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Archived: Tithebarn Good

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Inspection Summary

Overall summary & rating


Updated 29 April 2015

Tithebarn is registered to provide personal care and accommodation for up to 42 adults. Thirty eight people were living at the home at the time of our inspection. Accommodation is provided mainly in single rooms, which have an ensuite facility. There are two double rooms. The service is run by the Royal Masonic Benevolent Institution and is located in the Crosby area of Sefton, Merseyside. The home is fully accessible to people with restricted mobility. Accommodation is provided over two floors, with bedrooms located on the ground and first floor. The home has a separate unit for up to ten people with dementia care needs.

The inspection took place on 9 and 10 December 2014 and it was unannounced.

The home had a registered manager. 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 said they felt safe living at the home and were supported in a safe way by staff. Staff understood what abuse was and how they would report suspected or actual abuse. Procedures were in place for responding and reporting to the relevant agencies and the manager was fully aware of how this was done.

Staff had been recruited appropriately to ensure they were suitable to work with vulnerable adults. Staff were only able to start work at the home when the provider had received satisfactory pre-employment checks. People and their families told us there was sufficient numbers of staff on duty at all times.

The building was safe, clean and well maintained. Measures were in place to monitor the safety of the environment. The home was fully accessible. Aids and adaptations were in place to meet people’s needs and aid their independence. The dementia care unit was designed, decorated and run in a ‘dementia friendly’ way.

Staff were following the Mental Capacity Act (2005) for people who lacked mental capacity to make their own decisions. For example, some people had their medication administered covertly and the decision to do this had been agreed based on a mental capacity assessment and best interest meeting or discussion.

People told us they liked the food and got plenty to eat and drink. People had access to a health professional and staff arranged any appointments promptly.

Staff told us they felt supported in their roles and responsibilities. Staff received an induction and regular mandatory (required) training in many topics such as health and safety, infection control, fire safety, moving and handling, and safeguarding of vulnerable adults. Records showed us that they were up-to-date with this training. This helped to ensure that they had the skills and knowledge to meet people’s needs.

People who lived at the home had a plan of care. The care plans we looked at contained relevant information to ensure staff had the information they needed to support people in the correct way and respect their wishes, likes and dislikes. A range of risk assessments had been undertaken depending on people’s individual needs.

Medication was given at times when people needed it. We observed the administration of medication by staff. We saw that staff that ensured people took their medication by waiting with them. Medication was stored safely and securely.

Activities were arranged for people in the home throughout the week by an activities co-ordinator. These included quizzes, board games, arts and crafts, reminiscence and films. Entertainers visited the home once a month. Activities were also provided in the evening.

During our visit we observed staff supported people in a caring manner and treated people with dignity and respect. Staff knew people’s individual needs and how to meet them. We saw that there were good relationships between people living at the home and staff, with staff taking time to talk and interact with people. People told us they were happy at the home, and our observations supported this. Relatives we spoke with gave us positive feedback about the staff team.

A procedure was in place for managing complaints and people living there and their families were aware of what to do should they have a concern or complaint. We found that complaints had been managed in accordance with complaints procedure. A copy of the procedure was displayed in the foyer of the home.

Systems were in place to check on the quality of the service and ensure improvements were made. These included surveying people about the quality of the service and carrying out regular audits on areas of practice.

Inspection areas



Updated 29 April 2015

The service was safe.

Staff were confident about recognising and reporting suspected or actual abuse.

Risks to people’s safety had been assessed and were well managed.

Pre-employment checks were carried out on staff before they started working at the home to ensure they were deemed suitable to carry out their roles and responsibilities.

There were enough staff on duty at all times.

Medicines were administered safely and stored securely.



Updated 29 April 2015

The service was effective.

Staff said they were well supported through induction, supervision, appraisal and on-going training.

Staff were following the Mental Capacity Act (2005) for people who lacked mental capacity to make their own decisions.

People told us they liked the food and got plenty to eat and drink.

People had access to external health care professionals and staff arranged appointments when they needed it.



Updated 29 April 2015

The service was caring.

We made observations of the people living at the home and saw they were relaxed and settled. A relative told us they were happy with the care in the home and described the staff described the staff as caring, patient respectful and attentive.

We observed positive interactions between people living at the home and staff. Staff treated people with privacy and dignity. They had a good understanding of people’s needs and preferences.



Updated 29 April 2015

The service was responsive.

People’s care was planned so it was personalised and reflected their current and on going care needs.

A process for managing complaints was in place and people we spoke with and relatives were confident they could approach staff and make a complaint if they needed.

A variety of activities were provided in the home. Transport was available to enable people were able to access local amenities.



Updated 29 April 2015

The service was well led.

We found an open and person-centred culture within the home.

There were systems in place to get feedback from people so that the service could be developed with respect to their needs.

Processes for monitoring the quality of the service were in place at the home.