CQC report explained · a residential care home
What the CQC found at Higher Tunshill Farm
Not yet rated: the CQC has not published a rated inspection for this home, which is usual for a new registration.
- Safe?
- Inspected but not rated
- Inspectors found that medicines were stored safely and staff had training in safe administration. They also found no handwashing or cleaning facilities where medicines were administered and checked.
- Effective?
- Inspected but not rated
- This area was not examined as part of this targeted inspection.
- Caring?
- Inspected but not rated
- This area was not examined as part of this targeted inspection.
- Responsive?
- Inspected but not rated
- This area was not examined as part of this targeted inspection.
- Well-led?
- Inspected but not rated
- The home was not always well-led because medicines governance was not robust. Policies were out of date, audits did not identify errors and records were difficult to locate.
What inspectors found, May 2024
Higher Tunshill Farm was inspected but not rated; medicines were stored and given safely, but medicines oversight breached good governance rules.
This was an unannounced, targeted inspection after CQC received concerns about medicines. Inspectors looked at parts of Safe and Well-led. They spoke with children, relatives, staff and health professionals, observed medicines being given, and checked records and policies.
Inspectors found that medicines were stored safely and given in a way that respected young people's preferences. Children understood what medicines they took, why they took them and their possible side effects. However, records, policies, audits and procedures for medicines were not always complete or followed.
The home was inspected but not rated. CQC does not give a rating for this regulated treatment service because it is also an Ofsted-registered children's home. CQC identified a breach of the good governance regulation and will check the action taken.
Safe storage and administration
Inspectors found that medicines were stored safely and that staff had received training in safe administration.
“People were supported to receive their medicines safely.” from the report
Respect for preferences
Medicines were given in a way that respected the young people's preferences.
“Medicines were administered in a way that respected young people's preferences.” from the report
Children understood their medicines
Children could explain what medicines they took, why they took them and their side effects.
“Children knew what medication they took and why and what the side effects were.” from the report
Choice and least restrictive support
Inspectors found that children were supported to have choice and control, with policies supporting least restrictive care and best-interest decisions.
“Children 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” from the report
Medicines records were incomplete
seriousSome medicine record entries were unsigned and did not include important details such as the dose, frequency or strength. Some warnings were also missing.
“we found unsigned entries which also did not contain the necessary information such as dose, frequency and strength.” from the report
Weak medicines oversight
seriousMedicine audits were not completed by the people required by the policy, and errors had not been identified even after the issue was raised internally.
“However, other staff were completing the audits and errors had not been identified.” from the report
Gaps in medicines procedures
needs fixingPRN medicine protocols did not always explain what to check before giving the medicine or what to monitor afterwards. The effects on the child were also not always clear.
“Protocols were not always in place for medicines prescribed PRN (when required).” from the report
Cleaning facilities were missing
needs fixingThere were no facilities for handwashing or cleaning equipment at the place where medicines were administered and stock was checked.
“There were no facilities for handwashing or cleaning equipment where administration and stock checks of medicines were taking place.” from the report
Homely remedy controls were unclear
needs fixingOne child received ibuprofen even though it was not on the listed homely remedies. Authorisations for two children had expired.
“For 2 children, their authorisation to administer homely remedies was out of date and had expired on 14 July 2023.” from the report
Records and policies needed improvement
needs fixingMost policies were out of date, and information about treatment was stored in different places. This made it difficult to understand how holistic care was being delivered.
“The current record keeping system made it difficult to understand how holistic care is being delivered.” from the report
- 01What changes have been made to medicine administration records, including missing signatures, doses, frequencies, strengths and special warnings?
- 02Who now completes medicine audits, and how do you check that errors are identified and acted on?
- 03Are written protocols now in place for every PRN medicine, including checks before administration and monitoring afterwards?
- 04How do you check that homely remedy lists and authorisations are current before giving a remedy?
- 05Have the medicines policies and the system for storing treatment records been updated, and can you explain how staff now find the full record?
