Archived: Tylecote

Updated 20 June 2018

We carried out this comprehensive inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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.

Before the inspection visit we contacted the commissioning department at the local authority. In addition we contacted Healthwatch Lancashire. Healthwatch Lancashire is an independent consumer champion for health and social care. This helped us to gain a balanced overview of what people experienced accessing the home.

Before our inspection we reviewed the information we held on the service. This included notifications we had received from the registered provider, about incidents that affected the health, safety and welfare of people who lived at the home and previous inspection reports. We also checked to see if any information concerning the care and welfare of people living at the home had been received.

We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make

The inspection visit took place on 03 April 2018 and was unannounced.

The inspection visit was carried out by one adult social care inspector.

During the time of inspection there were nine people who lived at Tylecote. We spoke with a range of people about the care provided. They included four people who lived at the home, the registered manager and four staff members.

We closely examined the care records of three people who lived at the home. This process is called pathway tracking and enables us to judge how well the home understands and plans to meet people's care needs and manage any risks to people's health and wellbeing.

We reviewed a variety of records, including policies and procedures, safety and quality audits, three staff personnel and training files, records of accidents, complaints records, various service certificates and medicine administration records.

We observed care and support in communal areas and had a walk around the home. This enabled us to determine if people received the care and support they needed in an appropriate environment.

Updated 20 June 2018

Tylecote provides residential accommodation for up to nine people. The property is a three storey building located at the west end of Morecambe close to local bus routes. Some bedrooms have en-suite facilities and bathrooms are provided for residents. There are two lounges and one is used as a dining area. There are garden areas to the front and rear of the property. Street parking is available outside the home. At the time of the inspection nine people lived at the home.

At the last inspection in October 2015, the service was rated Good .

At this inspection we found evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. However we have made recommendations for the registered manager to improve medication procedures and ensure infection control systems improved. In addition we have recommended the provider develops a programme of refurbishment. This was so people were kept safe and lived in a healthy environment.

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

Tylecote is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, both of which we looked at during this inspection.

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 using the service felt safe. Staff had received training to enable them to recognise signs and symptoms of abuse and they felt confident in how to report these types of concerns.

People had risk assessments in place to enable them to be as independent as they could be in a safe manner. Staff knew how to manage risks to promote people's safety, and balanced these against people's rights to take risks and remain independent.

Safe recruitment processes were in place and followed by the service. Staff were not offered employment until satisfactory checks had been completed.

We found PRN (as required) medicines were not stored correctly and some were missing lables, making it difficult to be sure who the medicine belonged to.

We have made a recommendation about safe medicine procedures.

Infection control measures were in place however these were not always adhered to. The kitchen was in need of some refurbishment and cleaning and parts of the communal areas also needed attention. However during the inspection visit this was being addressed. We have made recommendations in relation to infection control and refurbishment of the environment.

Any accidents/incidents or errors had been used as a learning opportunity.

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice

Staff received an induction process and on-going training. They had attended a variety of training to ensure that they were able to provide care based on current practice when supporting people.

People were able to make choices about the food and drink they had, and staff gave support when required to enable people to access a balanced diet. There was access to drinks and snacks throughout the day.

People’s care and support had been planned with them. They told us they had been consulted and listened to about how their care would be delivered.

Care plans were organised and had identified care and support people required. We found they were informative about care people had received.

People were supported to access a variety of health professionals when required, including opticians and doctors to make sure that they received additional healthcare to meet their needs.

Staff provided care and support in a caring and meaningful way. They knew the people who used the service well. People and relatives, where appropriate, were involved in the planning of their care and support.

In order that people could maximise their opportunities and have their views heard the registered manager worked closely with the advocacy service to support people and to ensure they were not disadvantaged.

People's privacy and dignity was maintained at all times. Care plans were written in a person centred way and were responsive to people's needs. People were supported to follow their interests and join in activities.

Sufficient staff were on duty to meet people's needs. People told us staff responded quickly when they needed assistance. Throughout our inspection we observed there was a visible staff presence at all times.

People knew how to complain. There was a complaints procedure in place and accessible to all. No recent complaints had been received.

Quality monitoring systems were in place. A variety of audits were carried out and used to drive improvement.

Further information is in the detailed findings below.