Archived: Tansley House Care Home

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.

All people spoke positively about their lives at the home. Two people said they came to visit before being admitted there. Another person said, 'Staff are brilliant, they look after us well, I am never rushed; they help me at my own pace.' Residents said activities were organised they could choose whether to join. They told us they enjoyed the food provided. One person said, 'The food is very good and there's always plenty of choice.' We saw that a range of food and drinks were offered to people at lunchtime and from the menus we saw.

We found that improvements had been made since our last visit. These included procedures for obtaining people's consent to their care and in their care planning information.

We saw that people were protected against the risks associated with unsafe premises and cared for in a clean and hygienic environment. However, we found they were not fully protected from the risks of infection and those associated with unsafe medicines practice.

We also found that the registered persons' recruitment and selection procedures were not wholly effective in ensuring that people would be cared for by suitably qualified, skilled and experienced staff of good character.

We saw that staff responded to people's needs promptly and found that the number of experienced staff on each shift was appropriate to provide people's care.

We found that although people's needs were assessed, that information in their care plans and risk assessments did not always ensure the delivery of safe, appropriate care. We also found that people's consent was not always being obtained for their care.

We saw that the building was clean and comfortable although some radiators needed to be fitted with covers to protect people from the risk of harm.

We found that a complaints procedure was in place and that people knew how to raise concerns at Tansley House.