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Inspection Summary


Overall summary & rating

Good

Updated 8 December 2018

This inspection took place on 12 and 13 November 2018 and was unannounced.

Temple Ewell is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Temple Ewell accommodates up to 44 people in one adapted building. At the time of the inspection there were 41 people receiving nursing care.

There was 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We inspected Temple Ewell in October 2017 and the service was rated ‘Requires Improvement’ overall with two breaches of regulation. Following the last inspection, we asked the provider to complete an action plan to show how they would meet the regulations. At this inspection, we found that improvements had been made and the regulations had been met. The service was now rated Good overall.

At the last inspection, we found the registered person had not managed medicines safely and people had not received their medicines as prescribed. This was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

At this inspection, people’s medicines were now managed safely. Systems had been put in place to make sure people received their medicines and these had been effective. Medicine records were now accurate.

At the last inspection, we found the registered person had failed to maintain accurate records in respect of each person. They had failed to act on quality monitoring audits for continuous improvements.

At this inspection, checks and audits to measure the quality of the service had been completed. When shortfalls had been identified, an action plan was put in place and signed off when completed. Records such as care plans were now accurate and reflected the care being given.

Potential risks to people’s health and welfare had been completed, there was detailed guidance for staff to mitigate the risk and keep people safe. Accidents and incidents had been recorded and analysed to identify patterns and trends, action had been taken to reduce the risk of them happening again. Checks had been completed on the environment and equipment to make sure it was safe.

Care plans contained detailed guidance about people’s choices and preferences. Care plans were reviewed regularly and with people where they were able or their representative. People were supported to remain comfortable at the end of their lives.

Staff met with people before they moved to the service to make sure that staff could meet their needs. Staff monitored people’s health and referred them to healthcare professionals when their needs changed. Staff followed the guidance given by health professionals to keep people as healthy as possible. People had access to professionals such as the dentist and optician. People were encouraged to lead as healthy lifestyle as possible, for example, moving in their chair or bed. People had a choice of meals and were supported to eat a balanced diet.

People were supported to have maximum choice and control over their lives and staff supported them in the least restrictive way possible, the policies and systems in place supported this practice.

People were supported to be as independent as possible and where possible were involved in developing their care and support. People had access to activities they enjoyed and these reflected their interests. People were treated with kindness, staff respected people’s dignity and privacy. People were relaxed in the company of staff and staff understood how to support people when they were anxious.

People w

Inspection areas

Safe

Good

Updated 8 December 2018

The service was safe.

People were protected from abuse, staff understood their responsibility to report any concerns.

Potential risks to people’s health, safety and welfare had been assessed and there was detailed guidance for staff to mitigate the risk.

There were sufficient staff on duty to meet people’s needs, who had been recruited safely.

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

The building was clean and odour free. Staff used gloves and aprons when required, to reduce the risk of infection.

Accidents and incidents were recorded and analysed. Action was taken to reduce the risk of them happening again.

Effective

Good

Updated 8 December 2018

The service was effective.

People’s needs were assessed to make sure that staff could meet their needs. Care was developed in line with current guidance.

Staff received training appropriate to their role. Staff received supervision and appraisal to develop their skills.

People were supported to eat a balanced diet and maintain as healthy lifestyle as possible.

People were referred to specialist healthcare professionals and staff followed their guidance to keep people as healthy as possible.

The building had been adapted to meet people’s needs.

Staff were working within the principles of the Mental Capacity Act 2005.

Caring

Good

Updated 8 December 2018

The service was caring.

People were treated with kindness, respect and were given support when they were anxious.

People were supported to express their views about their care.

People’s dignity and privacy were respected. People were supported to be as independent as possible.

Responsive

Good

Updated 8 December 2018

The service was responsive.

Care plans contained details about people’s choices and preferences and were reviewed regularly.

People were supported to take part in activities they enjoyed.

People were supported at the end of their lives.

Complaints were recorded and investigated following the provider’s policy.

Well-led

Good

Updated 8 December 2018

The service was well led.

There was an open culture in the service, focused on improving the service for people.

Checks and audits had been completed. When shortfalls had been identified, action had been taken to rectify the shortfall and drive improvement.

People, relatives, health professionals and staff were given the opportunity to express their views about the service.

The management team attended local forums and training to keep up to date and continuously improve the service.

The service worked with other agencies to improve people’s experience.