Tregarland

Updated 16 June 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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.

This was a comprehensive inspection. This inspection took place on 23 and 25 April 2018 and was unannounced.

The inspection team consisted of one adult social care inspector.

Prior to the inspection, we looked at previous inspection reports. We also reviewed the information we held about the service and notifications we had received. A notification is information about important events, which the service is required to send us by law. 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.

We met most people using the service and spoke with four about their experience of living at Tregarland. We also used different methods to give us an insight into their experiences. These methods included informal observation throughout the inspection. We observed staff interaction with people.

We received feedback from two family members, three staff, the registered manager, and three health care professionals. We reviewed two people’s care records and two staff records. We saw records of meetings, and looked at quality monitoring information relating to the management of the service.

Updated 16 June 2018

Tregarland is a residential care home registered for up to 20 people with learning difficulties. Some also have physical difficulties. People live in one of the two buildings, each with all necessary facilities.

The care service is aware of the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. There were currently no plans to reduce the size of the service or amend the current registration at Tregarland but people using the service were living as ordinary a life as any citizen because the home is divided into two halves, independent of each other.

Rating at last inspection.

At our last inspection we rated the service Good. At this inspection we found the evidence to show that the service was overall Outstanding.

Tregarland is where people are treated with great respect by the registered manager and staff. This gives them dignity, self esteem and value. People said they are happy and feel safe. Health care professionals used the phrases: “Passionate about their patients”, Fantastic advocates for people”, “An enablement of respect” and “Staff make (my client) feel valued.” People using the service were relaxed, happy, confident and fully engaged in the running of their home and activities in the local community.

The management of Tregarland promotes people’s wellbeing. Each staff member takes a turn to organise and monitor the service when they are the ‘officer in charge’. It is their responsibility, for that day, to ensure people are fully supported, in a safe way. Staff grow in confidence, learning organisational skills, whilst knowing the registered manager is there for advice and support. There is very little turn over of staff at the service, several of whom had worked at Tregarland for more than 15 years. Staff said they loved working at the service. They receive training, supervision and support which help their success in the role.

People are 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. Every opportunity to provide meaningful activities is explored. This included the recent acquisition of an allotment and achieving one person’s goal of flying an aeroplane. People are supported to be active in the way the service is run. This includes being involved in staff recruitment, shopping, cooking and laundry. The registered manager facilitates how the home is run and always gives people the opportunity to come up with ideas and support each other. Innovative ideas help people learn, such as ‘stick on’ cardboard ‘germs’ to demonstrate the importance of hand washing.

Staff recognised where a lack of understanding affected people’s ability to use information to their advantage. To overcome this, staff would find different ways of presenting the information, using objects of reference, for example. This showed that staff understood and worked towards meeting the Accessible Information Standard, which is to help people with disability or sensory loss access and understand information they are given.

The service has a long history of working closely with agencies for the good of people using the service. This includes the local authority safeguarding team and health care professionals. One said, “(The registered manager) sees things ahead of time and tries to use preventative strategies.” People are safe at Tregarland through good management of staffing, medicines, infection control, individual risk management, and safety of the premises.

People receive a nutritious diet, which they enjoy. Health promotion is through a proactive approach to meeting people’s physical and emotional health care needs.

Further information is in the detailed findings below.