Archived: Tynedale Promoting Independence Centre

Tynedale Promoting Independence Centre is a residential care home that provides respite, short break and assessment for up to 6 weeks. Accommodation and personal care is provided for up to 27 older people, prior to them moving to a permanent placement, or returning to their own homes. Nursing care is not provided. There were 20 people living there at the time of inspection.

There was a registered manager who had been in post since 2009. 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 told us they felt safe living at the service and that staff knew how to act to keep them safe from harm. The building and equipment were well maintained and there were regular health and safety checks undertaken by staff.

There were enough staff to meet people sometimes complex needs and the staff were trained, supervised and supported to effectively meet their needs. The service had a number of vacancies but was using existing staff to cover shifts.

Medicines were managed well by the staff and people received the help they needed to take their medicines safely. Where people’s needs changed the staff sought medical advice and encouraged people to maintain their well-being. External healthcare professional’s advice was sought appropriately.

People were supported by staff who knew their needs well and how best to support them. Staff were aware of people’s choices and how to support those people who no longer had the capacity to make decisions for themselves. Families felt the service was effective and offered them reassurance that their relatives were being well cared for. Where decisions had to be made about people’s care, families and external professionals were involved and consulted as part of the process.

People were supported to maintain a suitable food and fluid intake. Staff responded flexibly to ensure that people maintained their physical wellbeing and worked with people as individuals.

Staff were caring and valued the people they worked with. Staff showed kindness, empathy and humour in responding to people’s needs. Families felt their relatives were cared for by a staff team who valued them and would keep them safe.

Privacy and dignity were carefully considered by the staff team, who ensured that people’s choices and previous wishes were respected. Our observations confirmed there was genuine empathy and warmth between staff and people living at the home.

People who were receiving end of life care had their needs appropriately assessed. Professional advice was sought where needed to promote advance care planning

The service responded to people’s needs as they changed over time, sometimes responding promptly to sudden changes in people’s needs. The service supported people to access appropriate support so the staff could keep them safe and well.

The registered manager led by example, supporting staff to consider new ways to meet people’s needs. The registered manager regularly consulted families and staff to look for ways to improve the service and audits and reviews of care delivery were carried out.

Training records held by the registered manager, were now accurate and up to date and showed when certain training had been completed, needed to be refreshed and when future training had been arranged.

We found that suitable staff appraisal and supervision arrangements were now in place. Overdue appraisals and supervision sessions had been conducted and records were now accurate and up to date.

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well-led?

Below is a summary of what we found.

Is the service safe?

People using the service told us they felt safe with staff who provided their care and support. One person told us, 'I am well looked after and cared for and I am safe.' Relatives we spoke with told us they were confident that their family members were safe at the home. We found safeguarding procedures were robust and staff understood how to safeguard the people they supported.

People were cared for in an environment that was safe, clean and hygienic. Equipment at the home had been well maintained and serviced regularly, therefore not putting people at unnecessary risk. There were enough staff on duty to meet the needs of the people living at the home and a member of the management team was available on call in case of emergencies. The building was clean, well maintained and secure and other appropriate measures were in place to ensure the security of the premises. One relative told us, "It is reassuring knowing that she is secure, safe and well looked after here; I have no qualms whatsoever.' Another relative said, 'The staff are caring and attentive; there are no issues there and I have no concerns about her being safe here."

Is the service effective?

People told us that they were happy with the care that was delivered and their needs were met. It was clear from our observations and from speaking with staff that they had a good understanding of the people's care and support needs and that they knew them well. We looked at how staff were supported to deliver care and treatment safely and to an appropriate standard. A relative commented, 'I've seen very good one to one contact between people and staff. The staff are pleasant and nothing is ever a problem and they seem to have good links with other services, like hospitals, GP's and social services. So far, it's all been brilliant.' A district nurse told us, 'Tynedale staff are really helpful, really organised and always willing to assist ' it's a good overall service.' However, we found that staff did not always receive appropriate training and suitable appraisal arrangements were not fully in place.

We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to staff training and appraisal arrangements.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. People told us they were able to do things at their own pace and were not rushed. Our observations confirmed this. One relative told us, 'They spend time with people and interact in a sensitive way. They are very encouraging and so caring ' it's amazing. They have gelled with my mam and family members are made so welcome." Another relative said, 'The home has a lovely atmosphere ' it's more like a family home as opposed to a care home. I'm always in and out and I think the staff are so attentive and caring.'

Is the service responsive?

People's needs had been assessed before they moved into the home. Care records for people at the service for assessment, or respite, were reviewed every two weeks to make sure that the information was accurate and up to date. Where people's needs had changed, their care plans were updated more frequently. Records confirmed people's preferences, interests, aspirations and diverse needs had been recorded and care and support was provided in accordance with people's wishes.

People had access to activities that were important to them and were supported to maintain relationships with their friends and relatives.

People and their relatives knew how to make a complaint if they were unhappy. We saw that six complaints had been recorded, investigated and resolved to the satisfaction of the complainant within the last 12 months. We saw the service had policies and procedures in place in relation to the safeguarding of adults and responding to any allegations of abuse.

Is the service well-led?

Staff had a good understanding of the ethos of the home and quality assurance processes were in place. People and their relatives were able to complete a customer satisfaction survey. Staff told us they were clear about their roles and responsibilities. This helped to ensure that people received a good quality service at all times. The provider undertook regular audits and risk assessments to monitor the quality of the services and there were effective systems to identify, assess and manage risks to the health, safety and welfare of people using the service and others. A relative said, 'It's really good; the service is well-run and managed and I am impressed every day I visit.' A local authority assessing officer told us, 'Overall. This is a well-run service and I have no concerns.' A district nurse commented, 'I have no concerns with the service; any issues or problem are rectified ' sorted straight away.'

We saw people were cared for effectively and care was planned for the individual.

We saw the home had effective systems in place to manage medicines. We saw that people were safe.

We saw there was sufficient staff on duty to provide care and support.

The provider had an effective system in place to record and monitor complaints. Complaints were taken seriously and responded to appropriately.

People who used the service were positive about the care and support provided. Comments included 'I've never had such a good fortnight in my life. The care is perfect'.