Archived: Trevanion House Holidays Limited

Trevanion House is a detached house located within its own grounds on the outskirts of Wadebridge in Cornwall. Accommodation is provided over two floors with adapted facilities for people with impaired mobility on the ground floor. Two guest lounge rooms and a restaurant are situated on the ground floor. The service has a fully licenced bar. Guests normally stay at the service for one to two weeks and are supported by staff to visit a wide variety of tourist destinations throughout Devon and Cornwall. In addition, the service also arranges a small number of trips to the continent each year.

The service was previously inspected on two occasions in 2016. In August 2016 we undertook a comprehensive inspection and rated the service ‘good’ overall with the key question ‘Is the service safe?’ rated as ‘requires improvement’. We found the service was in breach of Regulation 19 the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 as there was an inconsistent approach to following up on references when new staff started work. In December 2016, we returned to the service to undertake a focused inspection and found improvements had been made to the service’s recruitment processes. We rated the key question of safe as ‘good’.

At this inspection, in August 2018, we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People told us how much they enjoyed their holiday at Trevanion House and that they felt safe staying there and with the staff. One person said, “Yes, I’m very safe here’ and another said, “Yes, it’s a great place to have a holiday.” Staff knew people well as many people had returned on holiday over several years. Staff were aware of people’s care needs and care plans provided staff with the information they needed to ensure people’s personal and health care needs were met. Risks to people’s safety and well-being were assessed and management plans were in place to mitigate risks and to protect people. For those people who required support to manage their medicines or their finances, this was done safety.

People were supported to have maximum choice and control of their stay and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. People could choose where they wished to go and how they wished to spend their time throughout their stay at the service. Various trips were organised each day to the local places of interest people wished to visit.

Trevanion House had its own restaurant where people could choose what meals they wished. People could choose a cooked or a continental breakfast and in the evening, three course meals were served with each course having a number of choices. Packed lunches were available for people to take out with them.

There were sufficient numbers of staff to meet people's assessed needs and to support them safely when out on trips. Staffing numbers were arranged dependent upon the numbers and needs of the people visiting the service. Staff were safely recruited and received the training and supervision they needed for their role.

The service was well managed. The management team and staff communicated well with people, relatives and care providers prior to people arriving for their holiday. Feedback about the quality of the service was actively sought and the service used this to improve. People were confident any complaint they might have would be responded to promptly. No one we spoke with had any complaints about the service.

Further information is in the detailed findings below.

We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements.

This report only covers our findings in relation to the question ‘is the service safe?’ You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Trevanion House Holidays Limited on our website at www.cqc.org.uk.

The service provides holidays for adults with learning disabilities. It is registered to provide accommodation and personal care for up to 14 people. The house can also accommodate a further seven guests who do not require personal care and/or support . Trevanion House is a detached house located within its own grounds on the outskirts of Wadebridge in Cornwall. The service has a fully licenced bar. Guests normally stay at the service for a week long holiday and are supported by staff to visit a wide variety of tourist destinations throughout Devon and Cornwall. In addition the service also arranges a small number of trips to the continent each year.

Guests who we met on the last day of their holiday consistently told us they had enjoyed their time at Trevanion House Holidays Limited. They said, “The staff are wonderful”, “I am very happy”

“I have had fun” and “I have had a nice holiday.” There was a very pleasant and relaxed holiday atmosphere in the service. During our visit we observed frequent laughter and guests and staff sharing numerous jokes together.

Guests told us they had enjoyed a variety of activities both within the service and in the local community. Comments from guests included, “I have been out every day. I have had a really good week”, “We had Christmas dinner on Sunday it was lovely”, “I liked singing Elvis songs” and “There are fun things in the evening as well. We were well entertained.” One of the organisations director’s told us, “We are about promoting independence, fun and laughter” and it was clear from guests feedback that they had succeeded in this aim.

During our previous inspection we found that references were not available for all staff employed by the service. At this inspection we found staff files had been reviewed and where necessary additional references had been requested. The service had recruited two new members of staff since our previous inspection. Their staff records showed all necessary pre-employment checks, including Disclosure and Barring Service checks and reference reviews, had been completed prior to them starting work. This meant the service was no longer in breach of the requirements of the regulations.

Guests told us, “I do feel safe with the staff” and we found that staff understood their roles in relation to keeping people safe from any identified risk or avoidable harm. The service had systems in place to manage risks and records showed all accidents, incidents and near misses had been fully investigated.

