Archived: Tynevale Terrace

We found the following examples of good practice.

Staff were confident and knowledgeable about government guidance and what visitors were required to do prior to entering the service. Professional visitors and relatives were tested for COVID-19 at the service or provided a negative lateral flow test result from that day. Visiting professionals and staff provided evidence of their vaccination status to the registered manager before entering the service.

Staff wore appropriate PPE and could explain what PPE to wear and how to safely put on/remove their PPE. PPE was available throughout the home and there were designated PPE stations.

The management team had effective systems in place to check that safe infection prevention and control processes were being followed by staff. The home was clean and well presented.

Tynevale Terrace is a care home. People in care homes receive accommodation and personal care as single package under contractual agreements. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service is provided from one three storey building and accommodates up to three people who may have learning disabilities or autism spectrum disorder. Two people were using the service at the time of inspection.

At our last inspection in January 2016 we rated the service good. At this inspection we found the evidence continued to support the rating of good. There was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns.

This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People appeared safe and comfortable with the staff who supported them. There was a relaxed and friendly atmosphere around the home. There were sufficient staff to provide safe and individual care to people. People were protected as staff had received training about safeguarding and knew how to respond to any allegation of abuse. When new staff were appointed, thorough vetting checks were carried out to make sure they were suitable to work with people who needed care and support.

Arrangements for managing people’s medicines were also safe. People received a varied and healthy diet.

Staff knew the people they were supporting well. Care plans were in place detailing how people wished to be supported and people were involved in making decisions about their care. The records gave detailed instructions to staff to help people learn new skills and become more independent. Risk assessments were in place and they accurately identified current risks to the person as well as ways for staff to minimise or appropriately manage those risks.

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 told us they were supported to be part of the local community. They were provided with opportunities to follow their interests and hobbies and they were introduced to new activities. People told us their privacy, dignity and confidentiality were maintained.

People had access to health care professionals to make sure they received appropriate care and treatment. Staff followed advice given by professionals to make sure people received the care they needed. People told us staff were kind and caring.

People had the opportunity to give their views about the service. There was regular consultation with people, staff and family members and their views were used to improve the service. People had access to an advocate if required. Staff said the management team were approachable. Training was provided and staff were supervised and supported.

Further information is in the detailed findings below.

We last inspected Tynevale Terrace on 3 June 2014. At that inspection we found the service was meeting all the legal requirements in force at the time.

Tynevale Terrace provides accommodation and personal care for up to three adults with learning disabilities. Nursing care is not provided.

A registered manager was in place. ‘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 were protected as staff had received training about safeguarding and knew how to respond to any allegation of abuse. When new staff were appointed, thorough vetting checks were carried out to make sure they were suitable to work with people who needed care and support.

People received their medicines in a safe way. People had access to health care professionals to make sure they received appropriate care and treatment. Staff followed advice given by professionals to make sure people received the care they needed.

There were some opportunities for staff to receive training to meet people’s care needs. We considered some courses such as the safe handling of medicines needed to be more intensive with systems in place to check staff understanding of their learning. Staff received supervision and appraisal.

Some areas of the environment were showing signs of wear and tear.

Staff knew the people they were supporting well and there were enough staff on duty to provide individual care to people. People’s privacy and dignity were respected. Care plans were in place detailing how people wished to be supported and people were involved in making decisions about their care.

People’s nutritional needs were met and they received a choice of food. People were supported to be part of the local community. They were provided with opportunities to follow their interests and hobbies and were introduced to new activities.

People were supported to maintain some control in their lives. They were given information that helped them to understand and encourage their involvement in every day decision making.

Staff said the registered manager and management team were supportive and approachable. Communication was effective, ensuring people, their relatives and other relevant agencies were kept up to date about any changes in people’s care and support needs and the running of the service. There were effective systems to assess and monitor the quality of the service, which included feedback from people receiving care.

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well-led?

Below is a summary of what we found.

Is the service safe?

People using the service told us they felt safe with staff who provided their care and support. Relatives we spoke with told us they were confident that their family members were safe at the home. One person told us, 'I feel safe here, the staff look after me.' One relative told us, 'He's very safe and well looked after. He would tell me if there was anything untoward going on.' Another relative said, 'He is very safe there and well looked after; it's a good home.'

