CQC report explained · a residential care home
What the CQC found at Trelawney
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People told inspectors they felt safe, and relatives had no safety concerns. However, one possible safeguarding concern had not been reported externally, so the CQC recommended that the home seeks further guidance.
- Effective?
- Good
- People received support suited to their health needs and attended appropriate health checks. Inspectors found that daily notes and some capacity assessments lacked detail, and not all agency or relief staff had completed every relevant area of training.
- Caring?
- Good
- This question was not inspected during this focused visit. The report says the overall rating used ratings from the previous inspection for questions not inspected.
- Responsive?
- Good
- This question was not inspected during this focused visit. The report says the overall rating used ratings from the previous inspection for questions not inspected.
- Well-led?
- Good
- Management systems were effective and staff said they were supported by the registered manager. Inspectors identified limited policy guidance about relatives working together and noted that relatives had not been asked for their views for some time.
What inspectors found, March 2023
Rated Good; inspectors found kind, safe support, but identified gaps in safeguarding reporting, records and staff guidance.
This was a focused inspection on 14 February 2023. One inspector met five people, spoke with seven staff members and four relatives, and reviewed care, medicines and management records. Infection prevention and control was also checked.
The home was rated Good for Safe, Effective and Well-led. Inspectors found that people were supported to be independent, take part in activities and access their local community. Staff knew people well and provided kind and respectful care.
There were some shortfalls. One possible safeguarding concern had not been reported to the CQC or local authority. Daily records lacked detail, some agency and relief staff had not completed all relevant training, and policies about relatives working together did not do enough to reduce the risk of a closed culture.
This inspection did not look at Caring or Responsive. The overall Good rating used the previous ratings for the questions not inspected. The previous overall rating was Good, published in 2019.
Choice and independence
People were supported to make choices, develop independence and take positive risks. Their rooms could be personalised, and the home was adapted to support mobility.
“Staff supported people to be independent and have control over their own lives.” from the report
Kind and respectful support
Staff understood people's individual needs and protected their privacy and dignity. Relatives said staff knew people well.
“People received kind and compassionate care. Staff protected and respected people's privacy and dignity.” from the report
Health support
The home worked with other agencies and supported people to attend health checks and screening. Hospital passports were available to explain people's needs if they were admitted.
“Records showed the service worked with other agencies to support people's wellbeing and help them to live healthy lives.” from the report
Good management oversight
Inspectors found effective governance systems. Staff could explain their roles and managers reviewed incidents, restrictions and service information.
“Governance processes were effective and helped to hold staff to account, keep people safe, protect people's rights and provide good quality care and support” from the report
Safeguarding reporting
seriousOne possible safeguarding concern was not reported to the CQC or local authority. The manager said no one had been affected, but inspectors said external agencies should still be informed about potential concerns.
“We identified one occasion when a possible safeguarding concern had not been notified to CQC or the local authority.” from the report
Daily records
needs fixingDaily notes did not contain enough detail to show people's quality of life or whether they were gaining independence skills. The managers said they would look at improving the new recording system.
“Daily notes lacked detail. This meant it was difficult to evidence people's quality of life and whether they were being supported to increase their independent skills.” from the report
Agency staff training
needs fixingNot all agency or relief staff had completed training in every area needed by people living at the home. The rota was arranged so a suitably skilled staff member was always available.
“Not all agency staff or relief staff had completed training in all areas relevant to the needs of everyone living at HF Trust - Trelawney.” from the report
Closed culture safeguards
needs fixingTwo of the three staff on duty were related to each other on the inspection day. The provider's policy on relatives working together was out of date and gave limited guidance.
“HF Trusts policy covering relatives working together had not been updated since 2019. It contained limited guidance or information.” from the report
Involvement in meals
minorPeople had limited opportunities to help choose food, shop and plan meals. Inspectors did find that people were supported to eat and drink enough.
“There were limited opportunities for people to be involved in choosing their food, shopping, and planning their meals.” from the report
- 01What changes have you made to ensure every possible safeguarding concern is reported to the CQC and local authority?
- 02How do you check that agency and relief staff have completed all training relevant to my relative's needs?
- 03What has changed to make daily records show my relative's quality of life and progress with independence?
- 04How do you prevent a closed culture when relatives work together, and when was the relevant policy last updated?
- 05How can residents be involved in choosing food, shopping and planning meals?
This was a focused inspection of Safe, Effective and Well-led, with infection prevention and control also checked; Caring and Responsive were not inspected and the previous ratings were used for the overall rating. This explanation was written from the published report of 8 March 2023 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, June 2019
HF Trust - Trelawney was rated Good; inspectors found safe, kind and person-centred care, with previous problems improved.
This was a follow-up inspection after the home had been rated Requires Improvement in 2018 and had breached regulations. One inspector visited on 11 and 14 June 2019. They spoke with people, staff and relatives, observed care, and checked care, medicines, incident, recruitment and quality records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found people were relaxed, treated with dignity, involved in decisions and supported to have choice and independence.
The report says action had been taken to fix the previous breaches. Records and reporting had improved, and the home was no longer in breach of regulations. Inspectors did note that the senior support worker had no protected administrative time, although there was no evidence this had affected care.
Choice and independence
People were involved in daily decisions and could move freely around the shared areas. Staff supported people in the least restrictive way possible.
“People were in charge of their daily routines and able to make decisions about how their care was delivered.” from the report
Safe staffing and medicines
Inspectors found enough staff to meet people's needs, with flexible shifts supporting people's plans. Medicines were stored, given and recorded safely, with weekly audits.
“Medicines were safely obtained, stored, recorded, administered and disposed of.” from the report
Person-centred support
Care records described people's needs and preferences and were regularly updated. Staff worked with other professionals when people's health or support needs changed.
“Care plans recorded people's needs and preferences.” from the report
Improvement since the last inspection
The home had acted on the previous inspection findings. Inspectors found it was no longer in breach of the regulations identified in 2018.
“At this inspection we found improvements had been made and the provider was no longer in breach of regulations.” from the report
Limited administration time
minorThe senior support worker had no protected time for paperwork and supervision planning. Inspectors found no evidence that this had affected care, but the report says it could be difficult at times.
“The senior support worker did not have any protected administrative time.” from the report
- 01How do you protect time for the senior support worker to complete care records, supervisions and other administration?
- 02How do you make sure staffing remains sufficient when people want to go out or need support at the same time?
- 03How are restrictive practices reviewed, and how are people and their families involved in best-interest decisions?
- 04How will you support a new resident to fit in with the people already living here?
- 05How do you involve families in reviews, complaints and changes to a person's care?
This was a follow-up inspection after the previous Requires Improvement rating and breaches; inspectors reviewed all five key questions, and all five were rated Good. This explanation was written from the published report of 27 June 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.
Every inspection of Trelawney
5 rated inspections over 8 years: the service has improved, from Requires improvement to Good.
- March 2023Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2019Goodup from Requires improvementSafe: GoodEffective: GoodWell-led: Good
- June 2018Requires improvementdown from GoodSafe: GoodEffective: GoodCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- July 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2015Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- November 2013
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 26 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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