Templemore Care Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment using our previous methodology we rated this key question good.

At this assessment the rating has changed to requires improvement. This meant people’s needs were not always met.

This service scored 61 (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 did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

People’s care plans included their needs and individual preferences. Some relatives had been involved in care plan review meetings to support their family member. However, information was not always monitored to ensure staff had up to date instructions to follow. For example, some people with known pressure wounds were not included in the list for regular repositioning regime. This was raised with the provider who arranged for a review of people’s care plans and the information provided to staff.

There were regular ‘residents’ meetings held where people’s views were sought around the care and support, activities and menus. Feedback was mixed and concerns were raised about the quality of care and menus but there was limited evidence to show if any action was taken.

Overall, people and some relatives told us they were happy with the support provided and some spoke very highly of specific members of the team. At lunch time we observed staff provided tailored support to meet people’s individual needs, for instance encouragement to eat.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

People told us they could access health care services as required. A person said, “The chiropodist comes regularly. I don't see the doctor, but I speak to the head carer (if I need anything).” A healthcare professional told us, “When a referral is made to us, the senior will tell us what the concern is and provide the necessary information we need.” Staff told us they received relevant information at the daily handover meetings. People were able to access the local community groups such as the dementia club. The service worked closely with other organisations to promote inter-generational activities, such as with the local schools.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The provider ensured people had access to information in formats they could understand. For example, picture menus were used and information providing in large print. People’s communications were detailed in their care plans. Staff were aware of the importance of providing people with information in a format they could fully understand. This included large print, audio, and picture format if required.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not always involve people in decisions about their care or tell them what had changed as a result.

Prior to the inspection visit, CQC received concerns that complaints were not taken seriously. During the inspection visit people were confident staff would listen and act on their concerns. However, feedback from relatives was mixed. Several relatives expressed concerns about staffing, clothing and the quality of food. One relative told us action was taken after they complained to the registered manager for the second time about the standard of cleaning. The complaints folder contained some complaints, the investigation findings and correspondence sent to the complainant. However, not all complaints or concerns were logged. For example, a relative shared with us their concerns which they had raised with the care manager but there was no record of this. The care manager told us verbal concerns were documented in people’s care records. We could not be assured all complaints and concerns were known to management and investigated in line with the provider’s complaints procedure. This meant opportunity to learn lessons were also missed. This was raised with the provider to consider strengthening the management oversight of complaints.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it.

Assessments completed before people moved into the care home ensured appropriate adaptations or equipment required for their care was in place. Staff understood the needs of people, and agency staff relied on the existing staff to inform them about the support people needed. A staff member said, “When we had about 20 staff leave it put a lot of pressure on us and then having to cope with agency staff.” This supported feedback received from some relatives and our observations. This showed staff’s ability to ensure people had access to care and support when they needed it could vary. This was shared with the provider and they told us about the plans to improve the staffing and oversight.

All areas of the care home was accessible by wheelchairs including the garden. Care plans considered people’s needs and any adjustments needed to ensure they had equal access to services and in a way that works for them. People had access to visiting health professionals as needed such as the district nurses. Staff knew how to access people’s information for medical emergencies or out of hours support.

Staff and leaders did not always actively listened to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

Feedback from relatives about positive outcomes for their relative was mixed, for instance, a relative told us their family member who is on ‘fluid watch’ had been left without drinks which resulted in a hospital admission. This showed whilst the provider had systems in place to monitor people’s health the delay in effective oversight meant new risks or health concerns were not promptly. This was raised with the provider to address. The care home had an accessible vehicle, but it was limited to 3 people. The provider did have a access to a larger vehicle but this needed to be booked in advance. We observed instances where people living with dementia were reliant on staff when available, to spend time with them. People shared examples when staff and the care provided had a positive impact on their life. A staff member told us, “[Person] couldn't walk when he got here. [Person] had physio and I am proud that we worked with them to do the physio regularly and now [Person] is mobile.”

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

People had been supported to express their wishes about future care needs including where they wished to be cared for, was recorded in their care records. Relatives told us their family member’s end of life wishes had been discussed and recorded. Staff knew where people’s personalised end of life plan and documents relating to their decisions were kept. Staff were trained to provide end of life care. A staff member said, “I’ve cared for people at the end stage, with support from Marie Currie and the palliative nurses.”