Talbot House

Updated 7 December 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

This inspection was carried out by two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. We also consulted with mental health professionals and experts in eating disorders.

Service and service type

Care home name is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Talbot House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 27 October 2022 and ended on 18 November 2022. We visited the location’s service on 27 October 2022.

What we did before the inspection

We reviewed information we had received about the service since it was registered with the CQC. We sought feedback from the local authority, Healthwatch England and professionals who work with the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with three people and (with consent), three of their relatives. We spoke with eight staff including the registered manager, clinical lead, site manager and five care staff. We spoke with two professionals who work with the service.

We reviewed two staff files for recruitment processes and two people’s care records. We reviewed a number of other documents, health and safety records and policies.

Updated 7 December 2022

About the service

Talbot House is a residential care home providing support to up to seven people. The service provides support to people with eating disorders. The service is one of a few specialist care homes supporting people with these conditions across the county. At the time of our inspection there were four people using the service.

The care home accommodates people across three floors in one building. People have their own bedrooms with en-suite bathrooms. There are shared communal spaces such as a lounge, kitchen, dining area and garden.

People’s experience of using this service and what we found

Due to the specialist nature of the service provided, during the inspection, we regularly consulted with a number of professional experts in the field of eating disorders and mental health to help guide our judgements. The service had good care outcomes for people but there was a lack of clear and consistent systems to ensure the registered manager had good oversight of the service. This had resulted in inconsistent records, not all risks to people being identified, multiple medicine errors and a shortfall in staff understanding of some of the needs of people being supported. Professional experts in eating disorders agreed this could compromise the safety and wellbeing of the people being supported.

The provider was not registered to support people with learning disabilities or autistic people. However, they were supporting people with eating disorders who were autistic. We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

People were supported by staff who had received training in eating disorders, treated them kindly and made them feel safe and less worried. The service was clean and well maintained. Regular staff team supported people and there was no need for use of agency staff.

Where people had given consent to do so, their relatives were involved in their care and no decisions about care were made without the person being at the centre of discussions before plans were agreed.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were supported to access all relevant health professionals in order to support their recovery and ensure their health and wellbeing were being appropriately monitored.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 14 July 2021 and this is the first inspection.

Why we inspected

This inspection was planned based on the date the service was first registered with the CQC. We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to medicines, risk management, personalised care, staff training and support and systems to measure quality at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.