Trinity Fold

We found the following examples of good practice.

The service was accessing the government testing scheme.

The service was working with the local authority infection control team and other health professionals to ensure people's needs were met.

The registered manager was open and pro-active in sharing information with friends and family so they understood decisions around visiting and restrictions.

People had been provided with pictorial guides to help them understand the restrictions in place.

Staff supported people to stay in contact with relatives and friends via phone and video calling.

Further information is in the detailed findings below.

Trinity Fold is a residential care home providing personal care for up to 50 older people, some of who may be living with dementia. There were 48 people using the service when we inspected.

People’s experience of using this service and what we found

At this inspection we found improvements had been made in many areas. Leadership and management had improved with the recent appointment of a new manager, which resulted in better outcomes for people and an increase in staff morale. More thorough quality assurance systems had been implemented and issues identified had been addressed.

People were happy with the care and support they received and told us they felt safe. One person said, “I like it here. [Staff] are all very good, I oversee them you know. I'm happy here.” Care records had improved and reflected people’s needs and preferences.

People felt although there were a lot of events at Christmas, overall there was a lack of activities compared to what had been provided in the past. The manager was looking at ways in which this could be improved.

Medicines were managed safely. Staff were aware of risks to people and knew how to keep them safe. The manager was monitoring accident and incidents and taking action to prevent re-occurrences. For example, staffing levels had been increased and there was better teamwork which had improved outcomes for people. A new call system had been installed which helped keep people safe.

Staff were recruited safely, were well trained and had the required skills to meet people’s needs. Staff told us they felt well supported.

The home was clean and well maintained. There was an ongoing refurbishment plan which included improvements to make the environment more dementia friendly.

People and relatives praised the staff for their kind and caring approach. We saw staff treated people with respect and maintained their privacy and dignity. People had access to healthcare services. Most people were happy with the choice and quality of the food and said they received plenty to eat and drink.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 9 January 2019) and there was one breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Trinity Fold is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home provides nursing and personal care for up to 50 older people, some of whom may be living with dementia. Accommodation is provided on three floors with passenger lift access between floors. There are communal areas on the ground floor, including a lounge and dining room. There were 44 people in the home when we inspected.

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.

People’s care needs were not always being met as care plans were not always accurate or up to date. This meant people were at risk of receiving inappropriate or unsafe care. The issues we raised at the inspection were acted on promptly by the registered manager who notified us of actions they had taken following the inspection.

Activities for people were limited, particularly for those who chose to stay in their rooms. The activity organiser had been off work for a few months which had impacted on activity provision. The provider acknowledged this and told us of the plans they had to recruit new activity staff in the near future.

Medicines were managed safely. Risks to people were assessed and managed to keep them safe. Staff had been trained in how to identify and report abuse. Records we reviewed showed appropriate action had been taken to keep people safe and safeguarding referrals had been made to the local authority safeguarding team.

Staff were recruited safely and received the induction, training and support they required to carry out their roles. There were enough staff to meet people’s needs and keep them safe.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

The home was clean and staff followed good infection control practices. Checks were carried out regularly to ensure the safety of the premises and any equipment used. The home was comfortably decorated and furnished. However, some areas required improvement to make them more dementia friendly so people living with dementia could find their way around more easily.

People and relatives spoke highly of the staff who they described as kind and caring. We saw staff had developed good relationships with people and knew them well. Staff treated people with respect and maintained their privacy and dignity.

People told us they enjoyed the food. A choice of food and drinks were available at all times. People knew how to make a complaint and we saw complaints raised had been dealt with appropriately.

People, relatives and staff spoke positively about the registered manager and the way the home was managed. There were systems in place to measure monitor and manage the quality of the service. However, we found these needed to improve as issues we identified had not been resolved by the provider until we brought them to their attention. We made a recommendation about improving governance systems.

We identified one breach of regulation in relation to safe care and treatment. You can see what action we have told the provider to take at the end of the full version of this report.

Trinity Fold is a 50-bed home and is registered to provide accommodation and personal care for older people. Nursing care is not provided. The accommodation is arranged over three floors linked by a passenger lift. All of the bedrooms have en-suite toilet facilities and there are communal lounges and dining areas for people to use. The home is located a short distance from Halifax Town centre.

On the day of the inspection there were 44 people using the service and one person was in hospital.

There is a registered manager in post who has worked at the service for 10 years. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

We found staff were being recruited safely and there were enough staff to take care of people and to keep the home clean. Staff were receiving appropriate training and they told us the training was good and relevant to their various roles. Staff told us they felt supported by the registered manager and deputy manager and were receiving formal supervision where their could discuss their on-going development needs.

People who used the service and their relatives told us staff were helpful, friendly and caring. We saw people were treated with respect and compassion. They also told us they felt safe with the care they were provided with. We found there were appropriate systems in place to protect people from risk of harm.

The chef and kitchen assistant had a good knowledge of people’s dietary needs and preferences. People told us there was a choice of meals and the food was good. We also saw there were plenty of drinks and snacks available for people in between meals.

Care plans were up to date and detailed exactly what care and support people wanted and needed. Risk assessments were in place and showed what action had been taken to mitigate any risks which had been identified. People who used the service and relatives told us they were happy with the care and support being provided. We saw people looked well groomed and well cared for.

People’s healthcare needs were being met and medicines were being managed safely.

Activities were on offer to keep people occupied both on a group and individual basis. The activities co-ordinator was aware of people’s interests and was providing relevant sessions for them. People also had the opportunity to participate in the local community and enjoyed visits from children from a local nursery and school.

We found the service was meeting the legal requirements relating to Deprivation of Liberty Safeguards (DoLS).

Visitors said they were made to feel welcome.

There was a complaints procedure in place and we saw where concerns had been raised these had been dealt with appropriately.

We saw there were systems in place to monitor the quality of the service. When areas for improvement were identified action was taken to address these shortfalls. People using the service were asked for their views and were able to influence the way the service was managed.

'I am very happy here, it has been a very positive move for me.'

'The staff are very good and I get help when I need it.'

'The home is always clean and tidy.'

'I can follow my own routine.'

'There are activities on offer if you want to join in.'

'I can please myself if I spend time in my room or the communal areas.'

'I really enjoy working here.'

We found that people were treated with dignity and respect and were involved in planning their care and support. The system for administering medication was managed safely.

Our conversations with people and staff, together with observations on the day of our inspection evidenced that there were enough staff on duty.

The provider had an appropriate system in place for gathering and evaluating information about the quality of care the service provided.

'I like living here, the accommodation and the staff are very good.'

'Everything is very nice, if you want something staff will get it for you.'

'The food is very good and there is a choice for every meal.'

'There are activities to join in with if you want to. Tomorrow is an Italian evening with food and an Italian film.'

'The home is kept clean and tidy. I can choose if I spend time in the lounge or in my room.'

'If there was something I was unhappy about I would tell a member of staff and they would sort it out for me.'

'Staff keep me informed about my relatives wellbeing and talk to me about their care and support.'

'I enjoy working here, it's a good staff team.'