Archived: Tithebarn

Updated 29 April 2015

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 2014.

This inspection took place on 9 and 10 December 2014 and was unannounced. The inspection team consisted of an adult social care inspector and an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

We reviewed the information we held about the service before the inspection. We contacted one of the commissioners of the service to seek their feedback about the service. Prior to the inspection the provider had submitted a Provider Information Return (PIR). The PIR is a document the provider is required to submit to us which provides key information about the service and tells us what the provider considers the service does well and details any improvements they intend to make.

During the inspection we spoke with five people who lived at the home and three visiting relatives. We also spoke with four care staff, a cook and members of the management team.

We spent time observing the care provided to people who lived in the home to help us understand their experiences of the service. We also used the Short Observational Framework for Inspection (SOFI) when we inspected the dementia care unit. SOFI is a way of observing care to help us understand the experience of people who lived in the home who could not talk with us.

We reviewed a range of records, including the care records for three people who lived in the home, four staff personnel files, the provider’s policies and procedures, and records relating to the quality monitoring of the home.

We looked around the home, including some people’s bedrooms, bathrooms, dining room and lounge areas in both the main house and the dementia care unit.

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.