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Inspection Summary


Overall summary & rating

Good

Updated 7 June 2018

Tiltwood 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. Tiltwood accommodates up to 50 older people, who may also be living with dementia. The service is arranged into five individual units, named: Pines, Elms, Chestnuts, Walnuts and Willows. Titlwood also has an onsite day service which is accessed by some of the people who live at Tiltwood, in addition to being open to the wider community.

The inspection took place on 12 March 2018 and was unannounced. There were 40 people using the service at the time of our inspection.

The service had 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. The registered manager had been in post since November 2015.

We previously carried out an unannounced comprehensive inspection of this service on 15 March 2017. At that inspection we found one breach of legal requirements in respect of providing person centred support. As a result the findings from that inspection, the service was rated Requires Improvement. The provider sent us an action plan which identified the steps they intended to take to make the required improvements and this inspection confirmed that the provider had done the things they told us they would.

This inspection found that whilst people were experiencing a good standard of service, some staff did not always have the skills and confidence to meet people’s specialist needs. In addition, staff needed to ensure they always worked collaboratively to make sure they delivered the most effective support. The registered manager and provider had already identified these areas of improvement and plans were in place to ensure they were acted upon.

People now experienced a personalised approach to care and most staff had a good understanding about their wishes. Each person had been appropriately assessed and information used to develop a plan of care that outlined how support was to be provided safely and in accordance with people’s preferences. People were given choice and control over how they lived their lives and their right to be independent was inspected.

People were supported to lead healthy lives and encouraged to eat and drink so as to maintain a healthy and balanced diet. The registered manager worked in partnership with other healthcare professionals to ensure people received holistic care. Medicines were managed safely and people received their medicines as prescribed. End of life care enabled people’s final wishes to be respected and allowed people to pass with comfort and dignity.

Staffing levels were sufficient to safely meet people’s needs. Appropriate checks were undertaken to ensure staff were suitable to work people and training and support was provided to enable them to deliver their roles.

Staff understood their responsibilities in protecting people from harm and there were appropriate systems, processes and practices to safeguard people from abuse. Risks to people were identified and managed in a way that balanced both people’s safety and freedom.

The environment was suitable for people’s needs and the Registered Manager was continuously developing the sensory areas around the service. The service was clean with good infection control systems in place.

The atmosphere in the service was relaxed and people were treated with kindness and compassion. Staff respected people’s privacy and took appropriate steps to ensure their dignity was upheld. People had opportunities to participate in activities that were engaging and meaningful to them and the

Inspection areas

Safe

Good

Updated 7 June 2018

The service was safe.

Staffing levels were sufficient to safely meet people�s needs. Appropriate checks were undertaken to ensure staff were suitable to work people.

There were appropriate systems, processes and practices to safeguard people from abuse. Staff understood their roles and responsibilities in protecting people from harm.

Risks to people were identified and managed in a way that balanced both people�s safety and freedom.

The service was clean and good infection control systems were in operation.

Medicines were managed safely and people received their medicines as prescribed.

The registered manager took appropriate steps to ensure lessons were learned when things went wrong.

Effective

Requires improvement

Updated 7 June 2018

The service was not always effective.

Some staff lacked the skills and confidence to meet people�s specialist needs.

The registered manager worked in partnership with other healthcare professionals, but staff teams did not always work collaboratively together to deliver the most effect support.

People�s needs and choices were appropriately assessed and information used to inform their care.

Staff had understood people�s capacity and were more proactive in the way they protected people�s legal rights.

People were supported to lead healthy lives and encouraged to eat and drink so as to maintain a healthy and balanced diet.

The environment was suitable for people�s needs and the Registered Manager was continuously developing the sensory areas around the service.

Caring

Good

Updated 7 June 2018

The service was caring.

The atmosphere in the service was relaxed and people were treated with kindness and compassion.

People were involved in making decisions about their care and staff encouraged people to express their views.

Staff respected people�s privacy and took appropriate steps to ensure their dignity was upheld.

Responsive

Good

Updated 7 June 2018

The service was responsive.

People experienced a more personalised approach to care and staff had good understanding about their needs and wishes.

People had opportunities to participate in activities that were engaging and meaningful to them.

There were effective systems in place to ensure that people were listened to and concerns were addressed in a way that improved the quality of care.

End of life care enabled people�s final wishes to be respected and allowed people to pass with comfort and dignity.

Well-led

Good

Updated 7 June 2018

The service was well-led.

The registered manager actively championed highly personalised support and was continuously exploring new ways to improve and develop the service.

The culture within the Tiltwood was open and inclusive people and their representatives felt empowered and engaged in the running of the service.

The governance framework at both provider and management level ensured regulatory requirements were understood and complied with.