Archived: Timken Grange

Timkin Grange is a residential care home providing personal and nursing care to 66 people aged 65 and over at the time of the inspection. The service can support up to 66 people.

Timkin Grange is a purpose-built care home which accommodates people across three floors. Each floor has a communal lounge, dining area and kitchen. All bedrooms have private en-suite facilities. There are two lifts operating between floors which also give access to a library, cinema café and bar. There are communal gardens and parking.

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

Temporary staffing checks required further development to ensure staff were suitably trained, and they required further support and guidance to ensure people’s holistic needs were met. We have made a recommendation around this.

People had not been consistently protected from abuse. Medicines were not consistently managed safely.

People were not always supported as per their care plan with food and drink. People’s weight and food and fluid intake was monitored and recorded. People were supported with a fortified diet where required.

Laundry procedures had not been adhered to and people had lost clothing and items which were special to them.

Complaints and incidents had not been well managed, however, lessons were learned and shared where things had gone wrong and the provider continued to work on improving the service and develop more positive relationships with people.

Safety checks were not always recorded. However, the building was safe and well maintained we observed safety checks taking place during the inspection.

Internal auditing processes had not maintained oversight of the quality and safety of the service and we found gaps in several areas of record keeping.

Individualised activities were limited. People in their rooms or who needed help with mixing and meeting people were at risk of social isolation

Communication between the service and professionals was not consistently effective, for one person this had a negative impact on their well-being. Visiting professionals such as chiropody, district nurses and GP’s visited the service regularly.

People were not always satisfied with the continuity of care but told us staff were kind and caring.

Staff had not been trained in end of life care, but some staff were experienced in this area. End of life decisions were in place where needed,

The provider understood the regulatory requirements.

DBS checks and staff references were completed and there were enough staff available to keep people safe.

The staff and management team sought advice from other professionals to plan and deliver people’s care where needed. Care plans were person centred and detailed people’s cultural and religious needs. People and their families were involved in the assessment and review process.

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. People were offered choice and were included in making decisions in the home.

People were protected from the spread of infection. Staff used protective personal equipment when supporting people with personal care. Staff received regular training and felt the culture of the service had improved.

There was a range of planned activity delivered by an enthusiastic friendly team, and the home was an active part of the local community.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection The last rating for this service was requires improvement (published 9 March 2019).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified a breach in relation to the providers oversight of the safety and quality of the service.

Please see the action we have told the provider to take at the end of this full report.

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.

What life is like for people using this service:

People told us they felt safe. On inspection we found that people had not consistently received safe care. People’s medicines had not always been managed safely. Systems were in place to ensure that people were protected by the prevention and control of infection. However, we recommend this be implemented further by providing people with their own hoist sling to prevent cross contamination. Accidents and incidents were analysed for lessons learnt and these were shared with the staff team to reduce further reoccurrence.

The Manager and provider had a clear vison and plan in place for improvement that had commenced prior to our inspection. People and staff were encouraged to provide feedback about the service. Staff received supervision and regular team meetings were in place that gave them an opportunity to share ideas, and exchange information. The internal audit system had not always identified the inconsistencies in the recording and monitoring of information. The Manager was aware of their responsibility to report events that occurred within the service to the CQC and external agencies.

The registered provider followed safe recruitment procedures to ensure staff employed were suitable for their role. Staff received an induction process when they first commenced work at the service and received on-going training to ensure they could provide care based on current practice when supporting people. Staff had been provided with safeguarding training to enable them to recognise signs and symptoms of abuse and how to report them.

People received enough to eat and drink and were supported to use and access a variety of other services and social care professionals. People were supported to access health appointments when required, including opticians and doctors, to make sure they received continuing healthcare to meet their needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The principles of the Mental Capacity Act (MCA) were followed.

People received care from staff who were kind and caring. People were encouraged to make decisions about how their care was provided and their privacy and dignity were protected and promoted. People had developed positive relationships with staff who had a good understanding of their needs and preferences.

People’s needs were assessed and planned with the involvement of the person and or their relative where required. Staff promoted and respected people's cultural diversity and lifestyle choices. Care plans were personalised and provided staff with guidance about how to support people and respect their wishes. Information was made available in accessible formats to help people understand the care and support agreed.

More information is in the full report

Rating at last inspection: The Service was new so had not yet been rated.

Why we inspected: This was a planned first inspection.

Follow up: We will continue to monitor the service through the information we receive until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.