This was an unannounced targeted inspection of Safe and Well-led, focused on medicines risks; Effective, Caring and Responsive were not inspected in this visit. This explanation was written from the published report of 30 May 2024 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, July 2018
Higher Tunshill Farm: Inspected but not rated; inspectors found caring, safe and person-centred support, with long-term mental health outcomes not clearly measured.
This was an unannounced comprehensive inspection on 15 and 16 May 2018. Inspectors spoke with two of the three young people living there, managers, staff and health professionals. They reviewed care files, staff records, medicines records and quality checks.
Inspectors found the home was safe, effective, caring, responsive and well-led. Young people were involved in their care plans and decisions about daily life. Staff supported their health, education, relationships, activities and preparation for independent adulthood.
The report says all five areas were inspected but not rated. This means CQC did not give a formal Good or Outstanding rating in this report. The report was republished on 6 April 2023 because changes were needed, but CQC says the findings themselves were unchanged.
Young people’s choices
Young people were involved in decisions about their care, activities, food and personal living space. Their views were clearly recorded in care plans and other records.
“Young people's characteristics, personality and their wishes and feelings were demonstrated strongly throughout all records that related to them and staff knew each young person well.” from the report
Detailed risk planning
Risks were assessed in detail and plans were written for each young person. Staff used these plans to respond sensitively and with the least intrusive approach.
“Risk assessment and management plans were co-produced. Risks were recorded in exceptional detail to ensure staff were able to help the young people experience safe care and support.” from the report
Kind relationships
Inspectors saw staff communicate respectfully and empathetically. Young people described feeling cared for and supported.
“Young people were treated with respect and dignity and staff were very kind, caring and compassionate towards them.” from the report
Preparation for adulthood
Staff helped young people build practical skills, make choices and plan for education, adulthood and independent living.
“Staff worked proactively with the young people to promote their life skills to enable them to transition to independent life as an adult.” from the report
Open leadership
Leaders investigated incidents, shared learning and used regular audits to monitor the quality of the home.
“Leaders fulfilled their duty of candour through an open culture of reporting incidents, comprehensive investigations, learning and improvement.” from the report
Long-term mental health outcomes
needs fixingInspectors could see progress against short-term goals, but the records did not clearly show how longer-term mental health recovery would be measured for each young person.
“However, it was not clear how the long term desired mental health recovery would be measured for each of the young people.” from the report
- 01How do you now measure each young person’s long-term mental health recovery and progress?
- 02What has changed since the inspection in May 2018, including staffing levels and the management team?
- 03How are young people involved in writing and reviewing their care and positive behaviour support plans?
- 04How would you support a young person’s transition to adult services, education and independent living?
- 05How are incidents, medicines errors or omissions, complaints and learning from them shared with families and young people?
This was an unannounced comprehensive inspection covering all five CQC questions, but none of the areas received a formal rating. This explanation was written from the published report of 18 July 2018 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 Higher Tunshill Farm
Each visit the CQC has published, newest first, back to the day the home was registered.
- May 2024Inspected but not ratedcurrent ratingSafe: Inspected but not ratedEffective: Inspected but not ratedCaring: Inspected but not ratedResponsive: Inspected but not ratedWell-led: Inspected but not rated
- July 2018Inspected but not ratedSafe: Inspected but not ratedWell-led: Inspected but not rated
- December 2016Inspected but not ratedSafe: Inspected but not ratedEffective: Inspected but not ratedCaring: Inspected but not ratedResponsive: Inspected but not ratedWell-led: Inspected but not rated
- October 2014
Report published without a new overall rating.
- August 2014
Report published without a new overall rating.
- February 2014
Registered with the Care Quality Commission on 26 February 2014.
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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36 live-in carers within about an hour of Newcastle upon Tyne
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 £950 to £1,160 a week. 30 can care for a couple. 10 years' experience on average.
“Petty introduced herself to Mum every time she was caring for her and responded very quickly to Mum if she was distressed in the night.”
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