• Care Home
  • Care home

Archived: Trent House

42 Newport Road, Cowes, Isle of Wight, PO31 7PW (01983) 290596

Provided and run by:
McCourt Care Limited

All Inspections

30 June 2014

During a routine inspection

We considered all the evidence we had gathered under the outcomes we inspected. We spoke with five people who used the service and met three others; one visitor, four members of staff, the manager and a visiting health professional. During this inspection we looked at outcomes relating to people's involvement in their care, their dignity, care and welfare, safeguarding, staffing levels, quality assurance processes and the reporting of incidents affecting people who used the service. We used the information to answer the five questions we always ask;

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led

This is a summary of what we found:

Is the service safe?

We looked at four care plans which included the necessary information to inform staff as to the specific care people required. They also included risk assessments associated with specific elements of people's care, such as falling or tripping, using steps or self-neglect and specified the action required to manage those risks.

We found people who use the service were safe and protected from the risk of abuse because staff were aware of the need to report abuse between people who used the service to the appropriate authority.

Systems were in place to ensure the manager and staff learnt from events such as complaints, concerns, or safeguarding events. This reduced the risk to people and helped the service to continually improve. The home had up to date policies and procedures in relation to safeguarding and whistleblowing.

The home had proper policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLs). Relevant staff had received training to enable them to understand when an application should be made. At the time of our inspection nobody in the home was subject to DoLs.

The manager ensured there were enough staff working at the home to meet people's care needs.

Is the service effective?

The care plans we looked at were personalised to reflect people's individual needs and their likes and dislikes. The people we spoke with told us they were happy with the care they were receiving and their needs had been met. It was clear from our observations and from speaking with the staff that they had a good understanding of the people's care and support needs and they knew them well.

Staff had received training to ensure they had the skills necessary to care for people. Staff told us about the care they were providing for specific people which matched information in the person's care plan.

Is the service caring?

People were supported by kind and attentive staff. People said they had no concerns over how they were treated and they felt their privacy and dignity were respected. The records we looked at showed staff took account of people's individual wishes and these were respected, when providing care. We observed care in the communal areas of the home and saw staff interacting with people in a positive way.

People's diversity, values and human rights were respected. We looked in people's bedrooms and saw they were individualised and appropriate for the person's needs. Staff respected people's privacy and we saw them knock and wait before entering a person's bedroom.

People's wellbeing was enhanced through the availability of individual and group activities focussed on people's preferences, interests and diverse needs.

Is the service responsive?

There were arrangements in place to respond to short term staff absences, which were managed through the use of overtime and the provider's own bank staff.

We saw there was an effective compliments and complaints policy in place, which was published in the service users' guide. The manager showed us their complaints file and told us they had not received any formal complaints during the last year. The people and visitors we spoke with told us they knew how to complain but had not needed to do so.

Is the service well-led?

There was a clear management structure. There were also procedures in place to monitor the quality of service provided with audits of care plans, medication administration records (MAR), accidents and incidents and infection control. Where an issue was identified remedial action was taken.

A regular questionnaire was sent out to people, their friends and families seeking their views on the service provided. The manager told us the latest questionnaire was sent out a week before our inspection and so far they had only received one response. We looked at that response and saw the feedback was positive.

Staff attended regular supervision meetings and there was an effective staff meeting structure in place, where staff could raise any issues or concerns.

17 January 2014

During an inspection looking at part of the service

During our previous inspection on 15 November 2013 we found care plans did not provide sufficient detail to enable staff to support people in an appropriate manner and medicines were not managed safely. We issued warning notices requiring the provider to become compliant with these standards by 10 January 2014.

We also identified that people were not protected from the risks of inadequate nutrition and dehydration. We set a compliance action and asked the provider to tell us how they were going to become compliant with this standard.

At this inspection we found the provider had made improvements and had met the requirements of the warning notices.

We spoke with seven of the 15 people using the service and one family member. People told us they were satisfied with the way their care and support needs were met. One person said, 'I'm very happy with the care'. We looked at five care plans and saw they included risk assessments. These were relevant to the person and specified action required to manage risks appropriately.

A new file had been produced to record the dietary requirements of each person using the service. We saw people were provided with a choice of suitable and nutritious food and drink. One person we spoke with said, 'The food is lovely'. For people at risk of losing weight, food and fluid charts were being used and their intake was monitored effectively.

We found medicines were managed safely. We conducted a check of six medicines. All prescribed medication was in stock and medication administration records (MAR) contained no gaps. The number of tablets shown in stock tallied with the number detailed in the MAR charts. Medicines were kept safely and disposed of appropriately.

