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The Tulips Care Home II Requires improvement

Reports


Inspection carried out on 20 August 2019

During a routine inspection

About the service

Tulips Care Home II is a small residential care home providing personal care for up to four adults with mental health needs. At the time of our inspection four people were living in the service who had mental health conditions, with one person living with dementia.

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

People and their relatives were positive about the kind and compassionate attitude of the staff team. People and staff complimented the friendly and homely environment.

We observed positive interactions between people and staff throughout the inspection, with staff being knowledgeable about people’s needs.

Where people had limited communication, we saw they were comfortable and relaxed in the presence of staff. Due to the size of the service and the consistency of the staff team, people had developed positive relationships with staff.

People were involved in how they received their care and staff worked closely with them to help their understanding of how they wanted to be supported.

People were supported to a range of healthcare appointments and staff contacted the necessary health and social care professionals if people’s health changed.

People were supported to take part in a range of events and activities, both within the home and within the local community. Friendships were supported with people in the provider’s two other homes on the same street to help reduce social isolation.

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.

Although there were monitoring processes in place, there were inconsistencies with how people’s financial transactions were kept and recorded, which was not in line with the provider’s policies and procedures. There were also shortfalls with some health and safety checks.

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

Rating at last inspection

The last rating for this service was Good (published 2 May 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified one breach in relation to good governance. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality. 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.

Inspection carried out on 12 April 2017

During a routine inspection

The Tulips Care Home II is a small care home that provides support to a maximum of four people who have mental health issues. The service is situated over two floors with spacious rooms.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

The service had a manager in place. The service is not required to have a registered manager.

People received care and support from a service that demonstrated good practice in relation to safe medicines management. Records confirmed the administration, storage and recording of medicines was carried out safely. People were protected against the risk of harm and abuse by staff that received on-going safeguarding training and knew the correct action to take if they suspected abuse. Risk assessments identified the risk and gave staff guidance on how to manage the known risks safely.

Staff were aware of their responsibilities in relation to the Mental Capacity Act 2005 (MCA). The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. At the time of the inspection the manager was completing the MCA assessments.

People’s choices and decisions were supported and respected. People were encouraged to make choices and decisions about the care and support they received. Consent to care and treatment was sought prior to care being delivered.

People were supported to access sufficient amounts to eat and drink. The service encouraged people to maintain a healthy diet in line with their health care needs and preferences. People had access to a wide range of health care professionals to ensure their health was monitored and maintained.

People confirmed they were supported by staff that were compassionate, empowering and caring. Where possible people were encouraged to maintain relationships with people that mattered to them.

The manager developed care plans that were person centred and tailored to people’s individual needs and preferences. People confirmed they were supported to develop their care plans and these were regularly reviewed to ensure they reflect people’s changing needs and preferences.

People were supported to participate in a wide range of activities both in the community and within the service. The service placed emphasis on people integrating with the local community.

Both staff and the manager were aware of how to respond positively to complaints and concerns raised. Records confirmed the service had not received any complaints within the last 12 months. The service made the complaints procedure available to people.

The service questioned the service delivery through annual quality assurance questionnaires. The manager informed us that should people raise any concerns through the questionnaires action would be taken immediately to manage the concern.

The service carried out regular audits of the service to drive improvement. Audits looked at the safety of the service and where issues were identified, action was taken in a timely manner.

People and staff spoke highly of the manager and told us, they could approach the manager and their views would be listened to and acted on if appropriate.

Inspection carried out on 13 October 2013

During a routine inspection

This unannounced inspection took place on 13 October 2014. We last inspected the service in December 2013 where we found the service met all the regulations we checked.

The service provides care and accommodation for people with mental health needs. It is located in a large house with a garden. Each person using the service has their own bedroom and shares communal facilities, such as the kitchen and living room. At the time of the inspection there were four people using the service. The provider is in regular day-to-day contact with the service and manages it with the assistance of a deputy manager. The service is not required to have a registered manager.

People told us they felt safe at the service and liked the staff. Staff knew how to identify and report signs of abuse or neglect. Risks to each person had been identified and plans were in place to promote their safety. People told us they received their medicines safely. They said staff were available to give them the support they needed.

People were supported to keep well by maintaining a healthy life style and diet and to attend healthcare appointments. Staff were trained to meet people’s needs and received support to carry out their work. People said they were able to make decisions about how they were supported and staff respected their views and privacy.

People told us they were supported by a small group of staff who knew them well. They said all the staff were friendly and treated them with respect. During the inspection staff regularly asked people how they were feeling and supported them with any worries they had. A mental health professional who visited people using the service said it had a calm and homely atmosphere and was effective in promoting people’s wellbeing.

The provider had oversight of the running of the service and was described as approachable and friendly by people and staff. A mental health professional told us they thought the service was well-led, and planned and delivered people’s care effectively.

Inspection carried out on 5 October 2013

During a routine inspection

On the day of our inspection there were three people who used the service present at the home. The home was undergoing refurbishment and redecoration. In the areas where the redecoration was completed, it was found to be in good decorative order and provided a comfortable and homely environment. There were a number of reception rooms that could be used by people either individually or in groups. We found communal dining and social areas as well as private and quiet areas. We spoke to all three people who used the service on the day of our visit. One lady told us that she had been there for six years and that she was happy there. She told us she felt settled and comfortable. She told us that the food was good and that she could help herself to refreshments at any time. Another lady told us that she liked to prepare her own food and that she was able to do that without interference but that she knew she could call for help if she needed to.

We saw that one of the people using the service was in a reception area on her own and when we spoke with her she told us that she preferred to be on her own but that she could go and sit with the others or talk to a staff member when ever she wanted to.

All three people told us that they liked the sanctity of their own bedrooms and that they felt safe and well cared for.

Inspection carried out on 16 November 2012

During a routine inspection

We spoke with all four people using the service at The Tulips Care Home II. They confirmed that they received appropriate care and support, which met their needs. People consented to the care and support they received.

The premises in The Tulips Care Home II were well maintained. The provider had suitable arrangements in place to ensure the premises complied with legal requirements, such as health and safety, and fire regulations.

People with relevant qualifications, knowledge, skills and experience were employed to care for people at The Tulips Care Home II. Robust recruitment and background checks were completed before new staff joined the service

The provider sought people�s views, carried out audits and completed assessments of risks to assess and monitor the quality of service provision.