Background to this inspection
Updated
6 June 2017
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.
The inspection took place on 27 March 2017 and was unannounced. The inspection team consisted of one inspector, an inspection manager and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. They had experience of a range of care services.
We looked at notifications sent to us by the provider. A notification is information about important events which the provider is required to tell us about by law. We asked the service to complete a provider information return (PIR). This is a form that asks the provider to give us information about the service, what they do well, and what improvements they are planning to make. This was returned to us by the service. As some people who used the service were living with dementia we used the Short Observational Framework for Inspection (SOFI), which is a way of observing care to help us understand the experience of people who used the service.
We spoke with five people who lived in the home, one relative and one health care professional. We also spoke with three care workers, the registered provider and the registered manager. Throughout the day, we observed care practice, the administration of medicines as well as general interactions between the people and staff.
We looked at documentation, including four people’s care and support plans, their health records, risk assessments and daily notes. We also looked at three staff files and records relating to the management of the service. They included audits such as medicine administration and maintenance of the environment, staff rotas, training records and policies and procedures.
Updated
6 June 2017
We inspected Tansley House on 27 March 2017. This was an unannounced inspection. The service is registered to provide accommodation and nursing care for up to 20 older people, with a range of medical and age related conditions, including arthritis, frailty, mobility issues, diabetes and dementia. On the day of our inspection there were 19 people living in the care home, including one person who was in hospital.
At our last inspection on 27 August 2015 the service was found to be fully compliant and was rated good in all areas and good overall.
A registered manager was in post and present on the day of the inspection. 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.
Levels of cleanliness were inconsistent and risks to people's health and welfare were not always effectively managed. People’s involvement in their individual care planning was not routinely recorded. Care plans, including risk assessments, were not always reviewed or updated to reflect people’s changing needs. Inconsistent quality monitoring systems meant such shortfalls were not always identified and addressed.
We have made a recommendation regarding the involvement of people in decisions about their individual care and support, including the appropriate recording of any such consultation.
Staff had completed training in safe working practices. We saw people were supported with patience, consideration and kindness and their privacy and dignity was respected.
People received care and support from staff who were appropriately trained and confident to meet their individual needs and they were able to access health, social and medical care, as required. There were opportunities for additional training specific to the needs of the service, such as diabetes management and the care of people with dementia. Staff received one-to-one supervision meetings with their line manager. Formal personal development plans, such as annual appraisals, were in place.
Thorough recruitment procedures were followed and appropriate pre-employment checks had been made including evidence of identity and satisfactory written references. Appropriate checks were also undertaken to ensure new staff were safe to work within the care sector.
Medicines were managed safely in accordance with current regulations and guidance by staff who had received appropriate training to help ensure safe practice. There were systems in place to ensure that medicines had been stored, administered, audited and reviewed appropriately.
People were being supported to make decisions in their best interests. The registered manager and staff had received training in the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS).
People were provided with appropriate food and drink to meet their health needs and were happy with the food they received. People’s nutritional needs were assessed and records were accurately maintained to ensure people were protected from risks associated with eating and drinking. Where risks to people had been identified, these had been appropriately monitored and referrals made to relevant professionals, where necessary.
A formal complaints procedure was in place. People were encouraged and supported to express their views about their care and staff were responsive to their comments. Satisfaction questionnaires were used to obtain the views of people who lived in the home, their relatives and other stakeholders.