CQC report explained · a residential care home
What the CQC found at Tallis House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- There were not enough staff to meet people's needs consistently. Inspectors also found gaps in recruitment checks, moving and handling training, safeguarding training and the recording and investigation of unexplained marks.
- Effective?
- Requires improvement
- One new staff member had not completed enough training or competency checks before working unsupervised. Support with food, drink, healthcare and people's legal rights was otherwise described positively.
- Caring?
- Good
- This key question was not inspected during this focused inspection, so its previous rating was carried forward. The report says people were positive about the staff who supported them.
- Responsive?
- Good
- This key question was not inspected during this focused inspection, so its previous rating was carried forward. Inspectors did find that staff shortages sometimes limited when people could get up, go to bed or go out.
- Well-led?
- Requires improvement
- The provider's monitoring systems had not identified all the staffing, training, recruitment and accident-recording problems. Staff gave mixed views about management support and morale.
What inspectors found, September 2022
Tallis House is Rated Requires Improvement; inspectors found too few staff, gaps in training and weak oversight, although medicines and support with food and drink were managed well.
This was an unannounced focused inspection on 3, 5 and 10 August 2022. Inspectors spoke with people, relatives and staff, reviewed care and medicines records, checked recruitment files and observed care.
The home was not always safe or effective. Inspectors found insufficient staff, a staff member working without the required checks and training, and gaps in recognising and recording unexplained marks or injuries. People and relatives said staff were sometimes too busy to meet people's needs promptly.
The home supported people with medicines, food, drink and healthcare. Care plans included information about risks, and mental capacity and best-interest processes were in place. However, management checks had not found all the problems identified by inspectors.
The overall rating changed from Good at the previous inspection to Requires Improvement. The inspection looked only at Safe, Effective and Well-led. The other key-question ratings were carried forward from the previous inspection.
Medicines
People were supported to take medicines as prescribed. The home had suitable systems for ordering, storing and handling medicines, including occasional medicines and controlled drugs.
“People were supported to take the medicines as prescribed. There were suitable systems for ordering, handling and storing prescribed medicines and controlled drugs.” from the report
Food and drink
People received support with eating and drinking at a relaxed pace. Dietary needs and risks of malnutrition were recorded, and referrals were made when needed.
“Support to people who needed assistance was offered by staff and at a relaxed pace.” from the report
Risk records
Care plans included guidance about eating, drinking, mobility and skin risks. Fluid and repositioning charts were detailed and included targets.
“Monitoring charts were detailed and included a target for staff to follow to ensure people received enough fluid.” from the report
Healthcare support
People were supported to access healthcare services, and care records showed involvement from specialist services, district nurses, speech and language therapists and dieticians.
“People were supported to maintain good health, have access to healthcare services and receive ongoing healthcare support.” from the report
Staffing levels
seriousInspectors found that there were not enough staff, particularly on the ground floor. This affected people's waiting times, choices and ability to receive support when they wanted it.
“There were insufficient staff deployed to provide support to people.” from the report
Recruitment and staff competence
seriousA staff member was working unsupervised without a DBS check. Another had not completed moving and handling training or enough competency checks, creating a risk of harm.
“One staff member was working unsupervised on the ground floor without a Disclosure and Barring Service (DBS) check.” from the report
Training and support
seriousStaff did not always have the knowledge and skills needed to provide safe care. Feedback about supervision and management support was mixed.
“Staff did not always have the knowledge and skills to provide safe care and treatment.” from the report
Unexplained marks
seriousInspectors found unexplained marks that had not been noticed, recorded or investigated. A safeguarding concern was raised after the inspection.
“During the inspection a relative identified unexplained marks on their family member that had not been noticed, recorded on a body map or investigated.” from the report
Management checks
seriousThe provider's audits had not identified all the problems found by inspectors. Accident analysis also missed some records.
“Systems in place to monitor the performance of the service had not identified the concerns people, their relatives and staff had in relation to staffing, staff training and support and recruitment practices.” from the report
Infection control evidence
minorMost infection control arrangements were considered satisfactory, but the home did not follow best-practice guidance when it failed to ask inspectors for evidence of their lateral flow test.
“The provider was not following best practice guidance as they did not ask inspectors to see evidence of their lateral flow test.” from the report
- 01How many staff are now deployed on each floor, particularly at weekends, and how do you check that these numbers meet people's actual needs?
- 02How do you make sure every new staff member has completed DBS checks, safeguarding training and moving and handling competency assessments before working unsupervised?
- 03What action has been taken to ensure unexplained marks or injuries are noticed, recorded, body-mapped and investigated promptly?
- 04What changes have been made to your audits and accident analysis so that problems are identified before they affect people?
- 05Who is currently managing the home, and what progress has been made with the application to register the manager with CQC?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 15 September 2022 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 2021
Rated Good; inspectors found safe, kind and personalised care, with improvements since the previous inspection.
This was an unannounced planned inspection on 19 May 2021. Inspectors spoke with 10 people using the service, 12 relatives, 11 staff and two visiting professionals. They observed care and reviewed care plans, medicines records and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found suitable staffing, safe medicines practice, improved risk assessments, kind interactions and care plans that reflected people's needs and preferences.
The overall rating improved from Requires Improvement at the previous inspection in June 2019. The two earlier breaches had been addressed, and inspectors found the home was no longer in breach of regulations.
Kind and respectful care
Inspectors saw friendly and positive interactions. People and relatives spoke warmly about the staff and the care provided.
“Staff treated people with kindness, dignity and respect and spoke with people in a friendly manner.” from the report
Safe staffing and medicines
Staffing levels met people's needs, and staff were available when called. Medicines were stored, administered and checked safely by trained staff.
“Staffing levels in the service were appropriate to meet people's needs.” from the report
Personalised support
Care plans described people's needs, preferences and routines. People were supported to make choices, stay independent and take part in activities.
“Care plans had information about people's specific needs, personal preferences, routines and how staff should support them.” from the report
Improved management
Managers had strengthened audits, safeguarding systems and learning from incidents. Staff said the management team was supportive and approachable.
“The registered manager completed a range of audits to monitor quality and safety, this ensured they had good oversight of the service.” from the report
Mixed views about food
minorPeople generally liked the food, but some relatives felt it could be dull. The chef was trying different choices and seeking feedback.
“We did receive some mixed feedback from relatives in relation to the food.” from the report
Feedback survey still being analysed
minorA relatives' questionnaire had been sent out, but the provider had not finished analysing the results at the time of inspection.
“However, this was still being analysed by the provider.” from the report
- 01How do you use relatives' questionnaire feedback, and has the outstanding analysis now been completed?
- 02How do you check that meals remain varied and reflect people's preferences?
- 03How will you assess and support my relative's risks, including falls, mobility, skin care or distress?
- 04What training and supervision will staff caring for my relative receive, especially if they have dementia?
- 05How will my relative and family be involved in care planning and reviews?
This was an unannounced planned inspection covering all five key questions, including infection prevention and control under Safe. This explanation was written from the published report of 17 June 2021 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 Tallis House
6 rated inspections over 7 years: the service has held its Requires improvement rating throughout.
- September 2022Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2021GoodSafe: GoodEffective: GoodWell-led: Good
- February 2021Inspected but not ratedSafe: Inspected but not rated
- June 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- May 2018Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2015Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Good
- August 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 16 December 2010.
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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Most charge £1,020 to £1,260 a week. 25 can care for a couple. 10 years' experience on average.
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