CQC report explained · a residential care home
What the CQC found at 20 Talbot Street
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Requires improvement
- Some risks had not been recorded in assessments or care plans. There was no documented plan explaining how people's safety was managed at night when no waking staff were on duty.
- Effective?
- Good
- People's needs were assessed and reviewed, and staff had the training, knowledge and support needed. People were supported with food, healthcare, communication and decisions about their care.
- Caring?
- Good
- Staff were kind and compassionate, knew people well and respected their privacy and dignity. People were supported to make choices and take part in everyday tasks.
- Responsive?
- Good
- Care was personalised around people's preferences, interests and communication needs. People were supported with activities, outings and access to the community, and there was a complaints process.
- Well-led?
- Good
- The manager and staff created a positive culture. Audits, incident reviews and other checks were used to identify improvements, and inspectors found that previous medicine-related improvements had been made.
What inspectors found, March 2019
Rated Good overall; inspectors found kind, effective care, but safety risk plans were not always clear, especially at night.
This was an unannounced inspection on 19 February 2019. One inspector spoke with two people using the home, one relative, staff and managers. They observed care and checked two care records, medicine records, incident reports and quality checks.
The home provided residential and nursing or personal care for five people with a learning disability. Inspectors found that people were treated kindly, supported to make choices and helped to be independent. Staff understood people's needs, and people could take part in activities and access the community.
The main weakness was safety planning. Some risks had not been clearly recorded, including how people's safety was checked at night when there were no waking staff. The manager took immediate action during the inspection to document the arrangements and seek professional support to review night-time risk assessments.
The overall rating was Good. Safe was rated Requires Improvement, while Effective, Caring, Responsive and Well-led were rated Good. The home was rated Good at the previous inspection in 2016, and inspectors said improvements had been made to medicine guidance and checks.
Kind and respectful staff
Inspectors saw staff treating people warmly and checking how they were. Staff understood people's lives, preferences and support needs.
“People were supported by kind and caring staff.” from the report
Skilled and supported staff
Staff had relevant training, induction, supervision and opportunities to discuss further learning. Inspectors found they had the skills and knowledge to support people effectively.
“People were supported by staff who had the required skills and knowledge to help them effectively.” from the report
Choice and independence
People were supported to communicate, make choices and take part in activities such as laundry and preparing meals. Their privacy and dignity were respected.
“Staff were observed encouraging people to maintain their independence.” from the report
Activities and community access
Care plans recorded people's interests and preferred activities. People were supported to do things they enjoyed and to go out into the community.
“People were supported to access activities they enjoyed.” from the report
Improved oversight
The home had checks on medicines, infection control, cleanliness and the environment. Incidents and accidents were reviewed to identify learning and action.
“The registered manager carried out reviews which looked at any staff related issues, environmental factors and if procedures required any updates.” from the report
Night-time safety plans
seriousSome risks were not clearly documented, including how people were kept safe at night. There were no waking staff on duty, so inspectors could not see from the records how safety checks and support were managed.
“However, there was no documented assessment and management plan to show how risks were managed at night.” from the report
- 01What changes were made to people's night-time risk assessments and care plans after the inspection?
- 02When there are no waking staff at night, what checks and arrangements are now in place to keep each person safe?
- 03How do you make sure one-to-one and, when needed, two-to-one support is available for community activities?
- 04How are people's communication methods, preferences and changing needs reviewed and kept up to date?
- 05How are medicine checks carried out now, including checks for medicines given only when needed?
This was an unannounced scheduled inspection covering all five CQC questions and both the premises and care provided; end-of-life care was not assessed because the provider was not supporting people with it. This explanation was written from the published report of 21 March 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, September 2016
Rated Good overall, but inspectors found the home needed to improve medicines records and checks on accidents and incidents.
Inspectors visited without warning on 9 August 2016. They spoke with relatives, staff and managers, observed care, and reviewed care records, medicines, recruitment, training and quality checks.
The home was rated Good for Safe, Effective, Caring and Responsive. Inspectors found enough staff, suitable recruitment checks, caring relationships, personalised support, activities, good support with food and health, and help for people to make choices.
The Well-led rating was Requires Improvement. Medicines were generally administered correctly, but records for some as-needed medicines were incomplete and guidance was missing. The manager also did not review accidents and incidents for patterns that might prevent them happening again.
Kind and respectful care
Staff knew people well, respected their privacy and dignity, and encouraged independence and everyday choices.
“Staff had caring relationships with people and respected their privacy and dignity.” from the report
Personalised support
Care was adapted to people's communication needs, routines, interests and preferences. People were supported to take part in activities at home and in the community.
“People received personalised care from staff who knew their needs and preferences.” from the report
Training and health support
Staff had relevant training and induction support. People received help with food, drink and access to health professionals.
“Staff received the training and support they needed to care for people.” from the report
Medicines records
needs fixingStaff did not always record the time an as-needed medicine was given or the symptoms it was meant to treat. There was also no guidance for staff on using these medicines, and some non-prescription medicines needed review.
“staff did not always record the time the person received the medicine and the symptoms the person had exhibited.” from the report
Accident and incident monitoring
needs fixingAccidents and incidents were recorded, but the manager's checks did not look for patterns or trends. This meant the system was not being used fully to help prevent a repeat.
“This did not include reviewing accident and incidents to monitor for any patterns or trends to prevent future reoccurrence.” from the report
- 01How are as-needed medicines now recorded, including the time given and the symptoms being treated?
- 02What written guidance do staff now have for deciding when people may need as-needed medicines?
- 03How do you review accidents and incidents for patterns, and what changes have resulted from those reviews?
- 04When was the most recent family and resident quality survey sent out, and what improvements followed it?
- 05How do you check that the improvements identified in this report remain effective?
This was an unannounced inspection that assessed all five key questions and gave ratings for Safe, Effective, Caring, Responsive and Well-led. This explanation was written from the published report of 7 September 2016 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of 20 Talbot Street
2 rated inspections over 3 years: the service has held its Good rating throughout.
- March 2019Goodcurrent ratingstayed GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 11 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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