CQC report explained · a residential care home
What the CQC found at Terrance House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People told inspectors they felt safe, staffing levels were generally maintained, recruitment checks were completed and medicines were managed safely. Inspectors discussed the importance of enhanced health and safety checks, including ligature point checks, in the supported living setting.
- Effective?
- Good
- People's needs were assessed and reviewed, and staff received training and supervision. People were supported with food, healthcare, oral health and decisions about their care.
- Caring?
- Good
- People were treated with kindness, dignity and respect. They had privacy, could lock their bedrooms, and were encouraged to build skills and independence.
- Responsive?
- Good
- Care was personalised and adapted to people's mental health needs, preferences and communication needs. Activities, meetings and complaint arrangements supported people to express their views and avoid isolation.
- Well-led?
- Good
- Inspectors found a clear management structure, regular audits and an open culture. People, relatives and professionals were asked for feedback, although the home agreed to improve how survey results were shared.
What inspectors found, January 2020
Rated Good; inspectors found safe, kind and personalised care, with some premises checks and survey feedback to improve.
This was an unannounced inspection on 26 November 2019. One inspector and an Expert by Experience spoke with people, staff and managers, observed care, and checked care plans, medicines, recruitment, training, incidents, complaints and quality audits.
Inspectors found that people were safe and supported by enough trained staff. Medicines were managed safely. People said staff were kind, respectful and understood their mental health needs. Care plans were personalised and people were supported with health appointments, meals, activities and developing independence.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. The previous inspection, published on 6 March 2017, also rated the service Good. Inspectors noted some improvements still needed, including stronger health and safety checks in the supported living setting and clearer sharing of survey results.
Kind and respectful staff
People spoke positively about living in the home. Staff understood people's different mental health needs and supported them with kindness, dignity and respect.
“People told us that they felt that staff understood how to support their differing mental health needs and showed kindness and respect towards them.” from the report
Safe staffing and medicines
Inspectors found safe recruitment and generally sufficient staffing. Medicines were given by trained staff, on time and according to instructions.
“People were supported by staff who had been recruited safely.” from the report
Personalised support
Care plans reflected people's needs and preferences. Staff adapted support to how people were feeling and helped them develop everyday skills.
“Staff offered support flexibly to take account of how people may be feeling from day to day or at any given time.” from the report
Activities and independence
People could choose whether to join activities, including community activities. Staff supported people with cooking, laundry, shopping and budgeting.
“People had free choice about whether to join in or not with activities.” from the report
Supported living safety checks
needs fixingInspectors discussed the need for stronger premises safety checks in the supported living setting, including checks for ligature points. This was to reduce risks for people who might self-harm.
“We discussed the importance of enhanced health and safety premises checks such as ligature point checks.” from the report
Sharing survey results
minorPeople, relatives and professionals were asked for feedback, but inspectors discussed improving how the results and resulting actions were shared with people.
“We discussed how the service might improve the way outcomes from surveys were publicised to people.” from the report
- 01How often are ligature point and other enhanced safety checks carried out in the supported living setting?
- 02What action has been taken following the inspectors' discussion about supported living premises checks?
- 03How are survey results and planned improvements now shared with people living in the home?
- 04How will you support my relative to develop independence through cooking, laundry, shopping or budgeting?
- 05How are activities matched to each person's interests, and how can people choose not to take part?
This inspection covered personal care in the care home and supported living service; CQC also looked at the care home premises but does not regulate the supported living premises. This explanation was written from the published report of 24 January 2020 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, March 2017
Rated Good; inspectors found safe, kind and personalised care, with some care plans and activities needing attention.
This was an unannounced inspection on 31 January 2017. Inspectors spoke with people, staff and managers, observed care and a meal, and checked care plans, medicines, staff records and quality checks.
The home supported 46 people with mental health issues and had places for up to 48 people. Inspectors found enough suitably recruited staff, safe medicines practice, kind care and good support with health, food, choices and daily activities.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. This means the inspectors found the home was meeting the relevant requirements at the time of the visit. Two breaches found at the previous inspection had been addressed.
Kind and respectful staff
People were treated with dignity and respect. Staff knew people well and gave them time to express their wishes.
“There was a lot of warm, caring interaction between staff and people and a relaxed and calm atmosphere.” from the report
Improved risk management
Risks such as choking, falls, skin problems and distress were assessed. Staff had clear guidance and followed it.
“Risks to people's safety were assessed and there was guidance for staff on how to keep risks to a minimum.” from the report
Safe medicines support
Medicines were stored securely, given when needed and recorded accurately. Staff checked storage temperatures and expiry dates.
“People received their medicines safely and when they needed them.” from the report
Personalised care
Care plans included people's backgrounds, interests, health needs and preferred ways of receiving support. People were involved in decisions about their daily lives.
“Each person's care plan was personal to them and recorded the information staff needed to care and support people in the safest way that suited them.” from the report
Supportive leadership
Staff said managers listened to them and provided support. Quality checks were regular and actions were recorded.
“There was a culture of openness and honesty; staff spoke with each other and with people in a respectful and kind way.” from the report
Reduced activities during staff shortage
needs fixingPeople said they had fewer activities and less use of the minibus for a few months because an activities worker was helping with care. New staff had been recruited and the home said this was improving.
“People told us they were unable to take part in as many activities or go out in the mini bus as a result of this.” from the report
Cigarette smoke
minorA strong smell of cigarette smoke from the ground-floor smoking room reached hallways and rooms. The home had identified the issue and had a plan to resolve it.
“There was a strong smell of cigarette smoke in this area of the house which filtered through to hallways and rooms.” from the report
Complaints information
needs fixingThe complaints procedure had not previously been easy to understand and included inaccurate information. A new, clearer version was provided during the inspection.
“The complaints procedure was in the entrance hall. It was available to people but it was not written in a way that was easy to understand and some of the information was inaccurate.” from the report
- 01How many staff are currently on duty, and has the recent staff shortage been resolved?
- 02How often are care plans reviewed and updated when a person's needs change?
- 03What activities and trips are currently available, and how are people supported to take part?
- 04Has the cigarette smoke problem been fully resolved?
- 05Can we see the current complaints procedure and be told how complaints are recorded and followed up?
This was an unannounced inspection of all five rating areas, carried out to check improvements after two breaches found at the February 2016 inspection. This explanation was written from the published report of 7 March 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 Terrance House
3 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- January 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2016Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- December 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- May 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 20 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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