The Triangle Care Home

Updated 13 January 2023

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 Health and Social Care Act 2008.

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

The inspection team consisted of 2 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

The Triangle is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. The Triangle is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. A new manager had just been appointed who would be starting shortly.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service. We sought feedback from the local authority and professionals who worked with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We looked at notifications received from the provider. A notification is information about important events which the provider is required to tell us about by law. This ensured we were addressing any areas of concern. We reviewed the provider’s last inspection report. We used all of this information to plan our inspection.

During the inspection

We spoke with 8 people who used the service and 2 relatives. Some people living in the home could not verbally give us feedback. As such we looked around the home and observed the way staff interacted with people. We further received feedback from 2 relatives. We requested feedback from healthcare professionals. We looked at 6 people's care records and four medicine administration records (MAR). We spoke with 11 members of staff including 2 regional support managers, nurses, carers, the chef, the administrator and domestic staff. We reviewed a range of records relating to people's care and the way the service was managed. These included staff training records, 5 staff recruitment files, quality assurance audits, incidents and accidents reports, complaints records, and records relating to the management of the service.

Updated 13 January 2023

About the service

The Triangle is a residential care home providing personal and nursing care to up to 25 people. The service provides support to older people some of who lived with dementia. At the time of our inspection there were 22 people using the service.

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

We had received concerns of staffing levels, poor care, lack of activities and inconsistency in leadership. We found, the home had been using different agency staff and this inconsistency was impacting on people’s care.

Staff were continuously busy and did not have time to have meaningful interactions with people. The activities coordinator had just left, and people did not always have access to activities of their choosing.

Risks to people were identified, however, they were not always managed safely. People’s risk management plans and care plans were not always up to date. Recommendations from the last fire risk assessment had not been acted upon.

The inconsistency in leadership was impacting on people’s outcomes and staff morale. There were 2 support managers who were managing the home at the time of the inspection and a new manager had just been appointed. The provider’s quality assurance processes were not always used effectively.

Following the inspection, the provider shared with us their improvement plan which they were working through to address the concerns we found.

People living at The Triangle told us they felt safe living in the home. Staff knew how to identify and report any concerns. The provider had safe recruitment and selection processes in place.

Medicines were managed safely, and people received their medicines as prescribed. Staff had the necessary skills to carry out their roles. Staff had regular training and opportunities for regular supervision and observations of their work performance.

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. Staff had a particularly good understanding of when the principles of the Mental Capacity Act should be applied. People were supported to meet their nutritional needs and complimented the food at the home.

Rating at last inspection and update

The last rating for this service was good (Published 10 April 2019)

Why we inspected

We received concerns in relation to staffing, people’s care needs, activities and management of the home. As a result, we undertook a focused inspection to review the key questions of safe, responsive and well-led only.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, responsive and well-led sections of this full report.

We have received an improvement plan the provider is working to make improvements and will request an updated action plan from the provider and have an understanding what they will do to improve the standards of quality and safety.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Triangle on our website at www.cqc.org.uk.

Follow up

We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.