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Temecare Limited - Teme Court Residential Care Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 31 January 2019

We undertook an unannounced inspection on 18 December 2018.

Teme Court 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.

Teme Court is registered to provide accommodation with personal care for up to 21 older people some of whom are living with dementia. The accommodation is split across two floors within one large adapted building. At the time of our inspection, there were 13 people living at the home.

At our previous inspection on 19 April and 16 May 2018, we rated the service as 'Inadequate,' and it was therefore placed in 'special measures.' We identified the provider continued to be in breach of five Regulations. These included the provider’s failure to maintain people's safety through strong recruitment practices and staff training. In addition, the provider had not made sure people were provided with care in a personalised way and the overall leadership and governance of the service was not effective to ensure people received high quality care.

We asked the provider to send us a report explaining the actions they were going to take to improve the service. We also imposed conditions on the provider's registration to which restricted the provider from admitting any other people into the home to live. We undertook this inspection to see whether the provider had made the required improvements.

At this inspection, the provider showed they had made sufficient improvements to the service and it was no longer rated as inadequate overall or in any of the key questions. Therefore, the service is no longer in 'special measures.' However, we found the work to improve the service was still ongoing and further time was required to evidence the improvements could be sustained in the longer term which we have reflected in the ratings.

There was no registered manager at the time of our inspection. However, the provider had recruited a new manager who would be registering with us. 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.

The provider and the management team had taken some steps to address and reduce the risks of infections from spreading. The improvements needed to be continued to further reduce the risks of infections particularly in communal toilet and shower rooms.

Ongoing improvements were being made to care records so these provided more detail about people, were accurate and documented the risks related to people's health and well-being. Further work was needed to ensure people’s care records consistently guided staff in providing personalised care.

Staff recruitment records had been checked since our last inspection. This was work in progress so the provider could assure themselves people’s safety was maintained because all staff were suitable to work with people who lived at the home.

Staff had now received access to training and support to meet the needs of people they cared for. The provider and management team were checking staff’s knowledge and practices to assure themselves people were provided with effective care and improvements were ongoing.

The provider was taking steps to create a dementia friendly environment. Improvement work needed to be continued so the home environment meets the needs of people who the provider had agreed to provide care for and any hazards were remedied.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People’s choices and decisions were now promoted b

Inspection areas

Safe

Requires improvement

Updated 31 January 2019

The service was not consistently safe.

The provider’s infection prevention and control procedures did not always ensure risks to people from infections were adequately reduced.

Risks to people from hazards in the home environment had been reduced but further work was required to ensure the environment was well maintained in all areas.

Staff recruitment measures were being improved to reduce the risk of employing unsuitable staff.

Staff knew how to support people to reduce the risks of harm and staffing arrangements met people’s needs safely.

People’s medicines were made available to them as prescribed.

Effective

Requires improvement

Updated 31 January 2019

The service was not consistently effective.

Staff understood the importance of obtaining people's consent to care. Documentation to show specific decisions had been made on behalf of people and with their representatives who had the legal authority to do this was not always made clear.

Work was ongoing to make sure the home environment was adapted, decorated and any repairs undertaken to ensure it was in good condition and met the needs of people who lived there.

Staff had now received training to support the needs of people they cared for but they did not always put their training into practice. Arrangements to check staff’s knowledge and practices were ongoing.

People's experience at meal times had improved so people were supported in a more personalised way.

Caring

Good

Updated 31 January 2019

The service was caring.

People were supported by staff who knew them well and people were now consistently treated with dignity and respect.

Staff were caring to people and involved them in their care which had been promoted partly by the improvements being made.

Visitors were welcomed in the home.

Responsive

Requires improvement

Updated 31 January 2019

The service was not consistently responsive.

Care plans were being updated as they did not always show they were centred on the needs and preferences of each person.

Progress was being made and needed to continue to support people to follow their individual hobbies and interests.

People had access to the provider’s complaints procedures.

Well-led

Requires improvement

Updated 31 January 2019

The service was becoming well led.

The provider had recruited a new manager who was supporting them to develop and strengthen quality checking systems.

The improvements were ongoing and had not been tested over a longer period for their effectiveness and sustainability.

People could provide their feedback about the quality of their care.

Staff enjoyed working at the home and were being supported to provide good care.