CQC report explained · a residential care home
What the CQC found at Trelowen
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, November 2023
Rated Requires Improvement; inspectors found safe staffing and care, but concerns about the environment, nutrition records and management.
This was an unannounced focused inspection on 3 October 2023. The inspector met four people, spoke with staff, managers, relatives and a health professional, and checked care, medicine and management records.
The home was rated Good for Safe. People were protected from abuse, there were enough suitably skilled staff, and medicines were usually given as prescribed. However, staff did not always record the time of medicines given when needed, creating a risk that doses could be too close together.
The home was rated Requires Improvement for Effective and Well-led. Inspectors found worn and neglected areas, unreliable records about food and weight, and weak action to resolve known problems with the building. The overall rating changed from Good at the previous inspection in 2017 to Requires Improvement.
Enough skilled staff
Staffing levels and skills matched people's needs. Staff recruitment and induction processes also promoted safety.
“The numbers and skills of staff matched the needs of people using the service.” from the report
Staff knew people well
Staff understood people's individual needs and preferences. Communication tools were used where helpful.
“Staff understood people's individual needs and preferences. Where useful, communication tools were used to aid people's understanding and choice making.” from the report
Safeguarding
Staff had training about abuse and knew how to report concerns. People told inspectors they felt safe.
“Staff had training on how to recognise and report abuse and they knew how to apply it.” from the report
Working with other services
The home worked with health and social care organisations to support people's wellbeing and access to appointments.
“The service worked well in partnership with other health and social care organisations, which helped to improve the wellbeing of people living at Trelowen.” from the report
Poor condition of the environment
seriousParts of the home were tired, worn or damaged. Outdoor areas were neglected, and there were no clear timescales for putting things right.
“The environment did not provide a pleasant and homely environment which had regard to people's sensory needs.” from the report
Food and weight records
seriousRecords did not show clearly how much people ate. Significant weight loss for two people had not been escalated or acted on.
“The failure to monitor risks and maintain accurate records in relation to food intake and weight was a breach of Regulation 17” from the report
Weak management follow-through
needs fixingManagers had identified the need for environmental work, but plans were vague and did not show that problems would be fixed promptly.
“The timescale for improvements was vague and did not assure us they would be completed in a timely manner.” from the report
Medicine timing records
needs fixingThe time was not consistently recorded when some as-required medicines were given. This created a risk that doses could be given too close together.
“Staff had not consistently recorded the time PRN medicines were administered.” from the report
- 01What work has been completed to repair the worn carpets, damaged areas, bathroom tile, kitchen surfaces and neglected garden?
- 02What are the dates and responsibilities for completing the remaining environmental improvements?
- 03How are you now recording how much each person eats and responding to weight loss?
- 04How do you record the time that as-required medicines are given, and how do you prevent doses being given too close together?
- 05What actions were included in the provider's action plan, and what progress has been made since the inspection?
This was a focused inspection of Safe, Effective and Well-led only; ratings for the key questions not inspected were carried over from the last inspection. This explanation was written from the published report of 3 November 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, October 2017
Rated Good; inspectors found safe, kind and personalised care, but care plans were not available in an accessible format.
Inspectors carried out an announced, comprehensive inspection on 20 September 2017. They spoke with five people, staff and relatives, and checked care records, staff files, training records and other documents.
They found the home remained Good, as it had been at the previous inspection in August 2015. People appeared comfortable and safe. Medicines were managed properly, staff knew people's needs, and relatives described management as approachable.
People were supported to make choices, build independence and take part in activities they enjoyed. Information around the home used pictures and limited text, although people's care plans were only available on a computer and were not in an easy read format.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. This means inspectors judged the home to be meeting the relevant standards at the time of this inspection.
Safe medicines support
Inspectors found medicines were securely stored, properly recorded and given as prescribed. There were also clear instructions for medicines used only when needed.
“People received their medicines safely and as prescribed.” from the report
Skilled and supported staff
Staff had induction, training, shadowing and competency checks. They said they felt supported and could ask for advice.
“Staff were well supported by a system of induction, training and supervision.” from the report
Respect for choice
People were supported to make everyday choices, develop independence and take part in activities, relationships and holidays that mattered to them.
“People were supported to have maximum choice and control of their lives” from the report
Clear management
The home had clear lines of responsibility and an open culture. Incidents were reviewed so that changes could be made where needed.
“There were clear lines of responsibility in place.” from the report
Care plans were not accessible
needs fixingCare plans were kept on the computer and were not available in an easy read format. This meant people could not sign them to show they agreed with their care.
“However, care plans were not available in an accessible format.” from the report
Some supervision was overdue
minorSome staff had not received supervision for several months. Staff still said they felt supported and could get advice when needed.
“Some staff had not had a supervision for several months.” from the report
- 01How do you now make care plans available in an accessible or easy read format?
- 02How often does each staff member receive supervision, and how do you check that no one goes several months without it?
- 03How are people involved in agreeing and signing their care plans if they do not use written communication?
- 04How do you make sure staffing levels include staff who know each person's needs, especially when agency workers are used?
- 05What is the current position on the DoLS applications that were awaiting a decision from the local authority?
This was an announced comprehensive inspection covering all five questions, with one inspector speaking to five people and three relatives and reviewing care, staff and management records. This explanation was written from the published report of 12 October 2017 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 Trelowen
3 rated inspections over 8 years: the service has slipped, from Good to Requires improvement.
- November 2023Requires improvementcurrent ratingdown from GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2017Goodstayed GoodSafe: GoodEffective: GoodWell-led: Good
- September 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2014
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- November 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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10 live-in carers within about two hours of Cornwall
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,200 a week. 8 can care for a couple. 12 years' experience on average.
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