CQC report explained · a residential care home
What the CQC found at Templemore Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, March 2023
Rated Good; inspectors found safe, kind and person-centred care, with some staff pressure at busy times.
This was an unannounced focused inspection. Inspectors visited on 28 February and 1 March 2023, and inspection activity ended on 2 March. They spoke with people, relatives, staff and a health professional. They also reviewed care records, medicines records, recruitment files and other documents.
The home was rated Good overall. Safe, Effective, Responsive and Well-led were all rated Good. Inspectors found that people were protected from harm, medicines were managed safely, care was personalised, and staff supported people to keep in touch with family and enjoy activities.
Staffing was sometimes stretched, especially in the area for people with higher dementia needs. Some people waited for breakfast and staff had limited time to spend with them. There were also some gaps in staff training, although the manager said plans were in place to address these points.
The previous rating was Requires Improvement, published in November 2021, with a breach of Regulation 17. Inspectors found that improvements had been made and the home was no longer in breach. This inspection was focused, so the overall rating also used ratings from the previous inspection for areas not checked.
Safe medicines management
Medicines were received, stored, administered and disposed of safely. Staff were trained and checked as competent before giving medicines.
“Medicines were safely managed. Safe protocols for the receipt, storage, administration and disposal of medicines were followed.” from the report
Personalised care
Care plans reflected people's needs and preferences. Relatives said staff knew people's likes, dislikes and individual needs.
“People could be assured they received care that was person-centred from staff who knew them well.” from the report
Activities and family contact
People were helped to stay in touch with relatives and friends. They could take part in a varied programme of activities inside and outside the home.
“There was a full schedule of activities for people to enjoy both within the home and outside.” from the report
Improved management oversight
The home had introduced better systems to monitor care records, safety checks and service quality. Inspectors found that problems identified through checks were acted on.
“Processes to monitor the quality and performance of the service were in place and effective in assessing, monitoring and improving the service.” from the report
Staff pressure at busy times
needs fixingStaff were sometimes stretched, particularly in the area for people with higher dementia needs. Some people waited for breakfast while staff supported others with personal care.
“People were left waiting for breakfast whilst staff attended to people's personal care.” from the report
Some training gaps
needs fixingInspectors found gaps in staff training. The manager said there were plans to make sure staff training was brought up to date.
“We saw there were some gaps in staff training, the registered manager assured us there were robust plans in place to ensure all staff were up to date with their training.” from the report
End of life plans could be fuller
minorEnd of life plans recorded some important wishes, but inspectors said they could include more detail about personal preferences such as music, sounds or religious rites.
“These could be strengthened further to include for example, if they wanted any music or sounds playing or if they wanted a priest or minister to deliver their last rites.” from the report
- 01How have you changed staff deployment at breakfast and other busy times, especially in the area supporting people with higher dementia needs?
- 02Have all staff training gaps now been closed, and how do you check that staff remain competent?
- 03How will you make sure my relative's end of life wishes are recorded in enough detail, including music, sounds or religious support?
- 04What new audits and daily checks are now used to identify and resolve gaps in care records?
- 05How will my relative be involved in care planning, reviews, activities and decisions about the home?
This was a focused inspection of Safe, Effective, Responsive and Well-led; Caring was not inspected, and ratings for areas not inspected carried over from the previous inspection. This explanation was written from the published report of 10 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, November 2021
Rated Requires Improvement; inspectors found kind care but gaps in safety records, care planning and management checks.
The inspection was unannounced and took place on 23 September 2021. Two inspectors visited the home. They spoke with five people, four relatives, eight staff and a visiting professional. They reviewed seven care records, medicine records, staff files and management records.
People were treated with kindness and respect. Staff knew people well, supported their independence and helped them keep in touch with relatives. People received their medicines, food, drinks and healthcare support. The home appeared clean and staff used protective equipment effectively.
However, some risks and injuries were not recorded or investigated fully. Records did not always show that care tasks had been completed. Some care plans lacked important health information. Training was out of date for some staff, and the layout made staff deployment difficult.
The overall rating changed from Good at the previous inspection, published in May 2019, to Requires Improvement. The home was in breach of Regulation 17 on good governance because its checks did not reliably identify and correct problems. The CQC said it would continue to monitor the home.
Kind and respectful care
People and relatives said staff were kind, caring and respectful. Inspectors saw compassionate relationships and staff who knew people's preferences.
“Staff interacted with people in a compassionate manner and relationships between staff and people appeared respectful.” from the report
Independence and choice
People said staff involved them in their care and supported them to remain independent without doing more than necessary.
“Staff keep you independent, they do not do more than is needed, they are there if you need them, just not in your face.” from the report
Medicines and healthcare
Medicines were generally given by trained staff following best practice. People were supported to attend medical appointments and referrals were made when needed.
“People were administered medicines by trained staff who followed best practice.” from the report
Family contact and activities
People took part in activities and relatives were supported to stay in contact, including through video calls during lockdown.
“Relatives told us they were supported to stay in contact with their loved one.” from the report
Incomplete safety records
seriousSome unexplained injuries were not investigated and injury records did not always include enough detail. This could make it harder to identify causes and check healing.
“Not all unexplained injuries were investigated.” from the report
Missing risk information
seriousSome known risks did not have assessments, including risks linked to call bells, scalding and emollient creams. Some care plans also lacked important medical information.
“Not all risk assessments were completed for known risks to people.” from the report
Gaps in care records
needs fixingRecords did not always show that oral care, bowel monitoring and repositioning had been completed. This made it unclear whether care had been given or refused.
“Records of care tasks were not always completed appropriately.” from the report
Weak management checks
seriousAudits did not reliably identify missing information or incomplete records, including food and fluid charts, safety checks and cleaning records. This was the reason for the regulatory breach.
“The provider failed to ensure adequate systems and processes were in place to assess, monitor and improve the quality and safety of the care provided.” from the report
Staff deployment and training
needs fixingThe building layout made it difficult to keep staff in the right areas. Some staff training in moving and handling, dementia and mental health was out of date.
“However, due to the layout of the building and the deployment of staff, there were areas of the home that did not appear to be staffed appropriately.” from the report
- 01What action has been taken to investigate and record unexplained injuries, and how do you check that follow-up reviews are completed?
- 02How do you make sure risk assessments and care plans contain current information about medical conditions and specific risks?
- 03How are staff deployed across the three areas of the building, particularly when someone needs urgent help?
- 04What is the current position on staff training in moving and handling, dementia and mental health?
- 05How do managers now audit oral care, bowel monitoring, repositioning, food and fluid records and cleaning?
This was an unannounced inspection covering all five CQC questions, the care provided and the premises, including infection prevention and control. This explanation was written from the published report of 4 November 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 Templemore Care Home
7 rated inspections over 8 years: the service has improved, from Requires improvement to Good.
- March 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2021Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- May 2019Goodstayed GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2018Goodup from Requires improvementSafe: Requires improvementWell-led: Good
- March 2018Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2016Inspected but not ratedResponsive: Good
- January 2016Goodup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2015Requires improvementSafe: GoodEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Good
- November 2013
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- April 2012
Report published without a new overall rating.
- March 2011
Report published without a new overall rating.
- May 2011
Registered with the Care Quality Commission on 6 May 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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