Templemore Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question requires improvement. At this assessment we found the provider had made sufficient improvement and was no longer in breach of regulation. The rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 66 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and understood their responsibility in relation to reporting all accidents and incidents and safety events. There was an improved learning culture and staff understood the importance of timely reporting of incidents and accidents, which has improved people’s safety and care provided. These were reviewed and fully investigated by the registered manager, with appropriate actions taken to prevent recurrence. Analysis of incidents such as falls and skin injuries, identified patterns, and enabled management to take action to prevent recurrence. One staff member told us, “We discuss incidents in our meetings and the changes to practice or support; making sure we all get the same information, guidance and give consistent support.” This demonstrated learning from incidents was ongoing to deliver best care.

People and relatives felt confident to raise concerns and told us staff were responsive to incidents. The provider and registered manager were open, honest, and understood their responsibilities under the Duty of Candour. Correspondence was sent to people and their relatives following incidents, and when required an apology.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored.

Management and staff demonstrated awareness of the importance of coordinated and safe care pathways. Systems were in place to share relevant information when people’s needs changed or when they moved between services, helping to ensure consistency and reduce the risk of errors or omissions. Staff knew how to access people’s care plans which contained up to date emergency grab sheets to support a smooth transition to hospital ensuring individuals needs were understood.

People felt they received safe care and support, and when required, staff liaised with health professionals to ensure there was continuity of care. A relative told us “We get informed about everything and they arrange hospital transport. Mentally [Person name] is making progress as well as physically.”

Management team and staff all knew the people they cared for and the support they needed to promote their safety and wellbeing. They worked in partnership to ensure there was continuity of care, for example, evidence of reviews of people’s care, advice sought and timely referrals to GP, community nurses and other health and social care professionals. Feedback from a visiting health care professional was positive in relation to staff seeking advice and following instructions to manage specific health needs and conditions.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm, and neglect.

Systems and processes were in place to protect people from abuse, report and monitor safeguarding concerns had been embedded fully, and were supported by clear policies and procedures. Staff were trained to recognise abuse and understood how to report concerns. One staff member explained, “I would report concerns internally to the manager or deputy, ensure the person is safe, and record what was said or witnessed. I can also report concerns to the local authority, police, or the Care Quality Commission.” The registered manager shared concerns quickly and appropriately. They worked collaboratively with the safeguarding team when concerns were raised and took appropriate action.

People told us they felt safe with the staff supporting them and felt confident in raising concerns. One person said, “I feel much safer now; staff are around to help, and no one has to wait.” A relative told us, “[Person Name] is safe. They have established a routine of supporting them downstairs each day, and there is always someone with them.”

The service was working within the principles of the Mental Capacity Act 2005. Where required, appropriate legal authorisations were sought to deprive a person of their liberty, and any conditions attached to Deprivation of Liberty Safeguards (DoLS) authorisations were being met.

The provider and registered manager understood and managed risks to people by thinking holistically. Staff provided care to meet people’s needs that was safe and supportive to enable people to do the things that mattered to them. However, monitoring records were not consistently completed promptly and accurately.

People’s care plans included improved guidance on managing falls, skin integrity, and other health conditions, along with instructions from health professionals. There was information to enable staff to recognise pain or discomfort expressed by people living with dementia. Risk assessments and care plans were reviewed regularly.

Monitoring records showed staff were documenting positional changes to support with pressure care management and showed fluid intake targets were met. The overall recording had improved, however, some gaps and inconsistencies remained, such as staff not always recording catheter output when emptied and if support was provided with activities relating to personal appearance. Management had identified these issues, but these issues remained unresolved. Assistive technology was used such as sensor mats to alert staff when people at risk of falling moved independently. However, tables had been placed on the sensor mat preventing them from working properly. Staff were responsive when raised but increased vigilance is needed. The registered manager assured us this would be addressed and improvements monitored.

People’s needs and risks were assessed more effectively, with clearer measures to keep them safe. People and relatives reported being involved in assessments and reviewing care plans. One relative said, “[Person name’s] care plan has dramatically changed since they went in, and we have sat down and gone through it many times.” A relative told us their family member was at risk of falling so had a low bed and a crash mat in place.

Staff understood people’s needs and had appropriate training in areas such as moving and handling, first aid, and health and safety. We observed staff using equipment safely. People’s individual evacuation plans were kept up to date.

The provider made sure equipment, facilities and technology supported the delivery of safe care.

However, they did not always detect and control potential risks in the care environment.

