Archived: Temple Manor Care Home

We last inspected this service on 14 April 2016 to look specifically at the safety of the service. At the April inspection we identified a breach relating to:

Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 – safe care and treatment. The provider was not meeting the requirements relating to fire safety and the testing of electrical appliances was not being carried out as required.

Prior to the April visit, we had also carried out an inspection on 2 February 2016. At the February inspection we identified breaches relating to:

Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 – safe care and treatment. Communal bathrooms were not clean and there were risks of infections being acquired and,

Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 – good governance. Audits were not being completed and were not robust enough to identify issues relating to care records.

After both inspections, the registered provider sent us an action plan telling us about the actions to be taken. During this inspection we found that the assurances from the registered provider had been implemented with the necessary improvements being made across the service.

Temple Manor Care Home is owned by Temple Manor Care Home Limited. The home is in Temple Hirst, near Selby. It is registered to provide care for up to 19 older people some of whom may be living with dementia.

There was a registered manager. 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.

People told us they felt safe. Thorough recruitment processes were followed prior to staff starting work. This reduced the risk of unsuitable people being employed.

People were supported and cared for by skilled, well trained staff who took a pride in their work.

We found that people were encouraged to exercise choice and control in every aspect of their lives wherever possible. Key people were involved in best interests meetings for people who required additional support with decision making.

Any risks around peoples care were identified. Where risks were identified action was taken to minimise these whilst protecting individual's rights and freedoms.

People had food and drink to meet their needs. People were supported to receive their medicines as prescribed and to access their health care appointments to make sure they received appropriate care and treatment. A number of health care professionals were present in the service on a daily basis working alongside staff.

We observed good relationships were present between people who used the service and staff. We did not meet any relatives during our time in the service but left contact details in case relatives wished to share their views. Staff were knowledgeable about the people they supported. This was confirmed in feedback we received about the service.

People had comprehensive care and support plans in place. These guided staff on people’s preferred approach to meet their care needs. An example of this was how one person liked to have their clothes protected whilst eating at the table.

A complaints procedure was in place. People confirmed they knew who to speak to if they had any worries or if they were unhappy about something. People told us they had not raised a complaint but said they knew how to if they needed to. People told us they thought they would be listened to if they raised an issue. They said the registered manager and the registered provider would act upon any concerns raised with them.

The registered provider undertook a range of audits to check on the quality of care provided. People were asked for their views and their comments were used to identify improvements.

At our last inspection on 2 February 2016 the service was rated requires improvement and was in breach of two regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Regulation 12 Safe care and treatment and Regulation 17 Good governance. We will review the breaches of regulation at our next inspection.

This inspection took place on 18 April 2016 and was unannounced. The service provides residential care for up to 19 older people and people living with dementia.

The service has a registered manager. 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 this inspection we found the service was in breach of Regulation 12 Safe care and treatment. This was in relation to fire safety and the associated risk assessments. Although the service had completed internal fire safety checks and staff had received fire safety training we found the fire risk assessment for the service was out of date and did not include three bedrooms which were available for people to live in. The electrical safety certificate was in date but the provider did not have a process of checking electrical appliances to ensure equipment and appliances were safe. You can see what action we told the provider to take at the back of the full version of the report.

The service provides residential care for up to 19 older people and people living with dementia. The service has a homely feel, bedrooms are spacious and there are communal lounges for people to spend their time. The service has a secure garden which people care access via patio doors in the main lounge.

Temple Manor Care Home had a registered manager. 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 time of our inspection there were 16 people living there.

Although people and their families told us the service was clean there were some areas where we were concerned about cleanliness and the risk of infections being acquired and spread. This was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Although people told us they received a good standard of care we saw some gaps in care records which meant people were at risk of receiving care which was not planned or based on their current needs. We saw some out of date information in care plans. Some other associated care records were not up to date and the audits the service used had not identified these issues and so they had not been rectified. This was a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

The registered manager had failed to make statutory notifications which are required by law. They had not notified the CQC of two safeguarding incidents and a serious injury which a person who was using the service sustained. This was a breach of Regulation 18 Notification of Other Incidents of the Health and Social Care Act (2008) Registration Regulations (2009). We are investigating this matter further.

People told us they were safe and well cared for and this view was shared by the relatives we spoke with. The service had sufficient staff to meet people’s needs and staff had the time to ensure people were provided with a good standard of care.

Medicines were managed safely and people received their medicines from staff who were well trained. The service had safe systems to store, order and dispose of medicines.

People told us the food was good, they were given choices and had a varied menu. The chef knew people’s individual likes and dislikes. Care staff understood the importance of people having enough to drink and we saw people being regularly encouraged to drink and eat throughout our visit.

The service was working within the principles of the Mental Capacity Act and staff routinely sought consent from people and supported them to make their own choices.

People had access to routine health care professionals and where they needed more specialised support this was sought.

All of the care staff we spoke with told us they enjoyed supporting people and this was clear in their interactions with people, which were kind and warm. We heard examples of care staff going that extra mile to make sure people were well supported and were happy.

Care staff told us they felt well supported by the registered manager and provider and had access to training and supervision. Staff morale was good.

People's nutritional needs were assessed and continued to be monitored. Food being served looked appetising. People could eat wherever they preferred. A person we spoke with said 'The food is perfect.'

The home and grounds were well presented and maintained. Further plans were in place to enhance the garden facilities. This ensured that the environment was pleasant. One person we spoke with said 'It is a nice place to live. It is clean and tidy.'

During our visit we saw that there was enough skilled and experienced staff to meet people's needs in a timely way. This was confirmed by people we spoke with. People said the care staff were always 'popping in' to see if they needed anything. The quality of the service being provided was being monitored by the management team. Any issues found were acted upon. This helped to ensure that people remained satisfied with the service they received.