Archived: Tealbeck House

Tealbeck House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. At the time of the inspection there were 45 people living in the home, which comprised two floors and communal lounge, dining area and conservatory.

There was not a registered manager in post at the time of the inspection, however the service had appointed a manager in February 2018 who was in the process of applying to register with CQC. 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 home and that there were enough staff to meet their care needs. Staff were recruited safely. Staff were trained in protecting people from abuse and there were processes in place to ensure issues were raised and investigated appropriately.

Medicines were stored, administered and recorded safely, and the premises were made secure, regular maintenance and equipment checks were undertaken. Risks to people were assessed appropriately and people were protected from infection.

Staff received appropriate levels of training and support through induction, supervision and appraisal. People told us they felt confident staff were well trained and competent to perform their duties.

People were supported to maintain a healthy and balanced diet and they told us they enjoyed the food provided to them. People’s health and wellbeing was also monitored, and staff were proactive in requested advice and guidance from medical professionals where necessary.

People told us staff were kind caring and compassionate. Staff were able to describe how they supported people to remain independent and care plans provided further guidance on how to support people. Staff were also able to describe how they protected people’s privacy and dignity.

Care plans were written in a person-centred way which took into account their likes, dislikes and preferences. Conversations around end of life preferences were not always recorded and followed up. We have made a recommendation about the recording of end of life care plans.

There were a range of activities on offer and efforts had been made to improve the range of activities and community links, however some staff said that this required further resource and improvement to ensure everyone could enjoy meaningful activities. We have made a recommendation about activities provision at the service.

Staff told us they felt well supported by the manager and confident in their leadership of the service.

The provider was able to evidence how it engaged with staff and people using the service through meetings and surveys.

There was a quality monitoring system in place which provided oversight and enabled the provider to analyse trends and themes, as well as provide support to the manager.

Tealbeck House is a purpose built home located in Otley, Leeds. It is close to the local shops, library, pubs and post office. It is owned by Anchor Homes and provides care for up to 50 older people with varying physical and mental health needs.

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.

At the last inspection on 5 February 2016 the service was rated ‘requires improvement’ in two of our key questions. We raised concerns that the service had not had regular supervisions with staff and they had not identified this concern. At this inspection, we found some improvements had been made, but some further improvements were required.

Staff had an understanding of their responsibilities with regard to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). However the service had not referred people to the DoLS team for assessment, and they were therefore being unlawfully deprived of their liberty.

There was a quality assurance and monitoring system and audits had been carried out to identify areas where improvements were needed. However, audits had not identified the area of concern we raised on inspection. Risks had been identified and analysed to reduce the risk where possible. Staff had a clear understanding of risks and how to act to minimise risk when appropriate. Complaints procedures were in place. We found complaints had been acted on and completed in line with the provider’s policy. The registered manager encouraged people, relatives and staff to be involved in decisions about how the service improved and people were very positive about the management of the home. Staff had mixed views about the management of the service.

Staff had a good understanding of confidentiality. However, we saw some documentation was left in communal areas with people’s personal information on.

Care and support was personalised to meet people's individual needs. Changes in the care planning documentation had been made in line with reviews. The care plans were up to date and had been developed with the involvement of people and their relatives, if appropriate.

Staff had attended safeguarding training; safeguarding and whistleblowing policies were in place and staff had read and understood these. People told us they felt safe in the home. Staff managed, administered and stored medicines safely. People had access to healthcare professionals as required.

The recruitment process was robust, it ensured only people considered suitable worked at the home. There were enough staff working in the home to provide the support people wanted.

The home had a calm atmosphere and people said they were very comfortable living there. People told us they liked their rooms and were very positive about the food. We observed that staff treated people with respect and dignity and people confirmed they had their privacy and dignity respected. Staff told us they worked to improve people’s independence.

Activities happened on a daily basis and people were asked for their opinion about what to do. People confirmed activities were available for them to join in if they wanted to. Equipment and the environment were maintained. We saw receipts for servicing, checks on items used in the home and safety certificates.

Our last inspection took place on 13 November 2013, at that time; we found the service was meeting the regulations we looked at.

Tealbeck House is a purpose built home located in Otley, Leeds. It is close to the local shops, library, pubs, and post office. It is owned by Anchor Homes and provides care for 50 older people with varying physical and mental health needs. At the time of inspection 48 people were living in the home.

At the time of this inspection 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 and associated Regulations about how the service is run.

People and their relatives told us they or their family member felt safe at the home. There were effective systems in place to ensure people’s safety at the home, whilst encouraging and promoting their independence. Staff could describe the procedures in place to safeguard people from abuse and unnecessary harm. Recruitment practices were robust and thorough.

People received their prescribed medication when they needed it and appropriate arrangements were in place for the storage and disposal of medicines. Staff who administered medication were trained in medicines management.

People were cared for by sufficient numbers of suitably trained staff. Staff spoke of their training and said this supported them in their role. Staff had not received regular supervisions by the registered manager due to shortfalls in staffing levels within the service. Agency staff were supporting the home while recruitment of staff were being completed.

People’s needs were assessed and care and support was planned and delivered in line with their individual care needs and preferences. People had detailed, care plans in place which described all aspects of their care and support needs. However in one person’s care plan some information was missing. We brought this to the attention of the registered manager at the time of inspection.

Staff were trained in the principles of the Mental Capacity Act (2005), and could describe how people were supported to make decisions to enhance their capacity and where people did not have the capacity to make decisions these were made in their best interests.

Health, care and support needs were assessed and met by regular contact with health professionals. People were supported by staff who treated them with kindness and were respectful of their privacy and dignity. People were provided with a choice of suitable healthy food and drink which ensured their nutritional needs were met.

People participated in a range of activities both in the home and in the community and received the support they needed to help them stay in contact with family and friends.

Staff had good relationships with the people living at the home. Staff were aware of how to support people to raise concerns and complaints and we saw the provider learnt from complaints and suggestions and made improvements to the service.

There were not always effective systems in place to monitor and improve the quality of the service provided. Care plans and supervision audits had not being completed.

Most Staff were up to date with training; some staff had to cancel refresher training due to staff shortages. The registered manager was aware of this and was working towards all the staff completing all refresher training in 2016.

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People who used the service and staff spoke highly of the support they received from the care manager and registered manager. Staff said the management team were nice, approachable and if they had any concerns they would speak to them straight away.

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. People told us that they were happy with the care they received. One person who used the service told us: 'They do look after us well here. Staff are like friends.' Another person said: 'You can't really fault it. It's clean, staff are nice and the food is excellent.'

People who used the service, staff and visitors were protected against the risks of unsafe or unsuitable premises.

People were cared for, or supported by, suitably qualified, skilled and experienced staff. Disclosure and Barring Service (DBS) checks had been carried out for each staff member.

There was an effective complaints system available. Comments and complaints people made were responded to appropriately.

People said they felt able to tell staff if they required any changes to the way in which they were cared for.

People who used the service said they felt safe and would feel comfortable discussing any concerns with staff and the manager.

Staff were supported to deliver care to people to an appropriate standard.

We spoke with three people about medicines handling at the home. Everyone we spoke with was happy with the arrangements in place when care workers administered their medicines. One person described the care workers as 'kind' and said they got their medicines when they needed them.

The provider and staff were aware of their responsibilities regarding protecting people from abuse. Staff told us they knew how to raise concerns.

People's privacy, dignity and independence were respected. People's views and experiences were taken into account in the way the service was delivered.

The provider had quality assurance systems in place to ensure the quality of the service being delivered was meeting people's needs.