The provider and registered manager had made sufficient improvements to address the environmental risks identified at the previous assessment. Wardrobes were fixed to walls, and all window openings were fitted with restrictors. At lunch time, we observed a member of staff supervising the bain-marie until it was returned to the kitchen. We identified damaged handrails that posed a risk of splinter injury; this was raised with the registered manager, who took prompt action. They acknowledged handrails were not routinely checked or included in premises audits and assured us a full audit would be completed, with repairs where needed.

We observed staff stored equipment used in care delivery securely when not in use. The provider had invested in the premises, for example, creating a new wet room.

Environmental risk assessments covered all internal and external areas to ensure people could move freely and safely. Auditing and monitoring records showed that health, safety, and fire requirements were being met. Personal emergency evacuation plans were kept up to date to support a safe evacuation.

People and relatives spoke positively about the environment and had been consulted about the ongoing refurbishment and redecoration. One person, “I love the building it is like a home from home not an institution. I would say it is relaxed, pleasant and bright.” A relative told us, “It is bright, it is decorated beautifully and the dementia unit is laid out really nice. [Person name’s] room overlooks the garden; they love that and will be able to sit in when the weather gets warmer. It is just a nice place to be.”

The provider made sure there were enough qualified, skilled, and experienced staff, who received effective support, supervision, and development. They worked together well to provide safe care that met people’s individual needs.

People told us their needs were met promptly and reliably. One person said, “Staffing is better now; they rarely have agency staff.” However, some people and relatives feedback was mixed. Their comments included, “There is always someone around when I need them,” and “Overall [person’s name] is very happy, but they can get frustrated by the lack of staff.”

Since the previous assessment, there had been changes in management and significant changes to the staff team had taken place. The registered manager used a dependency tool to ensure staffing levels were appropriate. One staff member told us, “[Registered manager] will help us to support people if she needs to; like if there's been an emergency. She's spent a lot of time investing and talking to us, and it's made a difference.”

We saw staff had been deployed effectively to meet people’s needs and ensured a member of staff was present in each lounge and dining room; spending meaningful time with people and assisting them when needed. The registered manager had oversight of staffing to ensure they worked efficiently. People’s needs were kept under review to ensure staffing levels remained safe. Staffing levels were now consistently maintained across the home, confirmed by the rota and our observations during the inspection visit.

Staff also reported improvements in staffing levels, with one saying, “Staffing is much improved, occasional agency staff and we've got more new staff.” However, some staff indicated that an extra staff member was needed during busy periods, and to enable staff to check and complete records. Whilst we did not observe any delays in staff supporting people, we shared some of the mixed feedback with the registered manager.

New staff were recruited safely. They received induction, essential training, and regular support to ensure they were suitable for their role. Staff competencies were regularly assessed, and ongoing training ensured knowledge remained current with best practice. Staff received supervision and feedback to support their performance.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

People spoke positively about hygiene and cleanliness. One person told us, “The staff clean both rooms every day and every so often they move the furniture to give it a good clean.” Most relatives also said the home was always clean.

The provider and registered manager had made improvements since the last assessment. Cleaning products were stored securely, and all areas were visibly clean. Cleaning charts were up to date and covered all areas of the home, including dining rooms being cleaned after each meal service. Equipment was well maintained and kept clean. Infection control audits were completed to ensure the layout and hygiene of the premises remained safe.

Staff were trained and followed infection prevention and control procedures, to protect people from infection risks. We observed staff washing their hands regularly and using personal protective equipment correctly during care tasks, helping minimise the risk of cross‑infection.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities, and preferences. Staff did not always involve people in planning.

The provider and registered manager had made several improvements since the last assessment. The treatment room was secured, and all medicines, including those requiring additional security, were stored safely with regular safety checks. Medicines were disposed of appropriately.

We observed staff trained and assessed as competent in administering medicines safely. Time‑sensitive medicines for Parkinson’s disease, were recorded and administered correctly. Medicines with a limited shelf life, including liquids and creams, were dated on opening. Protocols were in place to support consistent use of ‘as required’ medicines, such as pain relief; however, staff did not always record whether these medicines were effective. We found one instance where a person prescribed eye drops for an infection had contradictory instructions. Discussions with staff showed inconsistent understanding of the medicine’s purpose, creating a risk to the person’s health. This conflicting information had not been identified before the inspection, indicating procedures for booking in medicines require strengthening. This was raised with the registered manager, who took immediate action.

People told us they received their medicines as prescribed, from trained staff and at the right time. One person said, “The staff look after our medicines; [Person name] has got to have their tablets at certain time, and it's always been on time.” Most relatives expressed no concerns in relation to how their family members medicines were managed with one saying, “Because [Person name] has been in there so long we rely on the home to tell us when things change.”