Background to this inspection
Updated
27 January 2022
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
This inspection was carried out by one inspector.
Service and service type
TNP Homecare 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.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with four people who used the service and seven relatives about their experience of the care provided. We spoke with ten members of staff including the registered manager, senior care workers, care workers and the chef. We spoke with one visiting professional. We reviewed a range of records. This included two people’s care records and multiple medication records. We looked at two staff files in relation to safe recruitment. A variety of records relating to daily care practices, risk assessments and management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with two additional professionals who regularly visit the service.
Updated
27 January 2022
About the service
TNP Homecare is a residential care home providing personal care to nine people aged 65 and over at the time of the inspection, although one person was residing in hospital. The service can support up to 12 people.
The home is divided over three floors, bedrooms were located on the ground and first floor. The second floor was used for the registered manager office. Two lounges, a kitchen and a dining room were situated on the ground floor. The dining room was currently being used as a staff and visitor COVID-19 testing area. A passenger lift was in place to enable people to access all floors. People had access to a paved garden, this was accessible to people who required the use of a wheelchair.
People’s experience of using this service and what we found
Some risks to people were not always monitored safely. Window restrictors were not compliant to Health and Safety Executive requirements. Quality auditing systems needed to be more robust to monitor medicines.
People felt safe living in the home and with the staff who supported them. Staff were safely recruited and inducted into the home. Risk assessments were completed and updated regularly. There were sufficient numbers of trained staff on duty and people told us they never had to wait long for support from staff.
Staff had excellent knowledge of peoples care needs and told us each person’s care and support needs, including their likes and dislikes. Staff described how they could recognise unsafe care practices and the action they would take to report poor practice.
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.
People were supported by caring and kind staff. They felt empowered to voice their own opinions and actively involved in daily life decision-making. People were encouraged to maintain relationships and family members told us how staff members encouraged independence skills.
The atmosphere in the home was relaxed and homily, the home was decorated to a good standard and there were festive decorations in accordance to the time of the year. There were opportunities throughout the day for people to engage in fun and interesting activities. People told us they were happy and enjoyed living in the home.
Mealtime was a positive experience for people. People enjoyed a selection of meals and both people and family members told us how they enjoyed the lovely home cooked meals.
The care provided was person centred. People were encouraged to decorate their own bedrooms and there were personalised objects such as photos of people in communal areas. People told us they could engage in their own interests and relatives told us people could take positive risks.
People could be confident their wishes for end of life care would be respected by staff. Relatives told us they were supported by compassionate staff during their family members end of life.
People felt involved in the care provided. Relatives told us they were informed following any changes and their opinions were sought. There was a culture of learning from when things went wrong.
The service worked in partnership with other professionals and the local community to achieve good outcomes for people. Professionals told us the registered manager was committed to providing a high standard of care. Staff members had confidence in the registered manager and told us they enjoyed working at the home.
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 15 October 2019) and there were multiple breaches 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
The last rating for this service was requires improvement (published 15 October 2019). The service has now improved to good.
Why we inspected
This was a planned inspection based on the previous rating.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
We have found evidence the provider needs to make improvements. Please see the Well led section of this full report. The provider has made significant improvement from the last inspection and has taken action to address the risks identified in this inspection.
The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for TNP Homecare on our website at www.cqc.org.uk.
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.