A medication audit had been completed a week before our inspection by a pharmacist. This showed the service was monitoring the management of medicines appropriately and their systems were working effectively.

15 November 2013

During an inspection looking at part of the service

During our previous inspection on 10 and 13 May 2013 we found care and treatment was not delivered in line with people's individual care plans. Not all care plans were up to date; identified risks were not managed effectively; food and fluid charts were not completed fully and people's mental capacity was not assessed effectively.

We also identified that not all medicines were in stock; advice was not available to staff about 'as required' medication and unused medicines were not stored appropriately. We set compliance actions and the provider wrote to us telling us how they would become compliant.

At this inspection we spoke with six of the 13 people using the service and two family members. People told us they were happy with their care. One told us, 'Staff are very, very good. They're kind and can take a joke'. A family member said, 'I'm very happy with the way they look after her'. We saw staff spoke with people in a gentle, caring way and allowed them time to express themselves.

We looked at the care plans and associated records of five people and spoke with six members of staff. We saw some care plans had been updated and a new care planning format was being introduced. However, the information included within care plans did not always provide sufficient detail to enable staff to meet people's needs in a consistent manner. Risks of people falling or developing pressure injuries were not being managed effectively.

People were provided with a choice of suitable and nutritious food and drink. However, food and fluid monitoring was not effective and people requiring a special diet did not always receive it.

We looked at the medication administration records for six people. We found all medicines were in stock and kept securely. However, records of controlled drugs were not accurate and the use of topical creams and ointments was not managed safely.

Information relating to the use of an 'as required' sedative was not available and risks associated with the self-administration of medication by one person had not been assessed.

10, 13 May 2013

During a routine inspection

During our last visit in January 2013 we found there were no risk assessments in place to manage the prevention and control of infection and personal protective equipment was not readily available to staff. On this occasion we found there were effective systems in place to reduce the risk and spread of infection.

We spoke with six people using the service. They told us staff treated them with dignity and respect. One said, 'They treat me OK'. We also spoke with three family members who said they were kept fully informed. One said, 'They call us when the review is done and always listen to what we say'.

People were cared for by staff who knew their needs, but care and treatment was not planned and delivered in line with people's individual care plans. Care plans were not kept up to date and some identified risks were not managed effectively. This meant there was a risk people would not receive appropriate or consistent care that met their needs.

Appropriate arrangements were not in place in relation to obtaining some medicines. Unused medication was not stored appropriately and there was no guidance available to staff on when it was appropriate to administer 'as required' medication. No audit of medication had been completed.

There were enough qualified, skilled and experienced staff to meet people's needs. The provider had an effective system to regularly assess and monitor the quality of service that people received.

9 January 2013

During a routine inspection

We spoke with four people who used the service and one relative of a person who used the service. We looked at three care plans. We saw that arrangements were in place to gain consent from people before care was delivered. People told us that they were happy with their care. One relative said, 'The care's very good'. A visiting care manager told us, 'Staff are very proactive and seek help when needed. They are approachable and friendly, and are keen to get it right'. Another person said, 'I couldn't be in a nicer place'.

We spoke with seven members of staff, including the manager, and looked at three staff files. Staff who had been trained in safeguarding demonstrated a good understanding of the principles.

The environment was clean and hygienic. However, personal protective equipment was not readily available, risk assessments were not recorded, and current guidance on infection control was not being followed. This could have put people at risk of infection.

We looked at equipment, such as hoists and mattresses. We found they were all fit for purpose and had been properly maintained. The equipment we saw was being used appropriately and met people's needs. Staff followed a programme of ongoing training, and received appropriate supervision. People's personal records, and other records relating to the management of the service were accurate and fit for purpose, but some records were not held securely.

15 February 2011

During a routine inspection

We spoke with people in the home's lounge and with other people who preferred to spend their time in their bedrooms.

People stated that they felt safe living at the home and that they had choice about how and where they spent their time and had choice about meals, which they stated were good.

One person had stated that they had been concerned about going into residential care but had been very pleased with their experience and would recommend the home to other people with a similar need.

People also stated that staff were available when they needed them and that they felt staff knew how to care for them. People said that their health and personal care needs were met.

People stated that the home has regular resident meetings and that they had been involved in decisions about the changes in the home's menus and about activities. People stated they felt able to raise any concerns with the manager or with staff.

One person told us about their involvement in the recruitment of a new staff member which they had enjoyed doing and felt it had enabled them to use skills they had gained during their long working life.

External professionals stated that they have no concerns about the home and felt that people's needs were met.