9 and 10 December 2014
During a routine inspection
Tyndale nursing home was last inspected on 9 September 2013. The home was found to be non-compliant in relation to the provision of care and welfare, assessing the quality of the service and staff support.
When we visited there had not been a registered manager in post for the last four months. 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.
Tyndale Nursing home provides nursing care and support for up to 27 older people. At the time of the inspection there were 19 people living at the home.
The lack of registered manager impacted on the support and guidance to staff. There were no effective systems to improve the standards in the home which meant that it was failing to meet the expected standards of care.
Staff lacked the guidance and support to be able to give medicines safely and in accordance with the relevant legislation. This put people at risk of receiving medicines inappropriately.
Some people told us that the staff met their care needs but this is not what we found. There was insufficient evidence to say that people were involved in the planning of their care. Records relating to people’s care and support needs did not always give staff the information they required to keep people safe. They failed to plan and assess people's needs in order to ensure they were met in a consistent manner.
The provider was not meeting the requirements of the Mental Capacity Act 2005 and assessments of people’s capacity had not consistently been made. The staff at the home, whilst understanding some of the concepts of the Act, such as allowing people to make decisions for themselves, did not demonstrate that they could implement this.
The staff demonstrated a degree of caring and compassion to people living at the home but did not understand how to meet all the needs of those people with enduring mental health illness such as dementia. People were not consistently offered choices at mealtimes such as where to sit and what to eat. One person who required staff support at lunch time was not offered this.
People told us there were enough staff to meet their needs. One person told us “I never have to wait long for help to get up in the morning.” Another said “When I ask for help there is always someone around to help, if I press my call bell someone comes”. Whilst there were enough care staff to support people living at the home the lack of management leadership impacted on the support staff received.
We made compliance actions in relation to; Care and consent to treatment, management of medicines, staff support, quality assurance, care and welfare, record keeping, food and nutrition and respect and involving people.