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Archived: Tilford Park Nursing Home Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 26 August 2016

Tilford Park Nursing Home provides nursing care and accommodation for a maximum of 42 older people who may be living with dementia. At the time of this inspection there were 38 people living at the home, all apart from two who were living with dementia.

This was an unannounced inspection which took place on 01 August 2016.

During our inspection the registered manager was present. 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 told us that they felt safe in the home. However, staffing levels did not ensure that people who lived with dementia received all the support they required at the times they needed. We observed that staff were rushed and had little time to spend with people outside of delivering care to them. You can see what action we told the provider to take at the back of the full version of the report.

Staff had some understanding of the Mental Capacity Act 2005 (MCA) and of the Deprivation of Liberty Safeguards (DoLS) and had received training in these areas. People’s representatives had not always been involved in decision making processes when people lacked capacity to consent to ensure their rights were upheld. You can see what action we told the provider to take at the back of the full version of the report.

People said they were happy and comfortable with their rooms and we saw that they were attractively decorated with some personal touches including photographs and memorabilia. However, some elements of the environment didn’t lend themselves to assisting the needs of people with dementia. We have made a recommendation about this in the main body of our report.

Staff said that they received sufficient support and training to fulfil their roles and responsibilities. Training was provided during induction and then on an on-going basis. A training programme was in place that included courses that were relevant to the needs of people who lived at Tilford Park Nursing Home. However, at times some staff did not demonstrate sufficient understanding when supporting people who lived with dementia. We have made a recommendation about this in the main body of our report.

Everyone that we spoke with said that the manager was a good role model. Quality monitoring systems were in place that included seeking the views of people in order to drive improvements at the home. Checks were not always completed in line with the provider's policy and action plans were not always recorded to improve identified shortfalls. We have made a recommendation about this in the main body of our report.

Potential risks to people were assessed and information was available for staff which helped keep people safe. However, at times staff restricted people’s movements without a clear rationale being in place. We have made a recommendation about this in the main body of our report.

People said that in the main they were happy with the choice of activities on offer and that they were supported to maintain links with people who were important to them. Access to further stimulation would enhance people’s wellbeing further. We have made a recommendation about this in the main body of our report.

People were treated with kindness and compassion. Although we observed that staff at times appeared busy and rushed we saw no signs of impatience with people. Staff appeared dedicated and committed. We observed that care was given with respect and kindness but it was clear that some people had to wait for too long for the help they required.

Robust recruitment checks were completed to ensure permanent staff were safe to support people.

People said that they were happy with the medical care and attention they received and we found that people’s health

Inspection areas

Safe

Requires improvement

Updated 26 August 2016

The service was not consistently safe.

At times there were not enough staff on duty or deployed to support people and to meet their needs at the times they wanted.

Risks were assessed and managed but at times staff restricted peoples� freedom of movement without justification.

Staff employed by the registered provider underwent complete recruitment checks to make sure that they were suitable before they started work.

People told us they felt safe. Staff understood the importance of protecting people from harm and abuse.

Medicines were managed safely.

Effective

Requires improvement

Updated 26 August 2016

The service was not consistently effective.

People consented to the care they received. However, at times the requirements of the Mental Capacity Act 2005 were not followed in full.

Some effort had been made to ensure the design and decoration of the home was suitable for people who lived with dementia. Further work should take place to enhance people�s quality of life.

Staff were received training and support to care for people. Further dementia care training should be provided to increase staffs understanding and practice.

People were supported to eat a choice of meals that promoted good health.

People told us that they were happy with the medical care and attention they received. People�s health and care needs were managed effectively.

Caring

Good

Updated 26 August 2016

The service was caring.

People were treated with kindness and compassion by dedicated and committed staff.

People were supported to express their views and to be involved in making decisions about their care and support as much as they were able.

People were treated with dignity and respect. Staff were able to explain how they promoted people�s dignity and privacy.

Responsive

Good

Updated 26 August 2016

The service was responsive.

People�s needs were assessed and care and treatment was provided in response to their individual needs and preferences.

People�s health care needs were responded to appropriately.

An activity programme was in place and in the main people expressed satisfaction with the range of activities available.

People felt able to raise concerns and were aware of the complaints procedure. Systems were in place that supported people to raise concerns.

Well-led

Requires improvement

Updated 26 August 2016

The service was not consistently well-led.

Quality monitoring systems and were being used to identify and take action to reduce risks to people and to monitor the quality of service they received. However, checks and records were not completed in line with the provider�s policy.

The registered manager promoted a positive culture which was open and inclusive.

People spoke highly of the registered manager and said that the home was well-led. Staff felt well supported and were clear about their roles and responsibilities.