Archived: Tranquility House

Updated 14 May 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 1 and 2 March 2016 and was unannounced. The inspection was carried out by three inspectors.

We focused on speaking with people who lived in the home, speaking with staff and observing how people were cared for and interacted with by staff. We looked in detail at care plans and records which related to the running of the service. We looked at four care plans and six staff files as well as staff training records and quality assurance documentation to support our findings. We

looked at records that related to how the home was managed such as audits, policies and risk assessments.

We looked around most areas of the home including bedrooms, bathrooms, the lounge and dining room as well as the kitchen. During our inspection we spoke with five people who live at the home, three visitors, two care staff, a senior carer and the owner/manager. We contacted two social care professionals before and after the inspection that had had recent contact with the service and received their feedback.

We reviewed the information we held about the service. We considered information which had been shared with us by the local authority, members of the public, relatives and healthcare professionals such as a social worker. We reviewed notifications of incidents and safeguarding

documentation that the provider had sent us since our last inspection. A notification is information about important events which the provider is required to tell us about by law.

Updated 14 May 2016

This inspection took place on 1 and 2 March 2016, the first day was unannounced. The previous inspection was carried out on 17 July 2014 and there were concerns around staff recruitment records. At this inspection, we found the provider had met the required actions.

Tranquility House is registered to provide accommodation and personal care for up to 20 people who may have dementia or similar conditions. The premises are a detached house situated on one of the main roads going in to Folkestone. The service has 16 bedrooms, four of which are twin rooms and all of which have a wash hand basin. Bedrooms are spread over three floors, which can be accessed by the use of a small passenger lift. The lift is not suitable for people using a wheelchair. People had access to four assisted bathrooms and a dining room, two lounge areas and a conservatory. There is a small car park and street parking available nearby. 18 people were living at the service at the time of the inspection, four people were sharing two of the twin rooms.

The service provider, Mrs Wratten, also works as the manager. Registered providers 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’s safety was at risk because there was no safety test certificate for the electrical instillation at the service and no processes were in place to safely manage water to safeguard people against the risks of legionella. There were no systems in place to ensure checks had been completed on fire safety systems, gas, electricity and lifting equipment.

People were not always kept safe from abuse, staff were aware of safeguarding procedures, although policies and procedures were not current and not all staff had received appropriate training. Staffing levels were not sufficient to meet people’s needs all of the time and recruitment processes were not always thorough and robust. Accidents and incidents were not analysed to reduce the risk of reoccurrence.

Medicines were stored securely and safely. People received their medicines when they should but there were shortfalls in the recording of topical creams administration and in medicines that are prescribed to be taken ‘As required’.

Elements of care planning were not person centred to reflect differences in people’s individual needs. Some records at the service were contradictory about the support people needed and some support plans did not contain the level of detail needed in order to ensure staff supported people consistently. The arrangement of some activities reflected staff availability, rather than being planned to meet people’s needs.

People were supported to maintain good health as referrals to health professionals were made in a timely way. People’s privacy and dignity was not always fully respected. However staff were kind and caring in their approach to people.

Most risks associated with people’s care and support were assessed. People told us staff acted

with their consent and felt that they were treated respectfully and that their privacy and dignity were

promoted. People were able to choose their food at each meal time, snacks and drinks were always available. The food was home-cooked and people told us they enjoyed their meals, describing them as “Very good” and “First class”.

People or visitors did not have access to an up to date complaints procedure. There were no effective systems for monitoring the quality of care provided or assessing and mitigating risks within the service. Records were not accurate or available during the inspection. Policies and

procedures required review to ensure staff had clear guidance.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of this report.