People were cared for in an environment that was clean and hygienic. Equipment at the home had been well maintained and serviced regularly, therefore not putting people at unnecessary risk. There were enough staff on duty to meet the needs of the people living at the home and a member of the management team was available on call in case of emergencies. The building was clean, secure and other appropriate measures were in place to ensure the security of the premises.

We found that the provider undertook appropriate checks before staff began work and effective recruitment and selection procedures were in place. We also found that people were protected from the risks of unsafe or inappropriate care and treatment, because accurate and appropriate records were maintained.

Is the service effective?

People told us that they were happy with the care that was delivered and their needs were met. It was clear from our observations and from speaking with staff that they had a good understanding of the people's care and support needs and that they knew them well. Staff were supported to deliver care and treatment safely and to an appropriate standard. Staff had received training to meet the needs of the people living at the home. A relative told us, 'His care and support is good and I have no concerns. Every day there is something for him to do.' Another relative commented, 'It's practically one to one support and care he gets. He's very happy there and he's always out and about.'

Is the service caring?

People were supported by kind and attentive staff. We saw that support workers showed patience and gave encouragement when supporting people. All the relatives spoken with talked highly of the level of care provided by staff. One relative commented, "We have no problems with his care; he would be straight on the phone if there was a problem.' Other relative's comments included, 'The staff are good; very caring,' and, "The staff are brilliant with him. From what I've seen, he loves them all, they like him and they all get on well together.'

Is the service responsive?

People's needs had been assessed before they moved into the home. Care records and risk assessments for people at the service were evaluated every month and reviewed annually to make sure that the information was accurate and up to date. Where people's needs had changed, their care plans were updated more frequently. Records confirmed people's preferences, interests, aspirations and diverse needs had been recorded and care and support was provided in accordance with people's wishes.

People and their relatives were consulted about the service people received and the environment in which they lived. Meetings for people and their relatives were regularly held. This demonstrated that the provider took account of the views of people using the service and their relatives.

People had access to activities that were important to them and were supported to maintain relationships with their friends and relatives.

The provider had a written complaints policy and procedure, which detailed the process that should be followed in the event of a complaint. People and their relatives' knew how to make a complaint if they were unhappy. We saw that no complaints had been received by the service within the last 12 months. We also noted that two compliments had been received by the service during 2014. We also saw that all four relatives who responded to the 2013 questionnaire sent out by the service, stated that they knew how to make a complaint and that they were confident that any complaint made would be dealt with in the correct manner.

Is the service well-led?

Staff had a good understanding of the ethos of the home and quality assurance processes were in place. People and their relatives were able to complete a customer satisfaction questionnaire. Staff told us they were clear about their roles and responsibilities. This helped to ensure that people received a good quality service at all times. The provider undertook regular audits and risk assessments to monitor the quality of the services and there were effective systems to identify, assess and manage risks to the health, safety and welfare of people using the service and others. One relative told us, 'We get called to meetings to discuss his care and other things.' Another relative commented, 'It's a well-run and well-managed home.'

We saw that people who used the service and their relatives had commented upon the care that had been provided. They said the 'home has a nice atmosphere ' very good' and the 'care is good'. People who used the service said they 'like the staff and all the activities', the home is 'very good and the staff are well liked'.

Family members also said people who used the service 'always look clean and well looked after'. We spoke to four members of staff and they commented 'this is the best place I have worked, I love it'. Staff also said they liked 'supporting service users and giving them the best possible opportunities available'.

We also checked on the safety and suitability of the accommodation and environment. We saw the shared areas were clean and tidy and bedrooms were well decorated and personalised by individual service users.

People spoken to had access to their care plan and we were told that any changes in their care had been discussed with them and their family members. We saw people were treated with consideration and respect. We reviewed three care records and saw that people's preferences and care needs had been well documented. Staff were knowledgeable about people's care needs and what they should do to support them.

They said that the care workers were 'all nice people'.

People who used the service said they were 'comfortable and safe' and that they knew who to complain to if they had concerns.

People spoken to had access to their care plan and we were told that any changes in their care had been discussed with them. They said that they had a key worker who would 'listen to them and talk over any issues'.

They said they 'liked to go out on activities with staff' and that staff were 'well liked'.

We also reviewed comments made by the relatives of people who used the service. We saw that relatives had said that 'the atmosphere is good, very pleasant', the 'care provided is good and the activities excellent'. They had also commented that 'staff are very good, excellent, always nice and friendly.

Relatives of people who used the service particularly commented that they were kept up to date with 'all aspects of care'.