Archived: Tracey House

Updated 4 May 2018

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 was 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 comprehensive inspection took place on 3 April 2018 and was unannounced. One adult social care inspector carried out this inspection with an expert by experience. An expert by experience is a person who has personal experience of using services or caring for a person who uses services. In this case the expert by experience had experience in caring for a person living with dementia. Prior to the inspection, we reviewed the information we had about the home, including notifications of events the service is required by law to send us.

Most people who lived in Tracey House were able to talk to us about their experience and we therefore spent time speaking with them. We did not conduct a SOFI during this inspection for those who were unable to talk to us. SOFI (Short Observational Framework for Inspection) is a specific way of observing care to help us understand the experience of people who are unable to talk to us. We did, however, use the principles of SOFI when conducting observations around the home.

We looked around the home, spent time with people in the lounge, the dining room and in their bedrooms. We observed how staff interacted with people throughout the inspection and spent time with people over the breakfast and lunchtime periods. We spoke with ten people and observed the other people who lived in the home being supported by staff. We spoke with six relatives, four members of staff, the registered manager and the provider. We also received feedback from seven external healthcare professionals.

We looked at the way in which medicines were recorded, stored and administered to people. We also looked at the way in which meals were prepared and served. We reviewed in detail the care provided to three people, looking at their files and other records. We reviewed the recruitment files for three staff members and other records relating to the operation of the service, such as risk assessments, complaints, accidents and incidents, policies and procedures.

Updated 4 May 2018

This unannounced comprehensive inspection took place on 3 April 2018 and was carried out by one adult social care inspector. We last inspected this home on 23 December 2015 when it was rated as ‘Good’ overall and in every key question.

Tracey House 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. Tracey House is registered to accommodate up to 24 old people in one adapted building. Nursing care is not provided at Tracey House. This is provided by the community nursing service. At the time of this inspection in April 2018 there were 24 people living in the home.

Tracey House had a registered manager 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.’

Tracey House was run with a firm purpose and a clear vision. People were held in high regard, had a good quality of life, had freedom to make choices and were supported to be independent. During our inspection we found each staff member at Tracey House, from the provider to the maintenance worker, displayed this purpose and vision.

People, relatives and external professionals praised the home and the staff’s caring attitudes. Comments received included, “I think their work is outstanding” and “I have always found a consistently high quality of professionalism and care at the home. One external professional stated, “I would have no hesitation in recommending the home to anyone, and would be very happy for any of my relatives to be resident at Tracey House.”

Staff treated people with respect and kindness. There was a low staff turnover at the home and this had enabled staff to build strong and meaningful relationships with people. The provider, registered manager and staff worked hard to ensure people’s self-esteem was promoted by acknowledging people’s skills, achievements and personalities. For example, one person’s relative had brought in some vegetables they had planted in their garden before moving into Tracey House. The cook had made soup for the evening meal with those vegetables and had named the dish after the person. Staff spent the day telling people about this dish and complimenting the person’s skills at gardening. This showed an admiration for this person’s talents and an acknowledgment of their accomplishments.

People were provided with enough high quality food to eat. The cook had attended a number of nutritional courses and food shows and had become the nutrition champion. In this role they had taken steps to improve people’s nutritional intake and create engaging activities around food to promote people’s enjoyment and wellbeing. They had introduced daily snack boxes to add additional calories to people’s diets, introduced packed lunch menus for when people had to attend appointments and had sought people’s feedback to tailor the menus to people’s preferences.

The provider and registered manager at Tracey House excelled in creating a culture where all staff members could provide outstanding care. The registered manager had ensured the ratio of staff to people was sufficient to enable staff to provide care that went above and beyond people’s everyday care needs. During our inspection we observed all different members of the staff team stopping and taking the time to speak with people and listening to what they said. People shared jokes and physical affection with staff who were calm, encouraging and humorous in their exchanges.

Staff worked hard to ensure people’s specific social and mental stimulation needs were met. Staff worked hard to continually improve on the activities people were provided and regularly asked people for their ideas and feedback. Following people’s feedback the home had recently hosted a dog show. People had been involved in making rosettes for the dogs as well as dog biscuits and judging the competition. People had thoroughly enjoyed this.

The registered manager was very keen for the people who lived in Tracey House to be a part of the local community. The home had hosted the local youth club, the guides and volunteer groups. Tracey House also held two open events each year in order to raise money for charity. These open events involved people making items, baking cakes, manning stalls, inviting their friends and relatives and interacting with the wider public.

The provider, registered manager and staff at Tracey House were passionate about providing the best, most compassionate and respectful end of life care to people. They had sought specialist training from external professionals and were continuously looking for new ways to improve.

People who lived in Tracey House were protected from risks relating to their health, mobility, medicines, nutrition and possible abuse. Staff had assessed individual risks to people and had taken action to seek guidance and minimise identified risks. Staff knew how to recognise possible signs of abuse. Where accidents and incidents had taken place, these had been reviewed and action had been taken to reduce the risks of reoccurrence. Staff supported people to take their medicines safely and staffs’ knowledge relating to the administration of medicines were regularly checked. Staff told us they felt comfortable raising concerns.

Recruitment procedures were in place to help ensure only people of good character were employed by the home. Staff underwent Disclosure and Barring Service (police record) checks before they started work. Staffing numbers at the home were sufficient to meet people’s needs. Staff had the competencies and information they required in order to meet people’s needs. Staff received sufficient training as well as regular supervision and appraisal.

Staff had a good understanding of the Mental Capacity Act 2005 (MCA) and put it into practice. Where people had been unable to make a particular decision at a particular time, their capacity had been assessed and best interests decisions had taken place and recorded. Where people were being deprived of their liberty for their own safety the registered manager had made Deprivation of Liberty Safeguard (DoLS) applications to the local authority.

Further information is in the detailed findings below