We carried out a review of the data available to us about Talbot Gardens on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Talbot Gardens, you can give feedback on this service.
Talbot Gardens is a specialist domiciliary care agency providing personal care to two people at the time of the inspection in a supported living setting. The service can support up to eight people, and there were eight people living at the supported living property at the time of the inspection.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
Although some improvements had been made in the governance of the service, we found there were still areas where records and audits could have been more effective in identifying areas of improvement and ensuring improvements had been made.
We have made a recommendation about governance at the service.
There were enough staff deployed to meet people’s needs, and staff received appropriate levels of training and ongoing support.
People said the service was safe, and there were appropriate safeguarding policies and procedures in place. Accidents and incidents were investigated and monitored and risks to people’s safety assessed.
People received their medicines as prescribed and medicines administration was recorded and audited regularly.
People said staff were kind, caring and compassionate. We saw staff had good relationships with people. People we spoke with said staff supported them to lead independent lives and pursue their interests and hobbies.
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.
Care plans contained information about people’s needs and personal preferences, as well as their diverse characteristics.
Staff we spoke with said they felt the registered manager was approachable and that there was a good working culture at the service. There was a clear vision and purpose for the service which focused on ensuring people who required support and were also deaf could lead independent lives and have care delivered by staff who communicated in British Sign Language.
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 24 October 2018) and there was a breach of Regulation 17 (Good Governance) identified. 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.
Not everyone using the service receives a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of our inspection there was only one person in receipt of personal care from the service.
This announced inspection took place on 24 July, 1 and 2 August 2018.
There was a registered manager in post at the time of our inspection. The registered manager was also the director and there was a separate manager who had day-to-day responsibility for managing the service. 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 we rated the service overall ‘Good.’ However, at this inspection we found that improvements were required and rated the service ‘Requires improvement. Improvements were needed to fully ensure effective systems and processes were in place to monitor and improve the service. Audits were not always carried out to identify any shortfalls in the service and records of incidents that occurred within the service, such as people falling and sustaining serious injuries, did not always record when actions had been taken to prevent re occurrences.
We could not be sure that people received the medicines they needed as records linked to the administration of medicines were not always signed by staff to reflect administration process and if people actually took their medicines. We found some medications had been omitted by staff and write that these had not been administered due to the lack of information provided to ensure safe administration.
Not all staff understood the Mental Capacity Act 2005. The person using the service did not have capacity. We found the provider did not include information to reflect that assessments had taken place as they lacked capacity. No systems were in place to monitor if a person’s capacity had been reviewed.
Some staff told us they did not always feel supported by the registered manager as they were not present. Staff meetings took place and staff were encouraged to discuss proposed improvements for the service. However, some staff felt issues they raised had not always been acted upon.
Staff received supervisions and appraisals in line with the provider’s policy. Inductions took place and staff received appropriate training although we discussed with the provider that staff would benefit from further training in the MCA Act 2005, to improve their understanding and application of this Act. Improvements had been made to ensure staff’s knowledge remained relevant and training was monitored to ensure staff completed their training.
The person who received care told us there was enough staff to meet their needs. Staff were recruited in line with the provider’s policy and these checks were robust.
The person receiving care told us they felt safe. Staff knew how protect people from potential harm or abuse. Risk assessments were completed and reviewed to support people with specific needs to avoid any harm.
Where people required assistance, they were supported to eat, drink and maintain a balanced diet. People were also supported with their health needs and annual checks carried out. Staff liaised with health care professionals and supported people to attend appointments.
The person using the service had good relationships with staff and told us their needs were met. People were encouraged to be independent and make choices regarding their care. Staff respected people’s privacy and dignity when in their home.
Care plans were carried out and provided instructions for staff to follow. At the time of our inspection the deputy manager was reviewing the person’s care plan we looked at in collaboration with the local authority, to make sure this was adequately person- centred. People received personalised care which responded to their specific needs and preferences.
Staff used individualised communication skill assessments to determine levels of dependency and support required from staff. We found a variety of methods were used to communicate with people including British sign language, writing on whiteboards and picture cards to support people to make decisions about their care and to give consent.
The provider had not received any complaints in the last 12 months but knew how to respond and investigate any concerns raised. There was also an application available to staff so they could raise concerns directly with the management should they wish. The person using the service told us they felt confident to discuss any concerns with the provider.
Surveys were provided to people using the service to monitor the quality of the care provided.
We identified one breach of the Health and Social Care Act (Regulated Activities) Regulations 2014; you can see what action we told the provider to take at the end of the full version of this report.
This was an announced inspection carried out 27 October 2015. At the last inspection in December 2013 we found the provider met the regulations we looked at.
Homelife is a specialist domiciliary care agency which supports people who are deaf and hearing impaired or have complex additional needs. It is part of an organisation, which also has supported living and a day care facility.
A registered manager was in post and present for the inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. 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 looked at records relating to the personal care that the service was providing and found care was well planned and reviews involved the people receiving care and their families.
Recruitment procedures were effective with appropriate checks made on people’s employment histories and with the Disclosure and Barring Service (DBS).
People told us they felt safe using the service. We observed very good relationships between people and their support workers and saw policies and practice that ensured people’s privacy and dignity were respected. Staff spoke highly of the registered provider and felt well supported by them.
We accompanied staff to the home of a person who used the service and observed good interactions between the person and their support worker.
We saw the support plan was detailed and included information on how to meet the person’s religious and cultural needs, the activities they took part in and how to manage any behaviour that could be challenging.
The staff we spoke with were able to describe how the person preferred their care and support to be delivered and the importance of treating them with respect in their own home. The person who used the service told us staff were very caring and always provided care and support in line with their agreed support plan.
The provider had policies and procedures relating to the safe administration of medication in people’s own home which gave guidance to staff on their roles and responsibilities.
There was a complaints procedure available which enabled people to raise any concerns or complaints about the care or support they received. The person we spoke with told us they were aware of the complaints procedure and would have no hesitation in making a formal complaint if they had any concerns about the standard of care provided.
We saw the provider had a quality assurance monitoring system that continually monitored and identified shortfalls in service provision.
The manager ensured on entering into a service agreement, all customers received an information booklet about complements and complaints. Staff had a responsibility to ensure all customers were supported to understand the booklet and were supported to report a complaint or a compliment.
Staff told us people received good care and support. Where different services were involved in delivering support the provider took appropriate action to coordinate a response to the person raising the complaint.
People told us they would tell their support worker if they were worried about anything and they would do something about it.
We spoke with one person who used the service and they said they were happy with the care and support they received. People told us they were well looked after.
We saw records that showed people had been involved in making decisions about the care and support they received. People had been asked to sign records to consent to the care and support planned.
People were cared for, or supported by, suitably qualified, skilled and experienced staff. Staff knew the people they were supporting very well. Staff told us people received very good care and support.
We found people were treated with dignity and respect and received care that met their needs.
People were not made aware of the complaints system in a format that met their needs.
We spoke to the other user of the service, who is profoundly deaf, with the support of the communication support manager. This person was very happy with the support they receive. They said they liked their support worker and they felt respected and fully involved in their care. They said that the support worker will support them in the way they want and they feel safe and comfortable with them.
We also observed positive interaction between staff and the person using the agency and we spoke to one of the support workers.
We also spoke to two professionals who have worked with the agency. Both professionals spoke very highly of the service the agency provide to their client, the respect shown by all the staff which their client reciprocates.