There was a registered manager in post. 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.

There were clear lines of responsibility in place. The business was owned by three directors who all were involved with the day to day running of the service. One of the directors was the registered manager. In addition there was an operations manager in place to support the directors. There was a duty director on shift seven days a week. An on-call system was in place so staff were able to contact a member of the senior management team at any time.

The premises were well maintained and decorated. There was a large garden which was well tended and an area for people to enjoy barbeques. The barbeque area was covered so it could be used in rainy conditions.

Guests arrived at Trevanion House on a Thursday evening. Staff showed them their rooms at this time and a meeting was held to explain evacuation procedures and other housekeeping issues. The following morning a meeting was held when people could choose what trips out they wanted to take part in on the first three days. Arrangements for the timings of meetings had been changed in response to feedback from people. A second meeting was held on a Monday for people to choose how they wanted to spend the rest of the week. Staff supported people to make meaningful and informed choices.

The atmosphere was relaxed and informal. People approached us to share their experiences of their holidays. On their return from trips out people spent time either in their room or one of the two available lounges. There was a range of DVDs and books available as well as free wi-fi.

People ate breakfast and an evening meal at Trevanion House. A packed lunch was supplied for people to have on trips out. The food was varied and people’s individual dietary needs were catered for. People had access to drinks throughout the day and there was a licensed bar available.

Staff had received training in how to recognise and report abuse, and all were confident any concerns would be taken seriously by the registered manager. Other training identified as necessary for the service was updated regularly. Staff received supervision and appraisals. New employees were required to complete a thorough induction which incorporated training, familiarisation with policies and procedures and shadowing more experienced staff.

There were enough staff on duty to support people to take part in their chosen activity and support them with any personal care. Staff took time to chat with people and reassure them if necessary. The systems in place to protect people from being supported by staff who were not suitable for the role were not robust. There was an inconsistent approach to following up on references when new staff started work. Some people did not have any references on record; some had only one and others two. The quality of one reference was poor. The organisation did not have a clear policy in place regarding references for management to follow when recruiting new staff.

The provider acted in accordance with the requirements laid out in the Mental Capacity Act 2005 (MCA) and associated Deprivation of Liberty Safeguards (DoLS). Staff recognised and respected people’s rights.

When booking a holiday people were asked detailed questions about their support requirements. The registered manager used this information to decide whether they were able to meet the person’s needs. They considered the needs of all the guests when deciding whether to accept a booking. Information from pre-booking forms was used to develop a care support log. This contained guidance for staff on how to support people well. Any risks were identified and staff told us they felt they had all the information they needed to do their jobs effectively.

There were effective quality assurance systems in place to monitor the standards of the care provided. People, relatives and staff were asked for their opinions and suggestions regarding the running of the service.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the provider to take at the end of the full version of the report.

We saw care support plans were detailed and gave direction as to the care and support people needed.

People were provided with appropriate nutrition and fluids.

We saw the hotel was clean and tidy. Infection control procedures were robust and in line with relevant guidance. There was information about infection control readily available throughout the home.

People were cared for by staff that were properly supported to deliver support safely and to an appropriate standard.

People who used the service were consistently protected against the risks of unsafe or inappropriate support as records were updated and stored securely in order to protect people's confidentiality.

We spoke with five people who planned a holiday at Trevanion House. We also spoke with three carers who had accompanied people to Trevanion House. Everyone we spoke with was positive about the care they received. One carer who had accompanied a person to Trevanion House told us, 'I have been bringing people here for a couple of years and it is very good. The place is immaculate and the staff are very good with the guests. Nothing is too much trouble'.

People told us and we saw evidence of requests for pre-care assessments of peoples' needs to ensure Trevanion House could provide the required level of care. The care support forms we looked at were sufficiently detailed to inform staff about the care needs of people who would stay at Trevanion House.

We reviewed medication records and saw that the provider was following appropriate procedures for recording and safe administration of medications for people who stayed at Trevanion House.

We inspected the premises and assessed that people who used the service and people who worked in or visited the premises were kept safe in accessible surroundings that promoted their wellbeing.

We looked at staff records and staff rotas for Trevanion House and found there were sufficient numbers of suitably qualified, skilled and experienced persons employed to safeguard the health, safety and welfare of people who stayed at Trevanion House.