Archived: Tollesby Hall Nursing Home

There were no care plans in place detailing how staff worked with people when they displayed behaviour that challenged; had active mental health symptoms; needed particular support around managing their pressure care; or were losing weight. We found that the current care records did not assist staff to identify emerging issues such as a change in continence needs or physical health.

At this inspection we found that the manager had worked with staff to ensure all care records accurately reflected people's needs and the care being delivered. We found that the care records were accurate. The provider has also introduced a range of documents staff could use when it was evident that people may lack the capacity to make decisions.

The people we spoke with told us, 'I have no problems,' and 'I like it here'.

People told us, 'The staff are very good', 'The staff are on the ball and always try to make sure we are alright' and 'I have been coming on respite here for a number of years and always find the care is excellent'.

We found that people's care was planned and delivered in line with their needs. The staff were very knowledgeable about people's care needs and how to meet them. However, we noted that the care records on the residential unit did not reflect the needs of the people who used the service.

We found that the building was well-maintained and in good decorative order.

During this visit we spent time observing care practices; talked with six people who used the service as well as seven staff. All the people we spoke with felt the service was delivering a good service and met their needs. People said 'The staff are superb', 'We always have plenty to do as the activities coordinator is on the go constantly organising things to do' and 'I find the staff extremely attentive and really know what is what'.

We saw that staff worked well with the people who used the service. We found that since the last inspection, changes had been made to the ways staff determined if people's needs could be met at the home. The changes had led to the staff being very clear about where their strength laid, so only admitted people when they could clearly meet their needs.

We found that staff had received training around good customer care; dealing with complaints; dementia care; mental health awareness; and managing challenging behaviour. The staff told us that they found this training had been informative and assisted them to improve their practice.

At the visit we spent time observing care practices; talked with seven people who used the service as well as six staff. People had mixed views about the service. Three people felt that improvements were required whilst the other people felt the service was good. We saw that staff worked well with the older people who used the service. However, we found that staff struggled to meet the needs of the younger people.

The home's statement of purpose stated they could admit older people and people with a physical disability. It did not discuss admitting younger people; individuals with mental health needs; or people with dementia care needs. We found that people been had admitted to the home with these needs. We found people were given rooms that did not accommodate their wheelchairs; staff had not received training around meeting some people's specific care needs and had difficulty supporting these individuals.