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Archived: Tranquility House Requires improvement

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Inspection report

Date of Inspection: 29 October 2013
Date of Publication: 29 November 2013
Inspection Report published 29 November 2013 PDF

People should get safe and appropriate care that meets their needs and supports their rights (outcome 4)

Meeting this standard

We checked that people who use this service

  • Experience effective, safe and appropriate care, treatment and support that meets their needs and protects their rights.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 29 October 2013, observed how people were being cared for and checked how people were cared for at each stage of their treatment and care. We talked with people who use the service, talked with carers and / or family members and talked with staff.

Our judgement

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

Reasons for our judgement

People’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. We looked at three people’s care records and saw that their needs were assessed prior to their admission to the home, and assessment visits were undertaken by senior staff to ensure that their needs could be met. We saw that this information was used to develop individual care plans and that care records included details about people’s specific needs. This meant that staff knew how to provide the care and support each person required. We spoke with staff who told us that they followed people’s care plans to help them meet the needs of people they supported.

We saw that daily records were used by the staff to monitor and comment on people’s progress and any changes to their needs. These included details about people’s personal care, their fluid and dietary intake, and clinical visits or medical interventions from health care professionals. We saw that care plans were reviewed and updated to reflect any changes in people's care needs and the support they required from staff. For example, one person who used the service told us that they were able to do certain things for themselves, and commented “it depends how I am feeling”. We looked at their care plan and saw that their needs had been clearly documented to reflect their fluctuating condition and how this affected their physical and emotional needs, as well as their personality and behaviour. However, we saw one person’s care plan that had been reviewed with ‘no changes’ noted, although other records showed that specialist equipment had been put in place to prevent pressure sores. This meant that staff may not have been fully aware of the changes implemented to support the person’s care needs.

We saw that care plans contained details of visits from health care professionals, such as doctors and community nurses. Records showed that staff reported and responded when people required health care support. For example, staff had requested a visit from a specialist nurse to support a person’s catheter care, when they had become concerned about possible infection. We saw that staff regularly monitored people’s skin integrity and requested visits from the specialist nurse if they became concerned about people who may be at risk of developing pressure sores. We spoke with a visitor who told us they had no concerns about their relative having access to health care professionals and said “the staff call in the doctor and district nurse when required; they are always in”.

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. We saw that care plans contained individual risk assessments where specific risks had been identified, for example, people’s mobility, when people went out alone and where people were at risk from pressure sores.

Records showed that people were able to undertake activities that met their emotional and social needs. For example, one person told us that they enjoyed quizzes, and we saw that they had ‘trivia’ books in their room. Staff we spoke with told us that it was important that they spent time supporting them to enjoy their quiz books.

There were arrangements in place to deal with foreseeable emergencies. We saw that on-call emergency contact details were available, which meant that staff could contact management or senior staff, should an emergency arise where they required additional support.

We found that the staff had an understanding of their responsibilities under the requirements of the Mental Capacity Act 2005 and had undertaken relevant training. Records showed that people were supported to make their own decisions on a day-to-day basis. The manager told us that advocacy support would be made available if people required independent support with decision making, for example, meetings would be arranged to include their care manager and family representati