clean environment. However infection control guidance had not been followed. Infection risks had not been assessed, staff rarely used protective aprons, and hand washing facilities in the laundry were unsuitable. People were not protected from the risk of infection.
People were cared for by suitably qualified and experienced staff. Effective recruitment processes and checks were undertaken. Medical records and records relating to the management of the service were accurate, fit for purpose and kept securely.
People told us that they could make decisions and that the staff were 'nice'. People said that they had no concerns about how their care needs were met. People commented that they could make choices and these were respected. We were told that staff were available when people needed them and knew what care they required. People told us the staff were 'wonderful' and that they felt safe and happy at the home.
We telephoned three relatives. All were very happy with the care that was provided at Tile House. They confirmed that they were fully involved in, and informed about, the care their relative was receiving. Relatives said they felt confident in the staff's ability to care for their relative. One said they would give the home 'ten out of ten'. All relatives said that if they had raised any questions or concerns these had immediately been resolved. All relatives said they would recommend the home to other people.
We spoke with two health professional involved in the care of people. They stated that they had no concerns about how people's health and care needs were met and were complimentary about the way the service met people's needs. .
Everyone, people, relatives and health professional, we spoke with confirmed that people's privacy and dignity was maintained at all times. We observed that staff were courteous and respectful of people's views and opinions and that dignity was respected. We saw that people were offered choices about meals, where they sat and activities.